Documenting and Analyzing the VillageReach Model:



INFORMATION FLOW AND SUPPLY CHAIN MANAGEMENT FOR REMOTE CLINICS IN MOZAMBIQUE:

BUILDING ON THE VillageReach MODEL

The Mozambique Project Handbook

The Interdisciplinary Program in Humanitarian Relief

VillageReach

Table of Contents

I. Introduction page 3

II. Purpose of the Project page 4

III. Project Objectives: page 5

What, why, how, and what will be produced as a result

IV. Working Timeline of Activities page 8

V. Background and Resources page 9

Appendix A page 19

Maps of Cabo Delgado province and Mozambique

I. Introduction

During Spring 2004, the University of Washington’s new Interdisciplinary Program in Humanitarian Relief (IPHR) offered a pilot course called Humanitarian Logistics, Electronic Information, and Supporting Systems. The course brought together graduate students with backgrounds in communication systems, industrial engineering and public affairs to study and work on improving humanitarian logistics – how goods and services intended to reduce human suffering get to where they are needed. This course also served as a planning platform to prepare students for field research in humanitarian logistics.

In partnership with VillageReach, a project was planned to study how information and supply chain management could be used to improve and extend the delivery of healthcare supplies to remote clinics in Mozambique, building on the already successful model being developed by VillageReach. This document is an evolving handbook for that project (). It is intended for use both by the partners to clarify project objectives, methods and activities, and by the students conducting Summer 2004 field research in Mozambique as a guide and resource.

II. Purpose of the Project

VillageReach’s goal of transporting supplies to health clinics in remote parts of Mozambique is complicated by poor infrastructure, unreliable data and unskilled labor. The country, which has been independent since 1975, is recovering from war and natural disasters as well as several centuries of exploitation by colonial powers. Consequently, much of the physical and communication infrastructure (i.e. roads, telephone lines, etc.) is poor and unreliable and the workers poorly educated and trained.

Currently, a large portion of VillageReach’s organizational knowledge of how to manage these difficult issues lies in the personal experience of several key employees rather than as formal organizational knowledge. Communicating with the clinics about the amount of supplies they need and gathering data about how the supplies are being used are an essential part of VillageReach’s operations. VillageReach must therefore find a reliable and repeatable means of gathering data from the clinics to ensure that they receive the sufficient amounts of supplies while keeping wastage and spoilage to a minimum. Furthermore, it is essential that this knowledge be institutionalized rather than being kept by a few key individuals. This is especially true as VillageReach expands its operations.

VillageReach is currently in a period of multifaceted expansion. It is expanding its service to supply clinics throughout the entire province of Cabo Delgado, as well as attempting to increase the area around each clinic that is served (the area currently served around each clinic only extends to about a 2 hour walk). In order to efficiently achieve expansion throughout Cabo Delgado, VillageReach will require standardized organizational procedures that are simple enough to be taught to new (sometimes illiterate) employees. This will allow VillageReach to apply lessons learned in their current service areas to the new areas, to reduce the learning curve of new employees and to manage the entire operation efficiently once it has been fully implemented. VillageReach must also create a plan to extend the area around each clinic that is served using the minimal resources that are available.

To achieve these goals, we plan to carry out an analysis of VillageReach’s logistics operations, paying special attention to how VillageReach staff and clinic workers (Ministry of Health employees) carry out procedures and collect data. Our main goals will be to document existing practices, to analyze the existing data collection system and recommend improvements, and to assist VillageReach’s provincial manager in developing a plan for the extension of services.

The two interns selected to conduct the field study component of this project combine experience in international organization development and systems analysis. Both interns have studied how IT can be applied to logistics systems of humanitarian aid organizations to increase programmatic and organizational efficiency. They have worked closely with VillageReach to help create this plan of action, and will continue to do so through the fieldwork and analysis phases of this project.

III. Project Objectives: What, Why, How, and Deliverables

This project has three primary objectives:

1. To document VillageReach’s current operations in Cabo Delgado,

2. To evaluate VillageReach’s current (evolving) information management system,

3. To develop a preliminary service plan for the extension of healthcare services to people in a wider radius around each clinic.

Objective 1: Document VillageReach’s current operations in Cabo Delgado – what they do and how they do it

Why is this important?

Currently, much of VillageReach’s critical operational information (i.e. delivery routes, timing, contact people, etc.) is not documented and exists only in the heads of the key people who carry out these operations. Institutionalizing this knowledge – recording it and making it available to the organization as a whole – will enable VillageReach staff and management to analyze current practices and to demonstrate organizational operations to outsiders (e.g., partner organizations). Analysis of current operations will allow VillageReach to recognize bottlenecks in the distribution of goods and collection of data and to correct those bottlenecks. The documentation of operations will allow VillageReach to create a template for the expansion of services to other provinces in Mozambique and to other countries. Finally, institutionalizing critical operational information makes VillagReach less vulnerable to unexpected fluctuations in staff.

How will this be accomplished?

To accomplish this objective, the interns will use ethnographic methods known as participant-observation. The interns will observe operations in VillageReach’s office in Pemba as well as the delivery of goods to clinics throughout the province. The interns will record observations and conduct interviews with VillageReach staff members. Areas of documentation include:

• Pre-trip planning of deliveries

• Allocation of funds to field team

• Reception of cargo at provincial warehouse

• Clinic visits:

o Cargo drop-off and collection

o Equipment inspection

• Record keeping, data collection and reporting by:

o VillageReach staff

o Ministry of Health staff (e.g., clinic health workers)

The interns will draft a report cataloguing current VillageReach procedures and practices based on data collected through observations and interviews. They will also conduct additional interviews with VillageReach staff to verify that the report accurately reflects current procedures and practices.

Deliverable to be produced?

➢ A final report cataloguing current VillageReach procedures and practices.

Objective 2: Evaluate VillageReach’s current (evolving) information management system – describe current system (including changes that are in progress), identify strengths and weaknesses, recommend and test potential improvements.

Why is this important?

An enhanced information management system would help VillageReach in several ways, including: enabling the demonstration of program effectiveness more concretely; improving accuracy in determining optimal quantities of supplies to deliver; pinpointing sources of wastage and identifying problems that could be rectified; and identifying and addressing inefficiencies in the current supply chain. Currently, staff at VillageReach’s Seattle headquarters are creating an information management system aimed at realizing these positive benefits.

The success of this information management system is partly dependent on the full participation of VillageReach staff in Cabo Delgado to collect, record, and report data accurately, completely, and consistently. Full participation is more likely if staff members are invested in using the system, and if the system is one that works for them (i.e. it is designed to be easily used within their normal work flow and environment). Consulting the people who will use the system and incorporating their input into the system design (i.e. user-centered design) will increase their sense of investment in the system and the likelihood that they will use it properly.

How will this be accomplished?

The interns will first investigate VillageReach’s current (evolving) information system by reviewing data collection forms, processes, and goals with VillageReach’s Seattle staff. They will then observing the practice of these processes by VillageReach staff in Cabo Delgado. As far as possible, the interns will also investigate the Ministry of Health (MoH) data reporting system used by clinic health workers (this will be constrained by access to the MoH system and the practices of clinic workers and other MoH employees).

The interns will then analyze VillageReach’s information system – where do lapses in accuracy and completeness occur? Why? What changes to the system could potentially remedy these breakdowns? Based on this analysis, the interns will identify and field test potential improvements. Methods likely will include creating prototypes of alternate data recording forms and processes and testing their implementation through questionnaires and interviews with VillageReach staff. The goal would be to identify the impact of these changes – would it improve current inefficiencies in VillageReach’s information management system? As far as possible, interns will also identify bottlenecks/gaps at the clinic-health-worker and MOH-data-recording-form level, and develop and test recommendations for closing those gaps. Again, access to the part of this system controlled by the MoH may be constrained.

Deliverable to be produced?

➢ A report identifying the strengths and weaknesses of VillageReach’s current (evolving) information management system, with recommendations for potential improvements and findings from any tests conducted to assess possible changes.

Objective 3: Develop preliminary service plan for extension of services to larger radius around each clinic through clinic-based outreach services and village-based capacity building.

Why is this important?

Each Ministry of Health (MoH) clinic is intended to serve 10,000 people, but in reality serves only 30% to 35% of that number. Typically, these are the people who live within a two-hour walk of the clinic. Another estimated 25% to 30% of the target population live within a radius that could be served by a clinic-based health worker with a bicycle (clinic-based outreach services). The remaining 40% of people who should be served by clinics live outside of that radius, but could be served through village-based capacity building – for example, by supporting community partners in villages with a medical kit and training. A plan addressing the logistics of these extensions is key to catalyzing action by MoH. If VillageReach is to be involved, a means of keeping track of services provided, resources used, and program impact is essential.

How will this be accomplished?

The interns will seek to address service-plan questions by working with VillageReach’s new Provincial Manager, Sr. Pinto, who has many years of experience in the MoH. They will conduct interviews with MoH member Sr. Paolo (who speaks English, was provincial EPI head, and is now in Montepuez where there is a regional hospital); Joao Rodriguez; Foundation for Community Development (FDC) partners; and possibly clinic health workers and clinic patrons.

Questions to be addressed in developing the preliminary service plan include:

• Defining services:

o What services will be provided by clinic-based outreach health workers?

o What services will the community partner be supported in providing?

o What will the geographic reach of each be?

o How frequently will the clinic-based health worker conduct outreach?

o How frequently will the community partner’s medical kit be re-provisioned?

• Identifying resource requirements:

o Staff, services, equipment, training, and financial

• Defining VillageReach’s involvement:

o Staff, services, equipment, training, and financial

• Developing reporting requirements:

o Operational

o Financial

o Demonstrating efficacy and impact

Deliverable to be produced?

➢ A preliminary service plan addressing logistical details of how healthcare services could be extended through clinic-based outreach services and village-based capacity building, with particular attention to recommendations for reporting requirements – how will records be kept of services provided and resources used, and how will efficacy be documented?

IV. Partners and Related Projects

VillageReach

VillageReach is a small Seattle-based nonprofit whose mission is to improve access to essential healthcare services in remote communities in the developing world (for a description of VillageReach and its involvement in Mozambique, see Section V.B.—VillageReach Involvement in Mozambique). To this end, VillageReach is engaged in a demonstration project distributing vaccines and medical supplies to clinics in Cabo Delgado, a province in northern Mozambique with 1.5 million inhabitants and one of the lowest per capita incomes in Mozambique.

The demonstration project has been successful in strengthening the public health system and improving people’s access to immunization and other services, but is hampered by inadequate information flow between the clinics served and VillageReach decision-makers. Accurate and timely information on numbers of vaccines administered, seasonal fluctuations in demand, numbers of clinic patrons turned away due to stock-outs, and sources of vaccine wastage would enable VillageReach to concretely demonstrate the project’s effectiveness, better determine quantities to deliver each month, and pinpoint breakdowns in the supply chain so as to address them.

Interdisciplinary Program in Humanitarian Relief

The University of Washington has established an Interdisciplinary Program in Humanitarian Relief (IPHR). This program integrates educational (both for university students and for humanitarian professionals on the job) and research components, including the support of graduate student international interns to conduct field study of humanitarian relief operations throughout the world. The IPHR was proposed jointly by the College of Engineering and the Daniel Evans School of Public Affairs (which houses the Marc Lindenberg Center for Humanitarian Action, International Development and Global Citizenship), but it also draws on considerable relevant strength across the university from units such as the Medical School and the School of Public Health and Community Medicine (AIDS medicines distribution programs and refugee medicine programs), Civil Engineering (water, sanitation and transportation), and the Global Trade, Transportation and Logistics Program.

The primary goals of IPHR are to (1) combine the very different perspectives of public management and engineering to teach about and do research on the challenges faced by international relief organizations; and (2) establish an international reputation as a resource for applied knowledge at the intersection of logistics, information technology and organizational management in humanitarian relief operations.

This summer as part of research projects led by experienced faculty and in partnership with local relief agencies, teams of IPHR graduate students will be conducting field research in Kenya, Ethiopia and Mozambique. In addition to their other training, each of these research interns has just completed a new IPHR course in “Humanitarian Logistics, Electronic Information and Supporting Systems.” Next year, two additional new IPHR courses will come on line, “Managing Relief and Development” and “Humanitarian Logistics.” In addition, IPHR will be working with advisors from humanitarian relief organizations (HROs) to design and deliver continuing education courses to humanitarian relief professionals.

IV. Project Phases and Activities

This project to improve information flow and supply chain management in support of healthcare deliveries to remote clinics in Mozambique is progressing in three distinct phases: (1) a planning, analysis, partnering, preparation phase; (2) a data gathering/field study phase; and (3) an analysis, reporting, sharing, looking forward phase.

Phase 1—April – June 2004

During this phase, the IPHR graduate student team has worked with VillageReach staff, particularly Craig Nakagawa, to define and prioritize the objectives of the project. Team members Jeremy Hyland of the UW’s Information School and Eric Bratton of the Evans School of Public Affairs have compiled background information on Mozambique and on VillageReach, along with resources that the interns will rely on while carrying out the project. The team members who will carry out the field project – Justin Gale of the Evans School and Kate Hulpke of the Department of Technical Communication – have focused on developing the project objectives and the plan for achieving them, with the help of Nakagawa and Professor Mark Haselkorn. Team member Quan Zhou of the Department of Technical Communication has served as team leader, coordinating group members, assigning tasks, and compiling members’ individual contributions into group presentations.

Phase 2—June– September 2004

During this phase, IPHR research interns will conduct field study in Mozambique, working closely with VillageReach staff. Following is the current timeline for this activity:

Note: This timeline is approximate and is subject to change.

June 14 – 25

Interns work at VillageReach Seattle office, becoming familiar with operations.

June 28 – July 8

Interns observe operations at VillageReach office in Pemba and interview VillageReach staff members.

July 9 – July 19

Interns observe VillageReach field deliveries and clinic operations and continue interviews.

July 20 – August 1

Interns interview other key contacts and test potential information system improvements.

August 2 – August 12

Interns draft reports.

September

Interns share findings with IPHR faculty and VillageReach Seattle.

Phase 3

The third phase of the project will occur after the interns return from their field study. The IPHR team[1] will take the lead in compiling results and making them available to all project partners so that they can contribute to analysis and compilation of findings and drafting of results. This phase will culminate with a final project report and a December workshop where we share and integrate the results from the three African projects (Kenya, Ethiopia and Mozambique) and one background study of HRO information use and technology. At this workshop, we will discuss what we've learned, and, if appropriate, think about what might be done next to build on these efforts (the IPHR has funding for interns in the summer of 2005).

V. Background and Resources

A. MOZAMBIQUE

Background

Mozambique is a very poor country that in the past years has been devastated by war and massive natural disasters. Mozambique gained independence from Portugal in 1975, but from 1977 until 1992, the country was ravaged by a brutal civil war. Devastating droughts, cyclones and floods have pummeled Mozambique since the end of the civil war. These problems, along with a past stained by centuries of exploitation by the Portuguese, have left deep scars upon the nation. However, by all accounts, the people of Mozambique are rebuilding their nation with amazing success. Since 1987, the country has implemented solid economic reforms that have produced steady economic growth. In fact, in 2002, Mozambique had the 17th fastest growing economy in the world at 7.7%. The country has also continued on the path of political stability, having held several multiparty elections since the end of the civil war. But, in spite of these continued improvements, Mozambique is still one of the world’s poorest nations and faces many difficult challenges.

Mozambique suffers from the second highest death rate of all nations at 30.04 deaths per thousand people. This number is influenced by a very high infant mortality rate, 145.7 deaths per thousand, and a large number of deaths from HIV/AIDS. It was estimated that in 2002, 13% of the adult population was HIV positive. Mozambique has the world’s tenth largest population infected with the disease at 1.1million people. Half of all those infected are between the ages of 15 and 29. The prevalence of HIV is highest along transportation routes, disproportionately affecting migrant and transport workers, miners and commercial sex workers.

Mozambique suffers a number of problems that can be associated to its status as a developing nation with very limited funds. For instance the literacy rate among adults over 15 is only 47.8%. This has been confounded by the latest civil war, which interrupted the current generation’s education. Because of this interruption, although the official language of Mozambique is Portuguese, a large portion of the current generation does not speak it, and instead use native languages.

Although most of the main tourist areas are relatively safe, foreigners, especially women, are strongly cautioned against traveling alone. In addition to stories of outlaws and bandits, accounts of police corruption are also common. Remember, a bribe can look very enticing when you are a policeman who is paid very little officially. It is also very important to note that traveling is made dangerous by the huge amount of unexploded landmines left from past conflicts. Best estimates put the number of remaining landmines at nearly a million. The best advice is to never go anywhere off the beaten path without first consulting locals. More information on landmines in Mozambique can be found on the International Campaign to Ban Landmines’ website at .

The Human Rights conditions in Mozambique have improved in recent years, but the overall status is still dismal. The worst violations come from the very poorly trained police force. Cases of excessive force and brutality are the norm. Although the constitution of Mozambique gives citizens many guaranteed rights, most police in Mozambique are either unaware or do not care. Beyond police abuses, Mozambique also suffers from high rates of child labor, worker exploitation, and domestic violence.

There are 16 major ethnic groups in Mozambique with the Makua being the largest. The Makua are from the northern provinces. The other major ethnic groups are the Makonde, also from the north, the Sena, from the central provinces, and the Shanagaan, who dominate the south. Each of the major ethnic groups have their own languages. While Portuguese is the official language, due to the long disruption to the educational system the vast majority of younger people do not speak Portuguese, but their native languages. Portuguese tends to only be spoken by the older generations.

Mozambicans practice a variety of religions. Arab traders brought Islam to Mozambique in the 8th century and Islam is currently practiced by about 20% of the population, mostly in the north and coastal regions. The Portuguese brought Christianity to Mozambique in the 16th century and it is practiced today by about 30% of the people, most of them Catholic. The remaining 50% of the people practice animist religions. Many Muslims and Christians also retain many of their traditional beliefs and practice them alongside their organized religions.

Information regarding development efforts in Mozambique can be found at the following:

▪ UNDP’s Mozambique website discusses many of the development projects it supports in Mozambique: .

▪ USAID’s Annual Report for FY 2003 can be found at .

▪ Pathfinder International provides high quality family planning and reproductive health services in Mozambique. More information on it’s programs can be found at .

▪ Information on the World Bank’s programs in Mozambique can be found at

Health Issues for Travelers

Before traveling to Mozambique, it is essential that any traveler fully understand the health risks that are present in the country. Most travelers to Mozambique will need vaccinations for hepatitis A, typhoid fever, and polio. In addition, they should consider vaccinations for rabies and hepatitis B. Travelers will also need to obtain medication for malaria and travelers’ diarrhea. Other immunizations may be necessary depending upon the circumstances of the trip and the medical history of the traveler. Travelers must also bring adequate protection from insect bites, particularly mosquitoes. Immunizations should be started 4-8 weeks before departure. ’s website outlines in detail health and other travel precautions that all travelers to Mozambique must consider.

B. VILLAGEREACH INVOLVEMENT IN MOZAMBIQUE

The Beginning of VillageReach

VillageReach involvement in Mozambique dates back to the flood of 2000, when VillageReach assisted the Foundation for Community Development in the coordination of flood relief. During this interaction, VillageReach encountered many infrastructure problems that made work very difficult. These issues greatly affected the future mission of VillageReach as an organization. VillageReach leadership saw a definite need for an organization that specifically handled the creation and maintenance of infrastructure for delivery of medical and relief supplies to isolated areas.

It wasn’t until 2002 that the current project in Mozambique started as a pilot based on an agreement between VillageReach and the Mozambique Ministry of Health. The basic premise of the program is that VillageReach will take over the delivery of supplies to clinics in the most northern province of Cabo Delgado. A map of Mozambique and Cabo Delgado is attached as Appendix A. This particular province was chosen for the pilot project because it provides an environment very similar to other developing counties. For instance, Cabo Delgado is one of the poorest provinces in Mozambique with only six percent of homes having access to electricity. The vast majority of residents also have very limited access to any kind of government-sponsored healthcare. Those who can make it to a clinic face extremely long wait times and in the past clinics have often run out of medical supplies. This has instilled a lack of confidence with the clinics among the general population.

The pilot program in Cabo Delgado has been immensely effective in alleviating many of many of the problems associated with clinic supplies and equipment. In fact VillageReach states that there have been no clinic supply shortages while they have been running the transportation system. The success of the pilot in Cabo Delgado has allowed VillageReach to acquire funding for an expansion into additional provinces and eventually all of Mozambique. VillageReach also hopes to formalize the methods used in Cabo Delgado so that similar programs can be started in other developing countries.

Before VillageReach

Before VillageReach, the Mozambique Ministry of Health loosely controlled transportation of medical supplies to clinics. There was no formalized supply chain; instead deliveries were dependent upon many different local drivers who would come into town from their remote villages to pick up supplies. The main motivation of these drivers was purely the fun and change of pace they would get from visiting the large city where the supplies were stored.

Basically drivers from the very remote villages where the clinics were would come into the district capital to pick up supplies. While at the district capital, they would have a fun time in a much more urban setting than they normally experienced back in the villages. The same process occurred when delivering supplies from the provincial capital to the district capital. Drivers from the district capitals very much enjoyed the excuses for traveling to the provincial capital to pick up supplies. There, they could hit the clubs, maybe see their girlfriend, etc.

The ad-hoc old system of medical supply transportation did work, but it was often very slow and sometimes unreliable. It lacked the professionalism and accuracy needed when the supplies that are being carried were needed for saving lives. VillageReach saw this problem as before mentioned, during the flood crisis of 2000. Two years later they convinced the Ministry of Health to outsource supply delivery to them. So far VillageReach has been very successful in transforming the supply chain into a much more professional and accurate system.

It is important to remember the supply situation pre-VillageReach because as VillageReach expands into new areas, it is going to find very similar conditions. When VillageReach replaced many of the local drivers for medical supply deliveries, it took away a reason for these people to go into town. That meant they won’t get to go as often, and this caused real resentment. Things like this need to be anticipated during future supply chain rollouts.

Current Operations

VillageReach currently has a two-man one-truck team that is responsible for all deliveries to clinics in the pilot project in Cabo Delgado. They pick up supplies in the provincial capital and deliver them to the district headquarters. From there they deliver the needed medical supplies to all of the local district clinics.

VillageReach’s role as simply the delivery system has led to some interesting issues. First, VillageReach does not currently control the service that brings supplies to their warehouse in the provincial capital. This means that there are often delays in this part of the supply chain. In addition, the clinic workers are under the authority of the Ministry of Health, which makes affecting changes in clinic policy very difficult.

Foundation for Community Development

One of VillageReach’s principal partners in Mozambique is the Foundation for Community Development (“FDC” [Portuguese acronym]). Started in 1990, FDC’s mission has been to “establish partnerships in order to strengthen the capacity of disadvantaged communities, with the objective of overcoming poverty and promoting social justice in Mozambique.” FDC seeks to accomplish its mission by helping to foster civil society within Mozambique through: training and capacity building of NGO’s, grant making, networking, advocacy and other projects. FDC’s website is located at .

Other Strategic Partners of VillageReach

The following are other strategic partners of VillageReach. The list was pulled from VillageReach’s website.

Ministry of Health

The Ministry of Health (MoH) of the country in which VillageReach operates acts as the primary partner. The MoH outsources logistics systems to VillageReach but remains responsible for procurement of supplies, building and staffing clinics and for a portion of the operating costs. This ensures local government long-term commitment to the program.

Bill & Melinda Gates Foundation

The foundation was created in January 2000, through the merger of the Gates Learning Foundation, which worked to expand access to technology through public libraries, and the William H. Gates Foundation, which focused on improving global health. Led by Bill Gates’ father, William H. Gates, Sr., and Patty Stonesifer, the Seattle-based foundation has an endowment of approximately $27 billion through the personal generosity of Bill and Melinda Gates.

World Bank

The World Bank Group’s mission is to fight poverty and improve the living standards of people in the developing world. It is a development Bank which provides loans, policy advice, technical assistance and knowledge sharing services to low and middle income countries to reduce poverty. The Bank promotes growth to create jobs and to empower poor people to take advantage of these opportunities.

Program for Appropriate Health Technology (PATH)

PATH's mission is to improve health, especially the health of women and children. An emphasis is placed on improving the quality of reproductive health services and on preventing and reducing the impact of widespread communicable diseases.

Children's Vaccine Program at PATH (CVP/PATH)

The Children's Vaccine Program at PATH works to ensure that all children receive the full benefits of new, lifesaving vaccines without undue delay. The Program initially is focusing on vaccines that protect children against respiratory, diarrheal, and liver disease. Global use of these vaccines will reduce childhood deaths by 33% and reduce liver cancer deaths by 75%.

Foundation for Community Development (FDC)

The FDC was founded in Mozambique by people who share a belief that community development efforts should be supported from within society. FDC's focus is on strengthening self-reliance and increasing material and financial resources at the community level. They place a priority on projects like education, health, water and training, which develop human potential, generate income, and put in place critically needed infrastructure. The FDC is also an advocate for several issues including the Anti-Personnel Landmines Ban, Child Development and Micro-credit.

Flora Family Foundation

The purpose of the Flora Family Foundation is to promote selected activities of charitable organizations and institutions as determined by members of the Board. It is predicated on the belief that each individual has an obligation to go beyond the narrow confines of his or her personal interests and be mindful of the broader concerns of humanity. The Foundation pursues these goals in order to continue, in small part, the personal philanthropy of William and Flora Hewlett, and to provide their descendants with a vehicle for philanthropic activity.

Glaser Progress Foundation

By focusing on three complementary program areas -- Measuring Progress, Animal Advocacy and Independent Media -- The Glaser Progress Foundation aims to build a more just, sustainable and humane world. The Foundation was inspired, endowed and is led by Rob Glaser, CEO of RealNetworks, Inc., the company that pioneered the delivery of audio and video content over the Internet.

Izumi Foundation

The Izumi Foundation exists to support and enhance the goals of Shinnyo-En USA. The goals of Shinnyo-En USA are to address the root causes of human suffering, to increase compassion and caring among all human beings, and to promote a society that respects all living things. The Izumi Foundation’s mission, within the framework of the goals of Shinny-En USA, is to alleviate human suffering through improved health care. The Foundation will use its resources to enhance the health and well being of all people, but especially the poorest and the most vulnerable members of society.

Craig and Susan McCaw Foundation

The Craig and Susan McCaw Foundation was established for philanthropic giving on behalf of Craig and Susan McCaw. Their giving is focused in such areas as children, education and the environment. The McCaws are interested in economic development, poverty alleviation and helping to give people access to technology worldwide. A significant portion of the foundation's grants go to organizations that display an innovative and entrepreneurial approach to their mission.

Nelson Mandela Foundation

The Nelson Mandela Foundation opened its doors on Sept. 9, 1999, to expand and formalize the work Nelson Mandela has done throughout his life. Mr. Mandela is personally committed to developing a strong infrastructure that continues and improves on his initiatives as his legacy to Africa, and his foundation is actively expanding and developing its three primary sectors: democracy, education and health care.

Getty Images, Inc.

Getty Images is the world's leading imagery company, creating and providing the largest and most relevant collection of still and moving images to communication professionals around the globe. From sport and news photography to archival and contemporary imagery, Getty Images' products are found each day in newspapers, magazines, advertising, films, television, books and Web sites. Getty Images' Web site is the first place customers turn to search, purchase and download powerful imagery. Seattle-headquartered Getty Images is a global company, and has customers in more than 50 countries.

Synergos

The Synergos Institute develops effective, sustainable and locally-rooted solutions to poverty. Synergos and its partners mobilize resources and bridge social and economic divides to reduce poverty and increase equity around the world.

Maintaining the Cold Chain

Vaccines are a critical part of the medical supplies transported by VillageReach. In the past before VillageReach took over, vaccine wastage due to improper temperature control was common. So fixing this was a problem that was of key concern.

The very sensitive temperature requirements of most vaccines make their storage and transport troublesome. A temperature of two to eight degrees Celsius must be maintained, any hotter or colder will cause the vaccine to degrade to an irreversible useless state. The process of keeping the vaccine in this constant temperature range during the full vaccine delivery process has been coined the “Cold Chain”.

A break in the cold chain would have disastrous results, so VillageReach goes to great lengths to insure the chain’s security. In addition to simply delivering the vaccines, VillageReach also supplies the field clinics modern propane refrigerators for vaccine storage. These new appliances replace the old and unreliable cooling units that were often in bad need of repair.

Beyond new refrigerators, VillageReach is also investigating new and better ways to maintain the cold chain – especially during transportation where the heat and the elements can become big issues. As VillageReach grows, the standardization of such equipment will become very important because of the costs of parts and labor for the long-term maintenance.

Sustainability through VidaGas

After the launch of the VillageReach’s pilot project in Cabo Delgado, it became clear that additional income would be needed to sustain the project long-term. VillageReach decided the best plan would be to create a for-profit business whose profits could be used to support the pilot project and whose product would be something that would aid VillageReach in its mission. To this end, VidaGas was established.

VidaGas sells propane that the Ministry of Health buys to use in the equipment at their field clinics (such as the new regenerators) that VillageReach provided. This way, VillageReach is provided with both funding and a reliable source of fuel for their equipment. VidaGas also sells to local people and businesses providing them with a clean alternative to the traditional fuels like wood and charcoal. To help the local peoples afford the new fuel, VidaGas offers micro-lending options that allow the purchase of gas and equipment at very little up front cost.

The VillageReach Team

Blaise Judja-Sato

Blaise founded VillageReach in early 2000 after a life-changing experience coordinating relief assistance to flood victims in Mozambique. He is responsible for setting the organization’s vision and strategy, driving overall execution, and managing the VillageReach team. Blaise is also responsible for VillageReach's key external relationships with strategic and funding partners.

Prior to founding VillageReach, Blaise served as Director of International Business Development for Teledesic LLC, a company formed by Craig McCaw and Bill Gates to provide broadband satellite communications services worldwide. Prior to that, he was the Africa Regional Managing Director for AT&T undersea fiber-optic systems. Blaise is the President of the Nelson Mandela Foundation USA and Vice-President of the US Friends of the Foundation for Community Development based in Mozambique. He serves on the board of trustees of the Africa-America Institute (AAI) and the UNICEF chapter of greater Seattle.

Blaise earned an MBA from The Wharton School of Business at the University of Pennsylvania, and holds Masters degrees from the Ecole Nationale Supérieure des Télécommunications (ENST) in Paris, and the University of Montpellier in France. A native of Cameroon, Blaise is fluent in French and English and conversant in Portuguese and several African languages.

Craig Nakagawa

Craig Nakagawa received his BA from the University of Washington in Seattle and worked as a pharmaceuticals analyst for the investment bank Lehman Brothers in Tokyo, Hong Kong, and New York. After six years abroad, Craig completed his MBA at the University of Chicago. He then worked on Wall Street and in San Francisco before joining the satellite venture Teledesic in Seattle. Later on, he transferred to ICO Global Communications in London after it’s acquisition by Craig McCaw. At both companies, Craig worked in new business development, planning, and corporate development. 

At VillageReach, Craig guides the overall financial control of the organization. He is responsible for organizational development and strategy and for assessing ventures for potential partnerships. Craig is also responsible for creating business models and strategies for the development of local businesses and partnerships aimed at supporting VillageReach’s core mission as it relates to community development. He holds several securities licenses and is a Chartered Financial Analyst (CFA). In addition to English, Craig is fluent to varying degrees in Japanese, Korean, and German. 

Lionel Pierre

Lionel Pierre is responsible for the logistical viability and success of the VillageReach distribution system. Lionel has extensive experience developing and managing heath care logistics for international aid organizations such as WHO, UNICEF and CVP/PATH. Familiarity with logistical transport, rural African health facility refrigeration grid management and assessment of EPI logistics systems enables Lionel to accurately advise and develop those aspects of the VillageReach program.

In addition to managing VillageReach’s in-country operations and personnel, Lionel performs several administrative and managerial duties. He is responsible for field personnel and contractors, both directly and through designees. 

A native of Haiti, Lionel has been educated in the United States, France, Uganda and Kenya in addition to his home country. He is fluent in Creole, English, French, Spanish, Hausa, and Malinke.

Didier Lavril

Didier Lavril oversees VillageReach's LPG (Liquefied Petroleum Gas) operations. Didier has extensive experience developing large-scale LPG facilities for multinational energy companies such as Energy UK and Addax. His hands-on management experience with LPG procurement, storage, and distribution in the Middle East and Africa enables him to understand and solve the complexities of implementing viable energy solutions in low-income countries.

In addition to advising VillageReach on how to meet its local energy needs, Didier is a consultant to VidaGas, a company started by VillageReach in an effort to provide low-cost LPG and LPG appliances to the Ministry of Health as well as local families and businesses currently dependant on kerosene, charcoal, and wood for their heating and cooking needs. 

Didier is a French citizen and studied at the University of Paris. He has worked in England, France, Netherlands, South Africa, Switzerland, Tanzania, and the United States. In addition to French he speaks fluent English and Spanish.

Provincial Manager

VillageReach is in the process of hiring a new provincial manager for its operations in Cabo Delgado. VillageReach plans on hiring someone by July 1, 2004. The new provincial manager will be in charge of VillageReach’s healthcare activities.

Joao Rodrigues

Joao Rodrigues is the current Provincial Manager in charge of VidaGas. Up until now, he has been in charge of both VidaGas and VillageReach operations. When the new Provincial Manager is hired for VillageReach’s healthcare activities, then Joao will work exclusively on the VidaGas operations. Until then he is splitting his time and is currently overworked.

Paolo

Paolo is with the Ministry of Health and is based in Montepuez, a regional town in Cabo Delgado that is within VillageReach’s current coverage area. His work is centered on EPI, the Expanded Program for Immunization. He speaks decent English and is familiar with VillageReach’s operations. VillageReach hopes to hire him in the near future.

Erik Charas

Erik Charas is with the FDC and is in charge of investments. He will be the principal contact at FDC. He previously lived and worked in Capetown, South Africa and speaks fluent English.

Other Possible Contacts/Resources

Health Alliance International (HAI)

Health Alliance International is an NGO based in Seattle and associated with the International Health Program at the University of Washington. HAI’s mission is to improve the health and welfare of disenfranchised people in Mozambique by assisting Mozambican institutions address health needs. HAI accomplishes this by providing teaching, service, and critical material resources. The executive director of HAI is Stephen Gloyd. His email is gloyd@u.washington.edu, or his staff contact is Julie Brunett jbrunett@u.washington.edu, or you can contact HAI’s office at hai@u.washington.edu.

Humphrey Fellow

Several people from Mozambique have been Humphrey Fellows in the United States, but only one was a fellow at the University of Washington, from 1992-1993. His name is Zefanias Muhate. He works at the Ministry of Education and is an advisor to the Minister of Education. His email is muhate@mined.uem.m. It is possible that this information is out of date.

C. Bibliography of Sources Used

Lonely Planet (2004).

Mozambique. Retrieved Online May 20, 2004 from



The World Fact Book (2003).

Mozambique. CIA. Retrieved Online May 20, 2004 from

U.S. Department of State (2002).

Mozambique. Retrieved Online May 20, 2004 from

VillageReach (2003).

Northern Mozambique Project. Retrieved Online May 21, 2004 from

(2003)

Mozambique. Retrieved Online May 24, 2004 from



Foundation for Community Development

Retrieved Online May 24, 2004 from



Pathfinder International (2002-2004)

Retrieved Online June 1, 2004 from



International Institute for Applied Systems Analysis (IIASA) (2001)

Retrieved Online June 1, 2004 from



Health Alliance International

Retrieved Online June 1, 2004 form



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[1] Prof. Mark Haselkorn, Department of Technical Communication; Prof. Benita Beamon, Industrial Engineering Department; Chris Coward, Director, Center for Internet Studies, Institute for International Policy; Elaine Chang, Assistant Dean, Evans School of Public Affairs.

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