Global Grant Proposal Form for Project G-2159

Last updated by Eduardo Luis Ercoli <eduardo@ercoliconsultoria.com.br> on 25-Aug-19

Step 1: Basic information

Project Title

Hemodynamic Equipment

Type of Project

[X] Humanitarian        [  ] VTT        [  ] Scholarship    

Primary Host Partner Information

The host partner is a: Club

Last Name:

Ercoli

First Name:

Eduardo

Email:

tarcisio@renalvida.org.br

Phone:

55 (47) 9 9982-8033

District:

4652

Club:

Hermann Blumenau

Primary International Partner Information

The international partner is a: Club

Last Name:

First Name:

Email:

Phone:

District:

Club:

Step 2: Committee Members

Grant Host Committee

Host Partner #1: Eduardo Ercoli <eduardo@ercoliconsultoria.com.br> (55 (47) 9 9982-8033)
Host Partner #2: César Arruda <arrudacesarde@gmail.com> (55 (47) 9 9260-0820)
Host Partner #3: Valmiré Ouriques <vsevalmire@gmail.com> (55 (47) 9 9999 5141)

Grant International Committee

International Partner #1: -
International Partner #2: -
International Partner #3: -

Do any of these committee members have potential conflict of interest? If so, please briefly explain.

Don´t have conflict of interest.

Step 3: Project overview

Tell us a little about your project. What are the main objectives of the project, and who will benefit from it?

BENEFICIARY: HOSPITAL ACSC SANTA ISABEL - BLUMENAU

PRESENTATION: Santa Isabel Hospital is a private entity incorporated with a philanthropic record based in Blumenau, Santa Catarina, Brazil. It is a hospital that concentrates referral care in transplants, over 3,000 transplants performed, kidney, pancreas, corneas and liver, and heart. These services cover the entire state of Santa Catarina, plus patients from other regions of Brazil and Latin America who come for care and surgery. The state has a population of almost 7 million, of which about 3000 patients are regularly treated for transplant follow-ups and all other specialties. In July 2019, he began the robotic surgery procedure with the installation of a robot for some procedures, in search of extremely fast patient recovery and the best applied technology.

GENERAL OBJECTIVES: Advanced solution for diagnostic and interventional procedures in Cardiology, Neuroradiology and Endovascular. With real-time imaging guidance, the goal is to remove barriers to safer, more effective and reproducible treatments, providing clinical value where it is most needed - at the patient's point of care. Intelligent and intuitive integration of imaging, patient information, and procedure-based applications optimizes real-time therapy guidance.

The Project is intended to acquire 01 ANGIOGRAPHER: AZURION 7 C20 (Philips Medical Systems) - Hemodynamic Equipment. We intend to involve approximately 15 clubs in the district.

Step 4: Area of Focus

Which area of focus will this project support?

[  ]

Peacebuilding and conflict prevention

[X]

Disease prevention and treatment

[  ]

Water, sanitation and hygiene

[  ]

Maternal and child health

[  ]

Basic education and literacy

[  ]

Community economic development

Step 5: Measuring success

Which goals of this area of focus will your project support?

-

How will you measure your project impact?

Measure

Collection Method

Frequency

Beneficiaries

Do you know who will collect information for monitoring and evaluation?

-

Step 6: Location and dates

Humanitarian Project
Where and when will your project take place?

-

Step 7: Participants

Cooperating Organization (Optional)
Provide the name, website and location of each cooperating organization.

Name

Website

Location

Why did you choose to partner with this organization and what will its role be?

-

Partners (Optional)

List any other partner that will participate in this project.

-

Volunteer Travelers (Optional)

Provide name, email of traveler(s).

-

Describe this person's role in the project.

-

Rotarian Participants

Describe the role that host Rotarians will have in this project.

-

Describe the role that international Rotarians will have in this project.

-

Step 8: Budget

What is the budget for this grant?

Local Currency:
Exchange Rate Used US$1 =

Category

Description

Supplier

Local
Amount

USD
Amount

Total Budget

-

$0

Step 9: Funding

Tell us about the funding you have secured for your project.

DDF Amount in US$

$45,000

Rotarian Cash Amount in US$

$4,500

Additional Outside Funding in US$

$0

Requested TRF Match in US$

$47,250

Total Financing in US$

$200,000

Step 10: Sustainability

Humanitarian Projects - Project Planning

Describe the community needs that your project will address.

-

How did your project team identify these needs.

-

How were members of the benefiting community involved in finding solutions.

-

How were community members involved in planning the project.

-

Humanitarian Projects - Project Implementation

Summarize each step of your project's implementation.

#

Activity

Duration

Will you work in coordination with any related initiative in the community? If yes, briefly describe the other initiatives and how they relate to this project. If no, please explain. Are local initiatives not addressing these needs? Or, if they are, why did you decide not to work with them?

-

Please describe the training, community outreach, or educational programs this project will include.

-

How were these needs identified?

-

What incentives (for example, monetary compensation, awards, certification, or publicity), will you use, if any, to encourage community members to participate in the project?

-

List any community members or community groups that will oversee the continuation of the project after grant-funded activities conclude.

-

Budget

Will you purchase budget items from local vendors? Explain the process you used to select vendors.

-

Did you use competitive bidding to select vendors? If no, please explain.

-

Please provide an operating and maintenance plan for the equipment or materials you purchased for this project. This plan should include who will operate and maintain the equipment and how they will be trained.

-

Describe how community members will maintain the equipment after grant-funded activities conclude. Will replacement parts be available?

-

If the grant will be used to purchase any equipment, will the equipment be culturally appropriate and conform to the community's technology standards? If yes, please explain. If no, describe how the project team will help community members adopt the technology.

-

After the project is completed, who will own the items purchased by grant funds? No items may be owned by a Rotary district, club, or member.

-

Funding

Have you found a local funding source to sustain project outcomes for the long term? If yes, please describe this funding source.

-

Will any part of the project generate income for ongoing project funding? If yes, please explain.

-

Is your economic and community development activity a microcredit project? If yes, upload your microcredit supplement file.

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