Why do we ask parents to pay?

There’s a saying in Swahili 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. 

‘Bure ni bure’ is a big part of why we ask parents for a financial contribution toward their child’s healing journey.

To be clear - we never let finances become a barrier to treatment; asking for this contribution is not about getting parents to shoulder the burden of the cost.

The families we serve come from backgrounds of scarcity, and their payment usually only covers 2-5% of the total bill. One of the most meaningful contributions we ever received was six eggs, from a mama who had  nothing else to offer. 

We ask because securing caregiver buy-in holds significant symbolic value, and it makes all the difference to the ownership parents take of their child’s healing journey.

Rather than treating families as passive recipients, we invite them to step up as advocates for their child, showing the world that children with disabilities deserve care, respect, and a future. 

The pride they take in bringing about this transformation is important for their child, but it also sends a powerful message to their community.

By investing in a world where children with disabilities are entitled to healthcare, and can participate in community life just like everyone else, they are helping to dismantle stigma and to make the case for inclusion and dignity for all.