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        <SpecificServicesProvidedTxt>PIVOT COMBINES A MORAL AGENDA OF RIGHTS-BASED HEALTH CARE WITH THE PRACTICAL GOALS OF HEALTH SYSTEM STRENGTHENING (HSS) AT THREE CRITICAL LEVELS OF THE HEALTH SYSTEM: COMMUNITY HEALTH WORKERS, HEALTH CENTERS, AND DISTRICT HOSPITALS. SUBSTANTIAL RESOURCES ARE DEDICATED TO STRENGTHENING AND MAINTAINING ESSENTIAL HEALTH SYSTEM INFRASTRUCTURE, SUCH AS MEDICAL FACILITIES, EQUIPMENT, PERSONNEL, AMBULANCES, AND DISPENSARIES.</SpecificServicesProvidedTxt>
        <RegionTotalExpendituresAmt>48193</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>MADAGASCAR</RegionTxt>
        <TypeOfActivitiesConductedTxt>INVESTMENT/AMBULANCES</TypeOfActivitiesConductedTxt>
        <RegionTotalExpendituresAmt>149187</RegionTotalExpendituresAmt>
      </AccountActivitiesOutsideUSGrp>
      <SubtotalOfficesCnt>1</SubtotalOfficesCnt>
      <SubtotalEmployeesCnt>1</SubtotalEmployeesCnt>
      <ContinutationTotalOfficeCnt>0</ContinutationTotalOfficeCnt>
      <ContinutationTotalEmployeeCnt>0</ContinutationTotalEmployeeCnt>
      <TotalOfficeCnt>1</TotalOfficeCnt>
      <TotalEmployeeCnt>1</TotalEmployeeCnt>
      <SubtotalSpentAmt>197380</SubtotalSpentAmt>
      <ContinuationSpentAmt>0</ContinuationSpentAmt>
      <TotalSpentAmt>197380</TotalSpentAmt>
      <GrantsToOrgOutsideUSGrp>
        <RegionTxt>MADAGASCAR</RegionTxt>
        <PurposeOfGrantTxt>FIELD OFFICE OPERATIONS</PurposeOfGrantTxt>
        <CashGrantAmt>48193</CashGrantAmt>
        <MannerOfCashDisbursementTxt>WIRE</MannerOfCashDisbursementTxt>
        <ValuationMethodUsedDesc>BOOK</ValuationMethodUsedDesc>
      </GrantsToOrgOutsideUSGrp>
      <TransferToForeignCorpInd>0</TransferToForeignCorpInd>
      <InterestInForeignTrustInd>0</InterestInForeignTrustInd>
      <ForeignCorpOwnershipInd>0</ForeignCorpOwnershipInd>
      <PassiveForeignInvestmestCoInd>0</PassiveForeignInvestmestCoInd>
      <ForeignPartnershipInd>0</ForeignPartnershipInd>
      <BoycottCountriesInd>0</BoycottCountriesInd>
    </IRS990ScheduleF>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 2</FormAndLineReferenceDesc>
        <ExplanationTxt>JAMES HERRNSTEIN (DIRECTOR) AND ROBIN HERRNSTEIN (DIRECTOR) ARE HUSBAND AND WIFE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11</FormAndLineReferenceDesc>
        <ExplanationTxt>THE RETURN IS REVIEWED BY THE GOVERNING BODY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>PIVOT WORKS, INC GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC THROUGH THE MASSACHUSETTS SECRETRARY OF STATE'S OFFICE AND THE CHARITIES DIVISION OF THE ATTORNEY GENERAL OF MASSACHUSETTS. THE CONFLICT OF INTEREST AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>