The Africa Exchange Project

I am retired after a 40-year career as an educational consultant in higher education. I hold a M.A. in Sociology, an M.Ed. in Instructional Media, and an Ed.D. in curriculum and teaching. My employment has included positions at Roxbury Community College, Boston College, Tufts University, New England Medical Center, and the Boston University School of Public Health. I have worked in developing countries to develop Master of Public Health Programs. Most recently I worked on a CDC grant with the Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania. While this gave me a deep appreciation of Tanzanian society and their health challenges, more importantly it fuels a passion to inspire caring people to work together across cultures to address worldwide health challenges.  This fervor drives my efforts to build awareness and commitment between a small rural community in Tanzania and the caring people in Boston MetroWest. 

2,500 people live in the Village of Pomerini, Tanzania. The Africa Exchange Project and its community partners have been working to build a health dispensary that provides quality care for everyone, especially mothers and children. We have recently recruited a permanent, qualified doctor and are now working with the government of Tanzania become a fully functional health center. Our proposed project will create a community-led health education and outreach program led and supervised by our new physician leadership in the health dispensary, district health officials and local leaders to create a community led healthcare dispensary that provides a governance structure for recruiting, training, and supervising community led health education and outreach workers. We will equip these workers with mobile technology using CommCare to improve community-based data collection and assist in providing continued education and support to Pomerini families. 

Our goal is to provide community-led health education and outreach and to improve access to quality clinical and prevention services in the health dispensary.  Access to health care services remains a global challenge. In 2015 there were an estimated 303,000 maternal deaths and 2.6 million neonatal deaths in Tanzania. Poorly equipped facilities and low wages result in the lack of skilled healthcare providers. Deteriorating roads coupled with inadequate and unaffordable transport often make it impossible for villagers, particularly mothers and their babies to reach adequate facilities to address healthcare needs. Upgrading the current Dispensary to a Health Center will not only provide basic laboratory diagnostics and inpatient care, but also comprehensive emergency obstetric care.

We intend to improve healthcare through developing a cadre of women healthcare workers working with the Health Center. Empowering women to take control of their health and their children’s, we will enable to health education and patient follow-up through mHealth technologies for a healthier region for the community and their neighbors.  As we improve access to and quality of care, we are transforming the lives of those less fortunate in Tanzania while raising both the resources for, and the awareness of, the realities of under development.

For more than 12 years the Africa Exchange Project has been assisting the community’s healthcare needs by funding extensive renovations in the dispensary and the housing for medical staff. We have provided basic medical equipment along with pharmaceuticals and eyeglasses. We have addressed issues of clean water by installing 43 borehole wells in and around Pomerini. In response to the COVID-19 Pandemic we have provided supplies and personal protective equipment directed to the community.

Our proposed project includes a human resources component as well as infrastructure improvements to the Pomerini Dispensary that will transform it into a  modern, technologically up-to-date healthcare facility, staffed by professionals, led by the community, and together recruiting, training and supervising  a cadre of community health workers. We are confident that as the level of service increases the Government will provide additional trained professional staff expanding both the scope and quality of health services. Community health workers will enable better patient education and follow-up and using mobile technologies to provide for and collect health data. Better services will also draw people from neighboring villages improving the economy and other resources for the community.

Pomerini is a rural village of approximately 2,500 people located in central Tanzania. This region is primarily an agricultural area and most of the men are subsistence farmers. Most women work in the home and  many make some money from sewing or working in dukas selling essential items or locally ground vegetables. Our project focuses on women and children, with an emphasis on health. We want to empower women and young girls to live the fullest life possible with more opportunities to control their lives and care for their families. Women play a key role managing the household, raising the children, and often providing income to the household. When trained as health workers these women can understand and advocate for women and girls while providing outreach and education for the entire community.

The Africa Exchange Project is truly an exchange project based on our core belief that both cultures enrich each other and elevate our humanity when we work together. We work with the community sharing professional knowledge, resources, and educational opportunities to create tangible outputs that encompass the provision of clean water, support for the services provided in the local dispensary, and education.

Our project provides the means to elevate opportunities for two groups of people traditionally left behind. One group is made up of those in the US willing to give of their abundance; the other is the impoverished people in Pomerini, Tanzania. Both groups are ’left behind’. Our project focus on healthcare outreach serves as a model for other dispensaries in the region thereby creating more positive health outcomes in the district. Our projects in education and healthcare including the provision of clean water accomplish this explicitly by elevating the understanding of, and between people by changing attitudes, beliefs, and behaviors.

The Africa Exchange Project has worked in Pomerini since 2007 as an outreach mission of The Plymouth Church UCC in Framingham, Massachusetts. It is telling that this beginning sprung from a visit by a congregant and followed by a mission trip of 17 people for a two-week period. The enthusiasm generated by the personal understanding and connection between the two communities led to the establishment of the Africa Exchange Project in 2007.

In 2008 the AEP hosted a choir of 13 people from the village who stayed in our homes for a 5-week period. Over this time, the choir performed 33 concerts in and around the Boston Metrowest area. AEP raised over $63,000, much of which was used to begin a fresh water well project to install borehole wells in the village. Since then, in addition to providing clean water, the AEP has built schools, supported school programs, and invested in healthcare for the village.

My work as an educational consultant for the Muhimbili University of Health and Allied Sciences for the past 9 years has enabled me to guide our development projects successfully and establish relationships with growth potential sufficient to warrant the creation of a nonprofit corporation.

I have been fortunate to have deep and caring relationships with many friends and colleagues in Tanzania over 13 years. In addition to leading our non-profit, I have led and continue to lead the International Outreach Mission for the Plymouth Church UCC in Framingham. As I have worked with Pomerini leaders and others, I have spent time with their families. I have learned of their struggles and seen them succeed against nearly impossible odds. We share a belief that we can make the world the kind of world we all imagine by being in true relationship, valuing each individual and being in shared community across borders and boundaries.

My passion for improving healthcare has been further ignited by the loss of a dear friend from Pomerini, an integral colleague in collaborative efforts between our communities. Our friend died of Extrapulmonary Tuberculosis, a disease which could have been treated if accurately diagnosed. Our friend was a victim of an underdeveloped health system. This loss of life dealt a severe blow to the community and all those he touched throughout the region. This loss has continued to fuel my passion and deepen my resolve to improve the health of our international neighbors. 

I have worked in the field of medical education for more than 30 years. For 20 years I worked with the Boston University School of Public Health. I worked for 9 years with the Department of Global Health on a CDC-Funded Project with the Muhimbili University of Health and Allied Sciences in Dar es Salaam. I continue to maintain professional and personal relationships with many Tanzanian colleagues. Together we have worked to meet the nation’s public health challenges by designing effective public health curriculum and promoting e-learning in partnership with the Open University of Tanzania.

I have guided student research teams from the BU School of Public Health working in the Iringa region. Using the Pomerini Dispensary as a virtual client in the Global Health course, Implementing Health Programs in Developing Countries, I worked with a student team to address human resource management, information technology, financial management and supply chain challenges.

In rural Tanzania, churches play a vital role providing institutional support to communities. In Pomerini the Evangelical Lutheran Church owns the Secondary School and the Dispensary. The Ilula Hospital, a Lutheran owned facility, serves as the district hospital in the Kilolo District. The hospital administration oversees operations of the church-owned dispensaries in the district including the Pomerini Dispensary.  I have met regularly with the Hospital Administration and the General Secretary of the Iringa Diocese to address healthcare challenges. These trusted relationships are essential for any NGO, including the Africa Exchange Project, to advance healthcare in the district.

For many years, the Pomerini Dispensary has been hampered not only by limited facilities and infrastructure, but also by a lack of qualified and committed leadership. Due to limited resources and a shortage of trained medical personnel, the Diocese appointed young people with undergraduate medical degrees to assume the role of Medical Officer-in-Charge of the Dispensary. While well-intentioned, these young people did not have the required medical experience or supervisory training to provide leadership for the Dispensary and adequately address the healthcare needs of the community and the surrounding villages. Villagers distrusted the staff and either chose to go to another dispensary or worse, not address their medical concerns at all. These young medical trainees frequently left for other educational or employment opportunities. This resulted in a lack of stability and an impediment to long-range planning. Through a series of meetings with the General Secretary of the Iringa Diocese we identified a permanent doctor. The Africa Exchange Project provided funds to renovate a dilapidated residence that had been set aside for medical staff. The Doctor and his family are now established members of the community, the number of patients has increased, and the quality of medical services has greatly improved.

I have represented the Africa Exchange Project and the Africa Outreach Mission of the Plymouth Church UCC in dealings with the Evangelical Lutheran Church of Tanzania and the community of Pomerini, Tanzania for 10 years. Using my frequent opportunities to visit in Tanzania, I have done my best to share the values and beliefs as well as the challenges facing the Pomerini community with our constituents in Framingham and Metrowest. 

In 2018 I initiated and directed the process of growing from a church-based mission project to forming a non-profit corporation with 501-C.3 tax status. To prepare for this process I attended several workshops on forming and incorporating non-profits. I worked within the governance of The Plymouth Church to enable the organization to move to a new financial structure.  I have been responsible establishing the Board of Directors,  seeking out  professionals with the various skill sets that are needed for the non-profit, including the ability to establish basic business practices, effectively market and communicate our brand, to increase its revenue through access to foundation funding, grants and corporate philanthropy, and to facilitate communication with our collaborators and identify and support projects that positively affect our partners in Tanzania.

Our proposed project will create a community-led health education and outreach program led and supervised by our new physician leadership in the Dispensary, district health officials and local leaders to create a community led Health Center that provides a governance structure for recruiting, training, and supervising community led health education and outreach workers. Our community health workers will provide more patient-centered treatments. Since they reside in the community they serve, they can bring health information where it is needed most. They can reach residents where they live, work, and worship. They are frontline agents of change, helping to reduce health disparities in under-served communities.

How many resources have been applied to large top down programs intended to benefit those less fortunate? How many of these programs are truly sustainable and empowering of the “beneficiaries”? Our premise is that relationships promoting mutual understanding across cultures creates the bonds to sustain a flow of funding and meaningful exchange of ideas and technologies.

Mobile health technologies help address geographic barriers that medical staff and patients experience in this region. Health outcomes across the care continuum can be transformed, producing better outcomes, and reducing healthcare costs. M-health applications with mobile devices can affect the collection of clinical data, providing healthcare information to Health Center staff for real-time monitoring of patients vital signs and direct provision of care. These health tools can increase patient engagement, help people self-manage their health, alert healthcare staff in case of changes in an individual's condition, and support medication adherence.

Pomerini Dispensary Logic Model

Our long range goal is to provide human resources, medical knowledge, and facilities to ensure that every man, woman, and child in the Kilolo District of Tanzania has access to safe and appropriate healthcare.

In the next three years we expect to create an innovative system that harnesses the power of community led health services so that all 2, 500 people in Pomerini will have access to quality clinical and outreach services. Within five years, we expect to reach 7,000 people from surrounding villages who will come to take advantage of the higher level of services and outreach and follow-up from community health workers enabled with mobile technology. 

Our goals for the next 3 years are to have an operating Health Care facility, fully staffed and with Community Health care workers working in and around Pomerini providing outreach and education. The Center will include a Health Resource Library and educational materials being shared with the community. We expect an increase in the number of patient visits and an improvement in health outcomes, specifically with a decrease in maternal and infant mortality.

In the next five years will continue to raise the level of service to include more emergency obstetric services and continue to expand clinical services to surrounding villages. In addition, we will train healthcare workers in the use of mHealth technologies and raise the telecommunications infrastructure and digital record keeping capacity of the Health Center.

The barriers we face are many, not the least of which is the COVID-19 pandemic limiting travel and face to face communications. When these restrictions are eased, we will face challenges of inter-agency communications. Since the Lutheran Church Diocese, the District Commission, the District Hospital, and the Health ministry are stake holders in this project, coordinating these groups will take time and persistence. The results of these collaborations will enable the deployment of human resources including trained medical staff. Funding will affect these personnel decisions along with providing some stipends for community health workers. Educational materials procurement will also require sustainable funding. Startup expenses for the Health Center, including medical equipment will require contributions from a well cultivated and committed donor base. Telecommunications infrastructure in this region is limited and often unstable. This will slowly improve over time. Transportation and supply chain issues will also need to be addressed in serving this semi-remote location.

The Plymouth Church UCC in Framingham, MA and the Evangelical Lutheran Church of Tanzania are the organizations which enabled the initial Pomerini-Metrowest connection which remains strong today. The Lutheran Church Iringa Diocese owns and operates many of the organizations and facilities which our projects serve. The Rotary Clubs in Framingham and Natick, MA have been interested supporters and provided small grants to the Africa Exchange Project. The Dover/Sherborn High School in Dover, MA is among several schools with programs which support a cross-cultural exchange. The Ilula District Hospital which supervises the Pomerini Dispensary, the Iringa Referral Hospital which provides emergency medical services for Pomerini Dispensary referred patients, and the  Ilula Nursing School are organizations we work with to support and expand the services of the Pomerini Dispensary. Restoring Vision Inc. is a nonprofit we have worked with to provide reading glasses to the community in partnership with the Pomerini Dispensary.

Our donor base is made up primarily of individual donors and these long-lasting relationships provide a flow of funds. We get small grants from local Rotary Clubs. We organize approximately 4 fundraising events per year and we run an annual campaign in November. When we host visitors from Pomerini or when we plan a trip to visit Tanzania, we are successful in our fundraising efforts as our Exchange makes the work and the relationships real to our donors. We have applied for funding through local banks and businesses which generates some income. Some of our donor’s contributions are matched by their employers. Our professional network which includes healthcare and international development expertise gives us access to relevant information and resources.

Our plan is to continue to relationships with and identify and promote giving opportunities for individuals and organizations in the Boston Metrowest area. The plan is to research foundation and philanthropic funding sources, especially those supporting areas of healthcare and pharmaceuticals in third world countries and to form relationships with funders and funding agencies which support for health care for women and children as well as empowering women in society.

We hold on average 4 events per year including a gala event which features visiting Tanzanians or preparations for Africa Exchange Project representatives traveling to Tanzania. Other events include concerts, dinner-dances, and donor-development events at local breweries. We hold an annual campaign starting in November and do individual social media campaigns using FaceBook.

Although we have a legacy and have built relationship-based working arrangements with our partners in Tanzania, we are a relatively young non-profit organization. We have been relying on a donor base of loyal, individual donors and this limits the scope of the projects we can entertain. We have committed to fund the construction of a Science Center for the Pomerini Secondary School. This is a $120,000 project which overstretches our capacity to address other Pomerini community issues that we want to support. The Elevate Prize would elevate the exposure of our work, bring additional resources including funding and relevant expertise to bear on our collaborations.  The gains which the Elevate Prize could offer the healthcare capacity of the region will have a ripple effect benefiting not only healthcare, but also education and the economic viability of the community and the region. Further it would leverage the cultural exchange upon which the Africa Exchange Project was built and accounts for the degree of sustainability we have been able to provide with our projects with our international neighbors.