: Updates

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.

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.

April Update from Chez Kristo

Dear friends and family,

April has been a trying month for Voices of Africa, but as always we are able to get by with a little help from our friends. We appreciate the support given to us by Mediterraneo Dar es Salaam and by Rebecca Shaw. Mediterraneo generously has provided for the education for all the children for the month. Rebecca Shaw came to visit from the UK and support Chez by giving each child football jerseys, sports shoes, and helping with our cleaning supplies.

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Our 5 youngest boys are still going to school at Joyworld. The headmistress says they are doing great and making progress daily. There has been a number of challenges and hurdles to climb to get the other children in school, but the government is finally cooperating. We expect to have all of the children happily in class in May. The local government officials have been coming to visit us and giving sound advice on the processes of the endless bureaucracy here in Tanzania. We are very thankful for their support.

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After months of waiting and pushing our organization has finally received official trust status in Tanzania enabling us to support and provide better services to the women and children of Tanzania with the blessing of the national government. We thank everyone who has been helpful and instrumental in this process.

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This month the Chez Kristo house has started undergoing renovations and will be painted and sparkling. We are looking for help and support to buy permanent beds and furniture for Chez Kristo. If you want to help, the beds are $100 each and we are in need of 12 in total for of the children and staff. We are in the process of having the first one made so we can post the picture and you can see what we are hoping to provide. For each donor, we will post a photo of the bed and the children who will be sleeping there.



Annual Report 2014

VOAF Annual Report 2014

Boxes of Love! Show African children you love them!

We are running a new campaign!

Boxes of Love is an invitation to everyone who has a Shoebox and a few extra items in the house to send love to children in Africa. Our preference is for the things on our Wish List but we would love anything as we are starting with nothing. We have four children’s homes in Mwanza working together to serve over 100 children! In our women’s health project in Magu we will be able to serve thousands of women. None of us can do it alone, but if we can all fill a Shoebox of Love we can make REAL things happen and change lives.

We request that each Box of Love weighs no more than one pound and has $5 (or 5 pounds) inside to pay for the shipping.

Be SURE to add a picture of yourself for our Wall of Love photo collage project. So your gift of Love will stay with us.

In the United States send to Voices of Africa c/o Kevin Borgersen  @ 144 Stewart St Asheville NC 28806.

In UK message us for an address.


If you want to send to us directly send to Voices of Africa PO Box 1120 Mwanza TZ. Care of Crystal Kigoni only. And write community donations not for resale in big letters on the box.

Questions? Contact us.


Homemade Football


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