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Community Health with Penda

7/30/2015

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PictureJun presenting on cancer screening
The Bass Team set out bright and early to attend one of Penda Medical Center’s community health events. We had spent the past semester studying the role small social entrepreneurs play in Kenya’s health care sector, with a special emphasis on Penda. After spending months studying Penda’s business model and community outreach efforts, it was incredibly exciting to finally see it in action!

The community health event was held at the National Cereal and Produce Board, located in an industrial area of Nairobi. We were led inside to a large conference room, where chairs and a projector were set up. The Penda staff introduced themselves, and included two clinical officers from Umoja: one medical and one dental, and other team members involved with community outreach. When the Penda staff learned of the Bass Team’s diverse backgrounds and skill sets, they immediately put us to work! Brittany, a PhD student and pediatric nurse was tasked with leading the nutrition presentation. Jun, a PhD student in cancer biology and pharmacology was tasked with leading the cancer presentation. Penda had teamed up with the National Cereal and Produce Board’s Wellness Director, in order to raise awareness among the employees of healthy behaviors and preventative health care.

PictureBrittany presenting on nutrition and healthy lifestyles
The Penda team kicked off the event by asking the audience if they knew what stress was, and how they expressed stress. The Penda staff then launched into a discussion about how stress can affect your overall health, and that it’s important to find healthy ways to cope with it. After the stress talk, Jun stood up to lead the cancer awareness presentation. She described how cancer originates in the body, and what the signs are that someone might have cancer. She stressed the importance of frequent screening. Then Brittany led the nutrition discussion, explaining that everyone needed to be careful of their sugar consumption by limiting sugar and carbohydrates in the diet and introducing more vegetables and protein. She also talked about bringing in exercise to your routine. The audience had many questions for Brittany and Jun, and it really showed how interested people were in their own nutrition and health.

After the presentations the Penda staff broke out into three stations: vitals, breast exams, and dental checks. Employees could wait in line and receive check ups in all three areas. Penda hosts these community events in order to raise awareness about preventative health care, but also to advertise their services and find new customers. Overall, the event encouraged more open discussion on preventative healthcare and healthy lifestyles, and hopefully promoted an environment where people feel comfortable seeking healthcare.

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Kenyatta University: A Thriving Community for Social Entrepreneurship

7/24/2015

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The morning of July 9th started off like any other at one of Kenya’s top universities. Students flowed in every direction across the expansive main campus of Kenyatta University (KU) in Kahawa, just 20 kilometers north of Nairobi. A buzz radiated from students chatting anxiously of upcoming exams and for some, the soon-to-be graduating seniors, hopes and uncertainties of post-university life. But for a multidisciplinary subset of 75 students from the Schools of Business, Economics, Applied Sciences and Engineering & Technology Schools, the morning of July 9th offered a brief retreat from exam prep to stoke a shared passion: social impact through entrepreneurship.

The SEAD and Innovations in Healthcare team, in partnership with the Chandaria Business Innovation and Incubation Centre at KU, was on campus to engage with the students about social entrepreneurship. Workshop topics catered to students all across the social entrepreneurship experience spectrum. For those less familiar with the field, we gave an overview of social entrepreneurship, tips on idea generation and case studies of successful social entrepreneurs. For those more seasoned, including a host of innovators currently steeped in the Chandaria incubation process, specific tools and resources were presented to help entrepreneurs evaluate their business models and identify potential blind-spots that could stall capital procurement down the road.

The session was energized with dialogue flowing from the students who clearly demonstrated an aptitude for entrepreneurship geared towards improving their communities. Student ideas, born from personal experience, ranged from biomedical implants and diagnostic medical devices to rural/urban supply chain transformation to community building through unifying university students and knowledge sharing. Students did not shy away from asking the questions most pressing to their business idea as they peppered us on subjects like capital mobilization, creativity around sustaining revenue streams, mentorship and networking channels, and transitioning from prototype to a market-ready product or service. The workshop concluded with a breakout session that encouraged student sub-teams to pressure test each other’s ideas by walking the idea through each component in the Social Business Model Canvas. The student’s commitment to improving their idea was evident and inspiring as they eagerly presented their enhanced business models back to the broader group. For students contemplating concepts like “value proposition” and “intervention type” for the first time, one student summarized the session’s benefit: “I’ve always known I’d one day start a business but didn’t know where to start. This workshop has given me a starting point.”

As the event came to a close, departing students were provided a resource guide that detailed East Africa Social Entrepreneur success stories and a social entrepreneurship reading list to support the students in their journey. For those students (who may be reading this post) with an insatiable desire for more perspectives on social entrepreneurship, here are some more resources to check out:

  • Health Market Innovations
  • Stanford Social Innovation Review
  • Aspen Network of Development Entrepreneurs
  • Health Systems Hub  

With that, the first program in the partnership between Chandaria Business Innovation and Incubation Centre and SEAD/Innovations in Healthcare has concluded but the broader conversation is just getting started. As facilitators, we were encouraged to see that the training and tools gained from Duke span borders and cultures. The opportunity to teach this workshop was energizing and rewarding. One student recapped a workshop theme like this, “Social entrepreneurs pair a purpose driven life with hard skills to make a business work.” That is a winning formula, indeed, and the passion and promise displayed by these 75 students was resounding evidence that a social entrepreneurial spirit is thriving at Kenyatta University.


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Mlolongo: Truck Point, Sex Work and Now Healthcare

7/14/2015

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PictureBass Connection team with North Star Alliance's staffs in front of their road side clinic.
The following post was originally posted on Diaries from the Field Blog. It was written by Jun Wang, a PhD candidate at the Duke School of Medicine and a member of the SEAD Bass Connections project Evaluation of Scaling Innovative Healthcare Delivery in East Africa. Read more about the project here.

Twenty kilometers Southeast of Nairobi, there’s a small town called Mlolongo. It is a key truck point for long distance truck drivers on the East African route from Monbasa or Tanzania to Rwanda and Uganda. All of the trucks entering Nairobi must stop here and be weighed and pay accordingly. That is how the town got its name, meaning “queuing,” because of the high number of trucks(2,400/night) waiting or parked along the highway at night. Being away from home for long time, earning a low income, isolation and driving long hours all contribute to truck drivers being involved in the sex trade, which is why Mlolongo is also known for its lively night and sex work. There are 18,000 residents, among whom 1,200 are sex workers. They pay 300 shillings (~3 USD) a day to rent a room in the brothel and they earn 500 shillings (~5 USD) each round from their clients, most of whom are truck drivers. 

Prostitution is a main cause of HIV infection. In Mlolongo, HIV prevalence is 12%, compared to the average of 7.4% in Kenya. And 12% is believed to be an underestimate. A lot of sex workers don’t want to go to the clinic and be tested because of the stigma. Prostitution in Kenya is illegal, and a lot of sex workers live double lives. They struggle against poverty under the cover of darkness and gaudy eyeshadow. But they also want to be respected as human beings, mothers and spouses. 

Wherever there is a problem, there is also an opportunity, an opportunity to save lives and create impact. Several blocks away from the brothels, we saw a big sign that reads “Roadside Wellness Centre.” That is where North Star Alliance’s “Blue Box” is located. North Star Alliance operates a network of converted shipping container clinics placed along Africa’s transport corridors. These containers are painted blue, which is why people call them “Blue Boxes.” North Star brings healthcare to hard-to-reach people like truck drivers and sex workers. North Star’s staff reaches out to the community, makes friends with sex workers and provides free health education sessions, free condoms and health services. Truck drivers and sex workers have the priority to be seen first if they go to the “Blue Box,” where they can have access to not only high-quality healthcare, but also respect and dignity. 


Wherever there is a problem, there is also an opportunity, an opportunity to save lives and create impact.

PictureA brothel we visited in Mlolongo.
A North Star staff member told us, "Each touchpoint is an opportunity to promote health and save lives. We provide free condoms in every room of the clinic. If they forget to get them when they check in, they can still get them when they see the doctors or when they check out. We also give condoms to our point person in each 'hot spot' so they can give the condoms to sex workers and their clients."

Another staff member told me that he moved to Mlolongo after he started to work for North Star. He said, “You need to to be part of the community so they will trust you, not as a doctor, but as a friend.” 

During our visit to one of the “hot spots" in Mlolongo, we had a short conversation with a sex worker. She said that she was very happy with North Star’s services, and whenever there was a new sex worker joining them, she told her about North Star. Sometimes she also brought her clients to North Star’s clinic if they had health problems. Last year, North Star’s Mlolongo clinic provided more than 31,000 healthcare sessions. 

I’m touched by the “magical” power of these small blue boxes, by the amount of hope and respect created. Often times when we talk about Millennium Development Goals in the class, we don’t necessarily realize that we are talking about these hard-to-reach people—those who live remotely, in poverty, always on the go or undercover. They may not be counted in our numbers, but they certainly need to be reached in order to achieve our goals. We need public sectors and social entrepreneurs, but we also need large corporations to take the lead in their social responsibilities.

North Star Alliance grew out of the partnership between TNT and the United Nations World Food Programme (WFP). While the primary focus of the partnership was hunger, the issue of health and mobility came to their attention. Thus TNT had committed itself to responsibly address the negative impact of AIDS-related diseases within the transport sector.  With the amount of expertise and capacity they have, it is not hard to understand why North Star Alliance was able to scale up and achieve big impact. And this is a great example that large corporations certainly can and should play a big role in global health and development. We hope to see more TNTs and North Stars in our future landscape. 


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Rwanda - Partners In Health, M+E, and Nurse Mentoring

7/10/2015

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PictureBass Connections students meet with the PIH Food Security and Livelihood women's group in Kirehe district, showing their accounting ledger.
The following post was originally posted on Diaries from the Field Blog. It was written by Brittney Sullivan, a PhD candidate at the Duke School of Nursing and a member of the SEAD Bass Connections project Evaluation of Scaling Innovative Healthcare Delivery in East Africa. Read more about the project here.

“The idea that some lives matter less is the root of all that is wrong with the world.” 
​
–Dr. Paul Farmer, co-founder PIH


We spent an incredible four days exploring Kigali, Rwinkwavu, and Kirehe district generously hosted by Partners In Health (PIH), a US-based global non-governmental organization with the mission of accompaniment for the poor.  Our first day in Kigali our Bass Connections team oriented ourselves to the country and Capital city by visiting the Genocide Memorial commemorating the brutal 1994 Hutu and Tutsi conflict that stemmed after years of oppression, colonization, and ethnic division.  The country was decimated and devastated by the sadistic torturing and murder of more than 800,000 Tutsi civilians in less than a 100-day period.  We somberly followed the genocide history through the well documented museum and then were able to visit the previous Presidential Palace where the President of Rwanda and Burundi were shot down just miles from the airport on April 4, 1994 which was the spark for the genocide to begin.

Monday we woke early and drove about two hours east to Rwinkwavu and spent the day meeting with PIH staff at their beautiful Training Center.  We learned about their robust Monitoring and Evaluation programs, their integration with the Rwandan Ministry of Health, their comprehensive Population Health Implementation Training (PHIT) program (established to integrate district-level health system strengthening interventions aligning with Rwanda’s 2009 National Health Sector Strategic Plan and the WHO Health Systems Framework), how to evaluate health system strengthening programs, their Verbal and Social Autopsy (VSA) for under 5 mortality.  Finally, we learned about their economic evaluation of the health system in Southern Kayonza and Kirehe districts.  It was a packed day of M+E, evaluations, and interesting information presented by intelligent and passionate individuals.  

We were welcomed to a farewell party for one of the Rwandan physicians who is about to begin his family/social medicine residency in the US.  This was a great time for informal conversations with both Rwandan and ex-patriot PIH staff to learn more about their day-to-day life in Rwanda and what it takes to have a successful and comprehensive health-focused NGO who partners with the public sector to improve health outcomes for Rwandans.  The close-knit and hard working vibe of the staff was definitely felt both during work hours and off-duty.  In our few days, a culture of excellence seems to have pervaded PIH and we felt warmly invited into their environment.


In just a few short days we gained so much insight into the dedication and impressive partnership, innovation, and evaluation that has gone into PIH's work...

PictureDuke Bass Connections Team with PIH Team at Kirehe District Office (Photo credit: Benjamin Ndayambaje).
Tuesday we were able to drive about one hour southeast to PIH’s office in Kirehe district and serendipitously had a tour on the official opening day of the new Phase 3 of the district hospital (located across the street from PIH’s office).  We learned about two amazing programs - the Food Security and Livelihoods program - a micro-finance/social entrepreneurship program where communities form small groups or co-operatives and buy chickens to generate income (via selling eggs, or later, selling the chickens).  This has been in response to childhood malnutrition, so initially the program was started for mothers after their child was hospitalized. Thus, to prevent malnutrition hospitalization again (many times from poverty and lack of access to food) PIH and their partners decided to get to the root cause of the problem and prevent malnutrition by creating a sustainable income generating activity that was community-based and community-owned.  We visited a local women’s group who were just about ready to purchase their chickens.  They shared their story, showed us their impeccable accounting book, and we were able to see the construction of their new chicken coop.  After seeing these women in the early stages of their project, we visited a man who had grown his small co-op into a large chicken enterprise where he housed over 2,000 cage-free chickens!         

Lastly, we learned about PIH’s Mentoring and Enhanced Supervision at Health Centers (MESH) program, where nurse-mentors trained in quality improvement and mentoring techniques are integrated into the MOH’s district supervisory team to provide ongoing, on-site mentorship to health center nurses and help drive systems-level quality improvement activities.  This was close to my heart as I spent last year teaching pediatric nursing in Malawi and also worked on a mentoring program to enhance nurse mentorship on-site in clinical settings.  In just a few short days we gained so much insight into the dedication and impressive partnership, innovation, and evaluation that has gone into PIH's work, which in turn has allowed for (we think) some of their scalable success. 

Overall, our Rwanda trip was an eye-opening experience and we were amazed at the cleanliness and functionality of the tiny yet populous country (albeit in our short four days in-country).  Rwanda has a country-wide plastic bag “ban” thus, plastic litter is shockingly minimal.  Thatched roofs are also banned, so driving throughout Kigali and two Eastern districts on well-paved or well-constructed dirt roads, houses appeared well constructed with tin roofs.  We learned so much from our short visit and are excited to embark on our journey to Kenya to compare and contrast what we observed in Rwanda through our visit with PIH with the Kenyan healthcare organizations and social enterprises we will visit and learn from soon.   

Murakoze! Thank you!

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We're Hiring!

7/6/2015

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We are in search of the next amazing CASE team member – could it be you? Help us spread the word!

The CASE Director of Programs is a critical role that will help to build and strengthen CASE and lead our work on our exciting Social Entrepreneurship Accelerator at Duke (SEAD).  We’re looking for a passionate, strategic, dynamic rockstar to join our amazing team and help to build the future of CASE.  Join us as we continue to prepare leaders and organizations to change the world!

Read below for details of the position. To apply, visit:http://www.hr.duke.edu//jobs/index.php and search for requisition 400974493.

Background:

Established in 2002 as a research and education center based at Duke University’s Fuqua School of Business, the Center for the Advancement of Social Entrepreneurship (CASE) prepares leaders and organizations with the business tools needed to achieve lasting social change.

CASE carries out its work through a very dynamic, interdisciplinary team that leverages expertise, time and passion of faculty, staff and students and manages a broad set of cross-sector partnerships at Duke, across the country and around the world.

In 2012, as part of the U.S Agency for International Development’s Higher Education Solutions Network, CASE and its partners at Duke launched the Social Entrepreneurship Accelerator at Duke (SEAD) to identify and support global health innovators to scale their impact, and to engage students and faculty in related research and educational opportunities.

This CASE Director of Programs position will report directly to the Executive Director of CASE, and will serve on the leadership team and work closely with the Co-Principal Investigator of SEAD, to support strategy, operations and administration of SEAD and CASE. The position will be a full-time CASE team member with responsibilities devoted 60% to SEAD activities and 40% to broader CASE activities.

Responsibilities:

SEAD Strategic and Operational Management

  • Provide overall operational leadership to the Social Entrepreneurship Accelerator at Duke (SEAD) to ensure that the program and all objectives and activities are delivered effectively.
  • Develop and set the vision and strategy for future of SEAD programming. Work with CASE and SEAD leadership team to develop and vet scenarios, establish partnerships and conduct business development and fundraising efforts to garner resources for SEAD beyond the life of the current USAID grant.
  • Manage relationships with the key SEAD partners, specifically the US Agency for International Development (USAID), the International Partnership for Innovative Healthcare Delivery (IPIHD), the Duke Global Health Institute (DGHI), Investors’ Circle and others. Serve as a primary liaison to USAID, participating in and leading meetings and calls with USAID stakeholders, managing communications, and keeping the SEAD team informed of key takeaways and opportunities.
  • Lead complex financial management and reporting for SEAD. Manage staff and processes to ensure accurate budgeting and projections, tracking and reporting, subcontractor relationships and coordination between funders and Duke University stakeholders.
  • Oversee CASE team members with SEAD responsibilities. CASE staff deliver SEAD activities such as student programs, marketing and communications, major events, financial and administrative management, and more.
  • Participate and guide taskforces and committees critical to the success of SEAD, e.g., Research and Evaluation; Student Engagement; and others.
  • Provide additional support as required by SEAD.
  • Review, develop and implement internal systems, procedures and metrics to increase effectiveness of SEAD operations and ensure success in meeting funder and program goals.
CASE Operational Management and Reporting

  • Contribute to the overall strategy and continued success of CASE, identifying new opportunities, establishing partnerships, identifying and shepherding revenue sources and implementing such activities.
  • Set and manage strategy and operations of key CASE student and alumni programs.  This may include the CASE student fellowships; experiential education opportunities; financial aid programs such as the CASE Scholars and Summer Internship Fund; alumni engagement and more. Ensure student programming is best in class, prepares our MBA students to become effective social impact leaders and is financial sustainable.
  • Engage, support and build capacity aof practitioners. Identify and vet partnerships; identify engagement opportunities (e.g., FCCP, CASE i3 CP, mentored studies, internships) and scope projects; advise student teams and practitioners.
  • Assist CASE Executive Director in managing and streamlining processes with other entities within Duke, including Fuqua Admissions, Finance, Development, Alumni Relations and more.
  • Review, develop and implement internal systems, procedures and metrics to increase effectiveness of CASE operations and ensure success in evaluating and meeting programmatic goals.
  • Provide additional support as required by CASE.
Requirements:

  • MBA plus at least 5-10 years of relevant work experience (which may include, but is not limited to, the following: nonprofit management; Federal grant administration; university administration/management; social entrepreneurship support; international development; or, management consulting).
  • Exceptional interpersonal and communication skills including ability to present complex ideas articulately and professionally, communicate effectively with multiple stakeholders, and build relationships with a variety of diverse actors, internal and external to the university.
  • Preference for work experience with intermediary and/or cross-sector organizations involving working effectively with a range of stakeholders and ability to adapt to evolving and complex situations.
  • Ability to manage large Federal research grants including financial management, budgeting and reporting.
  • Demonstrated effectiveness as both a leader and manager.
  • Demonstrated effectiveness in both strategic and operational planning.
  • Intellectual curiosity and demonstrated interest in understanding of social entrepreneurship.
  • Interest in academic environment and higher education.
For a complete job description and to apply, visit: http://www.hr.duke.edu//jobs/index.php and search for requisition 400974493.


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The Social Entrepreneurship Accelerator at Duke (SEAD)
A USAID Development Lab for Scaling Innovations in Global Health