The origins of this project lie in site visit made to Tambaram in May, 2003, by Tom Furtwangler. While consulting there for the CDC, he kept returning to the pediatric ward, where the children were passing their days with very little to entertain them or distract them from their illnesses. Small toys and coloring books he and his teammates brought were immediately put into use. Tom was struck by how a small investment in the ward itself, and the addition of a full-time social worker, could significantly improve the hospital experience of these families, and he returned home and began raising funds from friends and colleagues.

Many under-resourced hospital sites might be appropriate for this kind of external support, and indeed this project may eventually broaden to more sites. Tambram, however, is an ideal pilot site. Its staff is motivated and compassionate, and through collaborative agreements with the CDC and I-TECH, Tambram is already working to become a center of excellence in HIV care, clinical training, and laboratory methods. A suitable local non-profit (Hope Foundation India) was already working in the pediatric ward, and ready to expand their efforts. And as the public hospital in India treating the highest volume of HIV patients, Tambaram is perhaps the site with the very greatest need in all of India.

Public hospitals and institutions worldwide are on the front line of public health crises like HIV/AIDS and TB, with sites like Tambaram opening their doors to patients regardless of ability to pay, and despite facing extreme shortages of supplies and qualified staff. These problems are sometimes compounded by donors' perception (real or imagined) that public institutions in the developing world are red tape-bound bureaucracies, corrupt, or hopelessly inefficient. We have had the opposite experience at Tambaram, and we hope that this project can serve as a model for donor support of high quality care in public institutions in the developing world.