Honduras v Switzerland

USA v Algeria

What a great match and of course our team had to wait until the 90th minute to score.

GO USA!

Bring on Ghana!

South Africa v France

Honduras v Spain

On the way to the match with a great group of Hondurans. I wish the USA had better country cheers than just "U S A" but it's better than nothing :)

World Cup Update: USA v Slovenia

An American Moment at the World Cup

GHC on Fox News

There's a video clip at the end of this Huffington Post article on Global Health Corps from the Fox News report aired on Sunday night (June 13th). I can't download video while in Tanzania to see for myself but I've been told they used some video footage I took for my blog.

You can watch the whole story on Hulu (it's the last story on this episode).

Here's a clip from the story:

Africa World Cup

The 2010 World Cup started two days ago and is gripping this country (along with the world). I've never really followed futbol until last years Confederations Cup where the US played brilliantly and made it all the way to the finals. Since then I've been watching the English league (the favorite of most Tanzanians, go Arsenal! ) and have been getting more and more excited as the World Cup has been approaching.

This Friday I'm headed to Johannesburg for a week to catch games live! My first game is USA vs Slovenia on the 18th. I'll try to post some videos and pictures from my experiences there ASAP.

GO USA!

Also, congrats to Ghana today for achieving Africa's first cup win!

For an interesting mix of social justice and the World Cup check out this site.

Happy Sunday.

Tanzania Needs More Mamas

The Economist recently released an article about the challenges international organizations have faced when attempting to do business in Tanzania entitled “What’s the Hurry?” It resonates with my experience and offers some validation to what has felt like the most challenging aspect of my work thus far. The last paragraph captures the gist:

Mr Kikwete (the President of Tanzania) has at least tried to give the appearance of curbing corruption. A Bank of Tanzania official was acquitted of puffing up the cost of building a bank from $73m to $357m but found guilty of “abusing power”. Visiting businessmen, however, say they are still deterred by red tape, a weak legal system and a lack of skilled labour. Above all, they say, Tanzanians seem to lack a sense of urgency.

Call it a lack of urgency, a lack of motivation, or failed incentives, the real problem is that things do not get done. I can’t remember how many times deadlines have been missed, commitments have not been met, or meetings have been delayed by weeks, all while constituents assume a complete lack of responsibility or remorse. Inaction and failed follow through is business-as-usual and even a small amount of pressure against this culture can be viewed as being pushy and culturally insensitive.

When I’ve outwardly exhibited impatience during my year here, I’m invariably reminded by a Tanzanian around me “This is Africa” read "what do you expect?" But my travels to neighboring East African countries and this article suggest the lethargic pace of life is actually a culture more distinctly Tanzanian than African or East African. Some Tanzanians, however, are paving the way for a cultural paradigm shift.

One woman I’ve had the pleasure of working closely with this year from the district health management team in Kilwa defies the prevailing work culture in Tanzania. Innocentia Mangosongo, or Mama as everyone calls her, is the district head of maternal and child health though she clearly stands out as the leader of the male-dominated health management team. Tirelessly working 10 hour days and most weekends, I’ve observed Mama’s passion and vision driving the impressive progress being made to Kilwa’s health system. She leads by example and sets high expectations for staff members throughout the district. And, against all odds, things get done!

While long delays for business deals are undoubtedly frustrating, inaction and delays in the health field, unfortunately, have truly dire consequences in Tanzania. Kilwa is lucky to have Mama Mangosongo but many parts of Tanzania aren’t as fortunate. With time, my hope is that more Tanzanians continue to step up to work in a proactive, determined way because there’s no telling what a country full of Mamas can achieve.

Barbara Bush on Good Morning America about GHC

Here's the transcript of the interview but I couldn't find a good link to the video (search around a bit and you'll find it, just don't have the bandwidth here...).

An Eye Towards Sustainability

With only two months left to go in our fellowship, Goodluck and I have been focusing on how to ensure the work that we have done to increase data accuracy and system support is sustainable and maintainable by the health system’s own infrastructure when we leave.

We have recently been able to establish that the project we designed and implemented over the last 10 months to increase data accuracy has had a long term, lasting impact on the staff we enrolled in the program. I explained in an earlier post that during our data workshops we tested participants at the start and end of the workshop and established a resulting increase in data accuracy of over 200%. Although we designed our program to include additional visits to staff members to help cement the learning, I’ve continued to be concerned about long-term skills retention.

Last week, every facility from Kilwa was invited to a training on a new set of PMTCT (maternal health) data tools that we helped get translated from English to Swahili so that staff members could actually understand the forms they’ve been asked to compile. We took this opportunity to give them similar data tests that we gave them during the data workshops they attended up to six months ago to see both the long term efficacy of our previous training program and also the effect of the translated tools. Health workers achieved the same scores at the start of this training as they achieved at the end of the data workshops. In other words, the 200% increase in accuracy was maintained over time. Additionally, after sharing the newly translated tools, we tested them again and saw another significant increase in accuracy. All totaled, combining our training program and the translated tools facility staff has achieved close to a 300% increase in accuracy that we now expect to see sustained well beyond our fellowship year.

Another sustainability-focused program we’ve worked on has been to partner with the district health management team to design a decentralized management structure of mentors. The goal of the decentralized structure of mentors is to ensure consistent supervision and support throughout the district with data accuracy and supply stocking. District managers are supposed to provide this support but lack the time and funds to visit every facility each month, oftentimes failing to visit for months at a time. To solve this problem, we identified Kilwa’s most organized and passionate staff members and invited them to a weekend workshop to introduce the mentorship program, run them through in-depth data, lab, and health services training, and ask them to commit to taking on the extra responsibility to help improve the overall system of support for Kilwa health facilities.

I was skeptical about how our proposal would be received, considering all the difficulties we’ve run up against with overworked, poorly motivated staff members. I’m happy to report, however, that while there was an acknowledgement of the increase in work this would mean for each of the mentors, they fully grasped the significance of how much this type of system was needed and were excited at the opportunity to be involved. We’re looking to roll out the first two rounds of mentorship activities with our 12 mentors in June and July and adjust the program as necessary so that it will be fully functional in August when our fellowship year has been completed.

Goodluck and I are working with Clinton Foundation staff and Ministry of Health officials to roll out our programs to surrounding districts with the hopes of replicating the results we’ve achieved in Kilwa. There’s also a good chance that Goodluck will be staying on with the Clinton Foundation in Tanzania to help continue leading efforts to improve data quality and health systems. While I’m excited about the possible broader impact of the expansion of our programs, I’m mostly encouraged to know that the work we’ve done this year has had some significant impact, even if just to the Kilwa district.

Global Health Corps [GHC] has taken a chance in sending people like Goodluck and me into the global health field to try to create new, innovative solutions to persistent problems without having any experience with health care. As we’ve come up against seemingly never-ending roadblocks and unpredicted challenges throughout the year, I’ve doubted my efficacy and value to the cause of global health. However, going through the challenges and coming out with meaningful results has made me appreciate GHC’s model that much more. We need people who have enough energy and passion to persevere through bureaucracies, inefficiencies, and stale solutions to find a better way to do things because there’s always a better way.

Another GHC Article

This time it's on CNN. I even get a shout out in this one.