Follow the adventures of PSU students in India

The consultancy project that I was on was for the CARE Rural Healthcare Mission (CRHM). My team members Ali and Katie both have health care experience, I do not. But with our leaders thinking I'm good with systems, I supposed they had their reasons and I was happy to do it. My earlier surveys had been on health care and drinking water, and made for good background for this project. Some of our survey questions had been:
- Do you go to the doctor when you are not sick?
- Do you think medical care is affordable?
- What do you see as the biggest health problem of the village?
- Do you always have water facilities at your house?
- Where do you get your drinking water?
- What is your household income?

Our last day in the villages around Bhimavaram we started our project while other groups looked at water and virtual services. We were able to interview a Village Coordinator (VCO), a medically trained woman who staffs the local hospital to provide tests and medications for chronic care as well as basic primary care. She maintains close contact with a doctor who also visits the clinic for several hours each week. They can also use a cell phone or the virtual services camera and television located nearby to communicate in real time with a remote specialist if necessary. One of my early word confusions involved “hospital”. On the village level, it seems that any medical facility is called a hospital. We would probably call it a clinic, as it had no overnight beds or staff and no complex procedures were performed there. It just felt odd to me to refer to the “hospital” and not mean a big hospital in the city. Or actually “town” as Bhimavaram was called.

Once back in Hyderabad we met with Garish Babu, head of the CARE Rural Health Care Project. He had already sent us an informative power point, and went over questions we had as well as provided us with more data. We toured the Hyderabad CARE hospital, and saw the other end of the virtual services system. The head of the telemedicine department told us that 60 – 65% of the patients don’t have to travel to cities because of the technology.

Our third day of the consultancy we once again visited villages, our last chance before leaving India. Internet research can be done from anywhere (with a high-speed internet connection) but the primary research of talking with villagers could only be done while in India. On a side note, I was impressed with our internet access while we were in India. Especially the wireless access in our Hyderabad hotel, the Athithi Inn. I found myself sitting in the dark in my room one day, with just the light from my netbook’s screen for illumination (the window looked on the neighboring building, just a few feet away). When the front desk called to say that the electricity would return in an hour, it occurred to me that the internet still worked. I saw that again a few days later in a rural call center. The lights went out, but the computers stayed on. I also noticed a room full of car batteries wired together, what I suspect was responsible for the continuous computer power.

Anyway, on our last village research excursion we asked questions like:
- What time is it easiest for you to go to the doctor?
- How do you currently get your health information?
- How do you prefer to learn about health issues?
- Would you be interested in a program were you pay in at the beginning of the year, then if you or your family got sick or hurt you could see the doctor for free for a whole year?

We’d learned by this time that village people don’t go to the doctor for regular checkups, many times before we had heard “Why would I go to the doctor if I’m not sick?” This was research into specific areas of our consultancy project. Finally we put together a presentation for our client, given on my last day in India.

Still to come is the secondary research (thank you internet), number crunching, and final report preparation. I just hope it will be of some use to Garish and the CRHM.

Our whole last week in Hyderabad has been focused on consultancy assignments with local NGOs working on a variety of issues – and helping them to craft a plan that involves social enterprise. I was placed in a group of five students assigned to the LSN Foundation – who work with different disenfranchised groups – homeless, disabled, elderly and street children in many, many different ways. We were asked to focus on the PWD (persons with disabilities) portion of their work – and assess the effectiveness of their job placement and training programs, as well as their annual event the Abilities Mela – which is used as a platform to connect people with disabilities to different industries and services provided by the different organizations serving this community. There were two of us, myself and Brian, tasked to this endeavor, with the other three working on micro-entrepreneurship with the disabled, and product development opportunities.

This was quite the experience. Having come from working in a successful training program working with a disadvantaged population, I felt like I would be coming into something I was somewhat familiar with, and could provide educated suggestions. Brian and I came up with a fairly extensive set of recommendations for their employment and training strategies after interviewing successfully placed candidates, those that were still unsuccessful and a wide range of training institutions and corporations involved in hiring PWD’s. One of the suggestions we had to make was dropping their entire training program altogether – which I knew was the right way to go for the organization. Although I was originally excited to help them formalize their training program process, I knew that from my experience and what LSN’s perceived goals were regarding this population that the ability and capacity to create a robust training program and adequately serve the needs of the wide range of PWD’s they work with was not present.

Before we left, we gave a presentation on our work thus far to our class, and representatives from all the organizations that different groups worked with. We had some hard hitting recommendations, but unfortunately, only the consultant who we worked with attended – there were no actual LSN staff present. It will be an interesting process once we are back in the US to see how much interaction we are able to encourage so that we can come up with something that is actually beneficial to them, and not just an exercise for us. The learning process is a part of why we are doing this, but it would be hard for me to finish our report knowing that it wouldn’t be used. That would just be very disheartening. I came on this trip because I hoped that the deliverables we created would actually go towards making some positive change. I have high hopes that we will develop some really tangible and exciting opportunities for the Foundation, so I look forward to hearing feedback if that chance arises.

Overall this experience has been amazing – it was hard and tiring and frustrating, but I feel like I am coming out of it with a new set of skills – both personally and professionally, a new perspective on the work of both NGO’s and business, as well as a commitment to come back to India. The people here are amazing. I have never met such generous, kind, funny and thoughtful individuals. I hope to hold on to that image of this gigantic city teeming with humanity, where you can ask any stranger on the streets for directions and not only will they direct you in the right way, they’ll lead you through the traffic to your destination. Or, the woman living in the slums who walks blocks and blocks to meet you, and then takes you into her home to serve you tea. And the people that graciously took time to answer questions from groups of American students who don’t speak a single word of Telugu, and did so with enthusiasm.

A small subset of PSU Magic Bus India 2011 students arrived bright and early at LSN foundation HQ office, ready to make a difference. As we began our dialogue with the hosting organization, we quickly realized that there was not a scope well-defined, if one could call lack of scope not well-defined, and our team would need to begin unthreading all the tangles lines of intersection that wove into and out of the project to which we were assigned. If we didn't get a handle on this project fast, it had the potential to become a bit unwieldy.

To be fair, we were introduced to the project, through documentation that was received prior to the kick-off meeting with the client. We all briefly perused the documentation and felt the information received was sufficient to understand the foundation from which our work would be built. We would be focusing on a particular component of LSN called Abilities Mela that has focuses on person's with disabilities. Abilities Mela was is an annual event that serves as a platform to bring together NGO's, government, and corporate institutions for the benefit of person's with disabilities (PwD's). During the event PwD's can attend seminars, learn how to make products, get access to information that further promotes opportunities and benefits that are available to their specific target group and network with others that shared common struggles.

During our kick-off meeting, we asked the client for the specific outcomes that were requested so we could begin to understand what deliverables would be due at the completion of the assignment. The client was not prepared to answer this question and it became more and more apparent that the scope and the deliverables would have to be determined by the team. With only two and a half-day to nail down preliminary finding, this put the team in a state of stress. Add to it that the client was not prepared for us to start any work that first day only adds to the uncertainty of success.

We hoped for the best and headed out in search of people that could give more insight into where we might begin with the project and our unanswered questions of how/where improvements could be made. First, we meant with MEPMA, the government arm that is responsible for formulating strategies to implement poverty reduction with the urban poor, to include PwD's. The meeting was informative until the point in time that they insisted we had to meet with their boss and then insisted we come back the next day, since they promised to provide requested documents during the next day’s visit, we were held captive to the meeting. Hmmm, potential schedule conflict to mitigate and we hadn’t even delved into the project yet. Next mission – meet with manager of MESH, a company employing PwD’s in self-help groups that comprise a successful micro-enterprise selling products. The interview was insightful and our team was encouraged to find a successful venture. The interview ended around 6:30 pm and the team headed home for the day. On the way home, we evaluated the agenda for the next two days and quickly realized that if we stuck to the agenda, our objectives for the project would not be met. Time to reformulate our action plan.

Upon arrival at the hosting organization office the next morning, the team was able to talk to the coordinator and communicate the importance of interviewing the target audience. The coordinator understood our needs and removed a few meetings so that we could focus on only those meetings that proved valuable. Due to our tight schedule and the limited value that would be realized, we had to decline the government meeting set the previous day and hope and pray that they would still provide the needed documentation. Instead of visiting with government officials for the day, we headed out to a colony that consisted of a newly formed SHG. This SHG had been borne out of last year’s Abilities Mela. Meeting with these folks was invaluable, even if the LSN consultant skewed the meeting a bit. Our first meeting of the next day was with another NGO that ran a training program aimed at training PwD’s with skills that could be utilized in the workforce. We met some of the students and were able to analyze the products. The final interview in the allocated time was with a member of management from Dr. Reddy Foundation. During the interview, many lessons learned were exposed that can be included in the final report.

We left a bit disappointed that we never had the opportunity to meet with some unsuccessful PwD’s as we know they existed and existed in mass. With limited exposure to the whole truth, it becomes difficult to completely understand the levers in the system. However, even with limited knowledge there are many recommendations that, if implemented, can begin to make a noticeable difference towards improvement.