Proof of Care Whitepaper
reducing child medical poverty on a massive scale in Sub Sahara Africa through mathematics and understanding the true value of money
Mal James (who is he)
Masters Graduate RMIT Blockchain for Enabled Business Melbourne Australia and
MoreChildSurgeries.com Child Surgeries Tanzanian Foundation and Proofofcare.org
Marian’s surgical journey
Executive Summary
Proof of Care (POC) is a transparent, accountable system designed to improve outcomes for extremely poor children needing life-changing surgeries. It ensures that every act of care—from diagnosis to long-term follow-up—is seen, verified, and rewarded.
Whom It’s For
- Extremely poor children needing life-changing surgeries.
- Community-based Child Safety Officers (CSOs).
- Medical professionals and hospitals – mostly in developing countries.
- Donors looking to support measurable, meaningful outcomes.
This model recognises the incredible energy it takes to not just fund surgery, but ensure aftercare, integrity, and long-term uplift. It rewards the human connections that make this possible—from village CSOs to international donors—with purpose-built transparency and trust.
Proof of Care records individual acts of care surrounding a child’s surgical journey, resulting in a rating (up to 1000) that reflects actual quality-of-life improvement. It creates a closed-loop system of accountability that:
- Incentivises right actions (care, follow-up, advocacy).
- Discourages wrong or no action (inertia, corruption).
- Uses video evidence and community reporting as its backbone.
This is not just about surgery—it’s about change with proof. It’s a system where care is no longer assumed or symbolic; it is visible, measured, and improved. In an age of donation fatigue and broken aid models, Proof of Care re-centres attention on real results.
Key Elements
- Three Action Ratings: No Action / Wrong Action / Right Action — only the third is incentivised.
- Transparency via Video: Essential to validating care at every step.
- Triangular Connection: Child/family, medical system, and donor interact safely and efficiently.
- Direct Selling Analogy: CSO as trusted ‘agent’ managing welfare, paid based on real outcomes.
- POC Coin Model: Donors invest (e.g., $1,000 USD) and get ongoing updates, direct communication, and transparency on care progress.
- Savings-Based Incentives: CSO incentives are earned immediately and paid out upon request like a savings account for (land, business, health, etc.).
Lets be more specific on the size of medical poverty
Extreme medical poverty in Africa • 38 times less doctors • 22 times fewer nurses •135 times less health $ spent per capita. Tanzania v Australia
Sources: Lancet Global Surgery 2015
World Bank
Global Surgery 2030: Building Solutions Through Innovation
The groundbreaking 2015 Lancet Commission on Global Surgery, led by Dr. John G. Meara of Harvard Medical School and Dr. Andy Leather of King’s College London, revealed a critical global healthcare crisis: 5 billion people lack access to safe, affordable surgical care. Their comprehensive research, involving experts from over 110 countries, projected a staggering $12.3 trillion economic impact in low- and middle-income countries by 2030 due to untreated surgical conditions.
The Scale: The Commission identified that 143 million additional surgical procedures are needed annually to prevent unnecessary deaths and disabilities. Most critically, 33 million individuals face catastrophic health expenditures from surgical costs alone, often pushing entire families into poverty. This financial barrier creates a devastating cycle where treatable conditions become life-altering disabilities.
Key Scientific Recommendations The commission’s research emphasizes four crucial interventions:
- Integration of surgical care into national health systems
- Development of sustainable surgical workforce capacity
- Investment in healthcare infrastructure
- Creation of financial protection mechanisms
Innovative Solutions Emerging This is where new technologies and funding models like Proof of Care are beginning to address these challenges. By leveraging blockchain technology and smart contracts, these innovations directly support the Commission’s recommendations through:
- Transparent, efficient funding flows for surgical procedures
- Verified surgical outcomes through multi-point documentation
- Protection against catastrophic health expenditures
- Sustainable funding pools for ongoing care
Real-World Implementation The Commission’s findings have guided practical solutions in Tanzania and beyond. Working with established medical centers like Selian Ngaramtoni, new funding models are demonstrating how technology can bridge the gap between global resources and local surgical needs. These implementations follow WHO surgical safety protocols while building sustainable local capacity.
Looking Forward as Dr. Meara and Dr. Leather’s research shows, addressing the global surgery crisis requires innovative approaches to both funding and delivery. The emergence of blockchain-based healthcare funding platforms represents one way forward, combining the Commission’s emphasis on financial protection with transparent, verifiable surgical outcomes.
The science is clear: millions of lives can be transformed through access to essential surgery. Through continued innovation in healthcare funding and delivery, guided by rigorous research like the Lancet Commission’s work, we can begin to close this critical global healthcare gap.
References - Medical
ChatGPT has been used at selective times to improve readability
Action Steps & Milestones
Step | Action Name | What Happens | Media / Verification |
1 | Child Safety Plan | CSO initiates structured plan to manage child’s wellbeing pre-surgery. | Written plan / community validation |
2 | Child Safety Video | First video record of child’s environment, health, and context. | 📹 Video (home/community) |
3 | Create POC Rating | Initial Proof of Care score logged based on current child condition. | Scoring system |
4 | Donor WhatsApp Groups | Donor invited into private group to observe, interact, and stay informed. | Group message logs |
5 | CSO Child to Diagnosis/Surgery | CSO facilitates hospital engagement and transport. | Geo/video timestamp |
6 | Diagnostic Video | Medical video and summary of diagnosis and surgical plan. | 📹 Medical setting |
7 | Surgery | Child undergoes approved life-changing operation. | Surgical registration & report |
8 | Nurse Report & Aftercare Video | Nurse posts recovery progress and CSO provides video of post-op environment. | 📹 + nurse report |
9 | CSO Child to Home | CSO safely returns child to home with reintegration care plan. | Video & signed handover |
10 | 1-Month Review >> Rating Update | POC Score is updated after visible progress or concerns. | Updated score + CSO update |
S1 | 1-Year Review >> Final Rating | Long-term follow-up for ongoing wellbeing. Final Proof of Care score issued. | 📹 + written report |
S2 | 5-Year Review >> Final Rating | Long-term follow-up for ongoing wellbeing. Final Proof of Care score issued. | 📹 + written report |
Purpose of the System
This step-by-step model ensures:
- Visible proof of care.
- Donor engagement without interference.
- Clear accountability across time.
- Incentives only triggered by right actions.
Current focus now we are past 1000 child surgeries
- For Donors: Engage with a real child’s journey. Monitor, intervene, or just observe—knowing your support is not symbolic.
- For Communities: Empower your CSOs—they are the linchpins of local trust and action.
- For Medical Networks: Get registered with POC to be part of a system where transparency builds global trust.
This is happening now. 1000 small solutions completed with Proof of Care
PLEASE NOTE SOME IMAGES OF CHILDREN’S OPERATIONS MAY NOT BE SUITABLE FOR ALL AGES. WE DO GET PARENTAL PERMISSIONS FOR PHOT0S TO GO UP WHICH HELPS KEEP TRACK OF WHERE CHILDREN ARE AT AND REDUCE MISTAKES Go direct to public surgery google sheet click here
Proof of Care: Proven Implementation in Tanzania
Over a decade of ground operations, Proof of Care has developed and tested a robust healthcare delivery system, focusing on children’s surgical needs in Tanzania. Here’s our validated approach:
Operational Infrastructure
- 10 years of active presence with 7 field visits to Tanzania
- Network of established partnerships with major hospitals:
- KCMC (Kilimanjaro Christian Medical Centre)
- ALMC (Arusha Lutheran Medical Centre)
- Selian Hospital
- Child Surgeries Tanzania
- Team of 10 interconnected local staff providing comprehensive care coordination
Verified Process Implementation
- Weekly case review meetings via Zoom
- Systematic documentation through:
- Standardized Google Sheets tracking
- Three-point video verification system
- WHO Checklist quality control protocols
- Real-time WhatsApp communication with translation support
Quality Assurance System
- Rigorous verification of medical credentials
- Performance-based incentive structure for all providers:
- Surgical teams
- Outreach workers
- Hospital administration
- Support services (transport, nutrition, aftercare)
- Multi-language coordination through Google Translate
Financial Management
- Transparent monthly payment schedules
- Documented through standardized Google Sheets
- Evolution toward blockchain-based escrow systems
- Successful donor partnerships
Impact Measurement
- Direct dollar-to-outcome tracking
- Local video verification protocol
- Real-time communication updates
- Monthly financial reconciliation
Drawing inspiration from successful models like One Acre Fund, Living Goods, and Kiva, we’ve built a system that prioritizes local empowerment while maintaining rigorous verification standards. Our approach uses widely available technology platforms, avoiding costly bespoke solutions while ensuring scalability and accessibility.
This proven operational foundation now forms the basis for our blockchain-enabled expansion, demonstrating our commitment to practical, implementable solutions for children’s surgical care in Sub-Saharan Africa.
Lobikieki
Magda
Rahman
Who is Proof of Care
Our Clear Role in Proof of Care:
- Maintenance of Coin to rigour to goals delivery
- Investment return to need, solution and money
- Marketing of the Proof of Care solution.
3 Goals of Proof of Care Coin:
- More/better child surgery outcomes for children in medical poverty – (need)
- More/better incentives for medicos to improve child surgeries (solution)
- Improved sustainability of hospital networks via ongoing funding (money)
Call to Action:
For those interested in learning more about how Proof of Care can benefit both affluent and impoverished communities please contact Mal at [email protected] or 0408 107 988.