The following is a conversation between Jacques Sebisaho, co-founder and Executive Director of Amani Global Works, and Denver Frederick, the Host of The Business of Giving.

Denver: Amani Global Work’s mission is to care, cure, and make whole by providing healthcare to the most impoverished and forgotten areas of Africa. Founded in 2010, their work has been concentrated on the Island of Idjwi, located between the Democratic Republic of Congo and Rwanda. And here to tell us about that work and the impact that it’s had is Dr. Jacques Sebisaho, co-founder and executive director of Amani Global Works.

Welcome to The Business of Giving, Jacques.

Jacques Sebisaho, Co-Founder and Executive Director of Amani Global Works

Jacques: Oh, thank you, Denver. I’m glad and happy to be here and I’m enjoying it already.

Denver: Likewise. You and your wife began Amani back in 2010. Tell us the founding story and what the two of you set out to do.

Jacques: Yeah. Denver, this was really, I would say providence, to not say total luck. So we were going back home to set up an ecotourism business. But when we arrived on Idjwi where we were supposed to set up this infrastructure, the system, five kids had died. And then the following days, another two died. So me being a doctor and my wife being a nurse, we found it so strange to continue thinking of business when people were dying. So we asked the community leaders what they thought we should do to address that.

That is when we learned that these people are, just the word, the native people, the Pygmies, we call them Pygmies. They were not welcome to any health clinic. And the closest health clinic was around three to four hours walking distance. There was no motorcycle or car. They don’t have those things there. And that’s when we also learned that most people died very young. So we decided to set up a really small makeshift clinic, like Red Cross does in war zones, but this was not a war zone.

We made an agreement with the community that we’ll treat them for that period of time, and we’ll hire two nurses and start buying medicines. But within three months, they will have to take over so that we can continue our business. We did exactly that, but three months later, the community rebelled. They said that we cannot do that. You are a doctor and you are a nurse; we cannot let you do business other than treating patients, what we have been trained for. And that’s how the story started.

So we ended up building a small clinic of sticks and mud because we did not want to spend the little money we had on infrastructure. But we hired the nurses; we bought the medicines; we bought the beds and clinical tables, all gynecology beds. So we started the business like that. So that’s how we set up the business. And at that time, that was in 2005, so we were just using our own resources. We did not think of any structure. We were just thinking of just providing care with what we’ve got and with the community’s contribution.

Denver: Isn’t it funny how things begin? It really is. I think it’s a great founding story. You said people there die very young. What’s the lifespan on the island?

Jacques: So we ended up conducting a survey, a health survey in 2010 and 2011 with a group of Harvard graduate students from three schools. And we found out that the lifespan was 25 years of age.

Denver: Wow!

Jacques: This was mostly driven down by the natives’ communities that were dying extremely young. So it’s not that everybody dies at 25, so they drive down the lifespan for the entire community. They are 5% of the population.

Denver: Tell us a little bit about the island. I think it has about 300,000 residents. What do I need to know about this island that would really inform me in terms of what we’re going to talk about ahead?

Jacques: So let me just start by this… I am from that island, I grew up until the age of six, but it’s a beautiful island in the middle of a lake between Rwanda and the Democratic Republic of Congo. So you don’t have many islands like that in the middle of a lake. It’s the biggest inland island in Africa. I think it’s the 10th biggest island in the world inside a continent. And it’s divided in two parts, north and south, and they’re both ruled by two kings. One in the northern wing, one in the south. They’re all related to my mother.

So the island belongs to the Democratic Republic of Congo administratively and politically, but it’s completely separate from the rest of the two countries, Congo and Rwanda. And so all the wars that have convulsed the Eastern Congo and the genocide that happened in Rwanda never affected the island.

Denver: Wow.

Jacques: And so it’s a neutral place.

Denver: Yeah, sounds like an island of tranquility in some ways compared to everything going on around it.

Jacques: Absoluely. And people there, they’ve learned about Switzerland, they call themselves the Switzerland of Africa. That’s to describe a natual… I’ll just say what you need to know about Idjwi, it’s a place of peace and tranquility and beauty.

“…you need to treat people with dignity. It’s not because they are poor that they don’t deserve what everybody else has… We are humans. We have the same needs and the same expectations.”

Denver: Oh, but it is not the place of healthcare, or at least it hasn’t been. As you said, they’re three or four hours away… lifespan very, very short… how did you begin to get your arms around this and begin to try to build a healthcare system that was going to work for all the residents of the island?

Jacques: So after we set up that small clinic, people started expecting more. And this is when we really thought that you need to treat people with dignity. It’s not because they are poor that they don’t deserve what everybody else has… We are humans. We have the same needs and the same expectations.

So we transformed our healthcare clinic. We built a really beautiful, initially 50-bed hospital that we ended up turning into a 150-bed hospital. But that was not enough because we were just waiting. You know how the hospital functions, you wait for patients to come in, but their needs were so big, and we were thinking: How can we go to the communities?

And this is how we found out about the early stories of community health workers, these barefoot doctors that happened in India and even early America. We want to democratize the healthcare system to reach so many people. After we learned that, we started recruiting community health workers from the communities, working with village chiefs and communities’ members to propose the most respected people in the community.

And we insist that they ought to be women who know how to read and write. And so we trained them for 27 days. We equipped them. We gave them small medicines to treat malaria and pneumonia, diarrhea, malnutrition, and we supervise them, and we pay them. We give them a stipend. And that has turned out to be one of the best things that has ever happened.

So we were able to not only treat people at the hospital level, but we are also treating them in the communities, so really reaching out. Right now, we are around 99% of the households on the whole island.

“…and it’s also based on my personal experience on the mainland– I was marginalized. So I understood the marginalization they went through. For me, it’s just temporary. For them, it’s permanent.”

Denver: That is fantastic. And if I’m not incorrect here, before you even began all this work, you felt it was important that there be a leveling of society and that there’d be an empowering of some of those marginalized populations, which also included women who were never at the table when decisions were being made. Tell us a little bit about your thinking behind that and then how you went about achieving that.

Jacques: Yeah. As I’ve mentioned earlier, my mother is related to the kings, so she is related to both kings. And the native communities, they’re really not considered as humans, and they do not consider themselves humans. They consider themselves as subhumans. And when I got to Idjwi, for me that is the most shocking thing, and it’s also based on my personal experience on the mainland– I was marginalized. So I understood the marginalization they went through. For me, it’s just temporary. For them, it’s permanent.

And so we decided early on, when we set up this clinic, we told people that everybody will be treated equally. A Pygmy woman will sleep on the same bed next to the person who thinks they are more human. And if they don’t accept that, then they are not welcome to the clinic. So we were really very frank and blunt about that.

So for the first six months, no other resident than natives showed up at the clinic. It was tough, but we had to stick by our decision. So six months later, we were providing free care and our nurses were amazing, and people were surviving. And we actually faced a big situation. There was a cholera outbreak where usually 50% of the people died. So with that, they had no choice. You find that you had Pygmies on one bed, and you have another resident on another bed, and all got healed.

That’s what happened. So people started slowly coming and accepted the concept of being treated among the Pygmies. So that’s what we did. And the second thing we did, we decided that we’ll start training nurses and workers. And among them, 5% of our workers, our population, will be Pygmies. We did exactly that. We trained nurses, workers, and we ended up hiring them. It was difficult, but we stuck to our decision. So we were lucky because we had our resources. We do not depend on the communities so we could make our decisions and stick by them.

Denver: You stayed strong because very often you can begin to capitulate and try to do something a little bit lesser than what you wanted. Has there been any collateral benefits to this model? Because we’re talking about healthcare over the moment, but again, when you’re beginning to level society, I just wonder whether it’s been limited in this capacity, or whether it’s actually metastasized in terms of other aspects of society where there’s more acceptance of marginalized populations.

Jacques: So what happened, we studied another part of the island. And so the southern part, which also has a population of Pygmies, heard about that. So the Pygmies themselves rose up and they started saying, “We are also as human as you guys! We need to be treated as such.” And so, the Pygmies started reclaiming their rights in the south based on that. We ended up expanding to the south and the whole island. I would say from 2010 to now, it’s no longer a problem to see a native coming to the hospital, being touched by a nurse or a doctor.

So that is something huge that has happened there on Idjwi island. But more to that, on the mainland, you have a huge population of Pygmies around in Congo. The Congo forest is populated by those Pygmies. So people on the mainland learned about our model where we not only train community health workers, but  provide healthcare, the hospital, and the clinics because we now work with dedicated health clinics.

They heard of that, so we have been invited in the mainland to use this model, which is inclusive. So there is a huge demand. We also had the Minister of Health, the national Minister of Health, visiting us, spending a few days with us. So unfortunately, he left. There is no sense of continuity for our government for now, but there’s this attraction to what we are doing and seeing how they can expand it, or we can expand it outside of the island.

Denver: I tell you, I find the inclusiveness story to be equally interesting as the healthcare story here because they are both so challenging, but they are linked. So I understand your three-legged stool.  You got the referral regional hospital, and you’ve got the community health clinics, and you have the community health workers. What are the primary areas  then you focus on in terms of providing primary care?

Jacques: So we have these three levels of care, like the community health workers. These women, we currently have 300 of them on Idjwi island. So we just expanded to the mainland, so we have around another 117 of them on the mainland. They are trained. They carry the backpack with some essential medicines like ibuprofen, malaria pills, thermometer, or this rapid diagnostic test for malaria. They carry some pills for women who want birth control, like birth control pills. So they have that.

And they focus mainly on many diseases that kill children. So you have pneumonia, malaria diarrhea, and malnutrition, which is extremely high on the island. And then we also focus on women of reproductive age, those who are pregnant, because we do not want any woman to not be attended by a skilled birth attendant. So they provide that first level of care at that level.

If a child has fever, and the fever doesn’t subside in the next 24 hours, they immediately refer to the health clinic. They give them a referral token. And for that we cover the transportation costs and whatever needs to be given to reach the clinic. So once they reach the clinic, they are treated. And if the clinic is, let’s say they have malaria and they need blood transfusions, that is not done at the health clinic, it will be done at the referral hospital.

Then the clinic, the nurse will refer to the referral hospital. So at the referral hospital, if a woman has a normal delivery, community health workers don’t conduct a birth. They refer to the clinic where they conduct a normal birth that doesn’t require any surgery. And if it requires a C-section, it’s complicated, you refer to the hospital where there’s a C-section and blood transfusion.

Denver: Primary healthcare, that’s one of the things that sometimes, like even in America, we overlook. We’re all into the exotic, secondary, and tertiary, and specialists, but really primary healthcare on the front lines and making it easily available to everybody is really the cornerstone of everything when it comes to healthcare.

Jacques: Absolutely. Because what you have seen, primary care, we think of these highly sophisticated things, but we mostly forget that these small things like penicillin… penicillin has helped us so much. And with that, we have decreased the mortality rate in children by a little bit over 10%, 30%, which is amazing, of course. Just using these simple things like oral rehydration salts, just using ibuprofen. Make sure that you diagnose; you proactively go to a household, check on the health of the children and women. By just doing those simple things, we avoided death, like thousands and thousands of deaths.

Denver: One thing that I’ve observed is that in Africa and other parts of the world, when you build a hospital and you begin to really focus on the healthcare, something that comes along with it is the internet. And I know you’ve really looked at that in terms of the connectivity. Tell us a little bit about that hospital, that healthcare program, and what has happened to the way the island has become wired.

Jacques: So when we arrived there in 2005, there was none of that. So the only thing that people relied on was a small radio. And then, so we told them the story of Partners In Health. You have heard of Paul Farmer?

Denver: Oh, yeah, and unfortunately, he passed away just recently.

Jacques: Yeah, it’s painful so we cannot even stop mourning here. So Paul Farmer and Partners In Health built a beautiful hospital in northern Rwanda, in a small forgotten place. So we started showing pictures to the communities, and the community said: We want this.

 What we did, we organized a visit to see the hospital. And those people we took with us to Rwanda, they saw a computer, people using the internet; and they could watch movies, they could see things. One YouTube video we showed, they said: We want this.

And that is when we started thinking of internet. We first contacted an Israeli company to ask if they could provide us with internet. We made it happen. We used a huge satellite dish, it’s still there. This was in 2011, 2012. And from there, we contacted the other phone providers in the mainland if they can install cell towers on the island because we already have like around 50 workers who needed communication.

So they started putting cell tower communication on the island. With that came telephone connectivity, and then internet connectivity in some areas. That’s what happened around 2012… 2011, beginning of 2012.

Denver: Unbelievable. You bring satellite broadband to the island. Who knew, right?

Jacques: Yeah, it has its own advantages and disadvantages. We always wanted to keep this island really not close to people, but really protected; protect its pristine nature. But thankfully, the internet has not destroyed the community yet because the majority, I would say 95%, they are not connected to the internet yet.

“I think our proudest impact was inclusiveness, including native communities, the Pygmies, in the community… reinserting them in the community, hiring them as workers, builders, nurses, training them as community health workers, pushing them to go back to school. That’s number one thing, I would say the best thing we’ve accomplished. We cannot measure that, but it’s visible.”

Denver: That’s probably good in the long run. You’d never know with the internet these days in terms of what it can do. Jacques, what kind of impact have you had? You’ve been at this for a little bit over 10 years. How have the health outcomes changed? How has the needle moved since you’ve started this endeavor?

Jacques: Yeah. So I think our proudest impact was inclusiveness, including native communities, the Pygmies, in the community… reinserting them in the community, hiring them as workers, builders, nurses, training them as community health workers, pushing them to go back to school. That’s number one thing, I would say, the best thing we’ve accomplished. We cannot measure that, but it’s visible.

The second biggest thing was child mortality reduction. So overall, we decreased child mortality by 30% on all of the island. This could have been more than that, could have been around maybe 60%, 70% child mortality decrease because we were just focusing on the north, and three years ago, we expanded to the south. So that dragged down child mortality decrease. That 30% decrease was huge.

And third, we increased the number of women who give birth in a clinic, attended by a skilled birth attendant. We had most women giving birth at home. So that is increasing. We have numbers. At the end of 2021, we had 8,500 women. Going from 1,000 when we started in 2010 to 8,500 women in 2021, that is huge.

Three other big impacts were cholera outbreaks. Killed 50% of people who contracted it. From 2011 to now, 0% died of cholera because we know how to do it in a community of workers, the trained communities. When we see one case, we isolate it, we distribute chlorine to put in water– hand washing hygiene from cholera outbreak to Ebola and COVID. We really have mastered that on this island, across the island.

And lastly, it’s the number of health workers we’ve increased on Idjwi Island. So we went from three doctors on the whole island to 11 doctors. And we increased by over 50% the nurses’ workforce on the island.

So those are huge impacts that have happened on the island in terms of numbers that can be measured, which has helped us decrease child mortality, increase healthcare-seeking behavior from women, elderly, and children.

Denver: Every one of those– really significant. The other thing you’ve done is… if I can say, relatively inexpensively, and I say that to the extent that it’s about $18 per person, at least last I saw, and that compares to the DRC, which is about $40 per person. So you had said at the very start of our talk, that one of the things you would hope to do is to take this model and scale it, transport it to the DRC because there may be some efficiencies and effectiveness that would come from it. How is that going?

Jacques: So that is going well. So actually, one of the challenges, so from $18, we found out, like when the community is involved, all the village chiefs are involved, that cost could even go down further. So we are at around $10 now per capita.

Denver: Wow, that’s great!

Jacques: Quality primary healthcare to the communities. So as I’ve mentioned, the Minister of Health, the national Minister of Health came and spent a few days with us, observed our model. We visited the communities. We looked at how community health workers are working in the communities, health clinics, and the hospital. So his goal was to bring us, we as Amani Global Works, and his team to work on something, on a model, a revised model that includes our model and what they’re already doing, and see how we could expand it to the rest of the country, mainly the eastern part of the Congo, the northeastern part of Congo, and central part. That was the plan.

So we ended up expanding this as of December of 2021. We went to the mainland, eastern part of Congo. So it’s really going well. And now we have a partnership with Harvard. So early June, July, we have a team of professors and PhD students who will come, will start collecting a survey of these communities to see their real health situation before we even expand to those communities. That will happen in July.

“…I have learned that scaling is very difficult, but it’s the most beautiful thing if you want to really achieve impact and have a lasting impact on a country that needs hope.”

Denver: Being engaged in this and trying to scale this model, what have you learned about scaling? Scaling, as we know, ain’t easy. It’s not that difficult, relatively speaking, to create something, but then to replicate it and to transport it, it’s a bitch to try to scale something. As you begin to try to bring this to those parts of the Congo, what lessons have you learned?

Jacques: So the lesson I’ve learned there, it’s easy to stay focused in one area. It’s the easiest thing, and you can succeed then, and really, it’s easy. Scaling is the most difficult thing because it’s not… what I’ve discovered, it’s not addition. Actually, it’s subtracting what you have been doing, really. The challenge is to subtract.

Let’s say you work with community workers… they do this, you will have to make sure that they do the same thing where you scale too, and also ensure that the place you live maintains that quality. That is a big challenge. But what is worthwhile for us? Idjwi island being isolated, there are not so many people coming in and out. And having  spent 10 years, almost 10 years there doing things nonstop, we made it a model and a training center actually on the island.

So the people come and spend, some people come and spend 1, 2, 3 weeks and some a month just observing what people are doing. So we don’t train people on the mainland; people come and learn what is happening there, and they go and do it there. We come in to observe if they are doing it the right way, the way it was supposed to be done in Idjwi. But now we have to subtract some of the things. We have to really take some of the things down because you have Idjwi, is neutral,, is peaceful. No new people come so changes are not very much like… demographic changes don’t happen like on the mainland.

So I have learned that scaling is very difficult, but it’s the most beautiful thing if you want to really achieve impact and have a lasting impact on a country that needs hope.

Denver: Yeah. So if I heard you right, Jacques, then it sounds like the island is your hub, and everybody comes to the lab, which is the island, to see what’s going on. And then the DRC would be the spokes, and they would sort of take it back. And then the other thing that I think I heard correctly was that you don’t try to replicate everything; you try to replicate the essence. And if you bring too many things, it can be complicated, so you have to really get to the core and the essence when you try to scale something. And that’s where subtraction would come in?

Jacques: Right. So in Idjwi island, we do pretty much everything when it comes to healthcare. So we had to build the hospital. We had to build some of the health clinics or refurbish some of the government or faith-based clinics and supply medicines, supplement salaries for nurses because they both make much, not to do pretty much everything. We had to train nurses from scratch. Some communities, we had to pay for transportation costs from their homes, the clinic. It’s a chain, from community health workers, health clinics, we did everything that you can possibly imagine on primary care.

But going to the mainland, we cannot do that. It’s not possible. That one will not work, and that’s where it can become complicated. So you have to choose what is working there, and it’s trial and error. You can take everything and try to scale, and you observe for 3, 6 months and subtract. So what we went through on the mainland and on the coast, we tried to build a clinic and trained community health workers, but the clinic part did not work because there were existing clinics that were not functioning well.

So what we observed, only community health workers, trained community health workers, equipping them like the way they work in Idjwi would work very well and using this existing infrastructure that already was  in place. So we had to take out the health clinic element and the referral hospital element and focus on community health workers. And it worked well.

Denver: There you go.

Jacques: Yeah, it worked well. So that’s the subtraction that I was talking about.

Also on Idjwi island, we work with kings, so we did not have to work with political leaders. So it’s subtraction that you play with this subtraction/ addition. You have kings on the mainland, but then that’s not enough. You still have these politicians, and then it can be bad. They have to be included.

So on that play, you have to include them, which was not the case in Idjwi island. Kings have more power than on the mainland. So you play with that, and that’s where if you just come take something that is working in a place like Idjwi, you just replicate; you say,” I’ll go to work with village chiefs and kings, forget the politicians and just use community health workers, clinics, and referral hospital,” I think it’s a recipe for a disaster.

Denver: I look forward to reading your article on “Working With Kings And Politicians: Which Is Better?” 

Jacques: Oh, I love that. Oh, Denver, this is great. I’m going… working with kings and… Yeah.

Denver: We’ve been talking about a lot of models. Jacques. How about we talk about your business model? What are your sources of revenue? How do you support all this work?

Jacques: Our communities are poor. Let me just give you a small story. In 2012, we ran out because we’re using our own resources. So my wife, Mimy, and I went to the community and told them that we’ll not continue because we no longer had money, and they never wanted to hear that. So it’s really, they did everything they could. They sold their chickens, goats, and they gathered $1,500 — which was not significant– to continue this work. But that willingness to participate, to make things work for themselves really touched us so heavily.

And then, my wife contacted one of her colleagues at the New York-Presbyterian Hospital who was in contact with an organization called Segal Family Foundation. So I told him that we are about to shut down the whole system, the whole service we’re providing to communities. He said, “No, you cannot close down something you have built for a few years now.” It was around six years.

So he introduced her to that organization that gave us some money, and we finally organized ourselves. Already one year ago, we organized a  501(c)(3) organization. So we started receiving funding. So basically, we rely on giving from foundations and private donations. Our communities are so poor to really pay for the healthcare.

We wish that at some point, they will be able to pay for the healthcare. And we’re looking at these insurance schemes for the communities. We already have 400 workers, and we have a group that is coming in to organize the insurance so those 400 can afford primary care. So we hope that a few years from now, the community will be able to pay and cover for their own healthcare, and the government will take over on the mainland and supplement it because it’s cheaper. We were at 18, now we are at 10. They can save $30 on each person if they adopt this model. So that is our hope for the government and the community to take care of their care.

Denver: You know, the last two years have been tough all around the world, no question about it, with the COVID and a whole host of other things, which I won’t even get into or start listing. How do you think the nature of leading an NGO the way you do, is changing? And Jacques, how have you changed the way you lead the organization now compared to, let’s say, in 2018 or 2019?

Jacques: Yeah. So you have a model. It’s written. So you have to be… life is dynamic; so are epidemics and diseases. So today, for example, for us, we live in an epidemic region where you have like cholera, Ebola, and then comes malaria. So you have to be able and ready to change and train your staff to observe, to pay attention to the communities.

It’s not about being friends. People don’t have to be friends or love each other because diseases don’t see that, whether you are enemy or friends. If an epidemic happens, it will kill you, all of you equally, all of us equally. But what I’ve learned is to train people to not only take care of their regular business, but to open eyes to things, external challenges that may come that we didn’t plan for, epidemics.

And I would say in Idjwi, it’s not that we’re not affected by COVID, but we have fewer cases of COVID. Why? Because we trained our health workers, community health workers, nurses and doctors. Police opened their eyes to things like Ebola. We put at entry points chlorinated water systems way before COVID, so people are now used to hand washing. To pay attention to these little things and to be able to change fast, not only change fast, but also we have to be dynamic. We have to cooperate.

The world cannot live… whatever is happening with Russia, we can no longer go back. We are a global society. We are a small village. Nobody can bring us back to pre-Soviet, like during the Soviet era where each country operates. That will not work. Nationalism is good, but it’s not good for society. With nationalism, this will kill us like the plague killed many because we are isolated. One person can cure one epidemic like America can control that, but Asia will not, Africa will not. And then that will come back again.

What I’ve learned is that no matter what, no matter the economics and financial reason to prevent globalization, we are still and will always remain a global village. And the NGO, that the importance of NGO, we are not very finance-oriented. We are the link between these politics and finance people. We are the… that’s what I’ve come to understand, the NGO are the link between those two worlds.

Denver: Yeah. I’ve always looked at it as a cartilage. You know what I mean? That we have, just speaking to a doctor, I figured I’d say that. And as you were saying too, I love what you talked about your workers, is that it is always so difficult to maintain both a laser focus on what you need to achieve, but also have that peripheral vision to see what’s going on around you. And you have to really balance the two of them because that is really the key.

Well, let me close with this because you’re talking about a global village, that we’re never going to go back. You have had, in some respects, the perfect incubator to build a health system in this island, protected from outside forces. You can tinker; you’re in the lab. What elements of that do you believe could revolutionize and transform global health?

Jacques: I would say the community health workers. For a Christian, we are of Judeo-Christian tradition. For a Christian, the community health workers are like the disciples, the apostles. Idjwi, for me, the image I give of Idjwi island, it’s like the America, when our forefathers founded it. It isolated itself from Europe. It welcomed people, but it really isolated itself until it was strong enough financially and technology-wise to the point of helping Europe, Asia, and Africa.

And Idjwi is like that, small like Jerusalem. Jesus comes and trains his people, and the apostles end up going to Rome, Greece, and wherever, Ethiopia, and Egypt to spread this. And that’s the image I have of community health workers. That will revolutionize healthcare.

Here in America, we have a highly sophisticated healthcare system, researching this technology. We have made so much advance, but there is one small element that we are missing, the basic, which is making the epidemics hard to fight. And the only people who can help us fight this epidemic, the community health workers, these regular people who live in the communities who are trained to see the diseases that we cannot treat in hospitals anywhere anymore.

If somebody is coughing and just coughing, simple cough, it takes three days for a person to go see care even  here in America because they think that is just a simple cough. But a trained community… trained neighbor in the village, you will say, “Oh, you’re coughing. I come to check on you.” We already do that. We have this Meals on Wheels, you know, these are things we need to go back. I think Europe, America, and Asia need to train these people in communities where I don’t know how they’ll do it– to train most of them to live in communities and pay attention, to do simple things that our healthcare can no longer capture because we are very highly sophisticated.

I think community health workers will revolutionize the world, will help us prevent epidemics, but we need to just change the wording because when we say community health workers, we think of poor nations, even myself who works there. But we need to change the… make it sexy in a very appealing… I don’t know how we can name it, but that is the thing that will revolutionize healthcare for us.

Denver: Yeah, they should be among the most respected people in the community. And it’s a little bit of the model of mutual aid societies that you saw sometimes during the pandemic, that you don’t go to the big clinics. Everybody in the neighborhood watches out for everybody else and says, Hey, they need this, and they check in and all the rest of it. This is a little bit more formalized with the community health worker, but it’s really the same essence. Just watching for our neighbor, taking care of one another, and we will eliminate so many of our health problems with that simple act.

For listeners who want to learn more about Amani Global Works or financially support this absolutely wonderful work, tell us about your website, Jacques, and what they can expect to find on it.

Jacques: So our website is So if you go there, you will find our model. You’ll find a way to help, to support this work.

And just know, on Idjwi Island, the household income is $55 per year. It’s very small. We cannot afford healthcare, and it only costs us $10 per capita to provide healthcare for the whole year for one person.

Then these people, from giving birth to being attended… from being pregnant, giving birth, whether it’s normal birth or C-sections, from providing nutritious supplements to whole community, you can make a huge change on this island. Not only on this island, but also in the rest of DRC.

We are talking about a hundred million people. If these people are abandoned, they can be a source of many epidemics. DRC is a source of Ebola, so we need to build a strong primary healthcare system there.

And this is what Amani is trying to change. We don’t want DRC to be a place where diseases are coming from to spread all over the world. And you can believe in Amani to make that happen in DRC.

Denver: Hard to find a better deal for $10 than that, I’ll tell you that. I want to thank you, Jacques, for being here today. It was just an absolute pleasure to have you on the show. I enjoyed our conversation.

Jacques: Thank you so much, Denver. It was really an absolute pleasure and honor to be on your show. And I enjoy your enthusiasm, your passion, and your care for the world. Really, if we have many people like you, I think the world will be a different place.

Denver: I’m not so sure about that, but I thank you from the bottom of my heart.

Jacques: Thank you so much, Denver.

Denver Frederick, Host of The Business of Giving serves as a Strategic Advisor and Executive Coach to NGO and Nonprofit CEOs and Board Chairs. His Book, The Business of Giving: The Non-Profit Leaders Guide to Transform Leadership, Philanthropy, and Organizational Success in a Changed World, will be released in the spring of 2022.

Listen to more The Business of Giving episodes for free here. Subscribe to our podcast channel on Spotify to get notified of new episodes. You can also follow us on TwitterInstagram, and on Facebook.

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