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*The MOU should be revisited and updated throughout the year as need be and any updates should be sent to the National Office. Key Dates: st MOU Due to the National Office AT THE LATEST BY October 1 Updated MOUs due throughout the year Final MOU, updated to reflect any changes in the project plan, project budget, and money sent, is due to the National Office by July 15th. All money sent to partner must be accounted for in this final MOU.

Memorandum of Understanding The Memorandum of Understanding and Workplan between [chapter name] and [partner name] are documents meant to guide a GlobeMed chapter and partner in creating or strengthening their relationship. These documents express their mutual commitment to each other for a [month and year of beginning and end of academic year]. While these are not legally binding contracts, the MOU and Workplan present the expectations of the partnership clearly and honestly. They require and codify the process of dynamic conversation and cooperation at the heart of the chapter-partner relationship. In developing and implementing these documents, chapters and partners establish a vibrant relationship in which they work together, communicate frequently, and help each other meet both project and broader organizational goals.

The Memorandum of Understanding and Workplan are living documents. The chapter and the partner should continue to refer to and develop them throughout the year to ensure that they are still relevant. The Memorandum of Understanding and Workplan should also be reflected upon and evaluated by both parties at the end of the year so that the following year始s MOU and Workplan can be even more accurate and useful. The template below should be adjusted to fit each partnership so that it can best facilitate its unique development. While the information contained in this document will structure the logistics for effective communication and project work, the relationship that its discussion and implementation fosters is the real core of what makes GlobeMed partnerships successful.

The five areas that the MOU addresses (Communication, Project, GROW, Evaluation, and Reflection) are explained below:

Communication The GlobeMed Chapter and the partner organization are expected to communicate regularly about their work. This is done primarily through emails, phone or Skype calls. In addition, a Chapter Advisor from the National Office participates on at least two calls during the year to allow a space for reflection and feedback about the partnership. Why this is important: Regular communication is important because it allows for both the partner and the chapter to have an open dialogue, communicate progress on projects or fundraising, and allows for any new ideas to be shared between the two. Communication is essential for fostering any relationship and will allow the two to be in the loop on significant events in either party.

Project The project(s) selected by the GlobeMed Chapter and the partner organization should be beneficial to the organization and the community but sustainable without a prolonged commitment from the GlobeMed chapter. The specifics of this project will be detailed in the Workplan but this project does not exclude smaller projects that might come up throughout the year such as research that could be beneficial for the partner, advocacy for the partner, or anything else that could be beneficial to the partner or the chapter. These ad hoc projects do not need to be detailed in the Workplan and can be added throughout the year as the partner and the chapter see fit. Why this is important: The project is key to the relationship between the chapter and the partner. It benefits the partner by furthering the organization始s mission and makes a tangible impact in the community. It benefits the chapter in allowing it to have a concrete goal and to be more intricately involved in the organization, as well as clearly articulate what funds raised will go towards their partner organization.

GROW The GROW trip is ideally a 3 week+ onsite visit in which 3-5 students work with the partner organization on an onsite project that the two have developed prior to the studentsʼ arrival. Why this is important: GROW trips can be a fantastic tool for both chapters and partner organizations as they allow the two to form personal relationships between trip members, organization employees and community leaders. GROW trips remove the need for technological communication, allow the chapter to meet community members who otherwise would not be present in organized calls and allow for a firsthand account of the project that the two have been working together on all year. The GROW trip can aid the chapter in better advocating for the partner and should allow the partner to see the dedication of the chapter. Evaluation The chapter and the partner will develop a mechanism for evaluating the degree to which the partnership and the project were successful over the course of the year. Ideally, this will cover three specific areas: quantitative, project fit, and sustainability. Quantitative success essentially covers how well the project served its purpose. This could be measured in people served, structures built, gardens planted, people served or whatever other raw data is necessary. You should also explore how well the project addressed its ultimate goal. For example, if the project was to plant a garden to improve the diets of the community, you should measure both how many gardens were built and also how the diets of the community changed. Project fit simply measures how well the project fit with the partnerʼs mission, community, and staff. Sustainability measures the degree to which the program can be run by local staff after it is created in partnership with the GlobeMed chapter. These criteria can be evaluated however is best for the chapter and the partner. Why this is important: Evaluation allows the partner and the chapter to have tangible data on the impact of the project and the partnership. It serves as a guideline for future collaborations and helps to strengthen the project and the relationship.

Reflection The chapter and the partner will schedule an end of the year conversation to discuss how the year has gone and what can be improved for the next year, if the partnership is to continue into the following year. This should be an honest conversation between the chapter and the partner to lead to real improvements that can be beneficial for both. This conversation will take the evaluation into account but also will focus on how the relationship has functioned outside of the specific project(s). Why this is important: Reflection allows for improvements for the chapter, for the partner, and for the national office in future years. As we are continually trying to strengthen our programs, reflection provides much needed feedback on how we are actually doing.

Project Workplan for [dates of academic year] This workplan describes the commitment to project work between GlobeMed at [Chapter] and [Partner name] for [dates of academic year]. This workplan may but does not necessarily include the workplan for on-site visits to [Partner name] by GlobeMed at [Chapter], nor does it include any smaller or less intensive projects that may come up throughout the year (such as research ideas). I. Project Description


“TOGETHER LET US INNOVATE AND ACCELERATE THE EFFORTS, TO DETAIN TUBERCULOSIS” THE TUBERCULOSIS SITUATION IN PERU Tuberculosis has existed in the world since the beginning of mankind. However, to this day, it cannot be controlled and in actuality it is considered a public health problem and a global threat.

Although the rate of new cases has declined from 88 cases of pulmonary TB smear per 100,000 inhabitants in 2000 to 64 per 100,000 population in 2007, Peru is the third largest country in Latin America and the Caribbean with the highest rates of new cases after Haiti and Bolivia. The main risk factor for transmission in the country is still a lack of information on tuberculosis, overcrowding is common in human settlements and slums. These factors are compounded by other risk factors such as poverty, lifestyle (alcoholism, drug abuse, instability) and poor nutrition. Since the mid 90's the first reported cases of TB in the country were multidrug-resistant tuberculosis (MDR TB), resistant to the most powerful anti-TB drugs (particularly rifampicin and isoniazid). The reporting of these cases was rising from the number 396 in the year 1999 to 1.375 cases in 2001, reaching a peak of 2.784 in 2005. In late 2007, new cases dropped by 30%. The increasing number of sensitivity tests performed, which allows greater search, improved system of reporting and the decline in MDR TB mortality would indicate that it is indeed an improvement, although concerned about the persistence of dropouts to treatment3 . A form of TB is emerging is extremely drug resistant TB (XDR-TB), which has been reported in the country since 1999, in 2008 there were 58 new cases, accumulating 190 cases since the beginning of the notifications. The distribution of TB is not homogeneous in the country: 58% of TB cases, 82% of cases of MDR TB and 93% of XDR TB cases are reported by the Directorates of Health in Lima and Callao. It is also not uniform across the districts of Metropolitan Lima: Most cases of TB is concentrated in 19 of 43 districts that form and according to 2006 data, when compared to 2007, four districts, which have mainly contributed in increasing rates, these are: Callao, Comas, Independencia, La Victoria and El Augustino. While there have been achievements, the living conditions (such as overcrowding), lifestyle (alcoholism, drug addiction), poor nutrition, HIV coinfection, among others, allow the TB to find suitable conditions for transmission. Hence, the TB is a serious public health problem in Peru.

Conceptual Framework Tuberculosis is a complex disease because of its multi-causality, which involves biological factors, as it also involves political, social, economic, and cultural factors. It is devastating for its grave consequences that arise from it, which are not limited to a physical level, but it extends to a mental, economic, and social level. Tuberculosis in Peru represents a serious public health problem despite the efforts of the Ministry of Health. This is because until recently, programs to combat TB were directed mainly to bio-medical aspects of the disease and did not have a comprehensive approach that includes community involvement and addressing the determinants for transmission and retention. such as information on prevention and information, nutrition, lifestyle and socio-economic status, to name a few. The fight against tuberculosis is an action that calls to patients, families, health workers, civil society and other actors to mobilize regional and national public and community about the importance of prevention and control to reduce its negative impact on individual and collective health. Also, this fight should seek to overcome stigma and discrimination those affected by tuberculosis are often subjected to. This is why there is an importance of including the issue of human rights in all areas of intervention. In this sense, it is essential to have contributions by those affected for the recognition of their rights and responsibilities, and their participation in making decisions regarding the recovery of their health and their role in the fight against TB.

Education and training for changing attitudes and practices that prevent disease is vital. Training strategies are effective and validated "training of PATs As promoters Education" by people of similar social and economic status. While it is true that the organization and the acquisition of knowledge is important to address the problem of TB and to generate sustainable changes in individual and collective health of populations AERT-TB,

this is not enough. It requires the acquisition of competencies and skills to generate economic resources and access to better living conditions.

General Facts: Population Objective: People affected by tuberculosis Indirect Beneficiaries: Families of those affected by TB Community agents Local and Regional Government representatives Duration: 1 year Scope: Region- Callao Budget: $7070 USD General Objective: Contribute to the prevention of stigma and discrimination for people affected by TB, promoting respect for and practice of human rights through training, information and empowerment of the PATs. Provide food baskets for the families of the PATs as nutritional support during a patients long and difficult treatment. Also, establishing and building modular homes to prevent spread of TB infections of PATs to family members. Specific Objectives: Training of people suffering from TB as advocates for the development of educational activities, information, education, communication rights and obligations of people affected. To sensitize the community through the information without the stigma and discrimination against people affected with tuberculosis. To reduce the fear of stigma and discrimination, through the development of self-esteem, improving self-concept, developing social skills and the sense of life in those people affected by TB so that they may have favorable attitudes towards the adherence to their treatment and recovery. To build modular homes to prevent the spread of infection from PATs to their healthy family members. To collect statistical information from PATs to formulate data for ASPAT to begin to track their effect on the Callao region and the PATs. Expected Results: The Association of People Affected by Tuberculosis is strengthened and empowered to perform actions in the fight against Tuberculosis, promoting health as law, equity, social justice. 28 targeted families, trained and educated in the proper nutrition and controlling spread of infection within each domicile. 8 Modular homes built to create an environment where a PAT inhabit an area without fear of infecting healthy family members. 108 Food Baskets created and distributed to aide those PATs with a high level of difficulty in providing adequate nutrition for their family members and themselves. 800 Flyers posted on controlling the spread of infection and nutrition to spread awareness in the Callao region. 320+ surveys collected from PATs that will provide information regarding time of infection, income before and during treatment, as well as answers to other indicators to formulate data for ASPAT.

STRATEGIES: 1.1 Targeted families to educate on nutrition and controlling infection For the formation of educational outreach, coordinate with health personnel of health facilities to educate families on proper nutrition and infection spread prevention. These workshops will address the theme of Problems of TB in Peru, nutritional information and habits, as well as taking the proper precautions with an infected family member. At the end of this educational outreach, families will be able to help PATs in a more substantial way to ensure that they complete their TB treatment successfully. 2.1 Building Modular Homes Modular homes built to create an environment where a PAT inhabit an area without fear of infecting healthy family members. 2.2 Distribution of Food Baskets Food Baskets created and distributed to aide those PATs with a high level of difficulty in providing adequate nutrition for their family members and themselves.

3.1 Building Community Awareness Awareness campaigns will be conducted on the problem of TB patients, mainly in nutrition and controlling the spread of infection.

This activity is proposed through the preparation of 800 flyers and raising awareness through individual PATs and their families. 4.1 Collection of Surveys Surveys collected from PATs will provide information regarding time of infection, income before and during treatment, as well as answers to other indicators to formulate data for ASPAT.


The GlobeMed chapter would participate in day to day activities of an ASPAT work day.

Visits to health facilities to learn the situation of people affected with tuberculosis. Support the planning, organization, and use of computer systems ASPAT activities-PERU.

Definition of Social Indicators for monitoring TB care, TBMDR, TBXDR and other diseases such as HIV AIDS, diabetes mellitus, ETC. Listen Read phonetically Work with ASPAT to help implement some of its projects, such as the modular housing project and whatever else ASPATrequires help with.

Establish a data collecting system, to monitor the social indicators above, via electronic and web based means.

Operative Plan:

GENERAL STRATEGIC GOALS/ ACTIVITIES/ OBJECTIVE OBJECTIVES RESULTS PROJECTS Taking measures to prevent further infection amongst 28 targeted 1.1 Educational Train and educate the families of families, trained outreach in TB, families on proper PATs, providing a and educated in nutrition, and nutrition and ways sanitary the proper nutrition prevention to prevent further environment for and controlling infection to PATs to recover, spread of infection healthy family spreading within each members awareness of TB, domicile and generating data to measure impact.



2.1 Providing a Building and clean environment creation of $1000 for a PAT to 8 Modular homes Modular homes recover without for PAT's fear of infecting healthy family members 800 Posters placed Raise awareness in strategic public in the community places 3.1 Preparation of 250 Clipboards for flyers and through $200 information on flyer use within the clipboards region nutrition and infection control Distribution of

108 Food baskets

2.2 Providing adequate


Food Baskets

nutritional support to PATs and their families 4.1 Human Resources and operative costs TOTAL

$3584 $7070



ASPAT PERU: Association of People Affected by Tuberculosis in Peru. DIRESA: Regional Health Authority EE.SS: Health Facilities OSB: Social Organization Base WHO: World Health Organization PAHO: Pan American Health Organization PAT: People affected by TB TB: Tuberculosis TBMDR: Multidrug-resistant Tuberculosis XDR TB: Tuberculosis XDR HIV: Human Immunodeficiency Virus ESRPCTB: Regional Health Strategy for Prevention and Control of Tuberculosis. II. Chapter Objectives for Project

GlobeMed at the University of Chicago commits to contributing at least 3000 dollars for the project this year. Additionally, GlobeMed will help to plan and implement these projects over the course of the year and during the GROW trip. III. Partner Objectives for Project Please See Strategic Objectives in the above chart.

No financial transactions may occur before this Memorandum of Understanding is signed. This Memorandum of Understanding is effective as of [DATE submitted to National Office]. Chapter contact information: Name: Nataly Otiniano Skype ID: Email: Phone: Address: Partner contact info. Name: Melecio Mayta Ccota, Skype ID: Email: Phone: (511) 453-4265 Address: Emisor Mz D 2 Lt. 04 1er Sector A. H. Sarita Colonia- Callao, Peru Financial information: Method of Sending Money: Wire transfer to [Y Bank Account] *Before every wire transfer takes place, the chapter and partner should have a discussion project plans and update the project outline if necessary. On behalf of GlobeMed at UChicago Signed: Charles Wang Print Name:

On behalf of ASPAT Peru Signed: Melicio Mayta Ccota Print Name:



This Memorandum of Understanding has been received by the GlobeMed National Office: Signed: Print Name:


This is a suggested template for the documentation of responsibilities the MOU. However feel free to use whatever format works best for the partner and the chapter. Be certain that all of the below information is included in whatever format you choose. Please include additional information as relevant.

GlobeMed at [chapter name] agrees to...

[partner] agrees to...

Both GlobeMed at [chapter name] and [partner name] agree to...


Update the partner via email or facebook at least twice a month on the chapter始s work, and progress on project fundraising goals.

Update the chapter via Skype at least once a month on the partner始s work, and progress towards project goals.

Talk over Skype at least once a month to discuss updates and logistics of grow activities.


Raise $10000 for the food basket, modular homes, nutrition training, and TB prevention project.

Use funds raised by the chapter to implement the food basket, modular homes, nutrition training, and TB prevention project.

Have a detailed outline of the money being spent for each individual project being implemented at the partner site.

Take on additional work to support project as needed. Give all additional funds raised to the partner.

Complete all necessary pre-trip preparation as designated by the partner and National Office.


Share stories and other examples of impact of the project.

Evaluate whether an on-site trip for a small group of students should take place in the summer of 2012.

Determine whether an on-site trip is possible sometime between June 12th and July 4th by November of 2011.


Discuss the success of the relationship over the course of the year.

Implement the evaluation and report on effectiveness to the chapter.

Organize several conversations with the partner to discuss data collected

Use this data in formulating future projects

Discuss ability to raise funds and on campus excitement for project


Re-evaluate the chapter始s effectiveness in the summer and fall of 2012, and highlight areas of improvement. Discuss project effectiveness and use of funds at the end of the year

Develop an evaluation system to insure each area of evaluation is discussed: Quantitative, Project Fit, and Sustainability.

Re-evaluate chapter's effectiveness and impact in the summer and fall of 2012, and determine areas of improvement. Discuss future and upcoming projects to develop with the chapter.

Reflect on the partnership (reviewing the MOU and work plan) in spring of 2012, and determine whether the partnership should continue.

GlobeMed at UChicago GlobeMed at [chapter name]

ASPAT [Partner Name]

2011-2012 UChicago MOU  

2011-2012 UChicago MOU

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