Net Impact: "Diarrhea Needs a Rockstar"

Submitted by Francisco Noguera on November 19, 2008 - 17:33.
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(Editor's note: Today, November 19, is World Toilet Day, part of an awareness campaign led by Water Aid. This post is timely to stop for a second, think about and learn more a crisis that keeps 2.5 billion of the world's poorest citizens away from basic sanitation services)

Guest blogger Mike Pezone is a returned Peace Corps volunteer from the Philippines and a 2nd year MBA from The Johnson School at Cornell University.  He focuses on Base of the Pyramid business models at Cornell's Center for Sustainable Global Enterprise.  This past summer he worked in Mexico conducting the BoP Protocol to develop a water purification business model for an early stage startup.


By Mike Pezone

Water touches everything. This was reflected in the diverse backgrounds and interests of the panelists at the Saturday morning session about "innovative solutions to water and sanitation challenge".  Hailing from different corners of the water problem, panelists included Mikkel Vesterdaard - CEO of the company that created the Life Straw, Andra Tamburro - Program Director at Water Advocates (the first nonprofit organization dedicated to increasing American support for the global water problem), and Jeff Seabright - VP of Environment and Water Resources at the Coca-Cola Company.

Stan Laskowski, President of the Philadelphia Global Water Initiative Board moderated an engaging session between panelists and participants.  In my opinion the panel was less a discussion on innovative solutions and more of a call to action as each panelist cited statistics reminding us of the gargantuan scale of the current water crisis.

  • 1,000,000,000 people lack access to safe drinking water
  • 2,600,000,000 people lack access to proper sanitation
  • 50% of the schools in developing countries lack access to clean water
  • 75% of the schools in developing countries lack access to proper sanitation
  • Every 15 seconds a child dies from a water related illness

"Diarrhea needs a rockstar!" exclaimed Mikkel Vesterdaard.  I couldn't agree more.  If climate change has Al Gore and multiple celebrities have signed on in the support of HIV/AIDS, why hasn't a champion stepped up to capture media's attention for this mounting global challenge?  Two reasons, he argues.  One, diarrhea isn't sexy. And two, we pay attention to the crisis like we pay attention to background music. 

However, solutions and technologies to address these challenges exist. Resources exist. The profit motive is there. So what's holding us back? Where are we stumbling in our attempts to scale these solutions? According to Saturday's panel, it is lack of coordination. 

I will attempt to shed some more light on this by pulling together takeaways from the session below:

1. Local problems require local solutions

This is crucial and of course presents a significant challenge to scale.  Water quality, distribution, and access to sanitation can vary from community to community.    There can be no technological silver bullet as the problems persist on a community level, but the global community can aspire to develop a distribution/ coordination/ collaboration panacea that puts resources and technology in the hands of those that can put it to use. 

In an earlier session I assisted my BoP Protocol colleagues Patrick Donohue of Enterprise for a Sustainable World, Shara Senor and John Paul both from Ascension Health and Paul Gruber from the University of Michigan in an interactive workshop entitled - How to Scale Enterprises Created through the BoP Protocol.  The BoP Protocol is a business incubation process that enables corporations to generate new business opportunities through co-creation with community members.  Who better to help determine the proper distribution channels, messaging, pricing, and product prototype?  The Protocol eases coordination between both the corporation and the end user who both stand to benefit from a co-created product. 

This  Protocol workshop in particular was very much engaging and the participants generated their own ideas on how to scale BoP enterprises which proved very much applicable to the water and sanitation space.

2. Less supply driven problems,  more demand driven solutions

Andra Tamburo from The Water Advocates was adamant about this very point.  Governments, multilaterals and civil society need to ditch old development think and create more demand driven solutions for the water crisis.  New solutions must factor in local water consumption and sanitation habits, regional differences, human resources, water access, and technological know- how if they are to be sustainable.  Public policy needs to be crafted in such a way to ease coordination and to help the private sector see this as an opportunity to not only turn a profit, but to also and more importantly save lives.

3. Ability to scale requires new partnerships

Jeff Seabright of the Coca-Cola Company made an intriguing analogy between the local nature of the water problem and his company being the "canary in the mineshaft."  The enormous multinational has manufacturing plants and distribution centers spanning the globe and thus access to local information on water quality, distribution, and water stress. 

Using 300 billion liters a year, water lies at the center of Coke's core operations and the company recognizes it as mission critical.  To that end, Seabright points out that Coke's partnerships must be rooted in the company's core business to be successful. Thus, on a path to become "water neutral" Coke has forged a myriad of partnerships with NGOs, government agencies, and nonprofits to increase coordination amongst the partners and to execute on Coke's "Reduce, Reuse, Replenish" strategy.  

The session was a call for action and increased coordination amongst donor agencies, policy makers, NGOs, and the private sector.  Solving this coordination problem will not be an easy job, but opportunity exists for enterprises that can scale local solutions all the while forging nontraditional partnerships.  In the meantime "diarrhea still needs a rockstar."


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Submitted by Jenara Nerenberg on November 20, 2008 - 01:05.
Mike, Francisco, great post. 2 thoughts for you. Re Diarrhea needing a rockstar - PSI and YouthAIDS have partnered with celebrities to raise awareness and increase action in cause-marketing campaigns, especially around other dire health crises, such as HIV/AIDS. Perhaps you could give suggestions for who the participating rock star could be for diarrhea. I know Kate Roberts at YouthAIDS has started Five and Alive (child survival programs, including an initiative on clean drinking water) and I'm sure would be interested in hearing your thoughts. Re World Toilet Day - Related to the campaign, check out this story about toilets on Mt. Everest: http://news.yahoo.com/s/nm/20081117/od_nm/us_everest_toilets
Submitted by Paul Rigterink on November 20, 2008 - 09:52.
I am in the process of starting three businesses in Colombia: 1) a tree nursery and seed farm to provide seeds and nursery stock for high value food commodities and animal feed (in Los Cordobas and Cartagena) 2) a farm that demonstrates the latest technologies in backyard poultry and pig farming as well as the growing and selling of high value food commodities (in Monteria) 3) a sport club for poor people that will provide an hour of entertainment each day to create excitement and interest in the project (in Monteria and Los Cordobas). I believe my employees and customers can make a great deal of money based on the Business Process Reengineeering analysis I have done to date. For this reason I am calling the project “Mas Dinero”. The investment costs have been minimal since I am building businesses that BOP personnel can afford. However, I have two water related questions that I hope that university personnel working with BOP farmers can answer 1) How can I obtain or produce micro irrigation equipment in Colombia? 2) Is Moringa water treatment sufficient for potable water? (see http://www.echotech.org/mambo/images/DocMan/MorWaterTreat.pdf) If not what should I do to provide potable water?
Submitted by Jimmy on November 20, 2008 - 18:39.
I don't think diarrhea necessarily needs a rockstar. I think the primary communications challenge around diarrhea is how prevalent it is in the developed world, how mild the results are there, and how taboo it is to talk excrement the world over. It might be more productive to talk about dehydration, the importance of washing hands, breastfeeding, etc.
Submitted by Mike on November 22, 2008 - 11:59.
Hello Paul, Regarding question 1, check out International Development Enterprises. They have produced micro irrigation technologies that have been successful in many countries. However, I don't think they operate in Colombia. At the very least you could contact the technology specialist whose email is listed on this website. http://www.ideorg.org/technologies/index.php I hope that helps. Keep up the good work!
Submitted by Paul Rigterink on November 22, 2008 - 22:05.
Mike Thank you for your reply. I tried to get a sample of the IDE equipment last February when I met with most of the top leaders of Colombia (including President Uribe) but I was unsuccessful. There are a number of people from Colombia including embassy personnel trying to help me with this problem. It is frustrating to me that the international community has all these expensive international meetings on water but does not solve the basic problem of providing micro irrigation to small BOP landowners. I am back to using buckets on the heads of women to provide water for small land plots. This is the same technology I used 40 years ago. The people I worked with 40 years ago either were killed or became members of the FARC (Terrorists) according to the people in one of the villages I worked. I am not surprised. Dr. Paul Rigterink (website http://home.comcast.net/~prigter)
Submitted by Francisco Noguera on November 23, 2008 - 11:09.
Paul, I would be interested in hearing more about the specific equipment that you are looking for. I know of some micro irrigation projects that Pavco (a Colombian company that manufactures pipes and water pumping equipment) has done with small land owners. Would be glad to discuss further and eventually put you in touch with someone there. On another note, your case shows an inherent problem in the BoP movement... we need to come up with a way to easily transfer technologies from region to region. Think IDE and Colombia; it should not be difficult.
Submitted by Paul Rigterink on November 24, 2008 - 14:19.
Thank you for your offer of help. I am interested in low cost irrigation equipment such as the “family nutrition kits” that are sold in IDE/India (see http://www.ide-india.org/ide/pt/index.shtml; I believe that 1 million kits have been sold). They should be suitable for organizations such as Productivos Patios, Granitos de Paz, and AmazonPepper in Cartagena as well as the people of the Department of Cordoba. Any micro irrigation system that BOP businessmen can sell to BOP farmers such that both groups can make a profit would be acceptable to me. I also would like you and Mike to understand that events such as World Toilet Day creates a public relations problem for me. I realize that this is an attention getter and is probably good for fund raising. However, the drug dealers and guerillas from Venezuela and Cuba who have worked in the same area of Colombia that I have in the past like to declare that the elite gringos are only worried about their water bill and the quality of water for their estates. The drug dealers and guerilla leaders point out that they don’t have any flush toilets and that they drink the same water as the campesinos. They also indicate that micro irrigation equipment is only put in areas that the elite gringos favor. This is all done in the spirit of competition. The problem is the campesinos are generally angry at the ineffectiveness of the BOP programs that have been designed to help them over the last 40 years. In addition, they feel that elite gringos make fun of the way they have to live while pretending to help them. It creates dangerous situations when I go into these areas.

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