: Blog Post

A Strong Team of Women

We are incredibly blessed by the amount of strong ass women in our lives. We are a force that is much greater than any one of us alone. This week has been a tough one and without my dream team I wouldn’t know how I could handle another day.

In Dar es Salaam, Adella did a Usability Study of the microscope at Kairuki Hospital and it worked beautifully. All is well in the design process, but to get these tools to mamas in village we need more funds for additional out of Dar testing.

On the downside, a tenant moved out of the Volunteer House and took much of the Trust’s property with her. We had to spend two days scrambling to replace even the basics on our kitchen. Our new guests have been most kind given the unexpected circumstances. Our trustee, wise woman Sally has been a stronghold of strength and guidance on how cope with the situation in the best possible way.

Here in Mombasa, its been one thing after another. Sabenza has powered through taking care of the house and we are starting sprouting seeds for a garden. A single mother of 6, Sabenza cooks over firewood so we had her son, and a friend gather all the wood from the yard today.

The boys also helped to rebuild and sort out all the trash into a new recycling system. Now that all plastic bags have been outlawed including trash bags we have had to get creative. Here there are no garbage trucks so its 100% self process.

All recyclable plastics become seed trays, planters, pots, and rooting cups. Sabenza and I take cuttings and keep scraps of food to replant. Strong women think about food security.

Opportunity knocks, but trouble just walks in and sits down. That’s precisely what happened Tuesday night when a little kitten with a bad anal prolapse walked into the house. I couldn’t stand to see it die, but couldn’t afford in our budget to help it. Another strong woman named Revi stepped to the plate to help and her furry adorable namesake is alive and well after its operation.

Our wonder women in the US have been working to sell houses, raise bushels of children, and still somehow have time to help with marketing and fundraising.

One of the issues of fundraising is that big organizations give little ones like ours a bad name. I’m thankful for the women who keep me and our work afloat and rowing.

Speaking of wow women, I am so thrilled I was able to help my mother in law get a visit visa to the US to see my brother in law. She has carried so much for so long she deserves a vacation. I mean don’t we all?

As for my work I’ve been learning how to do clinical trials, and preparing a team, to be lead by an unstoppable Canadian woman, so can submit a grant to “gold standard” our tools and make way for FDA standard approvals.

Next week I’m excited that I’ll be able to help teach 3D printing here in Mombasa with a Maker Queen. No matter how topsy turvey the world may be, us strong women stand together. Who knows maybe one a group of softly gray haired women could take over the world. For now, one day at a time.

To learn more about Voices of Africa Foundation or make a donation, visit our website www.voicesofafrica.org.

It cost me an arm and a leg…

3D printing limbs in East Africa

I have said this countless times giving it only passing thought. This saying is often passed off under your breath, or when describing a shopping experience gone wrong, usually when you buy something that was too expensive. However what would be too expensive for you to have to give up an actual arm or a leg? What would you be willing to give to get that limb in some way replaced?


The leading causes of limb loss are severe injuries as caused in accidents and wars, cancerous tumors, birth defects, serious infection, and complications from diabetes. People give their physical arms and legs for these reasons so they can continue to carry on with their lives. In developed countries, such as the United States, there is access to prosthetic limbs. These often expensive medical devices allow the amputee to have some sense of normalcy and to continue with a functional life.

What do you think happens in developing countries? Places where war and other tragedies abound? The people who lose their limbs often are left without access to employment, and thus suffer throughout the remainder of their lives. There is a key role than 3D printing and new software development can play in serving those who have faced such a price for the chance to live.

Amputee in Sierra Leone http://www.irinnews.org/photo/201110241136160688/edward-conteh-president-amputee-and-war-wounded-association-founded-2000
Using recycled American prosthesis, Muhimbili National Hospital in Tanzania sells arms for around $500 each. The devices are handmade and require multiple fittings and adjustments. Although there is high demand for legs, those prosthesis are seldom donated and are largely unavailable. At present, using eNable and LimbForge designs we are able to print a variety of plastic hand and arm prosthesis. The plastics we are working with currently are not strong enough for legs, so we are watching and waiting for the technology for metal printing to reduce in price, as of now it is out of our reach. Fund raising is underway for new equipment and consumables to continue this project in Dar es Salaam, and perfect the model for export to other cities and countries.

With the help of a team of PhD students at Clemson University, we are also tackling the tough issue of precise measurements and scaling of the 3D models to the specific patient digitally using an iPhone. This component is especially important when dealing with children who grow and who will need new devices and fittings at various times. Wearing a prosthesis that does not fit well can be painful and uncomfortable, and cause additional damage to the amputation site. It is essential to ensure that the poor are not offered a lower quality product simply due to their economic disempowerment. Quite to the contrary, it is our purpose to design the best technology has to offer so that it can serve those who need it most.

Thanks to our partnership with the Handicapped General Partnership in Tanzania, and the Kigamboni Dar es Salaam local government, we have a listed of affected people who are waiting for our help. The government including the Commission of Science and Technology and the Ministry of Health are supportive and have offered technical assistance. Due to recent budget cuts in the health sector, neither are able to commit financial resources at this time. Necessity is the mother of all innovation, and it pushes us to achieve even in limiting circumstances.

We can foresee in the near future limbs replacement being available throughout the developing world with access to 3D printers, design files, and scanning technology. Using technology, we make it affordable and possible for everyone to live normally without their natural limbs. That will be priceless.

Attitude of Gratitude

God, the universe, happenstance, whatever you want to call it; it’s a mysterious thing. It’s just in those moments of “what am I thinking?!?” that inspiration comes knocking. For me, its often when I’m making my morning gratitude lists. Every morning in my head or sometimes on my chalkboard, I make a list of things I am thankful for and let that help guide my actions throughout the day. I find it keeps me inspired, gives me perspective, and keeps me stay focused.

This Good Friday of sorts and in celebration of Eid, I thought I’d share with you my gratitude list, and maybe inspire you to start living with an attitude of gratitude too. This is my gratitude wall. We use it to write messages of thanks to each other and as a reminder of what I am thankful for each day. We have a number of these chalkboards throughout the house for positive affirmations and artistic impressions.

1. Firstly, I am in awe that we have been keeping Voices of Africa afloat for 10 years now! And appreciative for the work we are doing in Tanzania and Kenya that is coming along one day at a time. As I look back at the years and our projects and ideas, I can assuredly say that we have learned and grown exponentially. We have a legacy that, although imperfect, we can be proud to have been a part.

2. I love my family! Without Eric to kill snakes, guard the house, and walk all over Mombasa everyday, I don’t know how we would live in Likoni. I am grateful for Phoenix, who always keeps me on my toes and shows me what true self confidence looks like, and for Terra and baby Alex, the softest part of my heart far far away in America.

3. I am eternally grateful for my team of coworkers and friends from around the world. Adella, my Tanzanian project assistant is a rock star and a model for other young women African engineers. My trustees and board are always supportive and know we have to stay faithful to our mission and goals. We have done amazing things with limited resources and we still have the will to carry on everyday and see this work to its completion. We are all in this together.

4. Our organization is made up of primarily unpaid labor and yet we survive! I am thankful for all the volunteers and interns we have had in the past, those who are there now, and those who will be coming in the near future. The mixing of great minds, different cultures, and unified purpose can do nothing but good in the world.

The “Out of Stock” 3D printing project is very near and dear to my heart, because based on my field experience in clinics with no tools, many did not even have a basic pain killers for women in labor, let alone the proper tools for antenatal care and birthing. There are so many things we can make using 3D printing that can save lives and we are only just beginning. I am grateful to have a life which is not only about me and the satisfaction that brings to me and others.

Elephant in Shimba Hills Park

5. And now that we are back in Coastal Kenya, I am thankful that there have been no phone calls about elephants in the farm as the fence being knocked down is a persistent problem. Perhaps with the rains less wildlife is drawn to the small, bubbling spring that feeds our cattle. For reasons known only to them, the elephants have been peacefully in their sanctuary. We are ready to start growing food and trees. A dream come true for a road worn aid worker who has learned that the best sustainability is self sustainability.

I hope that by sharing with you what I am grateful for in my life you can start to see more things you are grateful for in yours. There are always 5 things I can list that I am grateful for on even the worst day if I look hard enough. I find it to be central to my health and happiness.

What are you grateful for? Let me know in the comments.
Let’s let this attitude of gratitude spread!

Africa and the Fourth Industrial Revolution

Africa’s generalized image in the minds of much of the “developed” world is that of poor people, in some far off nation, possibly fighting somewhere, with great wildlife. While these are in part true, there is another side that the journalists rarely cover. It is the immense wealth of resources of Africa countries that can be their largest curse or their greatest blessing. All the drivers for economic growth are abundant and primed for exploitation, the question is who are and who should be, the beneficiaries.

Central Business District, Nairobi, Kenya

If the natural resources of most African nations were utilized for local development and growth, as many are now attempting, then an economic revolution becomes possible at the grassroots level forever redefining the trajectory of the continent.

Though no two countries in Africa are alike, after visiting 15 different nations and studying the continent, I can elucidate a few broad insights. First, presently and historically, the exportation of raw goods for external processing is a main form of economic wealth. Take a look at Nigeria and their oil riches, DRC and their diamonds, and Northern Kenya’s natural gas as examples. Even the small holder farmer has fields sown exclusively for direct export crops.

Coffee farmers grow amazing beans and are sold back their labor in single serving Instant sachets. The coffee farmers do not process the coffee so they cannot enjoy the fruits of their labor equitably, even at the breakfast table. A Kenyan from Limuru tea country once came back from the United Kingdom and told me that for the first time, he had tasted the sweetest leaves of his life, yet they came from his homeland. The raw commodities of Africa fueled the industrial growth and economic development of colonial masters and their subsidiary colonies. Remember, the American Revolution was in part sparked, by tea no less, which could possibly have originally been grown in East Africa.

Now, fast forward to the East Africa I live in today. I have WiFi internet at home, M-pesa, running water, online shopping for electronics, food delivery, Uber and electricity. That is a giant leap forward in comparison to 10 years ago. Technology and infrastructure development are lessening the gaps between people and between nations.

The children growing up in Kenya are adopting American media culture at lightning speed. More than half of the population of Kenya are youth below to age of 20, and they are all eager to learn to use technology. The middle class have all the same smart phones, tablets, laptops, and Netflix, yes Netflix, as their American counterparts. Often we have access to movies on DVD even before the American market!

The Fourth Industrial Revolution of 3D printing technology and the localization of micro industries continues to level the playing field. Digital manufacturing brings the hope for the design and development of new products for Africa, in Africa. New designs for jewelry, parts for machinery and electronics, consumer goods, agricultural applications, and healthcare are being released daily and can be sent via email and printed anywhere in the world.

Plastic filament at the workshop and products made in Tanzania

The medical tools being designed and printed by Voices of Africa were made by volunteers and interns in California, the Netherlands, India, US, Canada, and Tanzania. All have been prototyped on our Tanzanian made 3D printers and are being tested in Tanzanian medical facilities. It is the first time medical tools have been designed and manufactured in Tanzania by Tanzanians.

The Fourth Industrial Revolution poses an opportunity to change the collective image of Africa. Youth have new prospects for the future, and the information they need to realize a brighter tomorrow is at their fingertips. If ever there was a proving time for the continent, it is now.

Just Crystal and the Impossible Trifecta

I co-founded this organization named Voices of Africa Foundation. VOA has been the love of my life for the past 10 years, so I recently stopped to ask myself…

If I was to re-design my organization what would it look like and who would I be. You see, I am a writer by nature. Words flow from my fingers to the keyboard with the greatest of ease, when I am comfortable, and in the flow. However, recently the only flow my fingers were responding to were the influx of applications and grants to write to be able to justify the existence and impact of my life’s work.

Applications after application flow into my inbox each requiring days, if not weeks, of work in terms of answering questions, planning budgets, and writing programs. Including how they would be monitored and evaluated in 2 years before you even begin. No two proposals are ever the same and the time commitment is serious for a small organization.

Thankfully, the rest of our Voices of Africa team and are partners are wonderful and for the most part do a fantastic job at making sure we meet our collective goals. However as I am billed “the writer” of the group, I end up carrying the lions share of forcing myself to answer sometimes hundreds of questions and days of preparation only to be rejected. You may now be asking yourself, “Why do you torture yourself like this Crystal?” And I would not think it impolite or odd in the slightest. I am torturing myself because I founded this organization with a vision, mission, and a cause. The grey streaks from my temples are well earned from keeping an impossible dream alive sometimes by blood, sweat, and tears alone.

Voices of Africa Foundation’s mission is to empower impoverished women and youth to improve their communities sustainablely through the use of innovative and cutting edge information and communications technology and fair trade income generation.

I have held this mission in East Africa as the core of my identity for the last 10 years, and to be heart wrenchingly honest, sometimes I wonder where the cause ends and I begin. I have put the cause above my family, friends, and relationships. What is stranger yet is how those same people have willing accepted and encouraged it. Sometimes I want to be “Just Crystal”.

A person, a witness, a human, not an iconic person who is addressed as Madame by the educated and Mzungu by the less so. I started this organization as a young, idealist 26-year old naive mother-child who believed that she could change the world simply by believing it was possible. And since have been doing whatever was necessary to test, try, or fight to get the job done. Life is beyond precious, and humanity deserves better.

This “Just Crystal and the Impossible Trifecta” is the first in what will be an ongoing Friday series where I talk openly about my 10 years of work in Africa, updates on projects, experiences as an immigrant to Kenya, and my life in general and sometime in particular. This blog in no way illustrative of the views of Voices of Africa as an organization… It is JUST CRYSTAL, me, myself, and I sharing my world with the rest of humanity. Our organization has two board of directors and their vote is what makes our decisions. I do not believe that matters of magnitude should be handled by one person, just in case that person is wrong. And even I, have been sometimes wrong.

I decided to write this service as I need an outlet that isn’t dictated by someone else’s questions or interests, but the truth of the things that I realized in Tanzania, couldn’t be said out loud. Being American, at first I had a very loud mouth when I came to East Africa, and still do on some occasions. I recall in those first few months of honeymoon, I wanted to write about everything and daydreamed poems about our toilet that had no rooftop where flowers covered the remains of the day. I used to write to share, not only to compete for the funds we needed to operate. Even 10 years later, I do not rely on the charity for my survival, billing a fat expat salary, but rather invest in people and programs. Whatever is necessary to keep innovating.

One of our engineers, Paul, and our 3D medical printers designed in Tanzania

I have spent most of these years in three countries: Kenya, Tanzania, and a bit in the US. Being American, I am a huge fan of free speech. Kenya taught me, the hard way, there are some things it is OK to say and others more fragile. While the most challenging was Tanzania, where the entire population was muzzled by strict social media laws against criticizing the president or the government. To all of these gentlemen in power in the three countries where I work and reside, I want to know when exactly it became more important to spend on luxury and expensive campaigns when there are still people in need. When did it become acceptable for public service to become businesses?

At least that is somewhere where the president of Tanzania may have it right. You do not see the handouts and pomp and circumstance from the government of Tanzania because the government really is concerned with improving the country. In Kenya, politics is a free for all. City councils members to Senators throwing punches when they are to be legislating. Meanwhile in the US, 45 is digging a hole that only gets deeper and deeper. Eventually if not careful, it will create a sink hole and pull the entire country inside. My head spins thinking of the state of the world and luckily I am too busy trying to change it in our small way to be bogged down in the chaos.

How am I doing? If you really want to know I spent two months working on preparing two grants only to become a finalist, yet leave a failure in one, and watch the other program evaporate the same day before my eyes due to USAID budget cuts. When you’ve worked for something so long sometimes when you lose, you feel something akin to grief. You pass through all the stages denial, anger, bargaining, depression and acceptance because in that moment, a cherished vision evaporates.

Failure as an organization often feels like translates into personal failure. Thankfully, the same is true of successes and we have the most awesome team of people who have stuck with us through thick and thin. Maybe I have an overdose of resilience, because as soon as I came to the phase of acceptance, I started applying again.

This time I waited for the grants to come to me and I am being more selective. We are working on a new business plan for fundraising so that we are no longer beholden to the larger donor organizations. I would rather turn the “Out of Stock” project into a separate company if possible than continue trying to catch these big fish NGO funds if it isn’t possible. In the long run, this will be tremendously profitable; the numbers don’t lie.

It reminds me of how, why, and the principles I founded this organization. At Voices of Africa when we are on project team we are treated as equals. We all have the right to share our voices. Well, unless you are the Director… and then you are often muzzled about who and how you are and your private life becomes public. I have avoided any of the such until today… This is me, just Crystal, writing to you from Likoni, Kenya after a long and frustrating day.

None of us seek great riches or high salaries, but to serve the people in need using technology to the best of our ability on each opportunity we have been given. We are a team of predominately volunteers. And oh my, we have been given a great number of opportunities over the years.

All of this was to learn and to grow. It has allowed us to collect members from all over the world and have a truly international volunteer network. Thus, if we have created an international global network I can share my own adventures and maybe, just maybe, it will reach emphatic souls and they will come to help build something brand new with us.

A  documentary we made with our partners working on the World Bank ReFab Dar project talks about how we could make a million medical tools a day. Since then we have been working on ways to solve health care challenges with this technology and create a never before seen medical tool supply chain, especially designed for developing countries.

 We have had so many adventures over the years, and the “Out of Stock” project we have now is the culmination of years of real life field research. The Trifecta of software on tablets, 3D printers, and UAVs can use the best and latest technology created to serve those who need it the most. With these technologies, we can create products that solve real problems and produce them real time. The designs and files can come from anywhere in the world.

Here is a piece describing the process from sickbed idea to ready to test prototypes, I wrote this essay for an application just today:

For the past 3 years, we have been focusing on using patient management systems, tablets, 3D printers, drones, and other frontier technologies the develop product prototypes of these innovations in Africa by Africans to disrupt the medical supply chain and medical diagnostic models. We have dubbed the project “Out of Stock, Out of Time” and we seek to create a closed system of the manufacture and design of basic health care tools at the local medical facility level.

Our journey began when I was working as a consultant to an NGO working on the implementation of medical records systems in the Lake Zone of Tanzania. At that time Voices of Africa was running a children’s home for endangered street boys and I became dreadfully sick. During the course of my work I had visited more than 20 different medical facilities in the area and was most impressed by a hospital named Mugana Designated District Hospital run by the Cannosian sisters that was 3 hours away on a mountain top in Bukoba.

I had severe typhoid, my appendix was about to rupture, and my uterus had a growth and was threatening prolapse. With no graphic details required, I was a critically ill patient in a hospital with 2 doctors that served over 500,000 people, had predominately students as nurses as it was a teaching hospital, and was the primary birthing facility for the district population of more than a million. In the nearly two months I was there, I came across two stunning problems.

First, there were not a enough medical tools held in stock in the hospital facility and many of the medicines and tolls had to be bought from Indian drug vendors as they were not actually supplies by the government as per the law. The lack of medical tools inside the facility highlighted the problem with a lack of medical tools OUTSIDE the facility in the catchment area of people who ended up having to have home births and the high infant and maternal mortality rates there.

Second, the nursing school had nearly no teaching materials. By the time I left had a computer room, and VSAT for more up to date course materials however they did not have any medical models or have any 3D renderings to understand anatomy and physiology. Basically their education depending on testing new skills on unsuspecting patients. After visits to at least 10 more of these nursing college facilities, I saw the exact same problem over and over again and asked the board if we could try to tackle the challenge.

Mugana Hospital, Bukoba, TZ, A typical rural Tanzanian hospital

We first opened an office in Kigamboni, Dar es Salaam and established the Tanzanian Trust we have today. The Trust was formed to allow Voices of Africa to operate while I was able to join the World Bank as a Project Coordinator for the ReFab Dar project (www.refabdar.org). As Project Coordinator, I basically took the role of project manager and was given an immense amounts of freedom to innovation and explore. It was the best job I have had to date.

During that project, along with partners, we created a filament extruder to make plastic bottles in 3D printer filament with Reflow using the equipment in India now. We also designed two versions of ewaste 3D printers based off the open source techfortrade design. The latest printer has less ewaste components but has been designed for the sole purpose of making medical tools.

We have an 8 piece birthing kit for prenatal and antenatal care and a circumcision tool kit. With Cambridge University, we have been developing 3D printed microscopes for digital field based disease diagnosis particularly malaria and TB. The original concept for the Waterscope was for testing bacterial content in water. At the request of the Commission of Science and Technology and the interest of our disability partners, we have started to explore and test prosthetic and adaptive devices.

Engineer Adella and some early protoypes in our DBTi office

We decided at present that we would have a three pronged sustainability approach:

1. Recruit bright young minds for internship and volunteer placements with specializations that can help to increase the quality and quantities of both our machines and the medical products they are printing.
2. Increase fund raising efforts within the United States and recruit a more effective fund raising team.
3. Find investors rather than donors who will be committed to taking these products to market after the charity side of the social enterprise has completed the next required year of Research and Development.

Years ago when I first started working on medical technology in East Africa, I would have told you that this Trifecta was impossible. Now I know better, impossible things are happening every day thanks to brilliant minds and eager hands who believe another world is possible. This may just be the open invitation you have been looking for to serve the world and be Just YOU.