Innovation is often heralded as a major route to solving the global water and sanitation crisis. But is it the key, and should innovation be all about miracle inventions? Rémi Kaupp, Urban Sanitation Specialist at WaterAid UK, discusses whether and where it might be useful.
Do we need more innovation? It is one of the values in our new strategy, and the fact that so many people still don’t have decent water and sanitation in the 21st century should call for massive and rapid innovation…shouldn’t it? Well, I have three problems with it.
First, there isn’t much that needs improvement about having a tap connected to mains water and using a toilet that flushes into a sewer. These are services that most people around the world aspire to, and they fulfil people’s right to water and sanitation. Sure, they could be improved – we should use less water, we need to recover nutrients instead of losing them, etc; these ideas are already the focus of many engineers in richer countries.
Second, the main ingredients needed to achieve universal water and sanitation coverage are well known, and, as is common in international development, they are not glamourous: large investments of public money, stronger institutions, better coordination between actors, targeting the most marginalised – i.e. the bread and butter of WaterAid’s advocacy.
Third, and most irritatingly, when we say “innovation”, we often hear “invention”. Barely a week goes by without our technical advisers receiving news of yet another miracle invention that will surely save the problem worldwide. So what is wrong with these?
They are often point-of-use treatment systems, i.e. water filters, which can be useful in certain conditions (in emergencies, where people really have no choice but to gather water from a river or unsafe well), but often address a small part of the problem. Perfect water quality isn’t as problematic as the distance to the source in rural areas, and its price in cities, and therefore the quantity that people can use for hygiene and sanitation.
Many inventions are developed by Northern inventors with few ties to local communities or consideration of local markets, and assumptions are made about what people actually want or need. The market studies we conduct always give surprising insights into people’s aspirations and hurdles.
Many inventions use materials and techniques that are not available in the targeted countries, creating unsustainable supply chains. It is hard enough to have supply chains for sanitary pads and pump parts, let alone water filters or other more complex technology!
Looking beyond product development
I could go on, but enough ranting. We are nowhere near the target of everyone having safe water and sanitation, so we need to do better – and yes, we need innovation. We have to remember that there are many types of innovation beyond just the development of a new product. The SMS service used in Dakar for sludge collection tankers is an exciting example – the technical aspects are interesting, but, for me, the most interesting features are the strong leadership of the sanitation agency ONAS, the market studies that were used to design this new service, and the willingness to work between authorities and private operators. This sort of collaboration is a key innovative behaviour we need to see increasingly.
There are some great technical innovations in our sector, such as pre-paid water meters, simplified sewers, and the Gulper pit-emptying pump, and the lessons of their pilots are always very similar: they only work if they are developed in response to residents’ needs; they need to be led by the local water and sanitation agency or authority; and they are not usually standalone innovations but fit within broader actions towards improving water and sanitation.
Where is innovation needed?
So where do we need innovation? I have a few suggestions:
Pit emptying: Despite our attempts, we still haven’t found a safe and sustainable way to empty toilet pits and then to transport the sludge to a treatment station. The issue isn’t so much having a better pump or vehicle than finding how to run a sustainable business in that area, and what sorts of toilets would be both easier to empty and attractive to people.
Sanitation tariffs: Bills aren’t sexy, but they are the main resource utilities have to invest in more infrastructure. There are some ideas from around the world, but an issue is how to keep bills affordable for the poorest people while ensuring their right to good services is fulfilled.
Monitoring water pumps: We know pumps break often and after just a few years, so can we track their failure and repair rate? Although again there areexciting technological innovations in this area, the real shift needs to be in how data are used by institutions and businesses to keep pumps functioning.
Making facilities accessible: It has been a long journey to have more accessible toilets in Europe, and there is still much to do. We know the technology needed, but how can we make sure accessible facilities are everywhere more quickly? How do we overcome the joint issues of technology, regulation and endemic inequality?
These are just my ideas – please do suggest other areas in the comments! For instance, perhaps you know of something exciting happening in humanitarian emergencies.
For me, the value of “innovation” isn’t in finding the solution to all water problems worldwide; it is more about persistence and openness, the willingness to try new approaches with an open mind, to sometimes fail and acknowledge it honestly, to learn and adapt and try again. This journey can be as exciting as the last ten years in toilet pit emptying!
– See more at: http://www.wateraid.org/news/blogs/2015/november/Does-the-WASH-sector-need-innovation?&name=twitter&creative=referral&utm_content=WASH_innovation&position=Comms_policy_research#sthash.TfGZofC5.dpuf
Rémi Kaupp is WaterAid’s Urban Sanitation Specialist. He tweets as @RemKau and you can read more of his work here. – See more at: http://www.wateraid.org/news/blogs/2015/november/Does-the-WASH-sector-need-innovation?&name=twitter&creative=referral&utm_content=WASH_innovation&position=Comms_policy_research#sthash.TfGZofC5.dpuf
Each day, we could be flushing millions of pounds in poop down our collective loos. Zoe Cormier examines eight ways the world can harness human waste.
Methane is a simple product that can be created from human faeces. The main ingredient in the natural gas that is tapped from the ground before running throughout the national grid, methane heats our homes and cooks our food. But it can also be produced in anaerobic digesters, in which microbes degrade food scraps and other organic material in the absence of oxygen. Methane can even be made straight from sewage.
To prove that ‘not everything we flush goes to waste’, the FirstGroup transport company is running the first bus in the UK powered by poo. The Bio-Bus – launched in March 2015 – uses biomethane provided from the GENeco waste recycling and renewable energy facility in Avonmouth. The 41-seater bus runs along the aptly named number 2 route that links Cribbs Causeway in north Bristol to the south of the city.
The innovative vehicle can run for up to 300 kilometres on one tank (the equivalent of five people’s annual flushes). If successful, and if riders approve of travelling on human emissions, the company hopes to roll out even more ‘poo buses’.
An innovative feed for farm animals is being developed by researchers at the Sanitation Ventures group at the London School of Hygiene & Tropical Medicine. Their work is largely funded by the Bill & Melinda Gates Foundation’s Reinvent the Toilet Challenge, which is aimed at helping the 2.5 billion people worldwide who lack sanitation.
Speaking to us in May 2015, before his death in December of that year, according to Dr Jeroen Ensink, Senior Lecturer in Public Health Engineering at the London School of Hygiene & Tropical Medicine, they wanted to find a way to safely remove the human waste from latrines, but also generate a bit of income for these communities. Their solution was to use black soldier fly larvae to degrade the human waste. The plump larvae were then turned into a protein-rich product to be sold as fish food or chicken feed. Tests to see if meat and eggs that derive from human faeces-fed larvae are safe for consumption are taking place right now.
In space, what do you do with your poo? Early astronauts simply bunged their dung in a bag. This proved inadequate, and led to some unfortunate situations. Back in 1969 on NASA’s Apollo 10, Commander Tom Stafford is quoted as saying: “Give me a napkin, quick. There’s a turd floating through the air.”
Modern space loos are more sophisticated, yet they make the same mistake: not putting those turds to good use. Instead, scientists from the University of Florida suggest that lunar bases could convert faeces into fuel. They came up with a technique that would enable 290 litres of methane to be produced per astronaut per day – enough to power their rocket back to Earth. As a bonus, water from waste could be split into hydrogen and breathable oxygen. “We began working on this idea back in 2002, when NASA wanted us to help them plan for using waste for fertiliser and fuel in a base on Mars,” says Dr Pratap C Pullammanappallil, who worked on the research.
While NASA shelved its plans for a base on Mars, and later its intentions for a lunar station, others have not given up on the interplanetary dream of putting humans on other planets. Mars One, for example, aims to send humans to a permanent base on Mars by 2026. Meanwhile, Inspiration Mars – a private venture founded by American Dennis Tito – plans to send adventurers on flyby missions to the Red Planet by 2018.
One of the greatest hazards of interplanetary travel will be cosmic radiation, which is estimated to increase the risk of cancer by 3 per cent. Inspiration Mars’s solution? Line the walls of the space shuttle with water, food, and excrement. Could the power of poo really help us conquer the cosmos? Perhaps Oscar Wilde put it best: “We are all in the gutter, but some of us are looking at the stars.”
Poo isn’t the only powerful excretion – there is a urinal at the University of the West of England that can generate electricity from pee. The unit, which is partly funded by Oxfam, could bring power to off-grid locations such as refugee camps. The urinals contain microbial fuel cells, which are filled with live microbes that feed on urea. The system accesses the biochemical energy the microbes use for growth and converts it to electricity.
“This first step shows we can power lights inside the cubicle,” says Prof Ioannis Ieropoulos, from the Bristol BioEnergy Centre at the university. “The next challenge is generating enough electricity to go beyond the urinal.” Their research – which began 13 years ago – did not start with pee. The team initially investigated potential fuels for autonomous robots and examined the electricity that could be produced with various waste materials, such as grass clippings and shrimp shells. “Urine actually proved to be one of the best feedstocks for electricity production,” says Ieropoulos.
POO TO PLATE
The simplest way to make good use of waste is to use faeces as fertiliser. Throughout history, human waste has been used on fields in nearly every culture on Earth. Today, the thought of using our own excrement to grow food may seem revolting, but the tradition continues in developed countries. For example, roughly 60 per cent of biosolids – the sterilised end-products of wastewater treatment facilities – are spread onto land in the US (usually fallow fields or tree plantations).
In developing countries, however, untreated sewage is frequently taken from open pit latrines and used on farmland. While raw sewage is cheaper than traditional fertilisers, its usage can often lead to increased numbers of microbes and parasites. Thankfully, safer solutions are being devised. One innovative example is the Tiger Toilet, which is being developed at the London School of Hygiene & Tropical Medicine. The simple loos are filled with tiger worms that can convert poo to compost in about six months.
The hydrogen in hydrogen fuel cells is obtained via the electrolysis of water. A current is passed through water to obtain hydrogen and oxygen molecules. Using the same technique, oxygen and hydrogen can be cleaved from ammonia and urea – two of the main compounds in pee. In fact, the process is far more efficient with urine because less energy is required to obtain the substances.
Researchers at the University of Ohio are looking to harness this power in urine to generate electricity from large buildings, such as offices and sports stadiums. Meanwhile, a team at Caltech (another Bill & Melinda Gates Foundation winner) is working on solar-powered urinals with the capacity to generate hydrogen gas that can be stored as a back-up source of energy. One problem: researchers have waxed lyrical over the promise of the hydrogen economy for decades, with few results. Are these hydrogen visionaries just pissing in the wind? Time will tell.
MINE FOR GOLD
Talk about turning trash to treasure: scientists are looking at ways to extract precious metals – including gold, silver, platinum, copper and titanium – from sewage. What’s more, the amount is far from insubstantial: the waste produced by a million Americans every year could contain as much as $13m worth of metals. According to Dr Paul Westerhoff from Arizona State University, it’s unclear exactly where these metals are coming from because municipal sewage derives from more than just domestic origins. Waste from dentists’ offices is one likely trove because gold and silver is used in dental amalgams, while other potential sources are the cosmetics and personal care products that go down the drains.
But poo could also be serving up the goods: titanium dioxide, for example, is added to many doughnuts. Whatever the source, more research is needed to figure out where the metals are coming from and how to extract them. “If we really can mine $13m per year from a community of a million people, we could not only reduce the cost of treating municipal waste, we could also reduce the need to mine these metals from traditional sources,” says Westerhoff. “By reducing the need for mining, reducing the amount of metals that wind up on land and in forests as biosolids, and extracting something of value that reduces overall treatment costs, it’s a potential big win.”
This all points to a much bigger issue. Just as we now increasingly view paper, plastic and metal waste from households as a resource to be recycled rather than rubbish to be discarded onto landfills, we may need to think of our own excrement in the same way. We could call it urban mining, perhaps? Dr Jeroen Ensink of the London School of Hygiene & Tropical Medicine agreed. “We can only tackle the sanitation problem when we make it a commercial success. Only when you can turn waste into an asset will people start investing in its proper treatment.”
But is it really possible to extract these precious metals from faeces? “I have already told one of my PhD students that she won’t graduate until she gives me a gold ring made in this way,” chuckles Westerhoff.
From the start, 2015 was ripe for world-changing innovation.
In early January, we saw Bill Gates drink clean water converted from sewer sludge and human waste by a special processor. In February, social workers and computer scientists came up with an algorithm to prevent the spread of HIV among homeless youth. In March, a research lab created a microchip that could actually help bridge the digital divide in developing countries.
And the revolutionary ideas and inventions tackling the world’s most pressing problems kept coming throughout the year.
From a new sneaker that helps people with physical disabilities, to “nanosheets” that can absorb oil spills, to a bindi that delivers much-needed iodine to women in India, these are some of our favorite innovations that truly made a difference in 2015.
1. The machine that converts poop into clean drinking water
Approximately 2.4 billion people around the world didn’t have access to basic, safe sanitation in 2015, while more than 660 million people used unimproved drinking water sources.
The Gates Foundation talked to engineers to figure out how we could use technology to tackle these issues. Peter Janicki, CEO of Janicki Bioenergy, developed a machine that converts sewer sludge into clean drinking water, electricity and pathogen-free ash in a matter of minutes.
The processor can help developing countries both by providing clean water and energy, as well as employing entrepreneurs to run it in the regions where it’s needed most.
2. The algorithm that can prevent HIV among homeless youth
Homelessness affects about 2 million people between the ages of 13 and 24 every year in the United States — 11% of whom are HIV-positive. But researchers at the University of Southern California’s Schools of Social Work and Engineering developed a new algorithm called PSINET, which uses artificial intelligence to identify the best person in a specific homeless community to spread important information about HIV prevention among youth.
Computer scientists mapped the friendships of homeless teens at a local homeless agency in Los Angeles. The algorithm looks at this network of friendships, and runs through thousands of possibilities for the person with the greatest reach at a certain point in time. That “peer leader” can then learn about basic information, like where to get tested for HIV, and in turn provide researchers with more information about the homeless community.
According to the researchers, PSINET spread 60% more information to communities than typical word-of-mouth campaigns.
3. The sneaker technology designed for people with disabilitiesIn 2012, Matthew Walzer, who has cerebral palsy, wrote a letter to Nike asking the company to create sneakers that people with disabilities could easily put on and take off without the help of others. This year, the company — Flyease — that has a zipper extending around the back of the shoe.In 2012, Matthew Walzer, who has cerebral palsy, wrote a letter to Nike asking the company to create sneakers that people with disabilities could easily put on and take off without the help of others. This year, the company — Flyease — that has a zipper extending around the back of the shoe.
In 2012, Matthew Walzer, who has cerebral palsy, wrote a letter to Nike asking the company to create sneakers that people with disabilities could easily put on and take off without the help of others. This year, the company announced a new line of footwear — Flyease — that has a zipper extending around the back of the shoe.
Instead of laces, which are incredibly difficult for people with movement disorders, stroke victims and amputees, the zipper allows you to “peel” it open with one hand and slide your foot in easily.
Nike’s senior director of athlete innovation, Tobie Hatfield, designed the technology and worked with Walzer to develop and test the sneakers.
4. The life-saving device that can seal a wound in under a minute
Oregon startup RevMedX’s new device XSTAT 30 is a syringe filled with tiny, biocompatible sponges, which can be injected into a deep wound to absorb blood and seal it in less than a minute. While it’s been used on the battlefield since April 2014, it was recently approved by the FDA for civilian use.
A RevMedx researcher told PBS NewsHour that the sponges expand up to 15 times their size when they make contact with blood, which allows them to apply internal pressure to the walls of the wound cavity and block blood flow. The sponges would replace a medic’s traditional method of deeply packing a wound with gauze and maintaining pressure.
5. The “Internet on a microchip”
The WiderNet Project, based at the University of North Carolina, Chapel Hill, developed theeGranary Pocket Library — a microchip that taps into the power of smartphones, laptops and tablets to deliver offline information and educational resources to billions of people without access to the Internet.
WiderNet has connected with with ministries of education, ministries of health and schools of information science in various countries, and aims to fill each “library on a chip” with a few thousand documents that a given institution, such as a medical school in Zambia, identifies as its core material.
The project reached its crowdfunding goal in May, and is collaborating with librarians, educators and volunteers around the world to pinpoint the information needed most.
6. Dinnerware that makes life easier for dementia sufferers
The cognitive and sensory impairments associated with dementia often result in difficulty eating — spills, confusion by intricate patterns on dinnerware and more — and out of frustration, sufferers often eat less than they should.
To tackle this issue, industrial designer Sha Yao created Eatwell, an eight-piece dining set that uses more than 20 distinct features to give dementia sufferers more independence during mealtime. For example, the dishware has slanted bottoms for easy scooping, bright colors to distinguish food and especially ergonomic utensils.
7. 3D-printed rotors that freeze seawater into drinking water
GE has long been expert in steam turbine technology for the desalination of water, but in 2015 it began to miniaturize the process.
“As part of the water desalination technology being developed with the [U.S. Department of Energy], researchers are using the same steam turbine turbomachinery 3D printed in a miniaturized form to compress and stream a mixture of air, salt and water through a hyper-cooling loop that freezes seawater. By freezing the mixture, the salt naturally separates in solid form, leaving just the ice. The ice is then melted, leaving clean water.”
The design is a low-cost, low-energy way to create drinking water, and GE will continue to test the technology through mid-2016 to assess its feasibility.
8. The lamps powered by plants
Approximately 42% of rural areas in the Peruvian jungle don’t have electricity, according to Peru’s latest National Household Survey conducted by the National Institute of Statistics and Information.
During photosynthesis, the plant’s waste decomposes in the soil, producing electrons during oxidation. The UTEC team captures these electrons by using electrodes in the soil and storing it in batteries. This process can light the LED bulbs for up to two hours.
9. A revolutionary material that could absorb large oil spills
Researchers at Deakin University in Australia, along with scientists at Drexel University in Philadelphia and Missouri University, developed a type of “nanosheet” that can clean up oil spillslike a sponge. Each nanosheet is made up of flakes that are only several nanometers (one-billionth of a meter) thick with tiny holes, which can grow to the size of 5.5 tennis courts.
“The pores in the nanosheets provide the surface area to absorb oils and organic solvents up to 33 times its own weight,” one of the researchers said.
The team developed an early-stage prototype of the idea in 2013, when it was a powder and didn’t yet have a practical use.
10. The laundry device that lets washers reuse water for months
Washing machines use 20 gallons of water to remove one tablespoon of dirt. To conserve water and maintain efficiency, three graduate students at MIT invented AquaFresco, a type of filter that allows washing machines to reuse 95% of the water produced from each load.
The device filters out waste and recycles clean water and detergent for further cleaning cycles — up to six months’ worth.
11. The durable, flat-pack housing for refugees
The Better Shelter is a temporary shelter created with refugees in mind, and has an expected lifespan of three years. It comes in flat packs, which means aid organizations can transport it efficiently and assemble it without tools. The designer created the shelters with family needs in mind, so each one includes a solar panel and lamp to provide light.
Better Shelter teamed up with the U.N. refugee agency UNHCR and the IKEA Foundation to use the shelters in the countries where refugees need them the most, such as Greece.
12. A low-cost device that simplifies auto-transfusion
In some developing countries, when patients hemorrhage blood during childbirth, doctors use a ladle and cheesecloth to perform auto-transfusion — gathering and recycling blood for the same patient during a medical procedure. This DIY method is necessary because the machinery and supplies typically used for transfusions are so costly.
Sisu Global Health’s first device, the Hemafuse, is a low-cost product that makes the process simpler and more sanitary. It works like a hand-pump, sucking up blood and then passing it through a valve to a blood bag for later use. A filter removes clots and other particulates in the blood.
The Hemafuse won the 2015 Social Impact Prize at the SXSW Eco Awards in October and received a $100,000 investment from AOL cofounder Steve Case in September.
13. This 15-year-old’s energy probe powered by ocean waves
The probe uses a 3D-printed propeller connected to a hydroelectric generator via a pulley system. The generator turns the movement of ocean waves through the propeller into usable electricity — a small amount that would be enough to power a desalination machine.
14. The prosthetic hand that can generate a sense of touch
Most prosthetics can’t allow their wearers to regain their senses of touch, but DARPA’s latest version of its prosthetic hand uses neurotechnology to do just that.
Researchers wired a 28-year-old man’s prosthetic — a mechanical hand developed by the Applied Physics Laboratory (APL) at Johns Hopkins University — directly to his brain using electrodes on his sensory cortex and motor cortex. He became the first person to be able to “feel” physical sensations through a prosthetic hand, according to DARPA.
15. A simple toolkit to help girls wash and dry reusable pads
Product designer Mariko Higaki Iwai and a team of art students created Flo, a simple kit that allow girls in developing countries to easily wash, dry and carry reusable sanitary pads. Flo aims to ensure that girls don’t miss school or work due to the stigma of menstruation, don’t contract reproductive infections and illnesses, and also maintain confidence.
The product is essentially an enclosed basket spun between strings to wash sanitary pads and reduce drying time. The basket inside turns into a drying rack, and the kit also includes a carrying case to carry both new and old pads discreetly.
16. The student-made device helping babies breathe
According to the World Health Organization, acute respiratory illnesses are one of the leading causes of death among children under the age of five. Babies who have trouble breathing usually need Continuous Positive Airway Pressure (CPAP), a simple process that in developing countries sometimes only requires a tube submerged in water. But babies in severe respiratory distress require Nasal Intermittent Positive Pressure Ventilation (NIPPV), a process that often calls for costly machinery.
The NeoVent, which was created by undergrad students at Western Michigan University, uses an inverted bowl mechanism that oscillates to provide two levels of pressure needed to help babies breathe.
The device allows any medical center in the developing world equipped to perform CPAP adapt its machinery to perform NIPPV.
17. The eco-friendly brick that could revolutionize India
In India, there are hundreds of thousands of brick kilns producing close to 200 billion bricks per year — and the process contributes considerably to air pollution and greenhouse gas emissions. Paper mills also dump boiler ash in landfills, which affects both human and environmental health and has no practical use.
Tackling both issues head-on, students at MIT developed a new brick, called the Eco BLAC brick. The students made the brick from boiler ash using low-energy alkali activation technology rather than firing in a kiln.
In the end, the project recycles industrial waste into construction materials. The students are currently working in the city Muzaffarnagar, Uttar Pradesh, where they’re partnering with a paper mill owner to implement a pilot plant on-site.
18. The printable strips for in-home testing of infectious diseases
Researchers at Florida Atlantic University have created paper and plastic strips for in-home diagnostic testing of HIV, E.coli, Staphylococcus aureas and other bacteria, as well as a smartphone app that could detect these bacteria using images remotely.
According to Fast Company, the E.coli test is made of paper (cellulose) and printed with a mixture of antibodies and gold nanoparticles. If bacteria is found, a color change indicates a positive result.
The plastic HIV test will begin trials at Brigham and Women’s Hospital in Boston, and the researchers hope to commercialize the tests by mid-2016.
19. The bindi delivering much-needed iodine to impoverished women in India
Women in India traditionally wear a bindi — a small dot between the eyebrows — for religious purposes or to show they’re married, but it’s grown in popularity among all women.
The Live Saving Dot is coated with iodine and delivers the recommended amount of 150-220 micrograms of the nutrient daily to poor women in India, where approximately 350 million peopleare at risk for iodine deficiency. A lack iodine can cause a number of health problems, especially during a woman’s pregnancy.
Iodine can be absorbed through the skin, and the Life Saving Dot would be a particularly low-cost nutritional supplement — it costs only 10 rupees, or 16 cents, for a packet of 30 bindis. It has been distributed to women across rural India through health camps and clinics in several villages.
20. The beehive that harvests honey on its own
Two Aussie inventors created the Flow Hive beehive, which allows beekeepers to get honey on tap without opening the beehive and disturbing the bees.
The innovative hive’s frames consist of partially formed honeycomb cells, which lets the bees complete the comb with their wax before filling the cells with honey. Beekeepers then need only turn a handle to split the cells vertically, so the honey can drip down to the base of the frame and out of the hive.
The Flow Hive has a clear window so you can watch the bees, which the inventors say can help with scientific research without disturbing them.
21. A smartphone dongle for 15-minute diagnostic tests
A team of researchers at Columbia University’s School of Engineering has developed a low-cost smartphone dongle that can detect sexually transmitted infections from a finger prick of blood within 15 minutes.
Health care workers in Rwanda used the dongle in a pilot program by testing blood from 96 patients enrolled at prevention-of-mother-to-child-transmission clinics or voluntary counseling and testing centers. They only needed 30 minutes of training. Users just have to place the blood in the plastic collector, insert it into the microfluidic cassette, open the accompanying app, insert the cassette into the dongle and press the bulb to initiate flow. After 15 minutes, results are shown on the smartphone.
22. This advanced treatment for jaundice in newborns
Jaundice is the primary reason why newborns are readmitted to hospitals worldwide, and millions are not receiving effective treatment.
Award-winning medical device nonprofit D-Rev launched its latest newborn product this year —Brilliance Pro, an advanced version of its Brilliance Classic product from 2012, which treats newborn jaundice with sophisticated phototherapy.
Brilliance Pro uses an integrated light meter, has expanded functionality and is sleeker to work better in the NICU. It retails at $400, and the distributor is Phoenix Medical Systems in India.
23. The best knee joint prosthetic for developing world amputees
In addition to newborn health, D-Rev also works on mobility. This year it launched the latest version of the ReMotion Knee, a high-performance prosthetic knee joint designed for people in the developing world.
The ReMotion Knee works with standard prosthetic leg systems and withstands humid and wet climates, and it’s affordable at $80. So far, D-Rev has fit 7,351 amputees with the ReMotion Knee.
24. A temporary tattoo that helps diabetics track blood sugar
Patients with diabetes currently need to check their blood sugar multiple times per day with a painful finger prick. But nanoengineers at UC San Diego developed a temporary tattoo that non-invasively extracts and measures glucose levels in the fluid between skin cells.
The tattoo doesn’t yet provide the necessary numerical levels, but the engineers say it will eventually have Bluetooth capabilities to garner such readouts. The method could pave the way for more uses of the technology, such as delivering medicines through the skin.
25. The ocean acidification sensor that revitalizes conservation
The Wendy Schmidt Ocean Health XPRIZE aimed to improve our understanding of how carbon dioxide emissions affect ocean acidification, which affects sea life and disrupts the food chain.
The winner of the competition, Sunburst Sensors, developed a breakthrough sensor that can withstand long-term monitoring of pCO2 and pH, and could prove instrumental in understanding ocean acidification and saving the oceans.
26. The app that helps blind people see through others’ eyes
Be My Eyes is an iPhone app that allows users to “lend” their eyes to the blind. It connects blind users to volunteers around the world to use live video chat and have them describe what they see and answer any questions.
According to its website, the app has helped nearly 115,000 blind users so far.
It will help modernize old or inadequate city sewage systems that harm public health—especially in developing countries
This post by Aria Bendix (@ariabendix) first appeared here on Dec 30, 2015.
When we think about the most dire threats to our planet, poor sanitation rarely tops the list. And yet it’s a significant (and in some cases immediate) contributor to sickness and pollution in both rural and urban areas.
Every day, around 2 million tons of human waste are disposed of in water channels. Among other contributing factors, this sanitation problem limits the availability of uncontaminated drinking water—especially in developing nations, which often lack the proper treatment and drainage facilities. Overall, 2.5 billion people around the world currently lack access to improved sanitation, and 27 percent of urban dwellers in developing nations do not have access to piped water in their homes.
These sanitation issues apply to U.S. cities as well—albeit on a much smaller scale. As America’s urban populations continue to grow, so too does the demand for clean water. The U.S. Government Accountability Office reports that 40 states will experience some kind of water shortage in the next 10 years.
These shortages negatively impact water quality in unincorporated communities, as my colleague Laura Bliss has chronicled in her series on the water crisis in California’s San Joaquin Valley. Meanwhile, urbanized areas run the risk of sewer systems clogging and spilling over into rivers and streams due to excessive groundwater or stormwater. The EPA estimates anywhere from 23,000 to 75,000 overflows of sanitary sewer systems each year in the U.S.
The right infrastructure becomes critical in preserving water quality and preventing a shortage of clean drinking water. Unfortunately, most of the technology employed by cities today lags behind the latest innovations.
Reinventing the toilet
Currently, only one gold standard for sanitation exists: the combined sewer system that is already in place in developed cities. In a September post for The Atlantic, author Mary Anna Evans describes the initial design of this “modern” technology:
The EPA calls combined sewers “remnants of the country’s early infrastructure.” The first sewers weren’t designed to handle the constant and huge stream of wastes from our toilets, because they were invented when we didn’t have any toilets. Sewers were originally built to solve the problems of cities that were flooded with their own refuse—garbage, animal manure, and human waste left in the open rather than in a privy or latrine—during every rainstorm.
The fact that cities still rely on a technology that predates toilets points to just how archaic this system has become. Brian Arbogast, the director of the Water, Sanitation & Hygiene Program at the Bill and Melinda Gates Foundation, says that “there’s not an obvious market demand for changing the way we do sanitation in the developed world.” And yet combined sewer systems expend huge amounts of water and energy, in turn posing a serious long-term threat to our environment.
For the past few years, Arbogast and his team have worked with partners to develop new sanitation technologies. One of the most promising is a “reinvented toilet” that essentially functions as its own treatment plant. The concept is part of a broader initiative called the “Reinvent the Toilet Challenge” that aims to deliver sustainable sanitation to the 2.5 billion people who lack access.
Unlike traditional sewer systems, the reinvented toilet would harvest energy from actual human waste to kill germs in the water itself. The result is sterile water that’s safe enough to wash with, as well as human waste that can be re-purposed for healthy, odorless fertilizer. The main challenge is keeping costs low enough to reasonably implement the toilet across cities. With this in mind, the Water, Sanitation & Hygiene Program has priced it at no more than five cents per user per day—the same cost as many public toilets in developing nations.
The Gates Foundation has also partnered with manufacturing company Janicki Bioenergy on a device called the Omni Processor, which is able to convert feces into safe drinking water. The device’s steam engine makes its own energy for burning human waste so cities or towns don’t have to resort to energy-draining activities like burning diesel fuel. The Omni Processor was recently implemented in Dakar, Senegal, through an auspicious pilot program, with plans to eventually sell the product to wealthier nations.
Developing cities as sanitation testing grounds
If developing nations are turning toward new sanitation technology, why isn’t this shift happening in developed cities as well? One obvious explanation is that developed cities already have a functioning sewer system. But the real answer, Arbogast says, goes beyond the fact that “developed cities aren’t really innovating.” He contends that new technology will have to be tested in developing nations before developed ones are likely to follow suit.
“I firmly believe,” he says, “that if this technology can get out there in the market [in developing countries] … you’ll start to see building codes changing to incentivize the use of waterless toilets or to take the load off waste water treatment plants.”
Until then, it’s developing cities that require the most attention. The World Health Organization reports that 3.4 million people—mainly children—die each year from water-related diseases like cholera, dysentery, or typhoid. In a city like Dhaka, Bangladesh, Arbogast says, only 2 percent of waste is being treated at a plant. And in many cases, septic tanks carry human waste directly into the street—leaving city residents exposed to numerous pathogens. “No community has ever put themselves out of poverty without addressing sanitation,” Arbogast says.
As dire as these circumstances may be, sustainable sanitation is rarely the focus of global discussions. During COP21, Arbogast gave a talk on the relationship between sanitation and climate change in hopes of landing the issue on the international radar. At the conference, Arbogast says, many were surprised to hear how direct and devastating the link has become. Despite being familiar with the sanitation problem in developing communities, many conference-goers had overlooked the energy-draining and water-depleting activities of combined sewer systems.
Thankfully, these realizations are not too late. With innovations like the Omni Processor and the reinvented toilet on the cusp of completion, cities can start to think about replacing sewer systems with more environmentally friendly devices. Arbogast thinks these technologies will be ready for purchase in just a few years. Developed or not, those cities that make it a priority to update their waste disposal systems will certainly be more prepared for impending environmental challenges.
“Cities that invest in non-sewer sanitation are going to be far more resilient both today,” Arbogast says, “and even more so in the face of climate change in the future.”
Finally, a women’s cycle has made the news cycle. For roughly 250 million adolescent girls in the world living in poverty, having a period means having to carry a heavy burden of shame. In addition, a shortage of sufficient clean water, toilets and sanitary products in schools can limit their ability to attend school and participate in daily life activities.
As PSI continues to develop the market for toilets and sanitation across India and Africa, it has become apparent that not only does having a toilet bring dignity to entire families but also it positively affects women’s health. For girls and women having a toilet brings dignity to menstruation and allows for the safe storage of sanitary supplies. One of the most popular features of the toilets PSI is helping to construct in India is the small “cubby shelf” in upper right corner that lets women store sanitary supplies for her period, as seen in the banner photo above.
As more and more organizations are focusing on menstruation management and alleviating the burden created by period-related issues around the world with innovative solutions, market development and market research, here are four innovations that are helping girls and women cope with their periods:
Reusable pads are an effective way to provide girls, especially those in low-income situations, access to sanitary products that are affordable and safer than unsanitary, less absorbent materials such as rags and mattress stuffing.
However, reusable pads come with a unique set of challenges. Oftentimes, reusable feminine products can cause significant health problems when not cleaned properly. Social stigma and cultural taboos about menstruation deter girls from washing their reusable pads with normal laundry and causes embarrassment when hanging the pads outside to dry after they are washed. The reusable pads then remain damp and form bacteria that can cause reproductive infections and illness. Making matters worse, many girls often decide to skip school out of fear of being embarrassed or ashamed.
Luckily, students at the Art Center College of Design created “Flo”, a versatile period management system that allows girls to face their periods with dignity. Flo allows for longer-lasting menstruation management and is a low cost option in areas where disposable sanitary pads may be perceived as being too expensive.
Flo is a portable device that allows girls to carry, clean and dry reusable pads discretely and safely. The invention is comprised of two bowls lined with a basket casing, a string and a sealable carrying. Water and detergent go into the bowls so that the pads can be properly cleaned. The basket casing converts into a hanging rack that can be covered with a piece of cloth so that the pads can be hung discretely outside.
Thanks to Flo, periods can be safer, healthier and less disruptive to girls’ daily lives.
Period Panties for Girls
Designing for empowerment and purpose is the drive behind BeGirl, a for-profit social enterprise addressing menstruation management through revolutionary reusable period panties and pads.
BeGirl is working to close the gender gap in education that appears when girls miss school or drop out due to menstrual issues. BeGirl designs and produces two reusable options for girls, the PeriodPanty and the FlexiPad, which can be filled with safe and absorbent material, washed, and then dried indoors in less than 60 minutes. The design for both products employs soft comfortable fabric and strain-free material, as well as leak-proof lining, giving girls the confidence to wear either product to school without fears of uncomfortable accidents. BeGirl was designed with beneficiaries in mind, designed to be attractive to young girls and bring dignity in menstruation.
Not only does the design incorporate the user, but BeGirl also made sure their products were environmentally sound. BeGirl products lead to a 70% reduction in water used for washing in one year, eliminating 160 miles of walking for a girl to fetch water.
The Menstrual Man
Most men avoid the topic of menstruation like the plague. But one man, Arunachalam Muruganantham of India, was shocked by how his wife was managing her monthly period that he not only sought to create a more affordable sanitary pad, but he even wore the pads himself mimicking menstruation with goat’s blood to test his designs.
In India, only 12% of women use commercial sanitary products due to their perceived high cost and the traditional stigma surrounding menstruation and sanitary pads. Instead, many women use rags, dirt, leaves to absorb menstrual blood, contributing to the 70% of female reproductive diseases resulting from poor menstrual hygiene and even impacting maternal mortality.
Almost five years after he began his work, he developed a low-cost method to produce pads using pulverized wood fiber and built the model machine to make them, simple enough to be operated and maintained in India’s remote villages. After developing the model, he began distributing over 250 machines; today he has supplied machines to over 400 sites that benefit 1,300 villages. Each machine employees 10 women and can produce up to 250 pads a day.
Women in the villages make the pads themselves and sell directly to their customers, allowing them to not only menstruate with dignity but also create small social enterprises within their communities that benefit entire families. The women that purchase the pads are not only receiving the product, but they also receive information on how to use the pads.
A similar program by Sustainable Health Enterprises (SHE) has created social business around making sanitary pads from banana fibers in Rwanda. Banana famers process and sell their trunk fiber to SHE, which is then manufactured into sanitary pads in community factories. The factories are packaged and sold at affordable prices to women and in schools. SHE also works to educate women and young girls about the myths surrounding menstruation and about health hygiene.
Imagine a school-aged girl learning every day in East Africa without having to worry about her monthly cycle at school.
Femme International provides school girls with not only menstrual cups but also with the education and hygiene products they need to handle their menstrual cycles each month. Each Femme Kit contains everything a girl needs to keep the cup clean and to store the cup when she does not need it.
Menstrual cups are similar to tampons as they are an internal form on menstrual management, but instead of absorbing, they collect blood and are emptied when a woman removes the cup. Menstrual cups, unlike other menstrual products, can be used for up to 12 hours allowing girls to attend school without the fear of ridicule and accidents. Cups are made from silicone and can last for 10 years, drastically reducing not only waste but also the economic strain of monthly sanitary products.
Femme’s combination of health-focused workshops and the Kit have equipped countless girls with the knowledge and resources to manage their periods every month and attend school uninterrupted.
Thanks to these innovations, girls can be more empowered to reach their full potential and not be ashamed. With the sustainable development goals on the horizon, more and more attention is being paid to the status of women and girls. Without openly discussing and finding sustainable solutions for menstrual management the road to gender equality will be difficult. Menstruation matters. Period.
Over 90% of Kenya’s population uses wood, charcoal, or kerosene for their daily cooking needs
Young entrepreneurs are using the country’s lack of access to clean energy as a business opportunity
On October 28, 2014, World Bank Group President Jim Yong Kim visited Kenya’s Climate Innovation Center to see these innovative energy projects
In Kenya, over 90% of the population uses wood, charcoal, or kerosene for their daily cooking needs. These fuels pollute the environment and pose serious health risks such as respiratory infections or even death.
While the country offers several clean energy sources, such as bio fuels and solar power, their market is still in its infancy. Prices are often not competitive compared to less sustainable but cheaper alternatives, and the lack of adequate infrastructure prevents their adoption in many rural areas.
Mohamed Kadhi saw a business opportunity in Kenya’s lack of access to clean energy when he founded Consumer Choice Ltd (CCL), a clean technology startup that develops clean cookstoves and a bio-ethanol fuel. On October 28, Mohamed had the opportunity to showcase CCL’s product lineup to Dr. Jim Yong Kim, President of the World Bank Group, during his visit to the Kenya Climate Innovation Center, a business incubator supported by infoDev, the World Bank’s global innovation and entrepreneurship program. The bio-ethanol gel is an alternative biofuel made from molasses, a by-product of sugar extraction.
Mohamed Kadhi (left) demonstrates CCL’s ethanol gel and cookstove to Dr. Jim Yong Kim, President of the World Bank Group, during Dr. Kim’s visit to KCIC on October 28, 2014. Photo credit: The World Bank/Kenya Climate Innovation Center
Mohamed Kadhi (left) demonstrates CCL’s ethanol gel and cookstove to Dr. Jim Yong Kim, President of the World Bank Group, during Dr. Kim’s visit to KCIC on October 28, 2014. Photo credit: The World Bank/Kenya Climate Innovation Center
Another exhibitor during Dr. Kim’s visit to the Kenya Climate Innovation Center was the Keekonyokie slaughterhouse. This business has been recycling blood from a community-based Maasai slaughterhouse to create biogas for cooking. The slaughterhouse generates about 10 metric tons of slaughter waste. To manage the waste and turn it into something useful, the abattoir has constructed a biogas digester which channels waste into gas. The firm even stores the fuel in used tires, lessening the environmental impact of the operation.
While bio-ethanol fuel and biowaste-based gases are clean and highly efficient energy alternatives, getting Kenyan kitchens to adopt these alternatives at affordable prices remains a daunting challenge that would require carefully planned sales, marketing and financial strategies.
Since its founding in 2012, the Kenya CIC has been helping CCL and Keekonyokie with identifying potential target market segments and financing mechanisms, developing marketing strategies, and providing policy support through working with local policymakers in order to create greater incentives for the adoption of clean fuels.
The Kenya CIC supports 83 client enterprises – selected from over 330 applicants. With support from the governments of the United Kingdom and Denmark, the Center aims to spark the next wave of clean technology innovation in Kenya, and catalyze new solutions that promote Kenya’s private sector growth while achieving sustainable development objectives. Thanks to the services of Kenyan CIC entrepreneurs, about 8,300 persons have better access to safer, cleaner water, 55,000 people are better able to cope with effects of climate change, and close to 49,000 people are using low carbon energy sources. To learn more about how the World Bank is supporting climate-smart entrepreneurs, please visit www.infodev.org/climate.
A young girl receives medicine from a health worker at a mobile health clinic in Sindh, Pakistan. How do we scale up innovative solutions for global health challenges? Photo by: Vicki Francis / DFID / CC BY
If there’s one positive lesson to learn from the Ebola scourge, it’s that there’s no dearth of solutions to global health challenges. Prior to the current outbreak, the narrative was that there was no known drug for the disease; soon, vaccines and treatments will undergo testing.
Those experimental vaccines and treatments flew under the radar until the Ebola outbreak turned into a humanitarian tragedy and, eventually, captured headlines and the attention of global leaders. Urgency has created a market for Ebola solutions.
The same cannot be said for many other promising ideas in global health. Today, quite a number of medicines, health diagnostics and delivery mechanisms are lagging behind their potential.
“What we have is only a trickle of things transitioning to scale,” said Peter Singer, CEO of the Canadian government-funded Grand Challenges Canada. “So the next great challenge in global health and development is to turn that trickle into a torrent of things to scale.”
Scaling up new ideas in global health is a challenging venture. It requires leadership, funding and buy-in from a variety of stakeholders, from patients to providers, from the public to the private sector. Cross-sector partnerships can facilitate the process, but there’s no silver bullet to sustainably scaling up new ideas in global health.
Funding new ideas
More players than ever are engaging in global health, with corporations and philanthropic foundations taking on a particularly growing role. Often, they partner with one another to develop new ideas in global health.
The use of competitive grant-making mechanisms — sometimes called grand challenges — is a favorite among the likes of the Bill & Melinda Gates Foundation and U.S. Agency for International Development, and has been taken up by governments of emerging countries like Brazil, India and South Africa. Winners of these competitions usually end up with tens of thousands of dollars in cash rewards — not quite enough to scale up a promising idea, perhaps, but a good start.
These challenges have resulted in a slew of new solutions, from a mobile phone application that can help deliver health care to the doorsteps of people in remote villages to a cheap medical device that boosts the chance of newborn survival in the developing world. But despite their lifesaving promise following testing over many years, the majority of them risk remaining at the pilot stage.
“A lot of NGOs and funders are set up to try new things, to fund pilots and small-scale efforts and they don’t necessarily follow through with funding when something is ready to scale,” said Pam Bolton, vice president for strategy and innovation at Concern Worldwide U.S.
Private capital may help supplement that. More and more private investors are committing capital to efforts that generate social impact, including better health outcomes. Impact investments, according to one survey, havereached $46 billion and will likely grow this year by 19 percent.
Sustaining access to new ideas and effective solutions
Beyond financing new ideas in global health, the private sector has a role in developing new ways to advance health care and making new solutions more available to those who need it.
Pharmaceutical manufacturers, for instance, have launched more than 350 treatments over the last decade and have 3,200 compounds in the development pipeline. One of those could end up being a malaria vaccine.
But developing a drug that is safe and effective comes with an expensive price tag —somewhere between $4 billion and $11 billion. Much like donor agencies seeking partnerships with corporations to stretch aid dollars, pharmaceutical and medical equipment companies are partnering with one another and others to share the risks and reward of launching new global health solutions.
“Innovation is becoming more collaborative and we have moved away from profit-alone models to profit-together models,” said Andrew Jenner, executive director of corporate strategy and legal affairs at the International Federation of Pharmaceutical Manufacturers & Associations.
Members of the federation are working to develop treatments for diseases in the developing world independently or through product development partnerships, a form of public-private collaboration, such as the Drugs for Neglected Diseases Initiative, Medicines for Malaria Venture and TB Alliance. Pledged to donate 14 billion treatments for neglected diseases between 2011 and 2020, they have affirmed the importance of a “holistic fight” against these diseases to include working with the World Health Organization and other partners to strengthen capacity in developing countries.
Like product development partnerships, advanced market commitments are designed to incentivize the pharmaceutical industry to develop solutions that can fight diseases in the developing world. In this case, donors, largely rich governments and foundations, agree to subsidize the price of future vaccines for infectious illnesses and in turn a manufacturer agrees to sell them in developing countries at an affordable price. Gavi, for instance, has this innovative financing schemein place for pneumococcal disease — the leading cause of vaccine-preventable death among children under 5.
Another scheme somewhat akin to it is the public-private Pledge Guarantee for Health, which uses partial guarantees from U.S. and Swedish governments to enable traditional aid grantees, such as nongovernmental organizations and developing country ministries, to secure short-term, low-cost commercial credit to procure essential health supplies such as bed nets and contraceptives.
Adopting new ideas
Apart from accessibility, adoption is critical to scaling up new ideas.
Take the case of magnesium sulfate, which is proven to effectively treat pre-eclampsia, a disorder that kills 40,000 pregnant women each year, mainly in low- and middle-income countries. Yet despite its low cost — about $1 per dose — and beingdesignated as essential medicine by the WHO the use of magnesium sulphate has been low. Studies suggest that the low price discourages mass production of the drug and policymakers are not moving to change the situation.
A number of reasons may explain why decision-makers aren’t keen on scaling up effective solutions. For some, it’s the lack of money; for others, the fear of being accountable for allocating resources to what may be perceived as a risky activity.
Rwanda, for instance, actively pursues new and effective ideas from its development partners as it wants to become more like Singapore, a city-state esteemed for its efficient public service.
Strong support from local communities can help to promote new ideas, as well. Development initiatives tend to find the most success if implementers live and listen to locals and involve them in the design and implementation of solutions.
More importantly, the new idea should strengthen health systems. And that part isn’t going to be easy.
“I think it comes down to the question of how do we build a really strong health system?” said Jessie Cronan, executive director of Gardens for Health, which partners with government-run health centers in Rwanda to help families in rural regions with the highest rates of chronic malnutrition have a diverse diet by cultivating a home garden. “How do we reframe that role that NGOs play so that we’re playing a supporting role to government institutions in these countries so that it isn’t creating parallel systems but instead how are we working to strengthen what is already there so that there is true meaningful capacity building happening which is hard. It’s a lot easier to set up your own thing than to work with any government.”
Over the next month, Devex, along with leading players in global health, will explore how we can address that dilemma, as well as other emerging opportunities and challenges in saving lives and living longer.
From human-centered design to the lean startup approach, methods to develop innovative products and services emphasize the importance of understanding what customers really need. Here are some lessons in innovation that social entrepreneurs have learned from empathizing with their customers:
Don’t let technology take the wheel: “I used to think that the problem lies in technology. What we realized eventually was that the problem does not merely lie in the technology, but the psychology,” says Ashoka Fellow Swapnil Chaturvedi in a recent video on his work.
Swapnil, founder of Samagra, is talking about providing adequate sanitation in India, where over 50 percent of the population defecates in the open. His statement could be true anywhere else in the world; toilets installed in low-income areas often fall into disuse or end up being used for other purposes such as vegetable peeling bins. To mitigate this, when designing community toilets in Pune slums, Swapnil introduced a LooRewards system. Based on a mapping of the community’s needs, this system linked toilet use with discounts on washing and sanitation products, water purification systems or fortified, nutritional snacks sold by local producers. This helped Samagra engage over100 first-time users of toilets.
Michael Murphy, co-founder of the MASS Design Group also realized that sophisticated technology wasn’t essential, while designing the 140-bed Butaro Hospital in Rwanda. He reveals, “A common misconception is that design interventions that combat the health worsening effects of hospitals are more expensive or require advanced equipment and machinery, but we’ve seen that’s not the case. Hospitals all over the world can be harsh environments for patients—which is shocking to consider, as we think of hospitals as places people go to get better. But labyrinthine corridors, harsh lighting, and stale air can in fact jeopardize a patient’s capacity to heal. Beyond that, hospitals are actually making people sicker. According to the CDC, about 1 in 20 patients gets a hospital-acquired infection (something they did not arrive with) per year in the U.S. (CDC, 2013). In Butaro, we designed the building without hallways, instead creating open-air, comfortable waiting spaces that would reduce the transmission of infection, but still provide opportunity for check-in and interaction. MASS also incorporated ample landscaped areas for patients to have quiet space outside, or visit with their families.”
Build the solution for the most under-served customers: Your most engaged customers often come from the edges of the market. Swapnil admits, “When I started working on community toilets, I didn’t know women would become our biggest customers. However, we have observed that in urban areas, where everyone is stretched for land and privacy, men find a solution to the lack of toilets, but women can’t. They hold their urine and bowel movements, resulting in urinary tract infections.” Thus, women are keen users of Samagra’s community toilets and as its most vocal customers, they help get their friends and families to sign up. Samagra, in turn, pays special attention to their needs, by providing dustbins in each toilet stall for disposing sanitary napkins and prioritizing water supply in the women’s toilets.
For Michael, it was important to design hospitals that served patients as well as doctors better. For instance, hospital wards usually have patient beds facing each other, with a hallway in the centre for doctors to check on patients conveniently. Instead, the Butaro hospital in Rwanda has all beds facing the window, allowing patients to view the landscape. Michael explains, “There are myriad studies that demonstrate patients with a view to nature recover faster. Moreover, patients should not have to look at other sick patients when they are recovering; this represents a ‘factory-like’ setting of health care.”
Shift how the community sees you: “Hospitals should be, first and foremost, a public resource. This includes making the hospital an approachable space, where people can come to maintain their quality of life as well as receive acute care. That is why a lot of the spaces are landscaped,” asserts Michael. While building the hospital, he sought to expand its benefit beyond healthcare. “Health infrastructure requires massive investment and construction. This mobilization of resources should be transferred to the local community, by using local labor and materials, as well as providing on-the-job training. Butaro employed over 4,000 people, and transferred a few million dollars into the local economy as well. Beyond that, several masons trained at Butaro have gone on to other skilled jobs,” he states.
Focusing on positive outcomes for the community has prompted Swapnil to transform his rewards program from what he calls “transaction-based rewards” to “value-based rewards,” such as discounts on private tuition classes for schoolchildren. Samagra’s toilets also have bank kiosks that allow customers to deposit small amounts in their bank accounts regularly. This shift has resulted in increased revenue for Samagra, as “learning what customers care about through empathetic market research has allowed us to capture value and monetize it.” Transforming toilets into community connectors that allow slum-dwellers to access a broader range of services is powerful. Swapnil shares, “Since we installed a banking kiosk in the community toilets, rather than a place to relieve themselves, the toilet becomes a place to bank. People will never vandalise their bank; we’ve seen vandalism reduction by 85%. The toilet has become a place of business and a community centre of sorts.” Regular savings also allow customers to budget for the fees for using the toilet, and their payments have become more regular.
Innovations driven by empathy are now enabling Swapnil and Michael to expand the scope of their work. Michael’s MASS Design Group is currently completing construction on both a tuberculosis hospital and a diarrheal disease treatment center in Port-au-Prince, Haiti, as well as designing maternity waiting homes in Malawi and a Center for Global Health at Mbarara University in Uganda. Swapnil’s Samagra is evaluating options for adding more value-based rewards such as day-care centers for mothers who work in the informal sector and can’t afford to quit their jobs to take care of their children.
Let’s face it. Some days, most days, development work is far from sexy. What’s most needed to bring about changes in ordinary people’s lives is citizens demanding fundamental services, community organising and coalition building, governments and agencies managing their budgets – i.e. the day-to-day grind of making institutions function.
So why then is the development sector so obsessed with being ‘innovative’?
It may be because we are often working in challenging, changing, and complex operating environments, within the risk-averse policies and procedures of aid agencies suffering from bureaucratic inertia. We long for a new ways of thinking and working, and new ideas are way more fun and much less political.
Nonetheless, I am often concerned that the term ‘innovation’ gets over-used and misinterpreted in the humanitarian and development sector.
Rather than the usual ‘latest and greatest idea or fad’ and ‘get-to-scale’ mentality associated with innovation, I wonder if innovation can be re-defined to identify innovation first from the ground up? In other words, can more localised, grounded means of problem-solving generate the most effective ideas, products or processes to be labelled as ‘innovative’?
“It’s often easy to forget the great amount of innovation that indigenous, grassroots organisations employ. Even more so because they often don’t frame their work within the language we understand or associate with innovation. You must listen, dig, ask questions, and reframe in your head to see that within what they describe as a regular part of their work lies ingenuity.”
Doesn’t it just make good sense to support more opportunities for ‘innovation’ closer to where the problems are occurring? Aren’t the people who intimately know a problem from the inside out more likely to see where the possibilities for innovation lie? And from small initiatives, is there not the potential to pilot and learn for application in larger programs? Ultimately, where we are looking for innovation and who defines innovation is vital.
One of the most important roles of us as development practitionersis to encourage, coach, and uphold processes of individual and collective reflection to identify and overcome obstacles, resulting in changes or adaptations in our work. If you are a development practitioner supporting community- or country-led initiatives, the DIY Toolkit is a useful tool to enhance your support of development partners to think creatively about their programs and practices at all levels. Supporting people and leaders in the developing world to enhance their own efforts with openness and confidence is what gives birth to lasting innovation.
So perhaps it’s time to re-conceptualise ‘innovation’ for global development. What if the thing really makes something innovative is not the idea itself, but the learning that made it possible?
Jennifer Lentfer is the creator of the blog how-matters.org, which focuses on how the international aid, philanthropy, and social enterprise sectors can be more genuinely responsive to local needs. One of Foreign Policy Magazine’s 100 women to follow on Twitter, she has worked with over 300 grassroots organisations in east and southern Africa over the past decade, as well as various international organisations in Africa and the US, including the Red Cross, UNICEF, Catholic Relief Services, and Firelight Foundation, where in her career she has focused on organisational learning.
Through a kind of magic I don’t fully understand, some emerging poverty solutions—products, services, technologies—become shiny new objects that trigger something akin to a feeding frenzy. Celebration at CGI and SOCAP and TED, breathless articles in Wired and Fast Company, endorsements from celebrities, awards of all kinds—all that stuff is great if the thing has real potential for impact. Too often, though, the appetizer becomes the entrée and hyperbolic celebration displaces systematic evaluation.
That’s a shame, because we really do need to sort good ideas from bad, and it ought to happen before we stoke the fires of publicity. At Mulago, we’ve spend a lot of time trying to figure out if start-ups with a new “thing”—a product, service, or technology—are likely to create real impact in the lives of the people we’re trying to serve. Over time, we’ve evolved a set of four questions that help us make better predictions. Because we’ve been thinking a lot about cookstoves and indoor pollution lately, I’ll use improved cookstoves to illustrate how those questions work.
1. Is it needed?
Given the nature of the thing, is there a profound social impact to be had? Every thing ought to have a mission (preferably in one that’s eight words or less). If you can’t figure out a clear mission that matters, all you may have is a solution in search of problem—and some things ought to be killed while they’re young.
We might reasonably ascribe various missions to better stoves, including: improve health, prevent deforestation, save time and money, and decrease carbon emissions. Since indoor air pollution is a major killer and bad stoves are the major contributor, we think that the mission to “Prevent Respiratory Disease in Poor Families” is a compelling one and rises above all the others (especially since the evidence connecting the other potential missions is considerably more sketchy). So the answer to question one isyes, absolutely, we need better stoves.
2. Does it work?
If the thing is deployed as designed, under the conditions for which it was designed, will it have real impact? In the case of stoves, this is mostly about emissions: Does a given stove reduce pollutants enough to drive a significant improvement in health? Recent research indicates that most improved cookstoves don’t. It turns out that you have to reduce more than 85-90 percent of pollutants before you see any real reduction in respiratory illness (Burnett et al, 2014). A stove that emits 50 percent less pollution doesn’t accomplish much. To date, the only stoves that make the cut are the expensive “forced-draft” models that use a built-in fan to stoke a much more efficient burn. The answer for most stoves, however admirable the effort may be, is no. Really.
3. Will people use it as designed?
Behavior, behavior, behavior. Despite all that user-centered-design, iterative-rapid-prototyping stuff, people use and abuse things in ways that leave even the best designers scratching their heads. Too many—way too many—products have made their way into wide distribution without evidence that people use them as intended. Successful things, though, usually have these qualities in common: They fit well with local customs and culture, are easy to use right and hard to use wrong, and need little maintenance (and when they do, they’re fixable and you can get parts).
Everyone has heard about stoves that people use improperly—or not at all—but field researchers have handed the stove industry another fun surprise: Even when people do use that wonderful new stove, they often use the old one too (Ruiz-Mercado et al, 2011). It’s become known as “stove-stacking,” and you see it when you visit homes—there’s the new stove, fired up and roaring, and there’s the old three-stone fire still belching smoke in the corner. Oh no! If you want to fulfill the mission—prevent respiratory disease in poor families—not only do you have to provide an expensive stove, you might have to provide two! It kind of sucks, but that may be what it takes to get to yes.
4. Will it get to those who need it most (a lot of them)?
Nothing matters if the thing doesn’t reach the people it is intended to serve. If you don’t have a reality-based idea about distribution, you should hold off on the design process until you do. Three things matter above all else:
Price. If it’s too expensive, they won’t buy it. Knowing the customer’s price point is your first order of business, and you need to design the thing to hit that number.
Distribution channel. Poor people live in a world of market failure, and there are a finite number of ways to get things to them—the hardest is to set up your own network.
Sales. Somebody has to make the transaction happen—who are they and how are they going to do it?
And, of course, if the thing costs more than about 20 bucks, you’d better think about financing, too…
This is where stoves have always struggled: The affordable ones are inadequate, and the good ones are unaffordable. Even with the (unreliable) assistance of carbon credit subsidies, stoves that can fulfill our health mission are still too expensive. Emerging technologies will almost certainly lower the price of forced-draft stoves, but for the time being, they’re mostly out of reach for those who need them most. Financing can help, but poor people often have more urgent things to do with available credit.
One organization working on the stove problem that gets to “yes” to all four questions is Inyenyeri, a Rwandan company that leases ultra-low emission, forced-draft cookstoves to households at a nominal cost (about $7 per year), and sells customers the fuel pellets to burn in them. The pellets cost less than charcoal, and people who can’t afford to buy them can trade biomass for pellets. Inyenyeri leases families two or even three stoves to account for stacking. It’s still early days and there are a lot of moving parts, but it’s headed in the right direction.
The four questions are unforgiving; getting a no on any one of them means you won’t pass go on your way to impact. That doesn’t mean that a no answer should lead you to abandon the whole effort, but it should refocus your efforts on getting to yes. Stick with R&D, and avoid the big splash until you’re pretty sure you’re there—it’s the least we owe the people we serve.
Innovation Exchange brings together a community of WASH and IAQ field practitioners, NGOs, policy makers, academics, social entrepreneurs and others who want to explore the connection between innovation and development. We hope to foster dialogue to accelerate the uptake of innovative approaches and tools that contribute towards better health outcomes in households and communities.