St. Olaf Magazine | Winter 2019

Health is Life

Connections between Dodoma Christian Medical Center and St. Olaf College run deep, beginning with its founders, Bob and Barbara Griffin P’81, P’83, and sustained by a globally engaged community of St. Olaf alumni and parents who have helped accomplish the vision of bringing high-quality, sustainable, compassionate health care to the people of central Tanzania.

Bob and Barb Griffin P’81, P’83 had no idea that a meeting with a young woman from Tanzania in 1998 would change the trajectory of their lives. They were nearing the end of their careers — as a senior executive and president of the pacing division at Medtronic and a psychiatric nurse — when pastor Steve Lomen ’81 asked them to meet the daughter of a family friend, Peter Mwamasika, who was then the presiding bishop of the Dodoma Diocese of the Evangelical Lutheran Church in Tanzania (ELCT). The young woman was attending Harold Washington City College in Chicago, and Lomen thought she’d be a good candidate for admission to St. Olaf. He also hoped the Griffins might be willing to sponsor her.

“We’d traveled a bit and gotten it into our heads that sponsoring the education of a young woman from a developing country could have a ripple effect on her family, her village, and her country,” Bob says. The Griffins were immediately wowed by Happiness Mwamasika ’03, who told them at that first meeting that she aspired to be the first woman prime minister of Tanzania. “And she just might be,” Bob says. “We could tell she was special.”

The feeling was mutual, Happiness says: “Our bond was so strong and immediate.”

Happiness Mwamasika ’03, pictured at the home of Bob and Barb Griffin in 2003.

The Griffins and Lomen co-hosted Happiness that summer as she interned at Medtronic, while also encouraging her to apply to St. Olaf. She followed their advice and soon found herself stepping foot on the Hill as a first-year student.

“I will never forget the first day, being dropped off in front of Mohn. There I was, all the way from Africa, with these white suburban kids. I remember how much I cried when Barb gave me a hug and said goodbye,” Happiness says. “The Griffins are my parents just as much as my biological parents are,” she adds, explaining that the couple’s sponsorship lifted a huge financial burden from her older brother, who’d been working as a taxi driver in Chicago to pay for her education.

During her first week at St. Olaf, Happiness met Gaspar Msangi ’01, who was helping students move in to Mohn Hall. Instinctively greeting Msangi with “habari” (“hello”), he quickly responded in Swahili, and the two soon discovered they shared both a homeland and mutual friends in Tanzania. (Today, Msangi, who worked at Medtronic after graduation and attended Mayo Medical School on a scholarship, is a urologist practicing in the Atlanta area, and will be volunteering at Dodoma Christian Medical Center in 2019.)

Bob Griffin P’81, P’83We’re moved by the profound truth of the saying, ‘The world is full of people with equal ability, but not equal opportunity.’

Happiness went on to graduate with a degree in economics. Her family flew to Minnesota to attend her graduation, visiting the Griffins in Minneapolis. Given the Griffins’ medical backgrounds, the conversation turned to hospitals and health care in developing countries, particularly in central Tanzania, home to the nation’s capital, Dodoma. Nearly 75 percent of Tanzania’s 60 million people live in rural areas; 80 percent have no electricity, and 68 percent live in poverty. Its Dodoma residents suffer from Tanzania’s highest incidence of mother/infant mortality and face a severe lack of quality health care facilities to meet even basic needs. Malnutrition and diseases like malaria and HIV/AIDS are prevalent.

“Bishop Mwamasika, Happy’s father, asked us to come to Dodoma to see the state of health care there, telling us, ‘you will cry,'” Bob says. The Griffins accepted the invitation and arranged for 10 other interested individuals to join them. In July 2001, Happiness traveled ahead to prepare for the group to visit the Dodoma Diocese as guests of the ELCT. The group brought along school supplies and about 1,800 pounds of over-the-counter medications for local dispensaries that the ELCT managed in the region’s villages.

“We visited hospitals and clinics and, candidly, what we saw was disturbing,” Barb says. “But it’s important to note that the Tanzanians we met were doing the best they could with very limited resources in very old facilities. It’s not that there was lack of caring.” She still recalls the white-haired grandmother she saw cradling a newborn in a hospital ward after the woman’s daughter died during the delivery. “That shouldn’t happen in a hospital,” Barb says.

Bishop Mwamasika and the Griffins soon realized that a seed was being planted.

“While we were in Dodoma, the team was asked about supporting the diocese’s health care initiatives,” says Happiness, noting that such initiatives have always been supported by faith-based organizations such as the Roman Catholic and Lutheran Churches. “We had many discussions about how best to support and improve holistic health care in Dodoma.”

A mere two years later, the Griffins and Bishop Mwamasika co-founded Dodoma Christian Medical Center (DCMC) as an independent trust.  Its partners — a U.S.-based nonprofit organization and a Dodoma-based for-profit social enterprise business — help provide financial stability, enabling DCMC to stand as a model for sustainable health care in all of Africa.

When Dodoma Christian Medical Center was founded by Bob and Barb Griffin in 2003, the 240-acre site was grazing land for goats and cattle. In 2018, more than 100,000 medical and dental patients received treatment at DCMC, benefiting from its range of inpatient and outpatient services, including obstetrics and gynecology, pediatrics, dentistry, internal medicine, general surgery, physiotherapy, and ophthalmology.

The vision and commitment to provide ongoing quality medical services to the Dodoma region — impacting the health of hundreds of thousands of people — has drawn many Oles to support and work with the project, which is unique among global health care initiatives, says William Stauffer, M.D., ’88. A professor of medicine and pediatrics in the Division of Infectious Diseases and International Medicine at the University of Minnesota, Stauffer is a past board member for the nonprofit that supports DCMC. He also is the lead medical advisor to the Centers for Disease Control and Prevention’s Division of Global Migration and Quarantine, where he works on issues of travel medicine and refugee and immigrant health.

The Griffins and the local Tanzanians have worked together to meet the challenge of sustainability for the Dodoma Christian Medical Center since its initial planning stages in 2003.

“The traditional model of international medical work is a clinic started by doctors and nurses who are empathetic to extreme poverty. The idea of sustainability comes second,” he says. “So often, health do-gooders build a system internationally, but then that system is in chronic crisis because it doesn’t know where the next dollar is coming from. The do-gooders pull away, the project dies, and it hurts people.” Stauffer was impressed with DCMC’s economically feasible and sound business plan “to subsidize the medical center with both a nonprofit organization and a for-profit industry, which is an idea I hadn’t seen very often in international health care development,” he says.

Building a sustainable model of health care

Dodoma Christian Medical Center is a thriving Tanzanian-led regional hospital and health care facility that treated more than 100,000 medical and dental patients in 2018. Recognized by Tanzania’s Ministry of Health as the highest quality medical facility in the region, DCMC provides a range of inpatient and outpatient services, including obstetrics and gynecology (ob-gyn), pediatrics, dentistry, internal medicine, general surgery, physiotherapy, and ophthalmology. In addition, DCMC’s community health outreach programs provide critical preventive care and education to targeted rural districts in the large surrounding Dodoma region.

Recognized by Tanzania’s Ministry of Health as the highest quality medical facility in the region, DCMC treated more than 100,000 medical and dental patients in 2018.

“The journey to build DCMC has not been easy, but it’s been a journey of faith from its initial stage to its current stage,” Happiness says. “It’s through faith this project has been a success.”

It began in 2003, when the Griffins established a Minneapolis-based nonprofit, Dodoma Tanzania Health Development (DTHD), with the purpose of raising funds to help support the development of DCMC and its medical staff. Along with acquiring donations primarily from individuals, the organization formed partnerships with entities such as Global Health Ministries to provide much-needed medical equipment. At the same time, the medical center was registered as an independent trust in Tanzania, and a board of trustees, the majority of whom are Tanzanian, was established to manage the center. Today, those trustees include some of Tanzania’s leading business and health care professionals, including individuals from the World Health Organization.

DCMC Executive Medical Officer Dr. Jamhuri Kitange with Twin Cities ophthalmologist Chuck Yancey P’14, who led the development of an eye clinic at DCMC that now houses the most modern laser and exam equipment in the region.

“Our approach from the very beginning was that DCMC would be led by Tanzanians, because we didn’t want a colonialist model,” Bob says. “We wanted to be in the business of lifting up the capabilities of the country. The nonprofit [DTHD] supports the trust in Tanzania, which has first oversight for the center. Our role is not to steer their work but to support it, so all of the assets that are invested in DCMC from people outside of Tanzania belong to Tanzania.”

In the early planning stages, the focus was on the challenge of providing quality care in a clean and safe environment in a way that could be sustained year after year. To achieve that lofty goal, DCMC’s trustees realized that the medical center would need to be built incrementally, supported by reliable, long-term funding and strong leadership from both Tanzania and the United States. Other key pieces of the planning process included acquiring 240 acres of land (leased from Dodoma’s Capital Development Authority) and hiring the project’s first director, John Toso, a physician with experience running a hospital in Madagascar. To get the medical center up and running, Toso dealt with everything from clearing the land and navigating governmental regulations to overseeing infrastructure development and early construction.

Dr. Doug Griffin ’81, who assisted with DCMC’s largest cervical cancer screening initiative, confers with another physician about a patient, while his daughter, Grace Griffin, observe

The first health service offered by DCMC was dentistry, beginning with oral hygiene outreach programs in area schools and culminating in the opening of a dental clinic in 2007. Early on, the medical center also managed the region’s rural Lutheran dispensaries to provide basic medicines and preventive care; this was the beginning of its extensive community health outreach program. DCMC opened its reproductive and child health outpatient clinic in 2008 to provide prenatal and early childhood care; when the need to be equipped for childbirth and medical emergencies became apparent, the clinic added a surgical suite and neonatal area. Today, DCMC houses 50 beds, as well as CT scan and endoscopy facilities, an ICU, a nurses’ station, and numerous consultant and exam rooms. A planned expansion includes at minimum 100 additional beds, an ER, and additional surgery suites.

As DCMC grew, the Griffins and many close advisors realized that additional revenue would be needed to contribute to its future sustainability. They developed a separate for-profit company, the Dodoma Innovation and Production Company (DIPC), to help close the gap between fee-for-service and insurance payments at the medical center (although no patient is turned away because of the inability to pay) and donations (93 cents of every dollar) raised by the Minneapolis–based nonprofit.

In 2007, the Dodoma Innovation and Production Company was established as a for-profit enterprise to help support DCMC through the sales of bottled water and flavored beverages, produced at a nearby facility. Together, the business and the medical center have created many jobs in the area.

The company operates a modern, fully automated water-bottling plant near the DCMC complex, producing and selling bottled water and flavored beverages under the brand name Asante. Although the plant is still in the early stages of production, the investors in the company have committed to providing at least 50 percent of its annual profits to support the medical center.

“There are almost no sustainable hospitals in the developing world, and the fact that we have a triad of organizations — a medical center, a for-profit business venture, and a nonprofit organization — providing revenue is what makes us so different,” says DTHD’s executive director, Anne Leafstedt Hussian ’87, P’20. “That model of sustainability makes the project attractive to donors, to universities, and to the people and partners that support it.”

The University of Minnesota is one such supporter. Since 2016, its medical school has partnered with DCMC as a site for a short-term international elective for third-year ob-gyn residents. The residents — five have traveled to Dodoma so far — assist in the ob-gyn outpatient clinic and surgical suite and visit rural villages to observe health care delivery in a limited resource environment, says Phillip Rauk, M.D., ’83, who implemented and oversees the elective.

The university also established a physical therapy residency elective at DCMC in January 2018, and its School of Public Health has conducted community health research at Dodoma for the past few years.

“The opportunity to work abroad in a developing country gives our residents experience in managing and diagnosing disease with much more limited modalities and services,” says Rauk, associate residency program director and professor in the university’s Department of Obstetrics, Gynecology, and Women’s Health. “It allows them to use their knowledge and skill without relying so heavily on technologies available to them in the United States, as well as treat patients with diseases that they rarely see here, such as malaria.”

With the expectation that revenue from the beverage business will help sustain the medical center’s quality care and contribute to the long-term growth of its facilities and services, Hussian envisions using funding from the nonprofit as seed money for additional research and educational efforts at the medical center. “Ideally, we’d be able to support bilateral medical exchanges that not only send doctors to Tanzania but bring DCMC physicians here for training,” she says.

Anne Leafstedt Hussian ’87, P’20

There’s so much about DCMC that represents everything St. Olaf stands for. It’s about global citizenry and doing good in the world. It’s based on the values of treating people well and doing our best for humanity.

The DCMC trustees, too, dream of the day when exchanges that facilitate medical training are more common. “A regular program of sending doctors for a targeted period of time to work alongside and provide training to the Tanzanians would be ideal,” says Bob, who notes that companies such as Medtronic have indicated a desire to not only provide top-notch medical equipment to DCMC but to train its physicians in its use.

“Space is the only limiting factor to DCMC’s future,” Barb says. “People catch the passion for being able to do something, to be helpful, and it’s amazing to watch and see what happens.”

A Higher Level of Care

Providing quality, compassionate care is integral to Dodoma Christian Medical Center’s culture. Barb tells the story of a young woman diagnosed with Guillain-Barre syndrome who was referred to another facility for treatment. Out of concern for her, the medical director, Jamhuri Kitange, M.D., kept her at the hospital until her father arrived, despite the need for open beds. “He told me that he needed to explain to her father that she had a disease, not that she was involved in witchcraft,” Barb says. “The consequences of being known for witchcraft would have been terrible for the woman and her family.”

DCMC’s doctors and nurses often work long hours, providing care into the evening so that patients — many of whom have traveled long distances — are seen on the same day that they arrive at the clinic. That commitment to caring for others may be another reason so many Oles are compelled to be involved with the project, Hussian says.

A young woman weighs her baby at DCMC’s reproductive and child health clinic, which provides much-needed prenatal and early childhood care to expectant mothers and their families. The surgical center is also equipped to deal with childbirth and/or medical emergencies.

“There’s so much about DCMC that represents everything St. Olaf stands for. It’s about global citizenry and doing good in the world. It’s based on the values of treating people well and doing our best for humanity,” she says. “It’s incredible to be on site and see the quality of what’s been developed, the happiness of the staff, and the level of care the patients are receiving. It’s a pleasure and a privilege for me — and other Oles as well — to play a small part in it.”

Other Oles with ties to the project include Doug Griffin, M.D., ’81, the Griffins’ son and chief medical officer at Sanford Health in Fargo, North Dakota, who assisted with DCMC’s largest cervical cancer screening initiative; Cheryl Grasmoen P’06, an attorney and former foundation executive who serves as a DCMC trustee; Jack Hussian ’86, P’20, managing director at Wedbush Securities, who has advised the for-profit bottling business; Charles Yancey, M.D., P’14, ophthalmologist, who is assisting in building the capacity for eyecare at DCMC; Elizabeth Hendrickson ’06, who helps manage fundraising efforts at the U.S. nonprofit; and Ann Brownlow Rabie ’56, P’86, GP’21, retired RN and past DTHD board member, among many others.

Happiness worked at the medical center for a year after graduating from St. Olaf, assisting with its initial organization. She has since earned a master’s degree from the Heller School of Social Policy and Development at Brandeis University, focusing on the role of community natural resource management in Tanzania. Currently working as a consultant on tourism and conservation efforts, including youth empowerment projects, she lives in northern Tanzania with her husband, Jeremy Swanson ’00, and their three young boys. Her niece, Anna Gloria Mwamasika, graduated from St. Olaf in 2016 and serves on the Youth Advisory Board for the U.S. nonprofit, DTHD.

“DCMC started as an idea shared among people from different social, economic, gender, and racial backgrounds,” Happiness says. “Yet through our common core values of humanity, the result today is what we can achieve if there is unity, love, peace, and commitment to serve the underprivileged of the world.”

It’s a commitment the Griffins have shared since first traveling to Dodoma in 2001.

Happiness Mwamasika ’03DCMC started as an idea shared among people from different social, economic, gender, and racial backgrounds. Yet through our common core values of humanity, the result today is what we can achieve if there is unity, love, peace, and commitment to serve the underprivileged of the world.

“We’re moved by the profound truth of the saying, ‘The world is full of people with equal ability, but not equal opportunity,'” Bob says. “With a bit of investment from others, the Tanzanians at DCMC have sustained 15 years of bringing health and hope to Dodoma.”