2025

The Copperbelt region of Zambia is home to one of the largest copper reserves in the world, and produces a major percentage of the world's current copper supply. This proved strategic to UK and US efforts in WWII for shell casings and more, and continues to be strategic today for its common use in electronics and strategic defense systems. But, while Zambian families have always worked hard to extract the ore needed in the West and now globally, they have also suffered from an HIV Epidemic and other health and social issues that have left many unable to work, provide for their families, and buy food. International charities like USAID had provided humanitarian aid to help stem the epidemic's tide, but now, with USAID's withdrawal, this progress and the lives of many are now at severe risk.

https://www.britannica.com/place/Copperbelt-region-Africa

https://oxfordre.com/africanhistory/display/10.1093/acrefore/9780190277734.001.0001/acrefore-9780190277734-e-1212

Effect of USAID Pullout and Problem Statement

USAID clinics and offices closed without warning or ceremony, meaning that patients can no longer go to USAID clinics for the medicines, tests, and treatments that they were using and were critical to their survival. Even worse, they are having difficulty accessing government or local aid to assist them in USAID's absence.

The largest and most urgent barrier to continuing treatment is that access to USAID patient medical files has essentially been "lost" at least for now until/unless a way can be found to obtain them. Because these patients now lack the necessary documentation, they cannot apply for government aid or receive treatment at government clinics. This also leaves Pastor Billy and the remaining aid workers without records and unsure of the numbers and details of patients needing care. The loss of medical records and staffed clinics means that we must find a way to get these records and find ways to provide treatment both in-home and in a clinic environment; however, even more was lost when USAID pulled out that will need to be replaced in some way in order to solve this problem.

USAID confiscated all vehicles and equipment in use by local aid workers and sold these at auction at the US embassy 3 weeks later. So, inexpensive and immediate ways of getting trained aid workers to remote villages and patients will need to be put in place as soon as possible.

At the moment, logistics are further complicated by a large number of bridges being washed out by heavy rain, making access to mentally located clinics in major cities more unworkable for those living in remote villages.

Patients today include children, elderly, and those too sick to be moved, who will not be able to access aid at central locations likely to be provided by the government and their condition is deteriorating too rapidly to be able to wait for even that.

Effect of our work so far

A sense of hope is being restored and both Billy and others who are receiving limited assistance so far are feeling grateful; however, an immense problem remains and is getting worse every day.

Government of Zambia

Discussions at the political/policy level are on-going and some statements about "having a plan" have been made publicly; however, this remains only a wish today, as patients themselves are not yet seeing a difference. Further, based on experience with government action in similar cases, aid is expected to roll out first or only in major cities, not in remote villages as in the Copperbelt, which can be hundreds of miles from major cities. Today, patients living in the Copperbelt and previously relying on local USAID clinics are not receiving government aid and symptoms are beginning to show, including visible sores.

The Zambia Ministry of Health is attempting to "index" all of the underserved patients created by the pullout.  Currently, 5000 patients are known (3500 of these are rural, and likely not able to travel to a central city-based location); however, Billy and others are asking these patients who they know who is HIV positive and are getting strong response, which leads to an expectation of as many as 10,000 patients underserved that are likely to be indexed by the end of this effort. See below also for cooperation and support being provided by the ministry, such as a Memorandum of Understanding to help manage the risk of corruption and help with import duties.

Immediate Objectives

While working on plans and getting giving campaigns and possible grant requests going, we must recognize the real risks on-the-ground that are currently leading to Billy having to provide 3 funerals per week average, and causing patients without care to be developing early symptoms of progression toward full-blown AIDS, such as development of bodily sores. We must recognize that this first effort is a rescue, which must then be followed by a plan and long-term solution, but, for now, our work is all about saving people from imminent suffering and death.

As such, our most urgent objectives are:

1. Help people get their (USAid) records, so they can get help from government clinics and hospitals.
2. Focus on medicine for most vulnerable who can not make it to a clinic. 
3. Food aid for non-ambulatory patients 
4. Food support for school-age children living with or impacted by debilitating diseases like HIV

Immediate Next Steps/ To Do

1. Detailed Budget Proposal showing detailed expenses and required revenues (this will be expanded later to include forecasted revenues and sources based on outreach results).
2. Donation Levels to help with donation campaigns, for instance "Donate $5 to get one patient medications for 3 days" or similar.
3. Set up Initial GiveButter and GoFundMe campaigns
4. Research Charity Navigator so as to be able to show legitimacy
5. Find religious sponsor or register 501c(3)

If possible, we would like to get 2 or 3 target dates and durations of stay for Bishop Reynolds to visit and how long, so that Billy can work out logistics of his stay.

Logistics and Planning Approach: Initial Considerations

Planning Period: We must plan for a 3 year horizon, at which point a determination a future direction can be determined following the next US Presidential Election.

Food aid: This generally consisted (from USAID) and needs to consist of weekly and monthly food packages to help patients while they could not work or otherwise provide for themselves and their families, including school-age children. Patients cannot take their meds on empty stomach. Packages generally contained local/natural foods. Caregivers were bringing both meds and this supplementary food to non-ambulatory patients, but with attention to support, not dependency, and an objective of returning patients to health and to work and independence. 

But at least these things can be gotten locally.  Also, import through Tanzania available and many used vehicles

Medicines: will be purchased quarterly to reduce shipping cost.

Corruption and Risk Management: Plan must include risk management which recognizes not only the evolving physical and social logistics surrounding stable aid provisioning and delivery, but also the likelihood of confrunting institutional corruption. For instance, if medicine is purchased and delivered from India, the Ministry of Health will receive the shipment and contact us to collect it; however, it has been common for actual workers at the ministry to require bribes.  Some risk mitigation is already underway.

Billy is signing a Memorandum of Understanding with the Ministry of Health that will establish an agreement to act in specific ways regarding these shipments, specifically to indicate that there will not be any ad hoc fees or other delays and/or attempts to swindle us or divert those shipments as happened previously with USAID. This memorandum would have force of law and police could be involvedif it were violated. The Ministry of Health has demonstrated a high level of willingness to do this and further, that they will handle all customs and duties for us (We will still plan for possible and legitimate charges for distribution).

Clinic and Care Workers: We will need to rent a location for a clinic for blood tests (long-term patients need blood tests to see how the medicine is working) and tp act as a hub for distribution of medicines, tests, and food to caregivers, as well as a place for administrative activities, training, and more. The number of care workers will be provided in the upcoming Budget.

Transportation: Care workers will use bicycles, motorbikes or even possibly group transport (like a van or SUV) to do house-to-house deliveries. We can later expand to more vehicles if needed which would reduce the number of caregivers needed by allowing us to bring them all in a vehicle to service an area on a schedule. Nonetheless, because of high rate of mortality today, an initial approach based in the use of bikes and other more immediately available and inexpensive transportation must be where we start.

Religious Support: Pastor Billy has assembled and is growing a cooperative group of local churches, mosques, temples, and others because religious institutions are the most prevalent form of social organization and aid at a hyper-local village-to-village level. Some are already working on mobile clinics to do blood tests, weight check, etc... . 

Workforce and Workforce Support: We must recruit/select caregivers and they will need 5 things:

• Allowance or stipend (the government has benchmarks that we will use).
• Transportation: Bicycles, motorbike, or vehicle (especially to transport to hospital). Also group transport to area.
• Attire: reflectors, badges, etc... so they can trust them (people are very afraid)
• Backpack: to transport medicines safely
• Gum boots (fishing boots)

Note: The Ministry of Health has agreed already to provide scales (promised) for weighing babies, etc...

Administration & Support: We will need to produce regular financial reports and governance. We will also need to maintain active social engagement, including newsletters, stories, pictures, and videos, which can be disseminated through social media and a dedicated website.

Operational Personnel: We will need to select an Operational Director, Accountant, Communications & Media Coordinator