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!

Time....

Time....

Time has been a constant motif that I have identified throughout my brief stay here in Hubli, India. I had to adjust to the TIME change the first few days I was here, which had me a bit tired in the beginning. We are also reminded on a consistent basis about our short 2 month TIME limit for the implementation of our projects. "India TIME", however, is by far the most difficult concept to adjust to.

"India TIME" can be best explained by our experience yesterday when we attempted to meet a representative from the NGO that we will both be working with. We scheduled the meeting for 11. We left to go to Dharwad, the location of the NGO which is 45 minutes away, around 10 but we did not start our meeting until 2 pm! First, we attempted to have our contact pick us up from the bus stand when we arrived in Dharwad. He asked if we could meet at MG bank, so we took a 15 minute bus to get to the bank. After waiting at the bank for 45 minutes, we attempted to call our contact, but unfortunately his phone was turned off. We decided to look for the office ourselves using the address we had. We asked numerous people on the streets, all who were very responsive in attempting to help us.

We walked in circles for another 40 minutes until we came across someone who knew the location of the NGO, Bhoruka Charitable Trust. We follow the person, only to find out that the NGO was a 1.5 minute walk away from where we were the whole time! Of course, when we arrived, there were no issues about starting the meeting late. This is because there are certain events and factors that may occur here that one cannot pre-plan for. Therefore a 9 o clock meeting may start anywhere from 9 to 11!

Time has been a very positive concept today, however, in regards to our productivity in a number of important extensive meetings today. Our first meeting was at Karnataka Health Promotion Trust, which is a grant making organization for BCT. (The meeting was supposed to start at 1, but it didn't start until 2:15...) We brainstormed about changes that we could make to our program to use the existing health infrastructure in the Dharwad District. KHPT has begun to implement Village Health Committees, which consist of 10-15 villagers in each village that have been identified to establish a community based initiative to promote general health in the area. We can possibly utilize them as our village health directors. We were also informed of a government program that is also providing telemedicine in the area,but which is lacking on the community involvement side, something that we can provide in our pilot program. In addition, the NGO agreed to identify 10 villages that we can begin implementation with by this Monday.

Working in an environment with other innovators has really been beneficial to our project as well. Having discourses with like-minded thinkers has brought out some great ideas. One of which came from a meeting with a UC Berkeley Innovator, Anu, who is working on a Water Outsourcing project in urban areas of Hubli-Dharwad. She suggested restructuring our program to an experiment-type model. Since there are so many organizations that have attempted to implement projects similar to the one that we are implementing, what would really be beneficial to other innovators is which versions of telemedicine work and which ones dont. We can do this by trying 3 different versions of our project, keeping the same constants, but changing one factor so that be can better determine which factors are most conducive for productivity and sustainability. We were thinking about making one version a micro-enterprise, one version purely voluntary, and the other we are still researching.

We hope that this version will contribute more to the body of knowledge about telemedicine, and can help us better decide which is the best way to go about these types of programs. We hope to begin project implementation around week 3, so we are definitely working on a condensed time schedule.

Tomorrow we are going to meet with 2 government employees who work with the government version of telemedicine. They both said to come to the office at 10:30, but they both have staff meetings that start around those times, and one said "God only knows when those things end".... so we will see what time our meeting actually starts....

Until next TIME,

Breanna

End of Orientation and Beginning of Mobilizing Health

Orientation came and went in a flash. The three day orientation was a well-organized and helpful mechanism for all of the Innovators to get acquainted to our new surroundings as well as manage expectations about the work environment in India. Perhaps one of the best parts of the orientation were the site visits to local non-profits. It was inspirational to see the amazing work that these organizations were doing in a variety of fields. The non-profits served as a good reminder of why we, USC Global Impacters, are here and the work we can accomplish over the next 8 weeks. Special recognition should be given to the Deshpande Foundation and everyone who helped put together an excellent orientation session.

With the end of orientation, we moved onto our first day of working on our project. This morning, Rolf, Breanna, and I met with Abhi, an individual at Deshpande working on a project to encourage physicians to visit villages to provide health care. We were able to get his thoughts on our project as well as gain basic insight into how the medical system works in India. From there, R, B, me, and the Frontline SMS team visited one of the non-profits we are working with, the Bhoruka Charitable Trust (BCT). The meeting itself was helpful and informative as we were able to meet with the individuals we will be working closely with over the next several weeks. We agreed to have a detailed brainstorming session this Friday with a view to outline a project timeline/schedule for the remainder of our time here in Hubli.

While the meeting went well, it was a challenge to find where BCT was located. Leaving our sanctuary (Deshpande Scholar House) around 11 am, we did not arrive at our destination until 2 pm. Through a combination of monsoon, multiple bus rides, and overall confusion over where to meet, we had quite an adventure trying to find BCT. One can either get extremely exasperated at this situation or smile, know this is India, and make the best of the situation. We all choose the latter and enjoyed our mini-excursion on our way to BCT.


Furthermore, much to Rolf's delight, there was music playing on the bus to and from Dharwad. Unfortunately, there is no video of him dancing in his seat. Maybe in our next blog post.

Best from Hubli,
Ken

Safe Arrival and Beautiful Campus

(from left to right:Breanna and Saru)

All the fellows arrived happy and well this past Wednesday in Hubli. Some came from Kerala, others from Mumbai, and yet others again from Chennai. Everyone was safe and happy to arrive at the Scholars House, a complex that is currently entirely for us! Several of the fellows have their own room, and after some initial starting problems, everyone has water in their room as well. Breanna, Saru and I went out on a little morning walk Thursday morning across the College campus. The campus is large and features several major buildings from the Deshpande Foundation, notably the impressive Deshpande Center for Social Entrepreneurship, which is large and beautiful like the campus. On our little morning walk, Breanna, Saru and I were particularly impressed with the vivacity of the colors.


(Rolf)

Hubli light is different than the light in Los Angeles. Unfortunately the digital cameras don't catch the differences as well, but some of us also have actual film (cameras), which should give a much better rendition of the difference once developed.

Two more pictures from our morning walk:






Our next blog post will deal with our Orientation, but now we have to rush to visit an NGO at 6:00am.

Greetings from T5

So here I am, waiting around at Heathrow’s T5 Terminal, eagerly anticipating my flight to Mumbai. It has been a whirlwind past month for me as I just got back from Moscow a week ago. I cannot believe I am already done with my first year at Marshall's MBA program and just completed the capstone to the first year, PRIME. Travelling in Russia for two weeks was an extremely interesting, enlightening, and fun experience; now, onto India! This past week at home has flown by as I hurriedly got together everything I needed for this summer. Of course, I forgot to bring tape but better that than my passport. Besides that, I am ready for what will be an unforgettable summer.

I do not know exactly what to expect; all I know is that this will be a life changing experience for me and my fellow GIP colleagues. My current state of mind is to prepare for the unexpected and to keep an open mind and attitude. I am looking forward to getting to know my GIP friends better, meeting new individuals, and hopefully making a significant impact with our work in Hubli.

Let’s buckle our seat belts and get prepared for a wild, memorable, and fun ride!

And special thanks to the British Airways lounge being located on the second floor so I can sit below it on the first floor and bum off the free wi-fi.

Pre-Program Experience in Rural India: Installing Solar Panels!

I landed in Mumbai from Los Angeles a few days ago, and had a chance to join a group of junior college students from the H.R. College of Commerce & Economics on a trip to install solar panels in multiple villages several hours north of Mumbai. It was an amazing experience that has made me even more impatient and excited to start working in Hubli. A shout-out to Akhil and Gaurav for allowing me to participate in the sweaty work of such a fulfilling project! I'm attaching a few photographs from this past Sunday’s 22h journey as a teaser (like this blog post) of what is to come from the Global Impact team once we get going!

On a side note, I have been thinking about buying goggles because my cascading sweat notably blurs my vision. I don’t know what the villagers would think of a goggle wearing white boy though…either way, whoever invents a cooling mechanism or texture for clothing will be a billionaire! I’ve been considering getting a football outfit and then replace the padding material with ice cubes, or building an umbrella with a cooling propeller (below the arc) powered by a small wind turbine (above the arc) turning when walking in windy fields…occasional heat hallucinations: fun trivialities! :)

Test 1

This is a test of the USC Stevens Institute blogging system... thank you for your patience.