Nafisa Jiddawi, a diaspora working to improve maternal and child healthcare

"We all came back to Stone Town and back then, there was no one in our neighbourhood that I didn't know, and of course, most of my relatives live here, including the only grandparent I have left," she says.

However, the Georgetown graduate had to leave Zanzibar at the age of 12 and return to the United States, where she followed her parents into the healthcare field, graduating in 2014 with a Master of Science in Nurse Midwifery/Women’s Health Nurse Practitioner (NM/WHNP). Later on, she also specialized in Family Medicine.

To her, it was only natural that she returned home to Zanzibar because during her formative years, she felt like her family apartment in Stone Town was like an urgent care clinic, with people frequently coming in and out for medical care.

"While we lived in Stone Town during that time, my parents were always on call at Mnazi MMoja Hospital because there were very few doctors in Zanzibar at the time—maybe around 10 or thereabouts," she says.

"There also weren't any private clinics in Zanzibar then so when my parents weren't on call, people came to our home to seek for help."

It was during the volunteer work that she pursued in Zanzibar during her university years that she learned of the extreme health disparities and the lack of maternal healthcare for pregnant women in Zanzibar.

"I started developing a much better understanding of the health care needs of my community in Zanzibar at a very young age, fostering a passion for healthcare that I have carried into adult life," she says.

And by virtue of her birth, she is a US citizen, and currently, even after her blood roots lured her back to her ancestral home in Zanzibar, she is considered a foreigner and therefore has to live by the rules that guide foreign residence.

"I have to pay for work and residence permits every two years just like any other foreign national to live here in the neighbourhood where my mother and grandmother live," says Ms Jiddawi.

According to her, it feels like swimming against the current, and it is frustrating at times.

Investing in holistic healthcare

Though she went on to settle in the United States after her studies, where she is married with three children, her thoughts were always back at home.

 In 2018, she returned to Zanzibar, where she founded WAJAMAMA (Watoto, Jamii na Mama), a women-led hybrid model of a for-profit clinic and a nonprofit foundation that focuses on holistic health promotion and preventive medicine.

 "I always knew that at a certain point in time, I would have to come back and contribute to the wellbeing of this community that I am so connected to, irrespective of whatever the situation is," she adds.

According to Nafisa, she looks at WAJAMAMA as a symbol of hope for women’s health in Zanzibar.

The center is built around the belief that initiatives aimed at making the greatest change must prioritize the beginning of life.

And since each life begins inside of a woman, all of WAJAMAMA's initiatives prioritize women’s and children's health, and they work to make sure that women are the healthiest versions of themselves; socially, psychologically, and physically. Ensuring that women are holistically healthy before, during, and after pregnancy reduces risk factors associated with maternal and neonatal health, thus making healthy and beautiful beginnings more accessible.

 "WAJAMAMA is Zanzibar's first holistic healthcare center and has been challenging the status quo and setting new standards for healthcare services in Zanzibar,” she says.

“Our work has the power to break the circle of poverty and disease," says Nafisa.

She adds, “when children are healthy in their first two years of life, it helps with their cognitive development, their health, and livelihood for the rest of their lives.”

 In her assessment, one of the greatest challenges among pregnant women in Zanzibar is severe anaemia, which affects babies’ growth and increases the possibility of hemorrhage and intrauterine growth restriction.

 "If we were to collect enough evidence from our life-saving group prenatal care model and scale it throughout Zanzibar, then we would save hundreds of pregnant women's lives."

 WAJAMAMA has pumped close to Sh1.5 billion into the holistic center, community health services, and Zanzibar’s first high-tech simulation center at the State University of Zanzibar (SUZA). "We have built a modern simulation center at SUZA; before this, healthcare students had to practice their hands-on-skills on real people, risking making mistakes on them, but now they have an alternative because the mannequins in this new simulation lab, are like real human beings with real responses," says Nafisa.

This, according to her, means that by the time healthcare students get to real human beings in their clinical sites, they will be confident and their skills will have improved to safe standards.

Why diaspora special status is key

In her opinion, Tanzania (Zanzibar) can leverage the potential of its diaspora, especially with the promise by the foreign ministry that they are trying to look into a special status for the Tanzanian diaspora.

Remarkably, Tanzania is one of only seven African countries that do not allow dual citizenship, and the limitations that come with it are obvious.

This is a self-imposed disadvantage that restricts Tanzania, in comparison to its neighbours, from benefiting from the skills and resources of some of its most successful and affluent individuals, who may have obtained citizenship elsewhere but still have a role to play.

"There are opportunities in terms of grants to Africa that I cannot pursue because I am not a Tanzanian citizen, which people from countries such as Kenya and Uganda can pursue," she says.

According to her, by permitting dual citizenship, Tanzania could quickly receive billions of dollars in additional investment and an influx of world-class talent from the returning diaspora, ready to play a pivotal role in helping the nation achieve its pan-African leadership potential.

"Right now I would really like to grow and explore more opportunities at home, but to me, it still doesn't feel stable because, as a diaspora member, I am counted as a foreigner."