A second-year student in the Save the Mothers program, Festo Kagoma has, like most East Africans, known the tragedy of maternal death. He knew it early; as the fourth child in a family of six, Festo was named for an older brother who died of umbilical cord tetanus within days of delivery.

Born and raised in Tanzania, Festo says cultural pressures kept his mother from delivering her babies in a hospital. It was an unsterilized razor blade (used to cut the cord) that had led to the death of the brother for whom he was named. While still a child, Festo also witnessed the death of a neighbour due to pregnancy-related causes.

But his experience with maternal and infant mortality would become even more personal. “In 2012, my fiancé became pregnant,” Festo says. “It was unplanned.”

The couple were fearful; theirs was a culture with strong prohibitions against premarital sex, and the young man had not yet introduced himself to his girlfriend’s family. As the pregnancy progressed, Festo’s fears intensified. “Growing up, I always thought pregnancy was a game of life or death,” he says. Anxiety motivated him to stay close to the girl throughout her pregnancy. “I travelled a lot to escort her to clinics and any time she felt unwell.”

When the pregnancy reached 20 weeks, the girl’s health worsened and Festo knew he had to talk to her parents. He made some payments on the bride price (a substantial fee traditionally paid to a girl’s parents in East Africa, in exchange for the right to marry their daughter). Unfortunately, his fiance’s health continued to decline. By the 28th week, the girl’s legs were starting to swell and she began experiencing breathing problems. A medical doctor diagnosed the problem as high blood pressure, but the young woman’s parents disagreed, and took their daughter to a witch doctor.

Tragically, the baby died in utero. The witch doctor blamed Festo. The marriage was called off.

But such tragedy can be a powerful motivator for change. A high school teacher, Festo began to incorporate information on sexual and reproductive health in his teaching. As a result, there was a noticeable decline in early pregnancy rates in his district, and a corresponding increase in the rate of school attendance among teenaged girls.

In 2014, Festo learned from a friend about the Save the Mothers Master of Public Health Leadership program. “I went ahead to apply,” he says. “Today, I am convinced that this was one of the best decisions of my life.

Affording tuition was a concern. A teacher’s salary doesn’t do much more than provide for basics. “Save the Mothers has given me some contributions towards my fees,” he explains, “and I also sold some land that I had.”

Festo says the course has transformed him. “I have since been involved in several campaigns to change the attitudes of Tanzanians towards maternal health.” He also continues to work with adolescents, teaching them about sexual and reproductive health.

He is committed to the belief that cultural transformation is possible, and determined to work for it in his community after he graduates with his Master of Public Health Leadership. He knows now that “maternal death is not a normal thing,” he says, and that “it is preventable.”