Student Perspective: Free Healthcare in Andhra Pradesh

When I visited my family after the STEM Reverse Innovation program ended, I had the opportunity to shadow my cousin Kishan who was doing his Residency in the surgery department at a government hospital in Vijayawada, the capital city of Andhra Pradesh. My family joked that I would not continue to want to be a doctor after seeing the conditions of the government hospital, but I braced myself and powered through to explore what the government of India is doing for the healthcare of the poor.

Kishan had “injection rounds” that evening, basically checking on patients and providing painkillers for pain management of post-operation patients before the attending physician’s rounds. People often say that visiting India overwhelms your senses, an understatement when visiting the government hospital. Words cannot describe the unimaginable combined smell of wounds festering in the humid heat, of body odor of patients and families who have not showered in days, of bathrooms not cleaned for who knows how long, and of expired antiseptics. Families wailed at the bedside of hundreds of patients while nurses clamored around to appease families and communicate with other nurses about patients. Visually, all of the equipment was dilapidated, from the beds that looked like they belong in a World War II movie set to yellow-brown respirator tubes. The hospital provides completely free medical services to anybody who shows up at the door, typically geared toward those at the poverty line and below. As a consequence, government hospitals are overflowing with patients but lacking adequate supplies to provide them full medical attention.

As Kishan and the other residents started filling syringes for painkiller injections, it quickly became apparent that any sterility guidelines were thrown out the window. Filled syringes were tossed on the table that was clearly nowhere near clean, much less sterile. The tops of glass medicine vials were hacked off and onto the floor for janitors to (probably not) sweep up later. Exam gloves were not even in sight. When I voiced my concerns, the residents replied that the sheer volume of patients that they go through does not allow the time or resources to be sterile. One resident shrugged off my appalled look, saying that during a surgery earlier that day, HIV-positive blood was dancing on her bare hands. Bare hands. During a surgery. They went on to tell me that I came on a good day, at the beginning of the month when they still had supplies. The hospital receives about a week’s worth of supplies and drugs that have to last a month. The shortages get so bad that syringes and needles will be kept with the patient to reuse them for a couple of rounds of painkillers. Some days, the residents are forced to inject only saline and pretend that it’s pain medicine (which often still alleviates pain but that’s not the point).

Despite such challenges, the doctors were clearly brilliant and practiced excellent medicine. We saw patients recovering from miraculous surgeries, ranging from limbs that could have been amputated to brain tumors cleared right up. Naturally, such working conditions and stress from overwork put these doctors and nurses in terrible moods, but they treated each patient with the utmost respect and embodied the humanistic side of medicine that is increasingly absent today. If the attending physicians saw or heard about any nurses or residents putting in IV ports too roughly or snarking at patients or families (even something as minor as using informal rather than formal pronouns to address), they got an earful in front of everybody. Likewise, most patients treated the doctors with respect and adoration. As soon as a white coat strolled into the room, hands go up in Namaste to greet the doctors who don’t have to work here, don’t have to put up with frequent patient and family abuse, and don’t have to endure these working conditions to help people who are way below them in caste (a system still strong in the minds of many Indians). The ability to give hope to people who have nothing is why my cousin purposefully picked the government hospital over private hospitals for his residency, and that wholehearted Namaste is his reward.

Days 16-20: Reverse Innovation Customer Discovery Projects

The objective of this study abroad trip to India was for the students to learn about the various segments of poor people in a developing country and then work in teams to develop ideas for products and services that the poor could afford, that would improve their lives, and that, optimally, could provide jobs that would lift some out of poverty.

Students in UA’s STEM Path to the MBA are taught a process for innovation and design that involves repeated, quick development of ideas, testing these ideas through customer interviews, and pivoting the idea until the students arrive at an idea that they believe is ready for prototyping.  Once a prototype is created, students go back to potential customers, in much larger numbers, to validate the business model.

On days 16-20 of our trip, each day the four groups of students (team 1: product that makes use of cattle dung and urine; team 2: sustainable clean water; team 3: container for human transport of materials; and team 4: mobile web site for coordinating employment opportunities and potential employees) traveled to one of the local villages and talked about their business idea.  These clusters of interviews typically lasted 3-5 hours each day.  During the afternoons, the groups would work on adjusting their business models to better fit what they had learned that morning.  In the evenings, we would all gather, the groups would pitch the new iterations of their ideas, get feedback, and then hit the villages again the next morning.  After five days of iterations, the students presented their ideas one last time to the group and four leaders from these local villages.

I was able to go with a different group each morning, except for the employment app group, so this and the next couple of blog posts will share sort of a day in the process.  I hope you enjoy following their progress!

 

Student Perspective: A Naan-Fiction Experience

It’s been about a week since we left India and I am slowly coming to terms with what that means. I never imagined how impactful the trip would be for me, academically and psychologically. I do not think that we could have ended on a better note, relaxing at a beach resort in Mahabalipuram after a busy week of field research in Cheyur Village.

Looking back, there are so many memories that I will cherish for years to come. In the first place, traveling to my parent’s home country for a research project for school was never something that I had imagined would be possible. I also could not have foreseen being able to bring one of my close friends from the trip to my grandparents’ house, where we were able to talk about all the incredible experiences we’d had so far.

Unfortunately I had to miss the first three days of the program, the Delhi portion. However, during my time in India, I learned quite a bit about poverty in developing nations. Too many of the poor Indians that we talked to told us that they wanted guidance and help to get out of their economic situation. It seemed that, throughout their lives, they had been told that they were not capable of helping themselves and that they would have to rely on governmental programs and external aid to make any progress. While I feel that the government definitely plays a large role in the healthcare and education of these villages, it appears they have an artificial understanding of how much the administration can do. It was heartbreaking to see how few children were able to make it to high school, let alone college. Although it was neat to see that there were many governmental programs being implemented to promote education, such as providing each student who graduated from 12th grade with a laptop computer to continue their education.

A computer is a tool that may have a high cost, but has an almost unlimited value. These are the types of things Indians needs. The same goes for traditional merchandising. Indians are very interested in buy extremely low-cost products if they are able to produce at least 80% of the effect or the full-price (or developed world) version. Speaking of money, everywhere we went, we were told that, in India, it is far more common to see women make financial decisions than men.

At first this thought seemed a little peculiar to us. We tried coming up with all sorts of deep explanations for this phenomenon, but it seemed to boil down to this: women are generally better at saving money. Since they are used to making sacrifices for the children and family, women are less prone to taking large financial risks. Although, after seeing the closets of the some girls in Alabama, I’m not sure that is true in the US.

The role of women is actually hugely controversial in India, because they are expected to take of money, but they are also far more often forced to stop school and get married early. In the remote villages, we saw a number of women cover their faces with their shawls as the men in our group walked by. One lady even covered her face as I played with her baby girl.

Because of the great disparity between men and women, a number of women self-help groups have sprung up in India recently. We talked with many of these women. We were even able to host a number of women of one group at our hotel in Chennai.

This lady was an incredible woman with an unimaginable strength. She has done so much for her village and her people and meeting her gave us motivation to pursue our research.

Ultimately we came up with 4 products that we are hoping to pursue further. Here is a brief description of them for now.

  1. Two-ply fabric made from jute and  Tyvek ® to store produce fresh longer
  2. Job app to bring together employers and employees in search of each other in rural areas
  3. Cow urine capture system to use for organic fertilizer made from cow urine, feces, and milk
  4. Low-cost water filtration system for rural India

We presented our ideas to a panel of local Indians near Chennai and they liked all of our ideas a lot. We’re going to obviously do a lot more research if we want to proceed, but it’s going to be a fun road ahead.

 

Student Perspective: Shocked and Shaped

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Moving beyond the AIME building in Alabama to rural homes in Tamil Nadu, I have been shocked and shaped.

Shocked is probably normal for visitors to India – everything from the lingering spices, the sporadic honking, the nonchalant cattle in the road, the fact that a country with constant power outages sent a satellite to Mars at almost a tenth the price of NASA’s solution, or the fact that families can’t support their daughter’s “unaffordable” college education since they must pay 10 times as much for her dowry.

Shaped, on the other hand, was probably due to where I am in my life. With a quantitative background, growing business mindset, and fortunate opportunities in America, I’ve been shaped by the potential of India. I’ve been shaped by the increasingly flat world, shaped by the 1.2 billion adapting around me, and shaped by a group of elderly women who dug up their pipeline to find drinking water. As motivated university students, we’re used to investigating complex problems, creating solutions, uncovering insights — in the same way that a 20-year-old in India is used to pumping water to last 3 days, holding a bucket to collect cow urine, or asking around for a job for weeks at a time.

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Yes, the STEM Path to MBA generates a mindset for working towards the potential of the world. This experience in the developing world shaped me to understand why we need to access the potential of the world in the first place.

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In developed countries, about 80% of the population lives on $175 a day. In emerging economies, about 80% of the population lives on $2 a day. Very quickly, I saw these budget constraints in housing, food, college education, and health. However after 2 or 3 in-depth interviews, I’ve been able to see real people and their communities at work. They are farmers, factory workers, taxi drivers, and natural entrepreneurs. Working towards a better life together, they are shaped deeply by their families, their communities, their local governments, and their spirituality. When a husband got sick, the devoted wife worked the fields to continue their income. When an entrepreneur bought a water purification system, he began selling clean water to his entire village at ultra-low costs. There are Indian villagers living on 54 cents a day who laugh more than college students. There are mothers and fathers who simply want to watch more televisions with their kids, to give their teenage daughter more privacy, or to find consistent work. Most of these poor families are not beggars, but rather generously host our large group in their humble homes (which says a lot seeing as Southern hospitality shaped my standards). The level of sincerity here shocks me with every conversation.

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Even with shocking disparities in hygiene, education, and infrastructure, a solution-based mindset shapes rural India just as solutions motivate multi-national businesses. India is ripe with opportunities as social entrepreneurs, an aggressive government, and a motivated population raise a developing nation. There are multi-generational families who strategically pool their resources together. There are women’s self-help groups who actively work to shape their villages. There is a population of people who now see their size as an asset to the world, not a shock. Everyone has problems – some people dwell on them and others look for solutions. The solution-based mindset of many savvy Indians shaped me to continually tackle problems regardless of circumstances.

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With each continually conversation, I am further shaped to continue tackling problems that affect more people than I’ll ever possibly meet. I will approach my business classes, my role in a company, my business ventures, and my relationships with urgency and depth. When visiting the Mahatma Ghandi museum in the heart of Delhi, I stumbled across the story of a man wishing to donate all his money to the poor. Ghandi instead shaped the man’s perspective by ultimately saying “make use your resources and your business for the service of the poor.”

As one is constantly reminded in the developing world, our humanity is a precious gold. With my education as a tool, I’ll work to shock and shape this malleable world.

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