Malaria And Preventable Disease


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the problem:

We stood outside a padlocked, whitewashed government hospital on the outskirts of Naigaon, a remote village in rural India.

The building, about the size of a three-car garage, was small and box-shaped with barred windows and, by all appearances, abandoned. In an area where these state-run hospitals are plenty in number, they offer little to the people who live there. The building was empty.

"They've never seen a doctor here," said Jayesh, one of the staff members at the Comprehensive Rural Health Project (CRHP), a nongovernmental organization headquartered in nearby Jamkhed, where we were staying.

That was during a trip my classmates and I made last year to work with the Comprehensive Rural Health Project in Jamkhed, India. Through the Periclean Scholars program at Elon University, we're creating a feature-length movie that delves into the subject of health care in rural India. It's at once a piece about the country and its complexity, but it's also about health care troubles in the developing world. The deficiencies in government health services force organizations like CRHP to come in and teach villagers about sustainable health care, providing them with health services and knowledge they would otherwise lack access too.

The film looks into how the health care system in India has left people behind — and the alternatives that try to address this. Health care in India is an important topic to explore for several reasons:

- India has one of the fastest growing economies in the world by its public
health spending is ranked at 171 on a list of 175 countries
- Malnutrition, neonatal diseases, diarrhoea and pneumonia are the major
causes of death for children in India
- India has 0.7 hospital beds per 1,000 people compared with a global average
of 4
- The national mortality rate for under-fives in the poorest fifth of the
population is 92 in 1,000 compared with 33 for the highest fifth
- Only about 50 million middle-class Indians can afford private health care

This documentary aims to tell the story of India's poor and their struggle to access quality health care.

The first step toward change is to make people aware of the issue and of alternatives that exist to provide health care to those who fall through the cracks of state systems. Through this documentary we hope to raise awareness about the issue in India and to start a conversation about ensuring access to quality health care for poor communities world wide.

vital stats:

people impacted:

50

people involved:

25

why it's important:

As part of an organization called Periclean Scholars (for more info check out the elevator speech video below) we've spent the last three years studying India, its history and social issues in the country. Several of us from our organization have had the opportunity to travel to India and partner with individuals and organizations there, learning about their experiences and brainstorming pathways for sustainable change. This documentary is an outgrowth of everything we've learned and experienced.

"Health for All" will encompass complicated issues like the rights of health care and role of nonprofits, while centering around one simple point: people in poverty don't have access to basic care. The documentary aims to educate the general public as well as politicians and health care providers about the issues. We hope that it will raise questions about the access that poor communities have to quality health care world wide, and through education and increased awareness act as a catalyst for positive change.

By focusing on three different types of alternative systems in three different regions we're aiming to demonstrate various solutions and how they play out in different rural and urban settings. Viewers will see footage from a social business, a non-profit, a public-private partnership and a government hospital, all striving to provide health care services in various ways. Scenes cover thousands of miles, dozens of communities and four different languages. The documentary will demonstrate that there are no simple solutions, but there are concrete ways that individuals and organizations can work toward ensuring better health for all.

the plan of action:

As a documentary team, we're making a film that follows three different organizations as they pursue this idea of health for all. One of the organizations is in rural Maharashtra, working with impoverished villagers; another is based in the slums of Bombay; and a third is on the outskirts of Hyderabad. We need some point of comparison for these alternative systems, so we've also highlighted a government hospital in Delhi.

For the month of January we were in India shooting the documentary. We shot in Bombay for 5 days at a social business, Hyderabad for 4 days at a government-supported commission on rural poverty, and a nonprofit in rural Maharashtra for about a week. We also got footage in Pune, and we spent the last 4 days shooting at a government hospital in Delhi.

We returned to North Carolina with hours upon hours of B-roll and interviews and with an even greater understanding of the depth and complexity of the issue. The next few months will be spent writing, editing and producing the film, keeping in mind what we've learned and comparing it with the extensive background research we've done on the topic. The team currently working on making this project a reality includes directors, producers, writers, editors, researchers, editors, audio techs, a composer, artists, fact-checkers, translators and donors. There are dozens of students, professors and professionals involved in this project, each of us with a growing passion to share what we've learned about this issue with others. We plan to screen the documentary publicly both in the US and in India, to submit it to film festivals and to allow it to be used as an educational resource.

how you can get involved:

Join our pursuit of better health for all by informing yourself more about the situation of those who don't have access to quality health care in your community, and around the world. Check out the organizations that we showcased as alternatives and consider supporting their work in India as well:
www.jamkhed.org
www.swasthindia.in
www.serp.ap.gov.in
Let us know as if you have any questions, comments or suggestions for the documentary. We would love to hear from you.

project updates:

videos:

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Should parents have the right to refuse to vaccinate their children?

Shot in the arm

the problem:

We are helping to prevent malaria in affected areas in Africa.

vital stats:

people impacted:

2,700

people involved:

8

why it's important:

I want to help people and families who are affected by malaria. I think it's important because everyone in the world is part of a global community. Therefore we need to help others even if it does not directly impact us.

the plan of action:

We hold an annual fundraiser at our school hunger banquet. We sell jewelery every year. We also do a coin drive in the spring at our school. We sell smoothies too. All of the money we raise goes to buy mosquito nets for people in Africa. We go to Africa during the summer to distribute the nets and educate the people there about malaria.

how you can get involved:

People can donate money to us at our school Alexander Dawson and spread the word

project updates:

the problem:

Malaria, a disease that infects hundreds of millions of people each year, is recognized as a serious threat to public health (Sanjana et al. 2006). Worldwide, malaria cases are estimated between 300-500 million, with around 2.7 million deaths each year (Govere et al. 2000). Sub-Saharan Africa constitutes 90% of malaria cases and the majority of deaths globally (ibid). In most southern African countries, preventative measures and an increased awareness of treatment, such as the use of mosquito nets and indoor residual spray, have drastically reduced the number of cases (Opiyo et al. 2007). Economic and environmental factors, however, are very much linked to the persisting prevalence of the disease (ibid). The inability to pay for prevention and treatment, coupled with the mosquito-breeding climate, influence high rates of malaria throughout rural South Africa.

In HaMakuya, members of the community as well as representatives of Makuya Clinic feel that malaria is the single greatest health concern in the district (OTS 2011). From October 2010 to March 2011 there were over 50 cases of malaria reported (Nemaheni pers. comm.). Although this disease is extremely prevalent in the 19 villages that make up Hamakuya, it was found that most residents were unaware of malaria transmission and prevention measures (OTS 2011). In a household survey conducted in Dotha village, seven out of ten people associated malaria transmission with dirtiness, while only four cited a link between malaria with mosquitoes (ibid). In terms of prevention, only four of ten people correctly listed mosquito nets and/or spraying; the rest had no knowledge, giving examples such as burying mangos, cleaning water, or nothing at all (ibid). In addition, almost no community members had preventive tools such as mosquito nets and coils in their home (ibid). Many explained that they were unable to afford mosquito nets (ibid).

The lack of education and understanding of malaria in HaMakuya inspired the founders of MAP to create a program to target peoples’ misconceptions as well as directly address vector control issues. Although there is an existing malaria education system provided by Makuya Clinic, its location makes it inaccessible to a large portion of the community (Nemaheni pers. comm.). MAP hopes to build upon the clinics program and other existing education programs by expanding them into each village of HaMakuya in order to reach the greater population. Ultimately, MAP’s goal is to see a decline in the incidence of malaria in HaMakuya.

vital stats:

people impacted:

1,000

people involved:

25

why it's important:

Peer Education

Building on previous formative research with The Organization for Tropical Studies (OTS), The Malaria Awareness Program will use an education-based platform with the intent to increase awareness of malaria and consequently decrease incidence. Through a peer-education program, MAP plans to create a sustainable curriculum in which selected community leaders will be trained to teach their peers about malaria in an engaging way. These peer leaders will be selected with the aid of Makuya Clinic and Tshulu Trust through the newly established Malaria Centre of the Makuya Clinic. MAP hopes to select between one and three leaders per village to be involved in a short training program during June 2012. (See appendix A for program details). MAP will provide these community leaders with direction in facilitating small-group discussions and engaging their community in the learning processes. MAP will use the framework from the literary work “Manual of Active Teaching Skills in Malaria Education” (Rakhanshani 2004) in conjunction with “Comprehensive Community- and Home-based Health Care Model” (World Health Organization 2004) to guide the training of the peer educators. Community mobilization has proven to be effective in motivating health initiatives, as well as establish a sense of responsibility amongst the people (Heywood 2009). Through previous community based participatory research, the founders of MAP discovered that prevention and transmission are the areas in which the community most severely lacked knowledge (OTS 2011). The program will, therefore, specifically focus on those areas. Past research in HaMakuya also indicates that many community members prefer education to be brought to their home or to their headman’s home to avoid traveling great distances (ibid). MAP will work to ensure that its teaching program is accessible to as many community members as possible by bringing the program to specific homes within different villages. A recent study conducted in the Mpumalanga Province of South Africa indicated that the Tonga community expressed a desire to become “more actively involved in local malaria control” (Govere et. Al 2000). MAP’s key aims are to generate a feeling of empowerment, local ownership and responsibility, and application of action-oriented and participatory approaches (Malaria Journal, 2007). MAP’s goals are to increase community awareness, emphasize the importance of early diagnosis and prompt treatment, and enlighten the population of the role of mosquitoes in malaria transmission. The key component of the Malaria Awareness Program is sustainability. MAP will strive to create a curriculum that is professional, user-friendly, straightforward, and replicable so that it can be continued in the future without the presence of MAP.

Bed Net Production and Distribution

Another central goal of the Malaria Awareness Program is to give the community the power of prevention through the production and distribution of bed nets. Throughout this year MAP will be working closely with Dr. Lara Allen, Director of Tshulu Trust, a not-for-profit development organization based in HaMakuya, to train community members to sew bed nets. These bed nets will have long-lasting insecticide treatment (LLIN), which will guarantee effectiveness for a minimum of five years. Provision of insecticide-treated bed nets (INTs) are universally accepted as an efficaous and essential public health service in most parts of sub-Saharan Africa endemic for malaria (Guyatt and Ochola 2003). Additionally, a study conducted in India suggests that LLINs are safe, socially acceptable, and proven to decrease the incidents of malaria (Daman Sood et al. 2010). In addition, use of LLIN nets in sub-Saharan Africa has been shown to reduce all-cause mortality of children by an average 18%, meaning that 5.5 lives could be saved per year for every 1000 children under 5 years of age protected (WHO Global Malaria Programme). The founders of MAP will also solicit donations from universities and other institutions to both invest in the purchase of bed net materials and compensate the sewing team in HaMakuya. Working with trained community members to manufacture the bed nets allows for future production without the presence of MAP, which adds to the overall sustainability goals of the program.

MAP will work with Makuya Clinic to implement a three-pronged distribution approach. First, peer educators will sell the bed nets to the community members who have attended their education sessions for a nominal fee. Second, Makuya Clinic will retain some bed nets, which will be sold to patients. Mainly, this service will be of great value to women visiting the clinic for pregnancy and family planning needs because households with young children and pregnant women have the highest mortality rate post-infection (WHO 2011). Through this second mechanism of distribution, nurses will be able to recommend the bed nets to patients for whom they feel a bed net would be highly beneficial. Third, assuming there is demand for these bed nets among community members, small corner stores throughout HaMakuya can be equipped with these bed nets to be sold as an inexpensive local good. To accompany all distributed bed nets, MAP will provide instructions for their use and create a pamphlet, written in both English and TshiVenda, complete with illustrations to give a basic understanding of malaria, specifically how bed nets play a crucial role in the prevention of this disease (Rakhshani 2004).

Additional Considerations:

Computer Donation
In addition to the peer education and bed net aspects of the Malaria Awareness Program, MAP plans to fund a basic computer to be given to the Makuya clinic. It will be installed with basic programs, such as Microsoft Excel, Word, and Powerpoint. This will not only be useful for Ms. Nemeheni and the clinic with tracking records and storing data, but also prove a major resource when evaluating the success of the MAP program. It will allow for the easier retrieval of quantitative data and ability to analyze progress while not on location. Key indicators MAP will use for evaluation of effectiveness of its program will include the number of people targeted by education and number whom receive bed nets as compared to malaria incidence and surveyed usage of bed nets post-intervention. This information will be collected and recorded through the Makuya clinic’s computer.

Community Support
Although MAP plans for the most successful outcome, there are many factors that the founders cannot completely control. The community’s acceptance of the program is one of these risks. In order to counter this possible barrier, MAP plans to utilize all of its resources and ties with the community to prepare beforehand. To facilitate and strengthen achievement, MAP will draw from formative work and fully engage with all local partners. Community advice and support will be crucial to the Malaria Awareness Program’s success. MAP will hold an introductory presentation at the beginning of the program in order to establish greater trust and participation with the people of HaMakuya. This will take place at either the Makuya clinic or the Tshulu Resource Center, depending on which provides the most central location and maximal access for the community. This preparation will allow for problems to be raised and addressed before going into the field. The inclusion of a South African, TshiVenda speaking, student will also be key in establishing trust and connection with the community. MAP will also conduct a similar style feedback presentation at the conclusion of the program in order to relay the progress and gain feedback from the community.

the plan of action:

The Malaria Awareness Program will take place in the summer of 2012 from May 27th until July 28th. MAP plans to do preparatory work for one week in Skukuza (May 27th-June 3rd) to reconnect, pick up shipped supplies, plan and finalize their daily schedule and weekly goals, finalize pre and post-surveys, practice their education model/teaching curriculum, and conduct any last minute consulting with their advisory board. The students of MAP then intend to spend six weeks in HaMakuya (June 3rd- July 15th) where final logistics- including reconnecting with the Makuya community as well as mapping out of routes for travel, and implementation of the program will occur. MAP plans to invite a South African student from the HaMakuya region who is studying at the University of Cape Town to join us during our entire program in South Africa. This would be beneficial to assist in the planning stages and research process, allowing for greater knowledge, connection, and trust within the community and an opportunity for the advancement of the student. With a TshiVenda-speaking student on board, MAP hopes to create a stronger bond with the community and increase the sustainability of the program.

In HaMakuya, MAP will administer the pre-survey, train peer educators to mobilize their communities through malaria education, implement the education program, distribute and teach the use of bed nets in the highest risk communities, and administer the post-survey and feedback presentation. Pre-survey questions will be taken from the OTS general health survey (OTS 2011). These questions will span demographic data (gender, age, number of people in the household, education level, and employment status), past infections with malaria, knowledge of symptoms, transmission, and treatment (ibid). Peer education will be based on three models, the TAC treatment literacy program, the “Manual Active Teaching Skills in malaria education”, and WHO’s “A manual for community health workers”. These models will be used to implement an effective training and education program, as well as mimic specific aspects of their questionnaires for quantitative and qualitative data analysis. The distribution of bed nets will be based on advice from Mrs. Nemaheni (clinic manager of the Makuya Clinic), and “Manual of active teaching skills in malaria education”. Mrs. Nemeheni will direct MAP to the high risk regions of the HaMakuya district in conjunction with MAP’s formative community resource map (OTS 2011), while the work of Dr. Rahkshani in “Manual of active teaching skills in malaria education” will provide detailed instructions and illustrations for effective bed net use. The post-survey questionnaire will be drawn from both the work of WHO and Dr. Rahkshani, to assess the education of the program. These questions will be similar to those asked in the pre-survey, (knowledge of symptoms, transmission, and treatment) to evaluate the progression of the program.

Following completion, another week in Skukuza (July 15th-July 22nd) will be spent debriefing, analyzing surveys to find common themes, evaluating effectiveness of education program, and outlining and pre-writing for the final paper, completing a total of eight weeks on the ground in HaMakuya and Skukuza. The last section of the program will take place in Cape Town (July 22nd- July 29th), in which MAP will complete their final paper for publication, consult resources and professors in the region, and wrap up their research.

Contingent on funding, MAP hopes to return to South Africa in the summer of 2013 to refresh and retrain peer educators on malaria education, asses data from the clinic, and evaluate effectiveness of the entire Malaria Awareness program. MAP also hopes to survey homes and observe bed net use and proper adherence in households throughout HaMakuya.

how you can get involved:

One can help by donating on our website (http://www.razoo.com/story/Malaria-Awareness-Program) so that MAP has sufficient funds to complete this project AND by raising awareness in one's own community of the burden of malaria on sub-saharan Africa!

project updates:

the problem:

Operation Net is focused on helping end deaths from malaria by providing live-saving mosquito nets. We are proud to be a part of the global battle against malaria.

vital stats:

people impacted:

15,000

people involved:

75

why it's important:

I have been to Uganda, Africa multiple times and experienced the need for mosquito nets and witnessed the death of those who suffered from malaria. It was especially gripping when I realized that I was a foreigner and had a mosquito net every night... when the people of Uganda can't even afford one. Malaria is a preventable disease and the solution is so simple.

the plan of action:

Operation Net distributes mosquito nets in villages across Uganda currently through the help of volunteers. We plan to partner with other like-minded organizations to attack malaria as a team and move across Africa one country at a time!

how you can get involved:

Anyone can be a part of the fight against malaria. One mosquito net cost less than $10 and can protect up to 4 people! By donating to Operation Net you are able to purchase mosquito nets that are then distributed to people in need. You can also start a campus club for Operation Net to help us spread the word and fundraise. This is a huge help!

project updates:

the problem:

We want people to know others have the same illnesses out there. We want them to talk and know they are not alone.

vital stats:

people impacted:

0

people involved:

19

why it's important:

I know many people with various illnesses

the plan of action:

We want to get people from different places to meet

how you can get involved:

They can contact me and join the facebook group

project updates:

the problem:

Fountain of Hope Youth Initiative was founded in 2003 by a group of youths impacted by the effects of HIV/Aids, poverty, limited access to information, degradation of environment, tribal & cultural intolerance. The primary objective of FOH is to engage the youths and entire community in seeking local remedies that would help in elimination or reduction of the above issues. Our goal is to offer a noticeable contribution towards achievement the Kenya’s Vision 2030 & The Millennium Development Goals. FOH exists to offer a platform for youths and the community to exercise social obligations and therefore as an organization we strive to promote the philanthropic culture to the local community.

vital stats:

people impacted:

2,000

people involved:

5

why it's important:

I believe in generosity and doing unto others as I would like it to be done to me.

the plan of action:

I am the webdesigner for FOHLC website, I built the website on my own hosting and I need help continuing working on the project so it could have more exposure and more impact for the local Kenya community

how you can get involved:

Donate, invest, share

project updates:

the problem:

The Problem im planning to solve is hunger, homelessness, batterd woman, sick, poor, religious pratcie i school, troubled youth etc..

vital stats:

people impacted:

100

people involved:

10

why it's important:

It is important to me cause i hate to see my society go down hill and suffer from poverty. I came from a rough childhood and i know what it feels like not to have nothing i just want to give back and bea ble to help and give back to all.

the plan of action:

My plan to open up more shelter facilities food programs, build more schools and universities, afterschool programs keep kids engaged.

how you can get involved:

I need funding, dedicated people who will help and fight for the cause. Support and a better network to reachout to american society

project updates:


Check out our videos!

the problem:

Right now, more than 300,000 Kenyan youth live and work on the streets. Street youth face a life of disease, poverty, exploitation, and violence. Some street youth survive by collecting scrap metal for recycling as well as washing cars, while the more vulnerable turn to theft and prostitution. In Kenya, where education is neither free nor mandatory, many street youth have not completed Primary School let alone Secondary School. Millions of dollars are invested into humanitarian programs that offer food, clothing, and shelter, but they often fail to keep youth off the streets forever. In a country with an unemployment rate of 64% among youth between the ages of 18 and 35, street youth simply cannot compete in the job market.

vital stats:

people impacted:

300

people involved:

15

why it's important:

In 2008, I traveled to Nairobi, Kenya to volunteer with an HIV clinic in Mathare, the second largest slum in Kenya. The experience changed my life. Upon my return to the U.S. I changed my major from Biology to International Studies with the determination to go back to Kenya after I graduated.

I graduated in December 2010 and moved to Kenya in March 2011 determined to make a change in the world. Just a few short days after landing in Nairobi I met a former street boy, Wiclif Otieno. Wiclif's story, success, and passion for changing the lives of other street youth through KITO International was very inspiring. We became instant friends.

Wiclif taught me a lot about street life, poverty, and the importance of quality aid. I quickly fell in love with the KITO community and it didn't take long before Wiclif and I joined forces to continue KITO's growth.

the plan of action:

KITO believes that "moving off the streets" means "getting out of poverty." If street youth are given an economic opportunity that enables them to work their way out of poverty and become self-sufficient, they will stay off the streets forever.

Potential KITO youth are referred by partner organizations, recruited by team members, or apply on their own. KITO selects street youth through a participatory interview process. Successful applicants enter a vigorous 2 month training program which covers entrepreneurship, life skills, employability skills, and financial literacy. Upon graduation of KITO's Training Program, KITO youth are offered temporary employment with KITO's social enterprise, EcoSafi, where they learn to make bags from recycled material as well as practice the skills they have learned in a hands-on setting. KITO staff work tirelessly to customize each youth's exit strategy. KITO youth have the option to start their own business, go back to school, or find full-time employment.

how you can get involved:

Spreading the word about KITO International is very important to us. You can help us in these efforts by liking us on Facebook (www.facebook.com/kitointernational) or following us on Twitter (www.twitter.com/kitointl). KITO International is always looking for volunteers, interns, and donations to help us achieve our mission. To learn more about us please visit www.kitointernational.org.

project updates:

videos:

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the problem:

Poverty, Gangs, Childhood Obesity, Broken Homes, Lack of Education/After School Enrichment/Mentoring/Role Models/Knowledge/Resources. There are several underprivaledged students that turn to gangs and drugs after school because there are no or very few after school programs offered.

vital stats:

people impacted:

200

people involved:

40

why it's important:

It is important to me because I've seen several students turn to gangs and drop out of school. So many young ones are underprivileged and forced into negative lifestyles. I take any and all students who want to participate as well as students who are referred by teachers, parents and/or guardians. Typically those students have trouble at home or in school, and I use a one on one tactic to find out what there interests are so I can determine rewards for improvement. A lot of the students I've worked with were caught up in gang life/selling drugs, failing school and not participating in any after school programs because there weren't any offered at their schools. I thought that was one of the main reasons why students were turning to gangs, so I started by mentoring a few boys and they all got out of the gang life and became more focused on school, sports, arts and music. I think students just need the knowledge and opportunities to express there interests and talents to reach their potentials, succeed in high school and beyond.

Obesity is another issue that I have helped students battle. Teaching them how to eat healthier and giving them a work out plan that you motivate them through can do wonders. However, motivation is key and varies from student to student. It might be a work out plan playing basketball, wii fit, skate boarding, hiking or basic lifting/cardio etc. You just have to take the time to figure out what works best for each individual.

the plan of action:

Provide mentoring and after school programs such as Leadership, Music, Sports, Art, Tutoring, Guidance etc. Inspiration Mentoring

Mission Statement: Our goal is to assist students in reaching their fullest potential by offering them one on one mentoring and tutoring as well as several leadership and extracurricular enrichment opportunities they wouldn’t experience otherwise. We focus on students individual interests and reward them when they reach certain goals. Many of our students suffer from broken homes, gangs, obesity, poverty etc. We provide them with the knowledge and resources necessary to overcome these obstacles.

Every student is different, so every approach is different. We develop a, “Success Plan” for every student which includes goals with step by step, day by day, week by week and month by month objectives, so we can measure effectiveness and improvement. No one is turned down and we have a 100% success rate since we’ve started. Students have dropped out of gangs, improved academics and found passion for activities such as music, art, photography, outdoor education, sports, debate etc.

It is our belief that all students have a passion for something and want to learn, it is just a matter of finding out what that passion is and how to motivate each individual. If you can reward a student with an opportunity they’ve never experienced or dreamed of they will do anything to succeed. I have brought students to professional recording studios, vocal lessons, acting auditions/classes, movie sets, mountains for skiing/snowboarding/tubing, youth recognition ceremonies to receive awards I nominated them for, ribbon cutting ceremonies to meet the mayor, community service events and many other places/events all for the first time to show them I care about there individual interests and to earn their respect.

I base every “Success Plan” on a rewards system that students must earn to motivate them to reach their goals. I combat the lack of role models, broken homes, obesity and gang life on a daily basis. However, it’s these situations that keep me passionate and motivated to help. Some people go to third world countries to help better peoples lives, but I have found that are several people in my own community that suffer from some of the hardships. I believe it is my calling to do whatever I can to help and I will stop at nothing to succeed.

I would like to expand across the entire district and eventually state and country. I have a big vision for Inspiration Mentoring and want it to improve the nations education, obesity rate, crime rate and drop out rate. It will start off small in every school and build every year until every school in the area has a program.

how you can get involved:

Others can help by volunteering, mentoring, facilitating, advertising/spreading the word, donating etc.

project updates:

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