Week 2: A Sneak Peak into Behind the Scenes of International Development Work

Week Overview:

Monday, June 22^th, 2015 - Traveled from Bangalore to Chennai via train (~6hr train ride). The train stations are bustling here! There are so many people waiting, resting, eating, sleeping, walking and rushing with bags and packages varying in sizes.

Tuesday, June 23^rd 2015 – Sanjukta, Zubaida (CEO and co-founder of ayzh), and I skyped with IDEO, a design firm that selected the newborn kit for one of their design challenges to work on, for their interim report synthesizing their trip and proposing two areas of design opportunity: disposable + reusable and disposable everything. I thought they had great ideas, such as designing a tool tray that could be conveniently place in a small autoclave to promote good sanitation practices. I’ve been in contact with IDEO in the design process for the newborn kit with the intention to integrate our work.

Wednesday, June 24^th – Office work with ayzh: writing donations letters to various authors* to in order to have books for the International Development Design Summit (IDDS) and background research on some IDDS project ideas.

Thursday, June 25^th – ayzh met with a team from the Social Entrepreneurship Accelerator at Duke (SEAD) at a very nice hotel in Chennai. We went through workshop-like activities in thinking about the functional, emotional and health benefits for ayzh’s stakeholders (hospital administrators, OBGYNs/Nurses/Healthcare Workers, beneficiaries, investors, grant funders & government), and then identified key variables in ayzh’s impact and how to measure that impact to support their work. Please see “International Development behind the Scenes" below.

Friday, June 26^th – I moved to a hostel about 4km from the ayzh office. Another undergraduate intern, Garland, arrived. It’s nice to have another person my age interning with ayzh. Sanjukta, her friend Reagan, Garland and I spent the evening at the Chennai beach boardwalk. It was the perfect evening of freshly crashing waves, freshly roasted corn, freshly baked idlis & freshly blended fruit smoothies (Date Shake anyone?! :) ).

Saturday, June 27^th – I woke up at 5am to go to the Shore Temple in Mahabalipuram (about an hour North of Chennai) with Sanjukta, Reagan, and Garland. To give you a sense of how beautiful the temple was early in the morning, there were numerous couples taking wedding photos. I’ve never seen so many engaged couples in one place in my life! You can see a picture from our time there on my facebook. We also went to some other monuments in the area. It was great morning!

Some Unexpected Happenings:

·         Curfew at the hostel – The first night I did not even know there was a curfew at 10:30pm! The second night, we called a cab at 9:45pm, but did not get one until 10:30pm! When I arrived the second night, the watch man said, “not again.” I’ve definitely not gotten off to a good start at the hostel being late two nights in a row (Not to mention, needing to wake the watchmen and others up in order to leave at 5am Saturday morning). Oh boy. Luckily, he knows I have good intentions. He smiled slightly after I explained how I tried to get back in time and how sorry I was. One girl at the hostel told me that the watch gaurd cannot scold me because he cannot speak English very well. I supposed there are advantages to language barriers sometimes… but I definitely do not want to be late for curfew again!

·         Landry – How much time did it take my white pants (and some of my other clothing :( ) to become  stained beyond wear? Less than 2 weeks. I tried to do my laundry at the hostel, but the washing machines had something in them – sort of bark-like. While my clothes smell good, some of them have stains. I got my own buckets and stain remover supplies to try again with hand washing, but it may take a miracle. :/  If I determine it’s necessary, I can always get some new clothes and the clothes here are stunning. :)

International Development behind the Scenes:

It is really interesting to think about how to measure the impact of a product, such as a clean birth kit, that focuses on prevention. While the kit provides tools for addresses the World Health Organization’ six cleans*, there are so many variables in infection. In a hospital setting, the healthcare worker will still use metal tools such as scissors, which are hopefully sterilized. But you cannot control the healthcare worker’s behaviors, how the mother gets home (dirty bus?) and what occurs at home (using dirty rags?). 

Providing evidence for ayzh’s work by quantifying impact in the dimensions of each stakeholder is important, but it is challenging to derive numbers when there are many third variables with the complexity and interconnectedness of the world. Apparently, ayzh has a set of data that needs to be analyzed and I hope to help make sense of these numbers. J

How the well-established institutions invest people’s time and energy, finances and other resources to support small social ventures focused on international development (ID) work, such as ayzh, is quite interesting. For example, the well-established supporting institution may spend an excessive amount of money on sending people to consult with the social venture for a short, in-person meeting. While it is important for their people to be comfortable, I believe the money that goes to extravagant luxury is not necessary and could be spent in better ways to support the social venture. 

I am not going to say too much more on this, because I recognize I am very ignorant in this area. But I have begun to learn that the ways organizations interact with each other in ID work is very complex and fascinating. I would like to understand more in of where the money and resources go and why. If you have any other interesting examples or insights into this, please let me know!

Cheers!

Kelly

**The World Health Organization recommends the “6 cleans” to prevent infection during childbirth. They are: Clean hands of birth attendant, clean perineum, clean birth surface, clean cord cutting, clean cord tying instruments, and clean cloth for drying. The CBK provides the 6 items related to these cleans: gloves, soap, a blood-absorbing underpad, a surgical scalpel, a cord clamp, and a baby-wiping cloth.

*If you are interested in reading material the books are:

·         Half the Sky: Turning Oppression into Opportunity for Women Worldwide by Nicholas D. Kristof and Sheryl WuDunn (I did not send the email I wrote and don’t know the status)

·         Nudge: Improving Decisions About Health, Wealth and Happiness by Richard H. Thaler and Cass R. Sunstein (They actually responded!)

·         Value Proposition Design: How to Create Products and Services Customers Want By Alexander Osterwalder, Yves Pigneur, Gregory Bernarda & Alan Smith (Donating 100 Books!)

·         Poor Economics: Rethinking Poverty & the Ways to End It by Abhijit V. Banerjee & Esther Duflo (No response… yet?)

·         We are Like That Only: Understanding the Logic of Consumer India by Rama Bijapurkar (Also, did not send the email I wrote and don’t know the status)

·         Switch: How to Change Things with Change is Hard by Chip Heath and Dan Heath

·         The Impact Investor: Lessons in Leadership and Strategy for Collaborative Capitalism by Cathy Clark, Jed Emerson & Ben Thornley (I sent that today)

Frankencircuit

This week I returned to the electronics store in Arusha, and discovered that they actually had a lot of the components I had asked for the previous time I visited. This time, I brought pictures and had more success specifying what I needed. In addition, I found more old electronics to take apart. In Arusha, there are a number of fundis that repair things and know where to find old, dead electronics. I was able to salvage a number of useful pieces by using a soldering iron to pull components off of old PCBs. I needed a battery pack, so I improvised by cutting open an old flashlight and removing its battery pack. I needed four batteries instead of three, so I wedged an extra battery in and held it in place with an old empty piece of PCB, creating a connection with a blob of solder.

After scavenging some, I found enough pieces to begin building a little solar USB charger. The charger consists of 4 AA rechargeable batteries, a 5V solar panel, and a solder USB jack. The batteries are used to charge a phone or music player. The solar panel then recharges the batteries. This allows the user to charges things at night or during the day. Yesterday I was able to charge a phone using my prototype. It needs more testing, but so far it looks promising! The design of the circuit is really simple, and should be easy enough to teach people to build in a workshop if we can find enough of the right supplies. 

Setup of my solar project. Next week I will shift it to a prototyping board, and solder the connections to make it more secure.

Week 1: Welcome to India!

Hello! I will begin with a day-to-day basis overview of my activities (for those of you who would like to skim J) and then dive into some of my unexpected challenges and interesting experiences.

Tuesday, June 16^th – After arriving in Chennai, I briefly visited the Ayzh office and met with Rehana, the operations manager. She was incredibly welcoming and kind as she told me to call her any time and arranged for me to stay in the women’s Hostel in Chennai later in the month. Then, I traveled to Bangalore because my project mentor, Sanjukta, lives there.

Wednesday, June 17^th – I spent the day learning more details of my project. Sanjukta went over the Ayzh’s development as a social venture and how the Newborn Kit got started. The Newborn Kit won a challenge sponsored by IDEO (https://openideo.com/challenge/zero-to-five/ideas/shishu-information-and-delivery-ecosystem-for-first-48-hours-of-newborn-care), which means IDEO is helping support the project with some finances and a small design team. The design team was in India from May 31^st to June 11^th to learn more about the project context. They are currently working on developing prototypes based on their visit and we will have a Skype meeting with them this Wednesday.

Thursday, June 18^th – Sanjukta gave me an overview of the healthcare systems in India. She described hierarchy based on population density and how it is supposed to work in theory. We met with the translator, who will be traveling and working with me when I travel to the primary health center in Chamarajanagar. In the afternoon, we went to the government hospital in Bangalore, which was shockingly different from what I am used to (no hand sanitizer, no monitors, no doctor’s appointments – people arrive and wait).

Friday, June 19^th – Sanjukta, her friend Usha, and I traveled to a primary health center in Chamarajanagar District. I talked with some of the nurses, mothers and ASHAs (https://en.wikipedia.org/wiki/Accredited_Social_Health_Activist ) there. Because we had traveled so far, we decided to visit some of the temples and river as well. Rural India is stunning!

Working with Sanjukta:

Sanjukta’s warm, bubbly, caring nature is very welcoming! She set up in a hotel in a nice area in Bangalore and gave me an Indian phone card. She is easy to laugh, incredibly patient and quite flexible.  Working with her has been very fun for me! She has a lot of experience working for social ventures and human centered design and I feel fortunate to learn from her this summer.   

Despite the large amount of work required to prepare for the International Design Summit (IDDS) that Ayzh is hosting (http://iddsummit.org/events/idds-india-aarogyam), Sanjukta has put a lot of time into introducing me to the project and Bangalore. By traveling around the city with her, I have learned more about transportation (taxis and auto-rickshaws), the culture and the city, which has helped me feel more comfortable and confident.

District Hospital Visit: (Bangalore)

There were families sitting on the ground in the hallways and grounds of the district hospital. Apparently people do not make appointments with doctors, but just show up with the expectation to wait, which is essentially what we did. We walked around the hospital to go to the delivery room and track some doctors down.

At the district hospital, I was surprised by the lack of basic equipment, such as a heart rate monitor. Has no one designed for this sort of medical setup? Considering that doctors and nurses currently don’t use them, would it be used if it was developed? When I picture medical practice, I imagine a lot of equipment and it amazed me that medicine can even be practiced somewhat successfully without such equipment. In the labor and delivery room, where all normal births happen, the doctors were not wearing a face mask or shield and they worked. To see a labor and delivery room in the US, I would need to sign confidentiality forms and receive the patient’s permission.  As a visitor just walking into the labor and delivery room, I felt weird because I worried about imposing on the patient’s privacy. When we walked around the hospital and into the ICUs, I became conscious of my presence and lack of my own sanitation. Where is the hand sanitizer that I automatically reach for when I enter any patient area or room? I worried about contributing to the high infection rates and poor sanitation. Considering the high number of hospital-associated infections, I cannot even imagine the rate at this district hospital. My experience was more different than what I imagined. I was surprised that some ICU units were not full. I bet more people need care than are receiving it.  

Primary Health Center Visit: (Chamarajanagar District)

Talking with the women in the primary health center in Chamarajanagar (a beautiful area of rural India) was very challenging because I was unsure how to ask questions in a way to get the information I wanted. When I asked a new mother about how she felt about being a mother, she apparently stated “good” through the translator, one of Sanjukta’s friends. I realized asking such abstract, general questions would not help me get the detailed, nuanced information I wanted. Communication was challenging.

When I asked a nurse what she did not like and what she liked about her job, I was surprised by her response, “I don’t have a favorite or least favorite part. I just do whatever is given to me”. Her “do whatever is given to me” attitude suggests an indifference to her work probably because of burn-out. She works very hard, yet she does not seem to question or think about why she is doing what she is doing. I asked the question again because I was certain what she was telling me wasn't true. I can understand her through my lens as a student doing the work given to me in my classes, but (most of the time) I do the work with the belief that my work is valuable in some sense and is part of a larger process towards achieving some valuable goal. I wanted to understand the nurse better. I wonder what purpose this nurse finds in her work and her life. It seems my understanding is inhibited by my western, privileged assumption that everyone thinks about what they are doing and why they are doing it to develop their sense of purpose for the work they do. 

Little Challenges I did not Expect:

Traveling alone in India has been an adjustment because most of the drivers speak little English and I have no idea where anything is. I am adapting by writing down the addresses of places that I want to go and examining the map of the city on my phone as I travel. I have also recognized a couple times where I paid more than necessary for my ride because of my white skin. I now say, “turn on your meter” when I first get into the auto-rickshaw.

I tried to do a little shopping for the first time and I realized how awkward I feel in stores. In one small store, the sales person followed me around about three steps away, as if I need to be baby-sat while shopping. I felt uncomfortable because I like my space when shopping. I was unsuccessful in my first shopping mission, but my experience has gotten better.

Overall, my first week was incredibly interesting and stimulating. If you have any questions, please feel free to ask! :) Tomorrow, I will be traveling to Chennai by train with Sanjukta to work at the Ayzh office and help prepare for IDDS. 

Hello from Arusha!

the bicycle-powered maize sheller

Hi everybody!

I’m Adriana, and for the next three months, I’ll be posting updates on my work at Twende AISE (www.aisetanzania.org) in Arusha Tanzania. AISE—short for “Accelerating Innovation and Social Entrepreneurship”—is an innovation center that serves as a workspace, product design firm, and educational resource here in Tanzania. The goal here is to develop locally-designed, locally-manufactured, affordable, appropriate products that improve lives.

There are a whole slew of projects in action here, but for this summer, I’m focusing on a bicycle-powered maize sheller. Maize, or mahindi, is a staple crop, and removing the dried kernels from the cob is a laborious, time-consuming process. The bicycle-powered sheller was developed by folks from Global Cycle Solutions, right next door to AISE. We’ve assumed responsibility for the development and are eager to get these shellers out to market and onto bicycles.

So, how does that happen?

Thanks to the hard work of past teams, I arrived here to find a functioning sheller that mounts on most models of bicycle found in local villages. For the next five weeks, our team will make weekly trips around the Arusha area to field test with farmers and refine the design. By August, we plan to have 50 maize shellers fabricated. These 50 units will serve as a medium-scale test for manufacturing, distributing, and of course using the bicycle-powered maize sheller. We’ll sell them to farmers and spend the month watching them in action, fixing any problems that pop up, learning, and planning for the future.

First Week

This summer I am interning with an organization known as AISE-Twende, an innovation center in Arusha, Tanzania. I spent the first week becoming familiar with AISE-Twende, their current ongoing projects, and the resources available. Twende is an exciting place with a lot of passionate, resourceful people. My job is to come up with an electrical project that I can teach people how to build. I did a lot of research online for simple do-it-yourself projects, and found a tutorial on how to make a solar USB charger.

My boss, Debbie, told me about the location of a small electronics store in town that sold resistors and capacitors, and even microcontrollers. I went over to investigate what they had, and discovered that there were no .1µF capacitors, or even anything close.  This is the problem that many people face in Africa… not lack of ideas, but lack of supplies and resources to make them happen.

In addition to looking up potential projects, I talked to some of Debbie’s friends from electrical and computer related fields. I met someone from Arusha Technical College, who agreed to help source some of the components I need for the summer. I’ve also been looking into places where Twende can order more resources from China and Dubai for longer term ventures. I got my hands on some old electrical junk to take apart, which will likely have some useful pieces that I can use to create a Frankenstein circuit from old parts. I think that there should be more recycling of electronic waste, there are so many useful pieces that end up in the landfill that could be used in new circuits and pieces. Teaching people how to salvage pieces from old junk might make for a good workshop as well.

(left to right) Ad, Brandon and Tristan hard at work at Twende 

The Journey Before the Journey

Did you know that you need an India Visa to stay in India for more than 30 days? I did not know until two weeks before my trip and the process can take 1-3 weeks. Whoops! On such short notice, the situation led my father to do extensive research, while my mother and I attended a self-defense course. When explaining my travel plans, I have been told, “be safe” many times and I plan to do just that. The course was helpful in increasing confidence and developing some useful life-long skills. Preparing for this trip has been a team effort from the many people I have spoken with and my family.

After about seven hours of visa work (2 hours the night before to fill out the form and 5 hours to figure-out how to pay for it, make sure it was perfect and place it in the mail) on a Monday, I have never been happier or more relieved to see my passport with new stickers 8 days after I mailed it! Thank goodness I do not have to change my flight.

Did you know how hard it is find a decent pair of pants in the Seattle area that will be comfortable in 100 degree weather? I have probably spent more time searching for this than any other item. Well, the single pair of pants I found shall have to do.* They are white and it will be an adventure to see what color they become. I hope to find better pants in India, where such pants are actually sold. I also ordered a pair of shoes that do not exist. Luckily, the equipment difficulties only require some perseverance and flexibility to over-come.

Preparing for this trip has been quite the journey; I hardly imagine what my journey in Chennai, India and the southern region will actually be like. I am interning with a social venture called Ayzh (http://www.ayzh.com/) that focuses on maternal and infant health. Their hallmark product is a clean birth kit that provides women and healthcare workers all the components recommended by the World Health Organization for a safe and hygienic birth, using culturally appealing materials. They are currently developing a supplemental product of a newborn kit. The kit aims to provide mothers with thermal care, sanitation/infection. ­­In my introduction and prevention and breast feeding components to take care of their newborn. The products Ayzh are developing are important because India has one of the highest infant mortality rates.

During my introduction and preliminary research, I have learned many women consider it inauspicious to prepare for their baby by purchasing supplies before the baby is born. The financial risk is quite high for many and it has become culturally expected.  Many women wrap their newborn in dirty cloth or towels because it is their only resource available, but such materials increase the risk of infection. Ayzh’s newborn kit, led by Sanjukta, aims to help change maladaptive behaviors by providing the appropriate basic supplies and using appropriate communication avenues. My task as an intern will be to explore avenues that behavior can be changed by testing prototypes of the current kit.

I am somewhat daunted by my task, because behavior is very complex. Why would the words of a healthcare professional carry more weight than the new mom’s mother or mother-in-law? Why should the new mother do anything different than her own mother, when whatever she did obviously worked? The social and relational aspect of providing newborn care is more convenient and resonates at a deeper level for a new mother than the busy, somewhat impersonal healthcare professional.

Although I come to India with good intentions, I recognize I have a lot of challenges and learning ahead. I will meet and interact with many people with different backgrounds than I. I will learn about a new culture and healthcare system. I will learn some Hindi or other Indian languages. I will learn more about Hinduism and Islam. Given my learning journey ahead, I hope that my good intentions will actually align with my impact.

Speaking of learning and novel experiences, this is my first blog. Please let me know if you have any suggestions in terms of content, language, style, etc. If you have any questions, please do not hesitate to ask! If you develop any suggestions based on what I am doing, please feel free to share! I think your perspective based on your own experiences is important too! You can comment or email me at kellybrennan35@gmail.com. I welcome all feedback!

Cheers!

Kelly

Note: The project I described about the newborn kit development is what I currently plan to do, however, I may fulfill what role is needed once I arrive. I expect what I imagine myself doing and what I will actually be doing will be quite different. How much it will deviate? I don’t know. Probably more than I expect and I look forward to finding out.

*Update: I found a second pair of pants! Yay, REI!