Food Processing - First Few Days

Day 2:

We arrived in Ghana yesterday after a delayed flight from the weather at JFK. Unfortunately upon arrival we found that a good portion of our checked luggage was never loaded on the plane and was still in New York. Our late arrival and lost luggage lead to a change of plans, but we always make a goal of staying flexible on our trips, so when we arrived at ITTU today, we got to work and started our planning for the rest of our stay. We plan to shoot and co-design training materials, open bank accounts, fix machines in the filed, and start our production up and running again (which means we’re on the hunt for a new motor!).

                In the afternoon, we started the hunt for a new motor after asking for leads from ITTU’s manager. This was our first exploration out into Kumasi. Everything is sold in shops that specialize in unique products. We went to four different shops that sell air conditioner motors to track down what we wanted. Unfortunately, finding a motor the correct size was even more difficult than I originally imagined. Most of the motors were much too small (Ghana has a lot of air conditioning, but it is mostly single room units). Although we did not find what we needed on the first try, I think we will eventually find what we want. Where there’s a will, there’s a way.

Day 3:

                Today was filled with so many things. Both the technical and business teams were kept busy with brainstorming ideas for logos, working on the training manual, sourcing motors, making new bearings, and planning for our trip to the villages.

                On the technical side of things, we made some new bearing assemblies with bearings we brought with us. Unfortunately the bearing inserts compressed when they were pressed in, so we had to rebroach them. Machines at ITTU are much older than the ones we are used to at Olin. The arbor press was quite awesome (I had never seen one like it before), but not quite suited for the application we wanted as it is too short for our broach and parts to fit. Despite this, we were able to make it work, though we found out first hand that we do not want to continue with this manufacturing method.

                We also made a surprising insight about our wooden heads. We want to switch from plastic to wood for our heads to save on costs, so we tested a few things last semester about the wooden heads. When we arrived at ITTU, we found that one of the wooden heads made on the last trip had shrunk so much that the metal tooth sheet came off. We think that it is because the heads were made in the wet season, and we are now in the dry season, so the moisture content of the wood has dramatically decreased. This is something we will be investigating in the future.

                                       

                                                    Washing cassava for the training video.

On the business side of things, we are working on training materials, which are very important to making sure our machines do not break in the field. A major cause of our graters and presses going down is from improper maintenance and cleaning. To mitigate this, we are working on training manuals and videos. Today, with a grater, some cassava, and a makeshift tripod we filmed a practice video showing how to properly grate cassava and clean the machine.

During the filming, we were met by college students participating in the Innovate Ghana competition who came to visit ITTU. It was exciting for them to see college students doing similar projects and what is possible if you care about something so much. It was especially awesome to see Debbie (our CEO) interact with students not much younger than herself striving to be entrepreneurs and make change in Ghana like she is.

  Debbie said that women are not known to run machines or be entrepreneurs, let alone start a machine company. She is now a role model for other young people, especially women who want to make a difference in Ghana.. We look forward to seeing QueenTech grow and develop over the next couple of weeks and meeting the people we are directly impacting.

Vietnam Global Health - Visit to Samaritan's Purse

On Friday January 12^th our team had the pleasure of visiting Samaritan’s Purse’s Vietnamese office where we met Emily Arneson, health and nutrition program manager, and Matt Swenson, the director of SP’s Vietnam programs. SP is a Christian NGO focused on emergency relief and disaster response. Their long term focus in Vietnam surrounds maternal/child health (malnutrition), training (of birth attendants), agriculture, and working with the healthcare system.

All of SP’s work in the country is in partnership with the Vietnamese government: “The government is always here so in some ways the partnership ensures continuity” (quote from Emily Arenson). Their projects mainly begin following government requests for assistance, which also imposes staff and monetary limitations on their work. One example of an approach was the donation of MTTS’ medical equipment to Quang Nam Hospital. The Quang Nam People’s Committee approached SP about a medical equipment donation, and the organization then researched devices and sought headquarter budget approval. For each device the procurement team needed to quote at least three different brand options. Some of the metrics for choosing devices mentioned by Emily were: durability, including warranty and service plan; ease of repair; total cost of ownership; training; price; and contextual understanding. MTTS devices were chosen largely because of their price, quality, and location – supporting local manufacture was an important additional means of generating impact through this project.

Presentation of the Otter to Emily Arenson.

Demonstration of Otter functionality.

When asked about issues surrounding their work, Matt mentioned that tracking impact was the hardest part, and that they wanted to devote more thought to questions like: “what are we doing, is it effective? Useful? Impactful? Do our activites bring about the change we envision?” I find these questions to be very important. They should be kept in mind throughout the development of Otter to ensure that teams remember what it is we are working towards. Overall, it was incredible and inspiring to hear such experienced humanitarians talk about their work and vision. 

ADE team, plus Hoi and Hai of MTTS, outside of Samaritan's Purse office.

-- Written by Helena Donoso

The Key to Designing a Successful Solution: Listen to Your Stakeholders!

Written by Nicole Ciavola

“... it will save the patient money…” said the nurse at Ha Nam, a provincial hospital in Vietnam. My ears perked up immediately because I had been waiting for an insight into what our stakeholders, NICU staff at low-resource hospitals, cared about most. I was there to learn what they needed, what they wanted to accomplish, and how they measured that progress.

The question of how to identify and solve customer needs is the single most important question in entrepreneurship. The product or service a business is offering must solve a real, present problem for stakeholders if a company wants to create value. Unfortunately, many companies allow their focus to drift and instead prioritize making a snazzy product, courting donations, or any myriad of distractions. If you want to create a solution that will make a real difference in the lives of your stakeholders, you must listen to and understand their needs.

Understanding customer needs can be made more applicable when you look not only at what problem your customers are trying to solve, but how they measure the progress. Professor Ben Linder, one of the professors for Affordable Design and Entrepreneurship, a joint course between Olin College, Babson College, and Wellesley College, brought this concept to my attention. The course enables students to work on a social entrepreneurship venture in industries from Community Development to Global Health. Each project is developed in conjunction with global partners, which helps students engage in the cultural context of the places they are trying to solve problems within. Understanding the on-the-ground situation is absolutely critical when working to solve any problem, especially those that surround development. Many excellent initiatives to solve global issues have failed due to a lack of understanding of both what matters to stakeholders and the reality of the countries they are trying to serve.

During a team presentation, Professor Linder asked my team and I what “currency” our stakeholders cared about. By this he meant: what progress did they put value on, and what metrics did they use to measure it? If we understood what they cared most about, we could design our solutions to fit into their goals. Everything we do should be serving the customers’ end needs, and our communications should highlight the value we were bringing to them.

ADE Student Kai Levy leads an interview with the doctors and nurses of Ha Nam Provincial Hospital

In the case of the nurse at Ha Nam, she cared about giving effective treatment as efficiently as possible, to both cure her infant patients, and save the families money. Therefore, for me to engage what she cared about, our team would need to offer a product that would treat more babies, much faster, than they currently were able to. Thankfully, we were able to deliver that. Our team is working on eliminating hypothermia during jaundice treatment in low-resource settings, with a combination product called Otter and Firefly. Due to Firefly being a double-sided phototherapy device (the treatment for jaundice), it cuts treatment time in half. This means that, at minimum, every family will save 180,000 VND. Otter/Firefly meets the nurse’s need perfectly: treating the infants effectively and safely, and saving families significant money.

Stakeholder centricity is key to any successful product or service. It doesn’t matter how fancy the gadget, beautiful the design, or brilliant the business model, if at the end of the day it’s not what your stakeholders need nor want. Therefore, next time you are trying to solve a problem, ask yourself: What is the currency of your stakeholders? What do they care about? And how can you, when trying to solve problems in their context, communicate that in a way that they find important?

Food Processing - Cape Coast, Slave Castle and Accra

After six days of hard work at ITTU, we packed up into an AC tro-tro for a long ride to visit the slave castles at Cape Coast and Elmina. We first stopped at Elmina to look at the bay and harbor. 

Elmina Castle

 Fishing bay at Elmina

 At this big fishing bay there are Ghanaian frying little fishes right from the sea, buckets of crabs for sell and many other seafood.

Fishing harbor at Elmina

 Then we headed to Cape Coast castle for a tour. We first toured the museum for 20 mins to learn about the history of the triangle slave trade and Ghanaian Culture. Then, our local tour guide led us into the underground dungeon where thousands of male slaves were kept for months in the space of a 3 bed room apartment. The only light that comes to the basement space is through two tiny windows high up. Food was thrown in from the window, and sick slaves were left to die lying on top of each other. Many were kept for up to 6 months before going through the tunnel to the gate of no return, onto ships for America.

Entrance to underground slave dungeon

The English church right on top of the male slave dungeon

 Unbelievably, many English people go to a church right on top of the slave dungeon every Sunday. The governor's spacious house is also located on top, his single person taking up more space than a thousands slaves. Besides, he had the privilege to pick any female slave for the night.

View from the governor's home on top of the slave dungeon/ Harbor where the slaves were shipped from

This was a heart breaking and unforgettable experience. The cruelty against humanity reminds and nudges us to be compassionate and kind human beings.

After the visit, we rode to Accra to have dinner at a Cote d'ivoire restaurant with some friends. For the night we stayed at Ben's friend house. The next day we went to the cultural arts market and bought some beautiful African paintings, bags, hats and earrings. Then, we packed up and headed to the airport. We also bought lots of Ghanian chocolate both at a grocery stand and at the airport (pro-tip: at the airport they have a Ghanian store that sells many flavors of Golden Tree Chocolate (entirely Ghanian). So don't spend all the money at Duty Free). Ghanian chocolate tastes very original and delicious!

We have learnt a lot in Ghana and everyone of us is thankful for the experience. We are moved by Ghanaian's open and friendly nature and made lots of good friends that we will stay in touch with at ITTU. There had been some hard times that required us to be flexible, But that also contributed to giving us more perspective for the future.

Jun 3rd, 2017

VIETNAM GLOBAL HEALTH: VISITING YEN MINH HOSPITAL

Today and yesterday we made the 9 hour trip to visit Yen Minh, a referral hospital nestled in the mountains of northern vietnam that is much more similar in terms of treatment capabilities and resources to the district hospitals we have had in mind while designing Otter than previous user visits the Global Health ADE team has been able to conduct. This entailed plenty of gorgeous scenery and valiant battles with car sickness on the twisty switchback roads, but we managed to make it in one piece!

Caption: Gorgeous scenery nearing sunset while driving amongst the mountains of northern Vietnam.

Upon arrival, we were able to meet the Director of the hospital and offer our thanks, before touring the NICU and the Labor and Delivery wards with the Director of the NICU (Thi Minh Nguyen) and several other doctors from those wards. We saw some great examples of how the equipment they had was being used, such as positioning aides, the temperature probes on the incubators being plugged in but not attached to the babies, and a repeat of Firefly having a hospital gown draped over it because it was directly below the AC unit.

Caption: A patient at Yen Minh hospital napping in the incubator, with temperature probe plugged in… and coiled up to the side. Broken, perhaps?

Unbeknownst to us, our interview was to be with what seemed like the entire department of the neonatal ward! While a little intimidating at first, this meant we got some really valuable feedback from a whole group of folks and captured a number of useful back and forth conversations between the doctors-- thanks to our amazing and persevering translator Hoa Dang Thanh and MTTS liaison, Engineering Fellow Chloe Nguyen.

Caption: 11 people giving us great feedback on the interface of Otter… simultaneously.

It ended up being a very fruitful first visit (by either ADE or DtM!) with lots of great insights and answers for some of our persistent questions. Excitingly, the staff of Yen Minh believe Otter would enable them to extend Firefly treatment to some premature newborns and others newborns who need additional warming, and they also showed interest in Otter as a means of keeping a baby warm next to its mom.

Yen Minh is the first hospital we’ve ever visited that reported power outages, and they independently asked about getting a battery power source to help them get through a typical 2 hour outage with some active warming still available, as their only current recourse is abundant swaddling and waiting. Fortunately, it just so happens that both MTTS and DtM are both working on battery projects for situations just like this, with MTTS hoping to make theirs charge from either AC or solar after having visited hospitals in Nepal.

We also encountered for the first time a preference for the interface to be mounted along the long side of the bassinet-- possibly because their single Firefly is oriented with the long side facing the healthcare worker and not on a wheeled cart like we’ve seen in other hospitals. We definitely have some good future iteration on iconography and the form factor of the interface cut out for us-- for one thing, in this context, our ‘too cold’ snowflake was interpreted as a fan. Oops.

Caption: A patient at Yen Minh receiving treatment in Firefly, under the cover of a draped hospital gown as this Firefly is positioned right underneath the AC unit.

At the end of our visit we were thrilled to hear that they would be willing to have us out for a longer visit in the future, and with the keen feedback and discussions we had, we are looking forward to coming back with our next iteration of Otter.

Food Processing - Community visit!

After a week of work at ITTU, the team was very excited for our community visit trip this weekend.

On Saturday we packed the tro-tro to leave for Konongo at 7:30am. Konongo is a market town in the center of the village’s communities. Here we stopped at a local bakery owned by our partner’s family and picked up our partner to help us translate throughout the trip. We also got ingredients for dinner by squeezing through a small open market, as well as mattresses for the night.

tro-tro with matress packed on top at our overnight stay

Peanut butter (left) at the Konongo market. In Ghana, most foods are wrapped and sold in plastic bags.

Then we departed for the three villages Wyaso, Nyanpenase and PKK, where we looked at the women’s machines and fixed any issues in the hot sun. Children in the communities crowded around us as 'O bruni' (foreigners) is a rare sight for them.

Wyaso village, the first one we visited

At Wyaso a nut on the lead screws of the press came off so we changed 2 handles with new nuts onto the lead screws. We also collected samples

At PKK, we met with one of the most productive user of QueenTech’s machines Auntie Ak in her yard.  Her machine had several issues: it was overheating so rust and bearing rubber was oozing out of the bearings, and the weld on the foot broke so it was re-welded in an incorrect way. We decided to take away her machine with us to fix it.

One of Auntie Ak's son using a good grater to grate cassava

From left to right: QueenTech's program manager in Ghana, a friend who owns a bakery in Konongo who translate for us on the trip, Kinsford, Auntie Ak's husband who is an agricultural extension officer and Ben

Auntie Ak with two helpers tying up a bag of cassava to press

Then we headed to where we are staying overnight. The women there cooked a delicious groundnut stew with rice balls and yam chips for us, which we enjoyed in the twilight. We also had fun hanging up bed nets in creative ways. All the Oliners slept on the patio outside the main house, while the others slept in the rooms inside.

The yard we stayed at for the night

Groundnut stew with garden eggs and chicken

Bednets we hang outside on the patio

On Sunday we visited another community Adomkrum, where QueenTech has three owners Auntie H, A and R. Auntie H is our first customer. She has a great fashion taste and takes care of her machines very well. In Adomkrum the tech team fixed issues on Auntie H's machine and checked on R's machine. The business team interviewed Auntie H and R for a potential funding partnership. When asked what is her dream, Auntie H said she wanted to produce more and more gari. She mentioned that high schools now include gari as their lunch and she wants to supply for that. The more gari she produces, the more she can provide for her own children (which she has many). Queentech's program manager also had a successful conversation with A's husband about payment options, and received some money from him for grater loan repayment!


Auntie H and her husband

Regina with her grater

One of the many cute goats munching around freely in the villages. There are also many chicken (free running) and other animals, along with the children.

We have accomplished and learnt a lot on this trip, as well as met many hardworking and warm people (including the queen users). After two long days in the heat without showering, we headed back to the guest house for a cool shower and rest.

VIETNAM GLOBAL HEALTH – GROUNDING OUR WORK IN FEASIBILITY

The next couple of days mark the era of road trips.  I am currently sitting in a seven-seater car with Hoa, Chloe, Elizabeth, and Maire -- on our way to Yen Minh Hospital, 9h north of Hanoi.  The plan is to arrive in the evening, get some rest at the local hotel, and start Friday morning with our interview.  Another 9h trip back to Hanoi, a brief weekend respite, then two hospital visits on Monday.  We will need to process each interview right after they occur, so that we can adequately adapt and prepare for the next.

But all that has yet to occur. Olin's design curriculum unintentionally emphasizes gauging product/service desirability as the most glamorous aspect of these trips -- the criticality to product/service adoption, the rigorous interviews (and the resulting evocative photos!), the pivot-inducing insights. And considering Olin is an engineering college, we must actively check our impulses to create features for technology's sake.

But, feasibility (can we realistically make this?) and viability (can we stay in business?) are as equally important. Working with MTTS has therefore been a boon, because the ADE Global Health team has been able to explore design-for-manufacture and business viability in the context of an already-existing infrastructure and support system.

Source: Pinterest.

Because our visit to the district hospital Moc Chau fell through due to security concerns, we've spent two days, not just one, at MTTS. The cancellation was disappointing, but it bought us time we otherwise would not have had to review IEC's alarm standard and brainstorm a control panel that more holistically integrated alarms. And as scheduled, we: (a) brought our MTTS liaisons up to speed with our spring semester progress, and (b) solicited advice on design-for-manufacture and product point-of-view. These sessions will be key to situating next semester's engineering and design work.

DESIGN FOR MANUFACTURE

Greg (CEO, MTTS), Chloe (MTTS), Maire (ADE), and myself (ADE)
hovering around Greg's laptop, trying to distinguish response from echo

Challenge:  How to cost- and time-effectively embed the heating element into the bassinet?

We called e-BI, a vacuum forming broker located in China that currently handles Firefly bassinet production, to investigate the possibility of embedding the heating element directly into the bassinet as it is being vacuum formed.  This process would – if proven technically possible – would reduce the number of intermediary post-production steps and time between raw material and finished product.

After some back and forth, the e-BI engineers promised to deliver a range of proposals to MTTS next week.  Though we did not leave with anything definitive, the phone call, conducted over Skype, laid bare the challenges around brokering international manufacturing.  The internet lag and persistent aural echo was compounded by translation challenges: we would explain the product concept in English to e-BI’s project manager, who would translate into Mandarin for her engineers.  The engineers would ask Wendy clarifying questions in Mandarin, which she would translate back to us in English.  We spent a lot of time waiting for translation and fiddling with Skype settings, but I was particularly frustrated because though I could certainly *understand* the Mandarin, I don’t speak the dialect well enough to articulate a response past casual conversational.  When we ended the call, Greg sighed, “You see, this is why we try to keep manufacturing in Hanoi.”

Steffen and Trong said that this PCB, measuring a mere ~5" x 2",
is more than capable of filling all our electronics controls needs.

Challenge: How can we shrink PCBs to afford freedom in form-factor design?

Steffen and Trong, engineering leads at MTTS, stated that the relatively small PCB (printed circuit board) pictured above would be capable of powering all our electronics control needs, from heating element power management to button and LCD screen control. So far, we have been using Arduinos and other hobby components -- components that are bulky and, if scaled for the manufacture level, very quickly expensive.

By assuming this small PCB size, we give ourselves freedom in developing form factors for Otter's control panel because we have fewer and smaller components to house.

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These were just two of the many conversations our tiny team has held regarding product feasibility in the past 48h. We are truly fortunate to be working with MTTS. <I need a stronger conclusion here, indicating how all of our insights have allowed us to move forward. Especially since we are good at the horizontal, but not the verticals of T-shaped expertise.>