Dear Dr. Brandl To EAWM organisations opinion the agreements were not fullfilled from ELCT side. Can you specify, who was the counterpart of your organization in theese contracts ?Ashante for clarification
5:43 PM

Dear Sir, see the memeorandum of understanding, it was those times signed by myslef on behalf of EAWM and by the Bishop of SCD/ELCT and the Dr in Charge/BLH/SCD/ELCT.

The whole report gives a lot of insights even about your questions and if you read the notes, it is available under eawm@magnet.at.

I put in bold what in EAWM's oppinion was not fullfilled by ELCT side (mainly SCD but with increasing share from the ELCT headquarter side). For further information and copies of the many letters of EAWM board and representatives to SCD/ELCT representatives where most if them went unanswered (remarks in brackets):

Memorandum of Understanding on the Management and Support of the Program Entitled as:

“A Comprehensive Approach to Treat HIV/AIDS due to the Invention of Modified DOT-HAART (Directly Observed Therapy with Highly Active Antiretroviral Therapy)”

Initial Phase: 2 Years at Bulongwa Lutheran Hospital, the contract of the expatriate may be renewed yearly in agreement with EAWM of Austria and South Central Diocese and Bulongwa Lutheran Hospital.

Program partners and responsible signatories are as follows:

Rt. Rev. Bishop Shadrack Manyiewa on behalf of South Central Diocese, P.O. Box 22, Makete, Tanzania

Untw’alinamaka Kusiluka/Administrator and Dr. Godfrey Mpumilwa/Doctor in Charge on behalf of Bulongwa Lutheran Hospital, P.O. Box 42 Bulongwa/Makete, Tanzania

Dr. Rainer Brandl/Program Co-ordinator on behalf of EAWM (Evangelical Association for World Mission) Vienna/Austria

Presumptions:

The fundament for the proposed program was laid in early 2003 following the raising awareness of the escalating HIV/AIDS situation in Makete District, at the same time there were discussions coming up within international NGOs and the international community regarding the outstanding promotion of Antiretroviral Treatment for approximately 95% of the world’s HIV/AIDS victims. The proposal was worked out and promoted since July 2003 in close co-operation with BLH and Makete Development Association/Dar es Salaam.
The Doctor in Charge and the Program Co-ordinator have taken part in the EACS Conference 2003 at Poland.

(remark: I paid for the travel costs of the Tanzanian colleague and his participation at the conference out of my own pocket - no EAWM or Tanzanian funds were used)

These MDs have partly been on training for up to 3 months at a HIV/AIDS department and a department for Obstetrics and Gynaecology in Austria. This training has been organised and partly financed by EAWM. The major part of the costs was covered by private donations of the proposed program co-ordinator who prepared himself during the course of the last year in order to gain skills for the program’s need.
Neither the time of preparation nor the planned program would be possible without the accepted low salaries/allowances and the voluntaries within the hospitals staff and without the donations by the program co-ordinator and the donations of his friends and parents.
It is to emphasise that a number of people having taken part voluntarily in the preparation and without their support this work would not have been possible. We are especially grateful to Mr. Rayben Sanga/CPA and member of MDA (Makete Development Association), Dr. Huruma Sigalla/Sociologist/Austria, Dr. Godfrey Mpumilwa/BLH, Mr. Untw’alinamaka/BLH, Erika and Walter Brandl/Austria, Dr. Arno Lechner/Austria and Mag. Gottfried Mernyi/EAWM.

The preparation and calculation has been carefully done in a manner of saving funds and targeting the afflicted group of PLWAH (people living with HIV/AIDS). The decision of the program lead MD to stop his medical education for upgrading to a specialist for surgery was facilitated by the fact that it is most likely one of the biggest challenge for a Doctor in these days: To take part in saving people who easily could be saved! The huge mass of PLWHA in this world are just neglected and denied their human rights for treatment and care. It is the main objective of the program to care for these people and to prevent the further spread of the disease. We are on the battlefield against the murdering terror of infectious diseases - especially HIV/AIDS. It has to be announced as the real war against terror in these days and not much money is spent compared to the amount poured to the killing industries.

The program partners and signatories are keen to work together with people in the same commitment only. All the participants should either be committed to the program’s objectives or should be asked not to interfere with the various proposed efforts.

The management structure will aim towards a non hierarchic, discussion based, equality promoting and quality facilitating style, flexible and fast adapting to the need of the society suffering under HIV/AIDS.

1) The program will deal with the following issues which are comprehensively described in the detailed proposal:


Involve People Living with HIV/AIDS
Introduction of Modified DOT – HAART (Treatment with Antiretroviral Drugs)
Voluntary Counselling and Testing
Incorporation of Grass Root Leaders
Coordination with other complementary Programs and NGOs
Gender Issues
Conducive Economic Setting and Employment Creation
Promotion and Distribution of Condoms
Circumcision
Awareness Cultural and Social training
Administrative and Legal Regime
Alcohol
Improvement of the nutritive Situation of the population and esp. the PLHA
Operational Research

2) Responsibilities of the Program Co-ordinator are as follows:

Overall co-ordination together with the likely future co-ordinator.
Implementation of EATG (Emergency AIDS Treatment Group) by creating a conducive environment
Teaching on medical issues
Medical supervision
Co-ordination of the training programs
Co-ordination of eventually undertaken research
Reporting to the donors in co-work with hospital’s administration
Co-ordination of visits by PLAH from overseas
Write ups of by the EATG and community developed strategies
Control of the program’s budget

3) The partners confirm their willingness and strong support to work together in avoiding the possible weaknesses and obstacles of the program which may be:

Lack of Drugs
Quality of Drugs
Shortage of Medical Staff
Financial Constraints
Contradiction in Spiritual Beliefs
Lack of coordination to other programs with related targets carried out within the area of South Central Diocese.

4) Financing, Financial Management, Reporting, Monitoring and Auditing

Financing

EAWM/Austria has managed to solicit funds for the start up of the program’s initial two years phase. These funds will be supplied by the Austrian Government/Austrian Development Association and the Lutheran Church of Austria and private donations. These funds hardly cover the budget for the initial phase of the program (presuming that the Hospital is accepted for the government’s “Quick Start” Program launched by the Mkapa/Clinton Initiative) and are strictly to be used according to the budget calculation. The chairman and the secretary of EAWM are personally responsible to the Austrian Government and the Board of the Lutheran Church of Austria. This is acknowledged and carefully considered by the program partners.

The costs for salaries and offices expenses of EAWM in Austria are fully covered by other sources, the program’s budget will not be touched for this reasons.

The program partners will strive to open different channels to sustain the program’s budget. This will mainly focus on following duties:

For the Diocese and the Hospital:

To open the government sources for further staff grants according to the hospitals human resource developments plan respectively the program’s staff plan.
(remark: instead it is documented that the hospital and diocese did not pay taxes for a time or with a long delay - nothing was done to sustain the hopsital in favor of the patients)
To strictly maintain and report the PPF’s budget and development in order to increase accountability which this will hopefully lead to a sustainable support by the donors. PPF – which role is described extensively in the program’s proposal and the statutes - is funded from different private sources and small NGOs both from local (MDA) and overseas (former volunteers and staff, parishes and EAWM).

(remark: PPF is a so called poor patient's fund - reports are missing - at the time the program was working we took over this duty, to be fair: one treasurer tried to keep the books, but in general the SCD/ELCT/BLH is far from managing the fund - correpsondence at all to the donors, we are not sure if the money spent by Wakinga from Dar es Salaam or overseas was used for the poor sick and needy)

Actively seeking for dedicated partners within the country who will be supportive to the program’s objectives in a fund saving self supporting and income generating manner.
Actively striving for the support of the responsible persons and mechanisms within the country and the international community.

For EAWM and other possible partners:

To strive to open channels to further support the program’s sustainability. This work will be facilitated and eased by a clear and transparent documentation of the ongoing implementation. EAWM will use all the possible contacts and channels in Europe.

Program’s Budget Management

The program will have a separate budget, bank account (Signatories will be Programs Co-ordinator, Dr. in Charge, Administrator and Treasurer) fund control and reporting systems. The program co-ordinator shall be primarily answerable for the proper management and control of program funds.

Accounts and accounting records

Accounts will be held and updated by the program’s secretary and computer operator in close cooperation with the program co-ordinator, the hospital’s treasurer and BLH administration. (remark: most of the time there was no hospitals administration and far from being ready to coordinate, the program was rather atacked for not getting the funds under controll of Diocese/Bishop/Hospital's Staff) It will be presented to the diocese authorities in a yearly prepared package. For controlling purposes the diocese authorities and the external auditor and EAWM/Austria can evaluate at any time.

External and Internal Monitoring and Auditing

PIMA Associates led by a PCA and member of MDA is willing to do the overall auditing, which will also be done by the internal ELCT – South Central Diocese and ELCT - Health Department auditing process.

(remark: PIMA Associates for obvious and understandable reasosn refused to take this job as it was seen as a conflict of interest as its stakeholders were very much engaged in promoting and preparing the programme for the Diocese. The Diocese and ELCT did not make any attempt at all to provide technical assistance or any auditing process)

5) Program Implementation Evaluation

Evaluation of the program implementation has to be done every quarter in written reports, distributed to the partners and financiers.
The terms of references are described in the program’s proposal.
With the possibility of technical assistance by program partners we shall invite external medical personnel or NGOs (most likely Medicines sans Frontiers) with experience and skills in managing similar programs or activities to visit our Hospital once a year (at least in the pilot phase) to do medical auditing.
The audit shall focus on assessment of whether the program is on course; determine attainment of the program objectives and advice for possible adjustments.

6) Salary, Accommodation, Transport and Support of Program’s Co-ordinator

Salary of the Expatriate Program’s Co-ordinator will be paid by the program through the accounts of EAWM/Austria including income taxes, health insurance and pension fund according to the Austrian laws. Beside a flight ticket one times a year there are no further allowances given. Holidays and free time should follow Austrian laws and local agreements (5 weeks/year). The expected once a year trip to Austria will also serve for reporting and fundraising purposes.

Accommodation within the hospitals area shall be provided free to the expatriate and his relatives. In case other visitors will be accommodated at the hospital’s area not participating in the hospital’s work or the program they will be charged for a moderate accommodation fee by the hospital.

In case the Co-ordinator will build a house out of his own pocket the hospital and the diocese will make sure that there is no lost for the expatriate either by compensating for the construction costs or by leaving the house for his future use (e.g. for visits or tourist business, whereby the income will be shared with the hospital for maintenance and organisational reasons) for 20 years.

In case a house will be built at private land the hospital/diocese is assuring full support in technical and governmental issues for the program’s course of time.

Food and housing staff will be paid by the expatriate himself.

Transport for private reasons will be fully paid and organised by the expatriate himself. In case he manages to buy a car – which is not budgeted in the program – out of his own and/or private properties, the hospital/diocese will assist using their purchase channels in order to make use of tax exemptions.

(remark: I bought two cars privately and out of my pocket, used it mainly for the projects purpose, while hospital cars were used for business, nobody helped for taxexemption, I am a very good foreing taxpayer in Tanzania, while I used my private property mainly for the poor and for social and development work, as a good as I could understand, while the tax expemted church cars are reportedly used for the private business of church representavives, one hospital owned car surely worth about 30.000 US$ was reportedly sold for about 4.000 to one of the hospital's staff without any documents.

(This information is from the audit reports paid by NMZ/Mission One World (bavaria)/KPS and EAWM - beside EAWM all the other missions did up to now only react "internal" (that is what they say) and want to solve the problem within ELCT. EAWM has left the cooperation with ELCT this months officially - as nothing is moving which helps the people on the ground, this was declared even to the Lutheran World Federation, obviously also not able to work in favor of the betrayed poor of Makete)

Nowadays, I see my behavoiur as a typical countrproductive attitude of a do-gooder, who keeps a bad system running by funding it from outside, while ressources are stolen or mismanged)

Whenever the car is used for program’s purposes, km according to the common rates will be paid to the cars owner out of the program’s budget.
As the expatriate will pay privately for this car he is free to make use of it according to his own plans including rental, cost sharing and selling decisions. The expatriate will try to make sure that the car serves a community based development program after he left the country.

The hospital and the diocese will make sure to assist the expatriate in any official/governmental issue which is facilitating and necessary to smooth his stay, (e.g. obtaining a working permit, securing his right in front of officials/government).

(remark: I may just laugh here, as at no time the diocese was able, since the very beginning when we were in good understnandign to assist with permits, everything was done by myself and EAWM and supporters outside the church aho worked voluntarily for the sick and the poor and could have been seen as supporters of the church - unluckily the ELCT missed this chance)

7) Program’s visitors from overseas

Visitors who are substantially supporting the hospital either by work or by donations are whole heartily welcome and should stay for the same conditions as the expatriate, they will just share for transport and food. Decisions upon this status will be made following the information submitted by either the co-ordinator or EAWM secretary.
Other visitors have to find their way to Bulongwa by themselves in case they are invited by the hospital’s management. The accommodation will be provided by the hospital/diocese for a faire rate which also generates some income to the hospital.

Makete, 04/06/2007


Rt. Rev. Bishop Shadrack Manyiewa Dr. Godfrey Mpumilwa



Untw’alinamaka Kusiluka Dr. Rainer Brandl