Some wise soul said that change is the only constant, and Kafika House has taught me that this is certainly true. For the most part, the changes we experience are beautiful blessings: the blossoming that happens as children recover is just one example… 17 years on, I am still in awe of the wholescale transformation that our healing journey holds. 

Other changes, though, arrive disguised as obstacles, and that felt like the case earlier this month.

There’s a Swahili saying that goes ‘bure ni bure’ - it means ‘what is free is worthless’. The word for ‘at no cost’ is the same as the word for ‘of no value’. 

When Sarah first came to Tanzania, she volunteered as an Occupational Therapist at a rehabilitation centre for children with disabilities. She began to notice that when treatment or assistive devices (wheelchairs, casts, crutches) were given at no cost, families were much less likely to come for follow-up - or, when they did, that the assistive devices were often broken or hadn’t been cared for. By contrast, if the family had paid for any part of the process, they remained invested in the outcome; they took care of the devices, and saw the recovery process through. Paying for it  made it valuable, even if the cost had been nominal. 

We have a crucial role to play in supporting Tanzania’s Rehabilitation Strategic Plan (2021-2026). We’re proud to say that our services align with national objectives to improve access to rehabilitation for children with treatable disabilities, ensuring holistic care, support, and positive outcomes. Learn how we are helping to advance the national agenda when it comes to rehabilitative healthcare.

In 2023, we launched a bold five-year strategic plan to guide our growth. We built our strategy on four interconnected goals: delivering excellent care, extending our outreach, building strong partnerships, and ensuring the sustainability of our model.

June 2025 marked the midpoint of this five-year plan, and we took the opportunity to reflect on progress made and lessons learned.

Did you know the disability we treat the most is skeletal fluorosis?

This condition is much less common globally than, say, clubfoot or clefts - but in Northern Tanzania, the dangerously high levels of fluoride that naturally occur in the groundwater mean we see a heartbreaking number of children affected.

As part of our mission to bring our many-faceted healing journey into focus, we would like to introduce you to our clubfoot patients-in-waiting.

To bring our healing journey into focus, I thought I’d spotlight one of the conditions that makes up roughly a third of all cases we treat: cleft lip and palate.

This is among the most common congenital conditions worldwide, affecting around 1 in 700 babies.

I’ve realised that I start every letter in surprise at how quickly time passes, and how full and eventful the weeks and months are - and 2025 is no exception.

A heap of great things have happened, and I love to share good news - so grab a cuppa and join me for an action-packed update.

Somehow, it’s nearly November and we’re closing in on the end of another year. In the midst of the 2025 planning we’ve been busy with, I realised that 2023 was all about drive: expansion, achievement, growth, newness… This year, by contrast, has been all about systems. We’ve been setting up the organisational architecture that will secure our long-term sustainability, and I have great faith in the promise that our future holds.

There isn’t a day when patient safety isn’t at the forefront of our minds, but 17^th September is a good excuse to dive into what it really means to us.