When problems find people

Think of innovation in health and many people conjure up images of men and women in white coats – surrounded by coloured test tubes crouched over microscopes in sterile laboratories – developing intricate vaccines or other miracle cures. Yet these tightly controlled, high cost, industrial scale operations are only one end of a very long scale. In the developing world at least, we’re increasingly witnessing some of the more interesting, impactful healthcare innovations coming from lone entrepreneurs and problem solvers. Large multinationals just don’t operate in what can often be seen as the ‘scrappy long tail’ of social innovation. Not only are few present in these markets, many just don’t understand them – or even worse they don’t understand why they need to be in them.

It’s innovation in this ‘long tail’ that has most interested me over the years, a place where people innovate out of necessity, not luxury, and as a matter of survival or ethics, not profit or markets. Healthcare often gets a disproportionate amount of attention here because people continue to die and suffer unnecessarily. In my new book, “The Rise of the Reluctant Innovator”, six of the ten chapters cover health in one shape or form. One tackles it from a data collection perspective, one focuses on massage, another on genetic disorders, another on communications between community health workers and their hospital, one on patents and access to medicines, and another on solar as a lighting solution for maternity wards. Health is broad, deep and complex, and does not discriminate, and these chapters are a very real reflection of this.

In particular the book focuses on innovators who ended up fixing something they didn’t even realise was a problem. Josh Nesbit, for example, who devised an innovative mobile communications platform for community healthcare workers (CHWs) at a hospital in Malawi, after realising that, spread over hundreds of square miles, many were as detached from the hospital as most of the patients were. By distributing recycled mobile phones to the CHWs, and setting up a FrontlineSMS text messaging hub at the local hospital, suddenly hospital workers could connect with the hospital, and visa-versa, as and when required. Savings in time and fuel were immediate, and FrontlineSMS:Medic (as it was then called) rightly gained considerable interest and potential.

The project has since grown into a non-profit technology company, Medic Mobile, and work expanded to 20 countries across Africa, Asia and Latin America. By 2013, Medic Mobile’s programmes supported frontline health workers, families and patients in 10,000 underserved communities, improving healthcare delivery for more than six million people. Tangible results continued, with stock monitoring across Malawi speeding up 134 times, childhood vaccinations in India jumping from 60 percent to 90 percent, and infectious disease surveillance halting outbreaks. Not bad for a project which cost a few thousand dollars to get going.

What’s interesting about this story is that these types of communication challenge are a classic ‘low hanging’ fruit in healthcare. While much of the focus and money looks to solve the bigger, complex problems, many of the simple (yet equally as critical) ones are ignored. This needs to change, and thanks to lone innovators such as Josh – and others featured in the book – it thankfully is.

Josh is one of my ten ‘reluctant innovators’ because he saw a problem he never expected to encounter, and which bothered him to such an extent that he simply couldn’t turn his back on it. None were looking for a cause to occupy their time and dominate their lives, and in many cases they were fairly happy with life before the particular problem hit them. By taking on the challenge, though, and not turning their backs, they knew their lives would never be the same. And because of that, taking it on was never a decision made lightly, even if it was made for the greater good. 

Although the rewards of a successful career as a social innovator can be significant, for all the romance of the discipline it is an often difficult, frustrating and lonely journey, and far from romantic. The very fact that someone would choose this path over one much easier speaks of reluctance. The easy option isn’t the one they took.

We need to make sure that when people do take on these problems we have the right systems in place to fully support them – tangible things such as mentors, networks, access to funding and technology support. Not only because it’s the right thing to do, but because we have to if we’re to attract some of the brightest minds to the discipline, and keep them there.

For further details on “The Rise of the Reluctant Innovator” check out the book’s website. http://www.reluctantinnovation.com

-Ken Banks, Founder, Kiwanja.net, Ashoka Fellow

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