Managing Expectations

One of the key facets of business, especially when dealing with clients, is effectively managing expectations. This is one of the most critical skills I first learned when I started working. Setting and managing expectations is a powerful tool that can drastically alter satisfaction and perception of you as a professional.


Sometimes I have noticed, while working in Hubli, the inability to set or manage expectations. As I sit here typing this blog post, the Innovator’s residence, the Scholars House, has been without water and power since Saturday night. It is currently Monday, in the early afternoon. We are use to power outages so when the lights went out late Saturday night, I assumed that everything would be in working order the next morning. But no power and no water followed on Sunday and continue to be missing today. Obviously, this is annoying. However, this would have been more bearable if we were given notice for the reason for this interruption. Apparently, a new power generator is being installed and water needed to be refilled at the Scholars House. Yet, none of us were told that this work would be done this weekend and that there would be a period of time when we would not have access to current or water. A little notification would have altered my expectations and I would have been adequately prepared for the minor service interruption. However, due to the lack of setting of expectations, it has created more disgruntled feelings at the moment.

Specifically with SendHealth, expectations continue to play a critical role in the progression of our project. As we have known since the beginning, finding physicians to participate in our program is essential to making SendHealth function to the benefit of the villagers. We have been told by our partner NGO on three separate occasions that: 1) they would find a physician for us, 2) for us to reach out to physicians, and 3) again, that they would find a SendHealth physician. This time, KHPT guaranteed they would find a physician.

To complicate matters, during our search, we spoke with numerous physicians who all reached the same conclusion: that SendHealth will not work. They cited litigation issues, incentive questions, and issues with physicians being overworked. We appreciated the physicians honest and clear feedback and were grateful for their willingness to assist us in any other way possible. They admired our enthusiasm and wish to make a difference. However, this still does not change the fact that all the physicians we spoke with commented that connecting physicians with patients over mobile phones would not work. Instead, most recommended for us to focus on health awareness and education.

Who to believe? What will happen to our project? For the first time, I am worried that our project is suddenly derailed in our last week in Hubli. And not for the first time, I believe honest feedback about gaining physician buy-in to participate in our project would have helped us to change course and appropriately adjust our project. However, at this point in time, we need to continue the course and leave it up to KHPT to find a participant physician. Setting and managing expectations would have made a significant difference.

Nonetheless, the responsibility lies on us to understand how to work effectively in a different culture while still generating positive and substantial results. I am still confident we will leave impacting a number of lives and that KHPT will utilize our program to best reach those most in need. Expectations or not, the show must go on.

One week left. 2 months zipped by.

Ken

Around the World in 5 Days (or Further Thoughts from T5)

Here I am, back at Heathrow's T5 again. And again, here I am, bumming off British Airways Lounge's free wi-fi. This is the sixth time in the past couple months that I have been a guest of this terminal so the question begs, why am I here yet again?

The answer is my sister. I am in quite a unique position for an innovator; due to my sister's wedding in Los Angeles this past weekend, I was afforded the opportunity to travel home and take a short break from our project in Hubli. I left Hubli this past Thursday and am expected to return to Hubli tomorrow (Tuesday). Of course, special thanks must go to my teammates, the Deshpande Foundation, and the Stevens Institute for their understanding and freeing me to attend without guilt of abandonment.

So, what to expect before I returned home for a weekend trip? Would I be thrown into confusion when I wasn't stared at, asked for an autograph, or requested to be in a picture? Would I buckle under culture shock? Would I be unable to breathe due to the sudden personal space afforded to me? I admit, the anticipation of a warm shower for the first time in almost two months and a mouth watering In-n-out burger was palpable.

I must say, the return home was not as earth shattering and life altering as I expected. Maybe it was because I was involved with wedding related matters from the minute I landed to the minute I left. This may have helped cushion the culture shock blow. Or, perhaps it was my mindset, fully aware that this was a short trip and that I was not really "home;" cognizant that I would be returning to Hubli in a couple days. Regardless of the reason, my time in L.A. was busily spent celebrating my sister and brother-in-law's marriage with friends and family (old and new). Questions were asked about my summer in India but most were superficial questions as there was little time to go in depth about my experience thus far. I welcomed this, however, as I was already exhausted from the trip and my ability to adequately and intelligently remark on my India experience would have required more mental capacity than I was capable of at the time. Perhaps most importantly, I believe there is still a lot of unfinished business left with our SendHealth project and thus, my mindset was still in India and Hubli mode.

However, having spent a few days away from the intricacies of the project has allowed me the opportunity to step back and look at the big picture. I was getting obsessed with accomplishing our goals with so little time left in Hubli. To me, there was success or failure and nothing in between. However, even the short break at home clarified that this project is not about winning or losing but is about enabling our NGO partner, KHPT, to further reach and improve the lives of its core "customer." Let me be clear: SendHealth still has its goals it wishes to accomplish before leaving India. Yet, we should not be dismayed about our 8 weeks in Hubli being all for naught; we worked long hours, built many bridges, and established a strong foundation and tools for which KHPT to work with once we leave. Regardless of what occurs the next couple weeks, all of the Innovator teams can leave knowing our work will lead to actions that will have a profound effect on lives in Hubli/Dharwad.

I am grateful for the opportunity to celebrate my sister's wedding. I am further grateful that I can return to Hubli to finish up our project in the remaining two weeks left. I suspect that once I fly back to L.A. "for good," that the true nature and perspective of my time in India will hit me.

Lastly, great news regarding Mr. Deshpande, the Deshpande Foundation's co-founder; he has been appointed Co-Chairman of the U.S. National Advisory Council on Innovation and Entrepreneurship (NACIE). The Hindu published an article on its front page. Another amazing accomplishment for Mr. Deshpande.

Two weeks left. I guess time does fly.

Ken

Three Weeks Left and Counting….

Fast out the gates, slow to finish. We hope this will not befall our project. After a productive first few weeks in Hubli in which much was accomplished, the past couple weeks have slowed down considerably. Sicknesses, waiting for meetings, and general fatigue and tiredness catching up to us have all contributed to the deceleration of our project’s progress. However, signs are looking up and the engines are revving back up to full speed.

Since our first blog post, we have visited 10 villages to determine which 3 villages we plan to pilot SendHealth. Visiting the various villages was a breath of fresh air from the hectic and sensory overload lifestyle of Hubli/Dharwad. We were fortunate enough to rent a vehicle and a driver; while sometimes cramped (we were able to fit 13 people in a van that should only hold 7 individuals), it was relaxing to stare off into the blue skies with patches of white clouds lazily hanging above the farmlands. The clean wind whipping our face was a welcome relief from the hot, exhaust filled air in the city.

It was an extremely difficult decision to choose only 3 villages with which to implement our project. In the end and based on a variety of criteria including but not limited to health infrastructure, historical epidemics, health-seeking behavior, and willingness to work with us, we determined that we would initially pilot our program in Bennur, Kondikoppa, and Yadwad. Each village presents its own sets of challenges and strengths, which should lead to interesting results once we initiate the program.

After choosing the villages, we were feeling good and making solid progress. Then, out of the blue, it hit us: the dreaded wall. It came out of nowhere and we ran into it running at full speed. People got sick, people were suddenly exhausted, and our project champions finally fell under the weight of all their other projects. We took the time to catch up with other work and to settle on our next steps for the remaining month in Hubli.

Picture to the left: The process flow SendHealth will be implementing in the next few weeks.

We reassessed and focused on our workplan. Our workplan has gone through many different iterations throughout the past month. For example, we worked through different possible operational flows for SendHealth, eventually finalizing on the process flow illustrated in the picture below. The process flow we are implementing conveniently allows our partner NGO, the Karnataka Health Promotion Trust (KHPT), to expand the model and work with the government’s Integrated Disease Surveillance Project (IDSP) to improve existing epidemic surveillance, detection, and response systems. SendHealth has established the contacts, network, and awareness within the government to enable KHPT to use government resources, should KHPT determine it is advisable to do so after the initial pilot is implemented and adequately tested. In the process of distilling our process flow and consolidating our findings from primary and secondary research, we have been able to see how committed KHPT is to make this innovative pilot program a success. In particular, our main contact, regional manager Venkatesh Sabnis, has been a champion of our project, pushing us forward and providing constant feedback, “local” thoughts, new ideas, and valuable contacts. In addition, having a champion is an excellent luxury because working with field workers and their supervisors can be difficult with regards to scheduling meetings, honoring time commitments, and getting assistance when visiting villages. Venkatesh has brought accountability to the field workers on our behalf, thus helping to smooth the road for us.

In the process of distilling our process flow and consolidating our findings from primary and secondary research, we have been able to see how committed KHPT is to make this innovative pilot program a success. In particular, our main contact, regional manager Venkatesh Sabnis, has been a champion of our project, pushing us forward and providing constant feedback, “local” thoughts, new ideas, and valuable contacts. In addition, having a champion is an excellent luxury because working with field workers and their supervisors can be difficult with regards to scheduling meetings, honoring time commitments, and getting assistance when visiting villages. Venkatesh has brought accountability to the field workers on our behalf, thus helping to smooth the road for us.

Picture to the right: Villagers of Kondikoppa, one of three villages SendHealth is piloting its innovative program, listening to a field worker translating our questions and explanations into Kannada.

Nonetheless, we have not been able to re-visit the three villages we chose to pilot our program. The past few days has been considerably slowing down our progress. As we write this blog, we received another notice from a field supervisor canceling our scheduled visit to two of the three villages again. The village visits are crucial: not visiting them is frustrating and requires us to do other things earlier, such as ordering laptops, modems, and cell phones as well as working on training materials. We also are awaiting our physician contacts so we can confirm their buy-in and participation in the program.

With only three weeks left here in Hubli, we have a lot to do in order to be satisfied with the progress of our project. Time is creeping upon on us and we are fully cognizant that these next three weeks will fly by faster than you can say “thali.” After a bit of a forced respite, we are ready to finish strongly and sprint through the finish line. We look forward to updating everyone on our accomplishments at the end of our time here in Hubli.

Best,

SendHealth Team

Thoughts Over Thali

Jesse, part of the Crowdsourcing team and a friend/MBA classmate, and I were chowing down at our favorite thali place close to BVB college the other day. During our lunch, Jesse asked me what my thoughts were on international business and international development work after my experience thus far in India. It is an interesting question with a personally complicated answer.

One of the reasons I chose to participate in this program was to gain international business and entrepreneurial experience. I can unequivocally say that my experience thus far has exceeded my expectations in this regard and that I made the correct decision in choosing to spend my summer in India. Nothing surpasses gaining international experience better than physically working in a foreign country. Sure, I read up on "how to do business" in India and I spoke with individuals who have worked here as well as with Indian nationals. This helped prepare me for this summer but there is no way I could have fathomed the various challenges, issues, and rewards unless I was working in India. I strongly believe the same goes for entrepreneurism; until you jump in and start working, there is only so much you can learn through coursework and readings. For me, part of my interest and passion for entrepreneurism lies in the unpredictable nature of it; you must be adept at thinking on your feet, being nimble and flexible, and taking calculated risks. No better way to further hone these skills than to work on an innovative and entrepreneurial project (in India, no less!).

On the other hand, maybe this experience has taught me that international development may not be for me. I cannot say for certain as I keep vacillating between loving it and thinking that it is not my cup of tea. I am enthralled by the unique challenges international development presents and believe the ultimate reward of empowering others to enrich their own lives is an unparalleled goal. However, how do international development individuals know they are truly making a difference? What are appropriate metrics and evaluation methods to determine "success?" How do you overcome the sometimes surprising bureaucracy that can bring a fast-moving project to a sudden stop? These are just a few issues that I am constantly contemplating and ones without easy answers. Perhaps not knowing sufficient answers is what drives me away from pursuing international development as a career in the long-term.

I guess this may be just a natural feeling in any line of work but perhaps more so in international development. If nothing else, this summer has made me even further appreciate the individuals who devote their lives to the international development field. These select, unique individuals give up a lot to try to make other lives better. Many of us owe them a debt of gratitude for making sacrifices that many of us are not willing to make.

Ken

The Confusion of India

India is confusing: strikingly gorgeous landscape, architecture, and people intermingled with sometimes curious smells, poverty, and beggars. This is indeed a land of extremes in every sense of the word. One moment, it inspires you and delightfully heightens your senses; the next moment, it drives you to madness and exhaustion.

This extends to my perception of living and working here in Hubli. At one end of the spectrum are auto-rickshaw drivers. I know they are planning to rip me off. They know that I know that they are ripping me off. Nonetheless, the same dance is done with every auto driver. And every instance, I know I'm paying a foreigner tax. My negotiating skills have vastly improved but sometimes the fact that I am arguing over 5 - 10 rupees is ludicrous. Wouldn't auto drivers rather just take my first offer, which is still more than they would receive from a local?

At the other end of the spectrum are the multitudes of people I have interacted with who have been gracious, giving, kind, and welcoming. I am continually amazed at how any one of us can contact a stranger who will go out of his/her way to help us with our requests. They will become champions of our projects, escort us around various Taluks, and feed us delectable food and drink until we burst. When contacting people I have never met in the States, it is rare to find this type of openness and honesty from strangers: here in India, it's commonplace.

Interestingly enough, working in Hubli is oddly similar to my prior experience of working in the U.S. public sector: moments of brilliance and passion followed by flashes of frustration forcing me to the brink of gouging out my eyes with whatever sharp object lies close by. Similar to working at FEMA, I have been inspired by my fellow colleagues, worked rigorously to aid the individuals our project is focused on assisting, and been amazed at the resilience, tenacity, and empathy of our Indian colleagues. And similar to FEMA, I have been astounded at the time-lags to try to accomplish seemingly straight-forward tasks, confounded by the bureaucracy, and suspicious of intentions of some government officials. Patience continues to be the key while working in this environment. Nonetheless, the people we are working with are passionate and want our project to succeed as much as we do.

The sum of all these experiences is undoubtedly contributing to a thought-provoking, often head-scratching, and invaluable month so far in India. I am excited to see what the next month has in store.

Best,
Ken

Sending Health to Villages: Expectations and Telemedicine in Hubli

We all met in Mumbai’s airport in the domestic terminal. Rolf had already been in Mumbai for several days while Breanna and Ken were on the tail-end of a two-day journey from California. We hopped on our small twin-propeller KingFisher plane and after a short journey, landed safely in Hubli. Immediately after stepping off the plane and into the smallest airport we have ever seen, the realization hit us: we finally made it to Hubli/Dharwad!

USC Innovators SendHealth Video 1

The USC Global Impact Teams had been meeting since January to brainstorm, identify, and plan our projects for our summer in Hubli/Dharwad. Months of preparation led us to expect the unexpected; our projects would change and we would face challenges but we would be ready to find ways to succeed and overcome these obstacles. It is hard to believe how quickly the past 6 months flew by and that we are now physically in India, at the Deshpande Center for Social Entrepreneurship, working assiduously to improve access and availability of health care in remote villages.

Picture to the right: The BVB-Deshpande Scholar’s House – The Innovators home for two months!

Our initial project was titled “Mobilizing Health” and focused on linking remote villages with urban doctors via a text-messaging program, FrontlineSMS. We hoped to improve upon a pilot performed in northern India that had been promising. Telemedicine, a term denoting the use of telecommunication technologies to deliver medical information and services to people and/or institutions at/from a distance, has been gaining further momentum as a means to improve overall healthcare in various developing nations. Soon after speaking with various stakeholders in Hubli, we changed the name of our project to “SendHealth” as we believe this better explains what our team is trying to accomplish with our project and because it is easier for people to remember and pronounce.

Picture to the left: Innovators are introduced to sex workers participating in programs of SendHealth’s partner NGO KPHT.

Deshpande Foundation’s well organized and helpful orientation started immediately the day after we landed. A whirlwind three days helped us acclimate to our environment and surroundings. Inspirational, thoughtful, and busy, the orientation realigned our expectations about the work culture and interpersonal relationships required to succeed in Hubli/Dharwad. Everyone reminded us to be patient and build relationships but be specific and push when you need a task to be done.

We were itching to get started on our project and to hit the ground running. To some extent, we knew yet did not know what to expect. We consistently heard that everything takes longer in India but we wanted to get our project started immediately. The team aimed to visit villages as soon as possible to determine pain-points and the need of villagers related to health. Everything starts with the villages.

Picture to the right: We found that taking photos of/with villagers are a great way to connect with them. Above a picture of Rolf showing a picture of the child to the child.

After two weeks of many productive meetings with the Karnataka Health Promotion Trust (KHPT), the non-profit we are working with, and, among others, the governmental District Health Office to learn more about their Integrated Disease Surveillance Project (IDSP), we have yet to visit our target villages. We are eager to dig deeper into the details. Nevertheless, we have seen great value in meeting and listening to doctors, NGOs, and government officials, particularly as we identify champions of our project that will take over and help scale our pilot after we leave in August.

One of the major challenges for our team has been outlining the detailed process of how our telemedicine program will precisely function. We have a vision, at a high level, of how SendHealth will work. However, until we identify the specific needs and pain points of and from villagers in person, we cannot dive into the details as much as we would have initially liked. We are learning to remember that sometimes the process details develop organically, from the bottom-up, and that the most critical component is often the hardest to get to: identifying the specific needs and pains of villagers. We want to jump into the mix as soon as possible!

Picture Above: SendHealths tentative process flow from Villager to Doctor

Overall, everyone has been extremely helpful, hospitable, and enthusiastic to assist. We are very happy to be working with KHPT and to see their passion, alacrity, and willingness to help with our project. We are also extremely pleased that KHPT already has locations in mind to replicate this program in other districts after we operationalize and work out the kinks in our project.

SendHealth is acclimatizing to our new life in Hubli. The team is ready and eager to visit villages and listen to villagers! We look forward to updating everyone in our next blog post.

Best,
SendHealth Team
Rolf Hoefer, Kenneth Kim, Breanna Morrison

Pictures Galore

I just realized that I have not posted any pictures in my previous posts. Here are a few to nibble on in the meantime:

Deshpande Center for Social Entrepreneurship located on the campus of BVB College.













Downtown Hubli at night outside Tirumala after another delicious dinner















Breanna's birthday was June 11th; we celebrated in the traditional Indian style by feeding her cake and then placing frosting on her face. Happy Birthday!