3/31/22.  SCF Chooses Rulenge Hospital for Next Solar Power Site.

     The Sandy Christman Foundation Board of Directors has agreed to fund a solar power electrical generation project at Rulenge Hospital in Rulenge, Tanzania.

   This will be the Foundations fourth solar power project in the Kagera region of western Tanzania which sits two degrees south of the equator. Rulenge Hospital was built  in 1952. It has 50 beds and supplies medical care to a poor, rural, growing population. The hospital lacks many basic medical services and is 420 km ( 252miles) from a tertiary medical center in Mwanza, Tz. 

    We believe medical progress cannot be made without medical infrastructure improvements. To supply 21st  century healthcare requires reliable, affordable electrical energy. Currently Rulenge hospital gets electricity from Tanesco, a gov’t. run utility and also from the  inefficient  diesel powered hospital generator. By most estimates the hospital lacks  electricity  for more than 6 hours a day.  Imagine attempting an emergency c- section operation in the middle of the night with no electric lighting or power. Providing reliable, affordable electricity will give patients at Rulenge  Hospital an even chance that the rest of the world takes for granted.

    There is more to this story that is very timely and appropriate. Solar powered electricity improves health care and save lives. It also reduces cost at this or any poor  underserved hospital. It can also be a zero carbon solution to climate change and to  improving public and planetary health. 

      Each project we  complete proves to local people that solar power is an achievable, reliable and an affordable alternative to the  inefficient, carbon based utility grid that exists throughout Africa.  We can help the developing world transition to a carbon free economy. And we can do it in equatorial Africa where the effects of climate change may prove to be the most severe.

   Please read the attached, powerful letter from Sr. Dionesia MD, the medical director of Rulenge Hospital ( below).

Sr. dionisia Jasson <sr.dionisiajasson@yahoo.com>

Dec. 31, 2021, 9:01 AM  

 Dear Dr. Larry,

Greetings from Rulenge Hospital.

I am Sr . Dionisia OSF, MD and I am currently working as an acting medical officer in charge of Christ the King Rulenge Hospital. I would like to introduce the hospital  as well.

Christ the King Rulenge Hospital is a voluntary agency that was established by Canadian Sisters in 1952 as a dispensary before being upgraded to the hospital level in 1956.  It is located 45 kms from Ngara District, headquarters in which there is another hospital, Murgwanza, 350 kms from the regional headquarters and 420 kms from Mwanza City in which the referral hospital, Bugando Medical Centre is located.

This is a general multidisciplinary hospital run by Rulenge Ngara Catholic Diocese under the ownership of the Diocesan Bishop.  Targeting patients of low and medium income levels the hospital belongs to the secondary care category providing services in integrated units of Diagnosis, out-patient and in-patient departments.  There are other ranges of services provided by the hospital such as Reproductive Health, dental and ophthalmic services, surgery, obstetrics, diagnostic imaging (X-ray, Ultrasound) HIV/AIDS treatment and control, Laboratory Services and Theatre.

Our hospital has two sources of electricity; from the national grid and from our generator. However, the national grid is not stable therefore most of the time the electricity goes out and we have to use the generator. The situation has grown worse over the past 6 months because most of the time the generator is at work. We have gone beyond the budget  twice for purchasing diesel. We have shortage of funds, the hospital's need for electricity is also increasing due to use of more electric devices and fuel prices are growing higher.  As a result of all this, sometimes we have failed to manage the demand and so to provide quality health services as per hospital level. For example, during the recent outbreak of COVID-19, we had many patients who were in need of Oxygen from electric oxygen concentrators. Some of these patients did not get oxygen because the electricity was very unstable and of low voltage. We managed to save many but among those who died inadequate supply of oxygen was the contribution to their failure to survive.

In addition, we have premature babies that need a good constant supply of electricity in order to succeed in managing them. When the electricity is not reliable, we lose most of them. Again, most of surgical procedures are being performed with difficulty especially at night when the electricity goes off suddenly and repeatedly.

We think that the presence of solar power as the alternative source of electricity will bring a great relief to us with regard to various challenges faced due to shortage of electricity at our hospital.

I would like to ask for your assistance in achieving this which will be a great support not only for the hospital but also for the residents of the catchment area who will be receiving medical treatment at our hospital.

I am grateful in advance.

SR. DIONISIA JASSON

SCF PLANS TO SUPPORT BREAST CANCER RESEARCH IN TANZANIA

 

1/3/22:  SCF PLANS TO SUPPORT BREAST CANCER RESEARCH IN TANZANIA

 

THE ISSUE:   Breast Cancer is the leading cause of cancer death in women in the world. Globally approximately 700,000 women will die from Breast Cancer in 2022.  While there has been great progress in treatment in high income countries. Low and middle income countries lag behind because of lack of access to diagnosis and affordable  treatments. While the 5 year survival rate for all breast cancer exceeds 80% in rich countries, the 5 year survival is approximately 15% in low income countries. Breast cancer is the second leading cause of death in women in Tanzania.  Even worse, breast cancer rates in Tanzania are projected to increase by 80% in the next decade. There are several reasons for these inequities.

   

THE PROBLEMS: 1) Late presentation. For cultural and geographic reasons breast cancer is still a hidden disease in Tanzania. Many Patients, families and communities consider this an unspeakable problem. This results in women presenting late in their disease which limits successful treatments.

     2) Lack of diagnostic facilities for pathological testing: There are many different kinds of breast cancer. Treatment begins with a surgical biopsy and then the biopsy specimen is sent to a laboratory. Identifying which kind of breast cancer the patient has determines what is the best treatment. Optimal treatment depends on the presence of estrogen receptors  ( ER) in the tumor. Estrogen receptor positive ( ER+) tumors can be treated with effective medicine taken as a pill. Estrogen receptor negative ( ER-) tumors  requires IV chemotherapy and / or radiation therapy. There a very few pathologists and pathology labs that are able to perform accurate diagnostic identification of breast biopsy specimens Tanzania. Additionally, there a very few patients who can afford to pay for pathological testing.

    3) Unaffordable and inaccessible treatments. Currently chemo and radiation therapy are only accessible at a few centers in the country. In contrast to expensive intravenous chemotherapy  or radiation therapy Tamoxifen, an estrogen receptor blocker, is inexpensive and easy to administer pill which is effective in treating ER+ breast tumors.

    ONE SOLUTION:  What if the diagnosis of a type of breast didn’t depend on a surgical biopsy or a hard to access expensive pathology lab? Could diagnosis be made with a simple blood specimen? It turns out there are blood tests that can identify  inflammatory agents ( biomarkers) that reflect the presence of  estrogen receptor positive ( ER+) breast cancer. This testing at local hospitals and clinics to identify the breast tumor sub type is called  Point of Care testing (POC). Point of care testing simplifies access and reduces cost. Estrogen Receptor ( ER) status determines treatment. ER+ breast cancers respond to hormonal therapy drugs such as Tamoxifen. 

   Targeted pragmatic treatment: Tamoxifen, which is classified as a WHO essential drug, is a low cost effective agent to treat ER+ breast tumors. This  could negate the need for radiation or chemo therapy which are prohibitive for poor rural populations.

   RESEARCH PROPOSAL: Instead of relying on hospital based pathological testing. This research project proposes to test the accuracy and efficiency of a  point of care

( POC) blood serum based analysis to identify a specific inflammatory BIO marker that identifies  ER+ breast tumors. ER status determines treatment. ER + breast tumors respond to Tamoxifen. This simplified and cost effective approach could save and extend lives in a resource poor country like Tanzania.

New Direction for the Sandy Christman Foundation

   As we hope to emerge from the worst of the pandemic I am anxious to get the SCF back on track. Our Vision is: To Make Things Better. Our Mission is: health promotion and disease prevention in underserved low income countries. Our tactics have been to help bring better health care to Biharamulo Designated District Hospital ( BDDH) in western Tanzania. Since 2008 we have made 11 clinical trips to BDDH during which we directly delivered and improved health care. Each of those volunteer clinical trips lasted from one to three months and in that process we have created a bonded, long term relationship with the hospital and the surrounding community.

   After 13 years of experience I have seen that we can make a bigger impact on our vision To Make Things Better by creating a better infrastructure at BDDH. Specifically, that means bringing stable, reliable and inexpensive electricity to the hospital. Having 24-7 electricity creates a safer working environment and prevents medical and surgical disasters, something  that I have personally experienced. There are few more frustrating and scary moments than having the lights go out in a night time emergency operation. The electric power grid infrastructure in Tanzania is unreliable and unsustainable. Having reliable electricity allows health care improvement at BDDH to advance to and stay abreast of medical progress in the 21st century.

    Like everything, the situation in Biharamulo is changing. We are now, hopefully, seeing the beginning of control of Covid19. At the same time, we now face the growing reality of climate change.  Without immediate change on a global scale climate change will continue to get unpredictably worse. Sadly, the most destructive climate changes occur in the low income countries, all of  whom have had little or no contribution to its existence. Tanzania is one of those low income countries. 

     The SCF happens to be in a very good position to make things better, to promote health and prevent disease  and to help slow the effects of climate change.

With three successful solar projects completed in and around BDDH we have the experience and local credibility to help poor countries like Tanzania choose safer and cleaner and better economic alternatives to coal and diesel. COP 26 has shown us that on a global scale significant change to alternatives is very unlikely to happen by 2050. Because it is unlikely to happen is the exact reason why we need to do more, act now and follow our mission to make things better, safer, cleaner and less expensive 

    I believe our biggest impact can be if we help Biharamulo skip the 19^th century based carbon energy phase of its development. Diesel and oil and coal are still a strong temptation for developing countries because of their low startup costs. As poor developing countries make choices to fill their expanding energy needs we need to help them make solar energy become a choice to power their growing infrastructure.

     Expanding to solar power we can create clean, carbon free, reliable and affordable energy. Additionally, by doing so, we help a poor country do what rich countries are trying to do. Finally, by doing so, we can make things better over a wide spectrum, from effects on health care improvement all the way down to allowing a young student have electric light to do their homework at night. And every time we put up a new solar array it stands as an active advertisement and teaching moment to the people of western Tanzania. Each solar project we put up shows them that economic development and good health care go hand in hand and that progress doesn’t depend on carbon based energy. In essence solar power in Tanzania saves lives  and saves money. 

    Let’s do this.  We can be a model for change. We are small but we can have a big effect on a small, poor country that faces huge challenges and threats as it tries to grow. Even better, we can also affect the health of the planet itself.

 

SCF COMPLETES 3RD SOLAR PROJECT FOR BIHARAMULO DISTRICT

Site: St. Claire’s Secondary School for Girls, Biharamulo, Tz.
Date of Completion: Apr.6, 2021
Start of Construction:  March 24, 2021
Cost: $14,905.00 USD
Pump Capacity: 17 cubic meters/day (minimum)
Water Stage Capacity: 1,500 Liters
Financed by:  The Sandy Christman Foundation

ST. CLAIRE’S SECONDARY SCHOOL SOLAR PROJECT COMPLETED

On April 6^th 2021 the St Claire’s Secondary School for Girls finally had running water thanks to a project funded by the Sandy Christman Foundation.  It has been almost 3 years since the schools old solar powered water pump and batteries failed.  Now this school for 300 girls and teaching staff  has indoor running water for sinks, showers and toilets.

Working with our partners Power Providers Solar Energy Co. from Arusha, Tanzania this is now our  3rd successful project to bring carbon free, solar   energy powered projects to needy organizations in rural western Tanzania.

The design highlight of this project is the stand–alone solar powered water pump system is battery free. This reduces the upfront cost of the system, saves on maintenance and future battery failure and is a good simple system for a rural area with limited access to technical support.

Scope of Work

The Power Providers solar engineering team designed, supplied and installed a stand-alone solar water pumping system at Biharamulo, for St. Claire’s Girls Secondary School. Data used for design purposes was collected from client, including a drilling report and pump test (sent on 25 January 2021). The project requirements were to meet daily water volumes of up to 10m3/day, lifting water from the borehole up to the main tanks. This was achieved by designing and installing a stand- alone submersible solar pump with a 395Wp array to reach volumes of 17m3/day in least sunny condition on an average month.

Phase 2 of Solar Power Project Complete

  SCF BRINGS SOLAR POWER IN TANZANIA!

 SCF is proud to announce that on June 4th, 2020 Power Providers Solar Company commissioned and completed phase 2 of our solar power project for BDDH (Biharamulo Designated District Hospital). This has been a 4 yr. project from conception to completion. With the completion of phase 2 we have financed a project that supplies greater then 90% of the day time electrical energy use at BDDH. The solar project also charges batteries for night use and depending on demand and weather (clouds) the hospital could get 100% of it’s energy from solar power during the day.

This is a significant improvement for BDDH, for Biharamulo and for Tanzania by many counts.  The solar system saves money for the hospital, produces less CO2, and air pollution. It also results in less dependence on diesel fuel and a model for the future of clean energy production for Tanzania and Sub Saharan Africa. In addition there is another part of this project that is hard to measure but is vitally important. Heath care today is dependent on electricity. Whether it is an emergency operation in the middle of the night or just providing good safe bedside care, electricity is needed. Electrical power is not just for lighting. 21st century health care demands computers, data and devices.  Every provider of health care in Biharamulo has faced an emergency situation at BDDH where the power goes out at a critical moment.  This is never worse than at night. Nobody chooses to operate at night. So, if you are operating in the middle of the night, it’s an emergency! Now take the increased risk of an emergency operation and throw in a power outage with a complete blackout. Without light, surgery cannot continue. Believe me, I have been there. Try doing  a complicated, emergency C section in the middle of the night with a flashlight or kerosene lamps.  You have just been thrown from an emergency to a full blown disaster. And, unless you have a lot of luck you are also now an active contributor to the Tanzanian national maternal and neonatal mortality rate.  This is just not acceptable anytime, especially in 2020.    

    We are very excited to add to the quality of health care delivery at BDDH with the completion of this solar power project.

Below, see weekly solar energy production from the  system:

PHASE 2 SOLAR POWER FACT SHEET.

Contractor: Power Providers, Arusha, TZ

Financed By: Contributors to The Sandy Christman Foundation, USA

Construction Begun: May, 2020

Construction Complete: June 4, 2020

Daily Electrical Production: 50- 95 kW h

Cost: $45,000.00

7/21/20: SCF BUYS PPE FOR BDDH!

  

PPE FOR BDDH:  As the SARS CoVid 19 pandemic erupts around the world and surges in the US the Sandy Christman Foundation looked to our friends and colleagues at the Biharamulo Designated District Hospital (BDDH) in Tanzania.  We inquired about PPE for the hospital and we were told there was none. This was going to be a problem. I was unsure about what Covid-19 would do in Africa but I had been through some near misses with epidemics in the past so we thought we should act in a preventive manner. During   the  Ebola crises, first in east Africa and then in Kivu, DRC, I saw how fear preceded the arrival of Ebola. Even though it never came to Biharamulo, the Kivu district in the DRC is less then 200 miles from Biharamulo and border checkpoints are porous. Even in rural, impoverished west Tanzania everyone knew about Ebola and its deadly effects. One day in 2016 a Public Health official from Dar es Salaam came to BDDH to give hospital staff instructions on donning and doffing a hazmat suit in the event that Ebola could appear. A serious discussion turned into comedy as he stumbled and tripped his way into the suit. He finally needed help from a few of us. In the end the suit didn’t fit and as he left I wondered if this was his first try on.   Then in typical East African logic he left with the suit leaving the hospital and probably all of west Tanzania with no hazmat suits. Where we would get one, perhaps on short notice, was a question no one asked. Ebola remains active in the DRC (last outbreak reported June 2020). Luckily, to this day there have been no reported Ebola cases in Tanzania. 
   With that memory and knowing their limited resources the Sandy Christman Foundation decided to act last May to get PPE for BDDH.  The full extent CoVid remains a mystery but we are pretty sure HazMat’s while effective are not needed for this out break. With the help of Dr. Gresmus Sseboyoya we transferred $1500.00 USD to the hospital. Within a week the hospital purchased, masks, gowns, gloves, eye protection and sanitizer to prepare for the likely arrival of the virus. As of this writing the government of Tanzania is not recording CoVid cases or deaths. There is minimal or no testing done in Biharamulo and no facility to treat severe respiratory or multisystem failure from CoVid anywhere in western Tz. For further information on CoVid 19 in Tanzania or East Africa go to: www.https://coronavirus.jhu.edu/map.html

MASKS ON, SOCIAL DISTANCING....NEXT

   At the SCF we remain ready to help BDDH and the people of western Tanzania as the situation unfolds.

UNLOADING PPE

   

The Seventh Kingdom, Two Valleys Away.

 
 

  

11/17/20.      TWO VALLEYS AWAY

The clinic grounds

Preface: Futurist Kevin Kelly has talked ( see TED talk) about the Seven Kingdoms of life on our planet. You may recall from school Biology that all life on this planet can be categorized in 5 or 6 Kingdoms (depending on when you went to school). Kelly and others postulate how Technology is, or will be, a life form of its own thus Seven Kingdoms. We are not talking about religious or political kingdoms, this is biological kingdoms. Its stuff you either loved or hated in school. This story is about the boundary of the Seventh Kingdom.

   I went to visit a good witch doctor the other day.  His name is Pascal. My friend Ali took me. He came highly recommended (that’s always reassuring). Ali has used him in the past and many local people speak highly of him. He is way off the grid. We walked an hour and a half from the end of a dirt road into the jungle, maybe 6 kilometers. It was beautiful; a steep climb over 2 ridges and then we drooped into a lush green valley. No cell phone towers, no telephone or power lines. Water and sewer? For real? Here you’re on your own.

    When we got there things looked pretty normal. Pascal is a local healer aka a witch doctor. He is OK with either title.  As we approached his clinic he was sitting on a broken plastic chair in his yard. The seat was busted out but if you were careful you could still put your weight on it. He had 4 other plastic chairs in the same shape and a plastic table and some benches. They were scattered about the yard, tipped over at weird angles as if a big wind had blown thru last night (it hadn’t). The yard was hard pack reddish clay, nothing grew in the yard.  Pascal was busy with a big pile of local plants. There was a fire burning in the hot equatorial sun.  He was busy peeling a thin bark off them, saving the green stalks and boiling the bark.  As we arrived he continued to peel and then, after he finished the plant he was working on he got up slowly and greeted us. He was a gentle, smooth talking big man with a soft voice. He didn't say much and was not an overpowering presence. His eyes were ruddy and his teeth seemed in good repair. He was dressed in "fatigued" jeans and shirt and rubber sandals.  He was not alone.  In his yard were several chickens and ducks and several children. There was a single cow in a stick and log corral and 4 buildings formed the perimeter of his yard.

  There were 5 of us, my friend Ali, 2 medical students, nurse practioner and myself.  Pascal gestured for us to sit and make a circle as we balanced ourselves on the chairs, some with 3 legs all with missing pieces. Ali explained we were "doctors" and had come to visit him and see his practice.  He was OK with that. There were periods of silence where we all just sat and waited for a sentence to appear in the conversation. Pascal seemed to be translating Ali's Swahili, waiting 10 -20 seconds then responding with a soft thoughtful but short answer. Maybe his primary language was some 'local tongue”. There are over 60 dialects or local tongues in Tanzania. As we sat there I became aware of the sounds and smells Pascals home. There were sheep nearby, there was yelling and laughter of children. There was the smell of cows and cow poop very nearby, duck and chicken poop, and a cool green breeze as we sat in the shade of a big avocado tree. There were lots of flies and I wondered about mosquito's and night time here as I looked at the glassless and screen less buildings in front of me. His kids were nearby, dressed in hand me downs, shoeless, adorable and curious. They laughed and giggled as we shared digital portraits. Pascal’s wife appeared, she had a long red dress probably made from a Kanga. She was busy with kids, animals, planting and preparing food. Ali explained Pascal and his wife are both local healers and work together. I was introduced to his wife but her name was unpronounceable to me. I looked at Ali?  He pronounced a sound a couldn’t picture in my mind. If I tried to spell it would look like Ajebishewa, Maybe more like & (*$#@? |. I never did get her name right.

     Pascal's wife was more of a mystic; she did futures and clarified problems and troubles in your life and family. The medical students all had their futures read by her. I declined, deciding I liked uncertainty and besides I wanted to somehow ask Pascal about his herbs and " talk medicine" with him. With Ali's help we went into a dark un-lite hut and Pascal showed us his "pharmacy" There were at least 25 jars of stored herbs and plant extracts, most were in old Coke and Fanta bottles. Many of the herbs looked like ground up bark. I reflected that maybe Pascal is not so far off base here, Aspirin is derived from Willow trees and quinine, the original treatment for Malaria (rampant here), is from Chinchona tree bark.

  With Ali's translating Pascal explained he treats fever, sore bones and joints and headaches which by the way al all the classic symptoms of Malaria.  He knows about Malaria and diabetes and treats them with an herbal tea. There was a patient there who had broken his arm. Pascal had made a cast of bamboo sticks that surrounded his upper arm immobilizing the fracture and placed the arm in a sling. It was a beautiful piece of handi work and the patient was happy with the result. I asked how long will he keep that bamboo cast on and while the answer wasn't clear it sounded like days after the pain is gone. Thinking about it I'm guessing Pascal and his patient don't think of time in terms of days or weeks. This is not a calendar-based society. I asked what does Pascal do when someone is really sick and looks like they are dying. He didn't hesitate on this one, he is glad to send very sick patients to the hospital. I thought about that walk we just taken through two valleys and steep hills to get here, being sick, maybe delirious, maybe in the dark......

Broken arm set with a bamboo cast and sling

   Later as we sat under the avocado tree I showed Pascal a present I had brought him. I gave him my stethoscope. He knew what it was but wasn't so sure how to use it. After a quick 10-minute tutorial of how to place it correctly oriented in your ears, where to listen on the body and some quick pathology he seemed pretty happy to have it. I told him he had to practice every day. Wearing it around his neck he suddenly seemed to stand straighter, maybe a little more credible but still uncertain of its value to his practice.

  You might think it is waste to give an uneducated witch doctor who lives in the bush a $150.00 stethoscope. But try this. Pascal is the primary provider of health in this valley and probably several valleys around. He is educated, having learned what he knows from his grandfather, handed down in the oral tradition He knows his purpose here is to serve his people, to make them better and he is quick to say that. And he has “good reputation”, not on the Internet but here on the ground. Pascal brings medicine to the people, not people to the medicine. A stethoscope out here is also bringing medicine to the people.  While not technology it is a tool and a brick on the road to the Seventh Kingdom. Next year I'll bring a blood pressure cuff and see if Pascal has  a breakthrough medicine for that.

   It was a long hot walk back to the civilization of Biharamulo. I thought about how important it is to know our world and what is in it and about how close and yet so far we were from 21 century technology.  For Pascal and is family, the Seventh Kingdom has not arrived here but it’s only 2 valleys away.

Pascal and the stethoscope