Rice MBA Team Visits Rural Poor

A tiny hut in rural Rwanda (photo by Vicki Chang)

Child with leg infection (photo by Vicki Chang)

Kigali, Rwanda (March 4 & 5, 2010) -- Morning meetings at regional hospitals and afternoon field trips to rural communities, one of them one of the poorest of Rwanda, characterized Friday's work for Rice MBAs who are working to commercialize Rice technology in Africa.

"I have seen poverty, but this was incredible," said Sharad Malhautra of the backpack team. "We drove out of Kigali on a paved road. Then we turned off road on to a rutted path. Finally we stopped and hiked for an hour to the village. The people there had little to eat. We saw a man who looked like he was dying and a little boy with serious infection on both legs."

Many villagers in remote areas suffer from infection, malaria, and lung diseases like TB.

Despite claims by the Rwandan government that every village has a community health volunteer, villagers in this community told Malhautra they had never seen a health volunteer.

CPAP and IV Drip Monitor Big Hits with Doctors

Meantime in Kigali on Friday morning the SmartDrip IV Drip monitor and "Baby Bubbles" CPAP device both received enthusiastic approval from doctors at University Central Hospital of Kigali ("CHK" or "Chuck" as its called by locals), the second largest hospital in Rwanda.

Of all the Rice medical devices, the IV "SmartDrip" device consistently met with enthusiastic reception. It's portability, ease-of-use, and low cost make it a winner to doctors and nurses who currently pay top dollars for comparable devices. Doctors want the SmartDrip now.

Shelley Cao demos popular SmartDrip IV Monitor

The CPAP controlled air pressure device which is designed to inflate newborn's lungs when they have difficulty breathing was also popular, but doctors wanted to see the device modified to use oxygen as well.

Hospitals were less enthusiastic about the backpack and c-clamp dosing devices, although the backpack was popular with community health clinics and in rural areas (like the one mentioned above at the beginning of this posting).

Kathik Alagappan demos EasyDose C-Clamp for Controlled Oral Dosing

Rwandan health officials had the most reservations about the c-clamp device that regulates the amount of medicine that can administered from one dosing syringe. Health workers were concerned about the clamp being sold apart from a dosing syringe. Some nurses expressed concerned about cleanliness of any kind of reusable dosing device. Although currently, most Rwandans re-use spoons or dosing cups to give medication to their children, an unsanitary practice, especially in villages where clean water is rare.

Power, Water, Remote Regions, Maintenance

(Saturday morning, March 6, over breakfast, Hotel Gorillas) -- Dr. Jeffrey Rose, MD, of Ascension Health told the MBA teams that despite great improvements in health care, Rwanda still faces incredible infrastructure challenges -- non existent or unreliable power, untreated water in rural districts, and non-existent or poor roads.

"But beyond the problems with infrastructure, Rwanda needs a plan for maintaining the medical equipment it has," said Rose, whose organization gathers and refurbishes donated medical equipment only to see it break down and never be fixed. "Maintenance is a huge problem for any medical community, but in Rwanda the problem is worse because there are no trained maintenance people to work on equipment."

Rose challenged students to develop business models for a countrywide solution to its maintenance deficit.

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This post ends the blog until the students return midweek. Many students will be hiking or taking tours to see the gorillas in the wild.

The MBAs will spend the rest of spring term developing their business plans for each of their products.

A Proud Lioness Watching Her Pride

Two of Dr. Agnes' nine million charges.

Kigali, Rwanda (Thursday, March 3) -- It may have been their most important meeting during their stay in Rwanda.

Representatives from the SmartDrip, EasyDose, infantAIR, and Lab-in-a-Backpack teams sat nervously waiting for their meeting with the permanent secretary of Rwanda's health ministry, Dr. Agnes Binagwaho, aka "Doctor Agnes."

Students reasoned that if Doctor Agnes supported their bio-tech products, they might have a better chance of those products getting in the hands of the Rawandan medical commuunity.

But as Dr. Agnes told the MBAs, impressing her doesn't guarantee anything.

As Dr. Agnes and many others explained to the Rice students, Rwanda prides itself on rigorous honesty and attention to the rules.

Before the teams' products can become a part of health care in Rwanda, they must pass rigorous inspection and testing. Doctors and hospitals must be convinced of the devices' value. Pricing must be fair in a country where most citizens earn less than a dollar a day.

Never misses a beat

Dr. Agnes is smart, inquisitive, honest, funny, and critical. She is the perfect person for the complicated job of administering health care for nine million Rwandans, a role she takes on like a lioness protecting her pride.

Dr. Agnes Binagwaho, permanent secretary of Rwanda's healthy ministry, meets with Rice MBAs and bio-engineers

Although her assistants interrupted her for her signature several times during the hour and a half meeting, Dr. Agnes never missed a beat.

She explained Rwanda's rigorous purchasing process to approve medicines and medical devices. She eyed the students' product demos with a critical eye, asking questions and making observations. And she volunteered names and phone numbers for contacts who could help Rice teams introduce their products in to Rwanda's medical pipeline.

You had the impression that she is the steady hand guiding Rwanda's health services into the 21st century.

Dr. Agnes about the Rice program:
Sharing knowledge and saving lives is "really Christian"

Land of a Thousand NGOs

Rice Professor Marc Epstein and Josh Ruxin at Heaven

by Gale Wiley

Kigali, Rwanda (March 2 & 3, 2010) -- Here in the "land of a thousand hills" it has been a real world learning experience for Rice MBAs and undergraduate engineers as they navigate Rwanda's health care system, identifying its dizzying number of suppliers, distribution channels, officials, certifications, regulations, and what seems like a thousand NGOs.

For example, on Tuesday, the C-clamp "EasyDose" team visited hospitals where doctors said the team's device for regulating oral dosage of drugs "has potential." On Wednesday the team interviewed health care management and supply chain consultants. Thursday, it met with the President's Emergency Plan for AIDS Relief (PEPFAR), the Bureau des formations médicales agrées du Rwanda (BUFMAR), and the AIDS Foundation.

Wednesday the CPAP (infantAIR, Inc) team met officials from UNICEF, the Center for Disease Control (CDC), and the Columbia School of Public Health. They met with organizations that train Rwandans how to use drugs. They met with organizations that serve as a bridge between health care workers and patients.

On Tuesday the backpack team toured a tiny health clinic in the Bugesera district where they saw the efforts of Project Access to modernize rural clinics by using computers, record keeping, inventory management, and refrigeration. Earlier in the week the team met with a physician who formed an organization of Rwandan doctors focsuing on something they call "mobile health care."

Using QuickBooks at Bugesera health clinic

Tuesday, the SmartDrip team showed its battery-powered IV monitor to doctors at Rwanda's biggest hospital where the team learned that over hydration is not as serious a problem as the team had thought.

On Thursday each team sent a representative to meet with Rwanda's minister of health.

Monday night at his wife's restaurant, Heaven, Josh Ruxin, a five-year resident of Rwanda and a well known authority on comprehensive approaches to fighting poverty with emphasis on scaling up national health programs, met with the Rice teams. Ruxin is the country director for the Millennium Village Project and founder of the Access Project for the Global Fund to Fight AIDS, Tuberculosis and Malaria.

His advice to the students was practical and to the point: if you want your products to succeed, find a market and a revenue stream.

Wednesday the teams dined at the Bridge2Rwanda house, not far from Hotel Gorillas.

Bridge2Rwanda is a Christian NGO that advises Rwanda's government, builds schools, and encourages entrepreneurship at all levels.

Breakthrough for Backpack Team

Beds and mosquito nets in Nyamata rural clinic

by Gale Wiley

Kigali, Rwanda (Tuesday, March 2, 2010) -- The backpack team is exploring a deal to supply its "community hospital in a backpack" to entrepreneurs who are launching a business in Burundi.

"Two entrepreneurs from Florida have trained 16 Burundi nurses who will provide basic mobile medical care on a fee-for-services basis," said EMBA Leonard Yowell, a backpack team member. "The nurses would use a micro finance loan to pay for their backpacks that the nurses would use to carry their medical supplies."

Presumably, as the nurses earn money by providing basic health care, they could pay back their loans, replenish their community backpacks with supplies, and have income -- all at the same time.

The Burundi deal is exactly the kind of business Professor Marc Epstein would like to see for his teams of MBAs who are working to commercialize four Rice-developed bio-medical devices:

• a backpack
• a C-clamp that controls oral syringe doses
• an IV drip monitor, and
• a battery- powered device for helping babies to breathe.

The Burundi deal would create jobs, improve basic health care, and most of all not rely on foreign aide -- a truly sustainable model for an emerging economy.

More good news

On a tour of Utexrwa, the only textile plant in Rwanda, the backpack team confirmed from Raj Rajendran, Utexrwa's managing director, that his company could produce backpacks for the team, thus generating jobs for Rwandans.

In his native Hindi, backpack team leader, Sharad Malhautra, confirmed with a production manager that not only could Utexrwa provide waterproof material but it could also produce backpacks.

Of course, the backpack team still has many hurdles before them.

• Will the Rwanda's testing labs provide the stamp of approval for the backpack's many medical devices. (Just because a microscope has been approved in the United States, for example, does not mean the device will pass Rwanda's testing laboratories.)
• How do medical suppliers operate in Rwanda?
• Outside of the Burundi deal, who in Rwanda would be the ultimate consumer for the backpack in Rwanda? NGOs? The Rwandan government? Entrepreneurs like the two orlano businessmen?
  
• Can the backpack team develop a flexible business model that will entice an entrepreneur to invest in or run this company?

Monday a Big Day for Rice Teams

Backpack team

by Gale Wiley

Kigali, Rwanda (March 1, 2010) -- On their first working day here, Rice teams of MBAs and engineering undergraduate technical advisors met with government officials, heard sobering advice from local entrepreneurs, and visited district hospitals to show their products.

"It was a good day for everyone," said Professor Marc Epstein, who is leading his class on their mission to commercialize Rice bio-medical devices designed for emerging countries like Rwanda. "The students heard lots of promising news."

To improve the efficiency of their quest to meet as many medical officials as possible, the CPAP and IV Drip teams created two new teams, half of its members joining half the members of the other team.

IV "SmartDrip" Drip and CPAP "Baby Bubbles" Team Join Forces

The SmartDrip and CPAP infantAir teams joined forces, a move that paid off.

“We went to King Faisal Hospital with no expectations,” said Sachin Agrawal. “But we ended up getting a four-hour tour of the hospital which led to lots of exposure to doctors who were curious about our products.”

As the two combined teams toured the hospital, doctors started appearing.

As David Tipps put his team’s CPAP device through its paces, doctors made suggestions for how the unit could be improved.

“They really really loved the device,” said Agrawal.

The SmartDrip team showed their battery powered, low-cost IV monitor to doctors.

“One doctor said he could use 15 or 20 IV monitors now," said Agrawal. "He said he has five infusion pumps and 30 patients who need the pump, each of which costs several thousands dollars."

The doctor told us our device could replace his current pumps, Agrawal said. "The doctor liked our device's simplicity, cost, and portability."

The other IV/CPAP team visited Mahima district hospital where they saw HIV and neo-natal clinics.

“We saw several babies that could have used our CPAP device,” said Will Pike. “They had about 35 babies on the wing, from newborns in kangaroo pouches to babies under bilirubin lights for treating jaundice."

"The doctors loved our CPAP device," said Pike. "They made several suggestions for improving it. They wanted to order one now for testing."

Backpack Team

At Gikondo district hospital, the backpack team met up with a head nurse who stood in awe at the diagnostic portable backpack's many medical devices incuding a microscope, centrifuge, and lab tools.

“She said there was a pressing need for the backback because the clinic sends medical teams into the field to attend to serious cases,” said Leonard Yowell.

Later, the head of a local NGO of 20 local Rwandan physicians gave more insight on how medical care is delivered and organized.

Undergraduate Engineer Vani Rajendran demos backpack

At the end of the day, the backpack team met with Manna Energy, a water purification venture using carbon credits and a "for profit" model.

C-clamp Team

“On one of our visits to a local district hospital, one doctor told us that our C-clamp device alone doesn’t make sense without the oral syringe,” said Jan Goetgeluk. “We think it makes sense to offer the c-clamp as part of the oral syringe package.”

Medical officials told Goetgeluk's C-clamp team that Rwanda needs more oral syringes. A clinic nurse who monitors HIV patients told the team that many parents use spoons to give doses of medicine to their children, a practice fraught with error.

The C-clamp device which regulates the amount of medication a patient receives via an oral syringe is a practical and cheap way to manage the dosing problem, said Goetgeluk.

CEO Praises Rice MBAs Work in Rwanda

Kigali, Rwanda (Sunday, February 28) -- The CEO of one of Urwego Opportunity Bank in Kigali congratulated four teams of Rice MBAs and engineering undergraduates for finding ways to commercialize their Rice bio-medical ideas.

"You are looking to present those ideas to venture capitalists to see whether you can get their support," said Lee. "This work is real and applicable, and I know you appreciate that."

The four teams have brought four bio-technologies to Rwanda to find markets, establish prices, seek suppliers and distributers in Rwana -- all in an effort to create business plans for potential investors.

Click arrow below to see video.

Jeffrey Lee, CEO of Urwego Bank in Kigali

Jeffrey Lee, who describes himself as a financial enterpreneur, has worked from branch banking to project finance, from community banking to corporate banking.

From February 1, 2009, he has been leading Urwego Opportunity Bank in Kigali, Rwanda as CEO.

Teams set to work today

Kigali, Rwanda (Monday, March 1) -- Over breakfast the teams will hear from Dano Jukanovich of Karisimbi Partners and Clare Akamanzi of the Rwanda Development Board.

Karisimbi Business Partners seeks to alleviate poverty by developing ambitious and strategically-placed Rwandan entrepreneurs. "We pick up where micro-finance, business incubation and small business development models leave off," reports their Web site. "Karisimbi Business Partners builds businesses by developing the management capacity of promising mid-sized ventures with untapped potential."

After the meeting, teams begin the legwork of their projects, spreading out across Rwanda to determine market need, potential suppliers and distributors, and see firsthand the face of Rwanda's health care system.

In the evening the teams will report what they learned and will plan their next day's work.

Thoughts On Rwanda

-- Quote from a placard at Belgium's Genocide Museum in Kigali

by Gale Wiley
February 27, 2010

To understand this post, first look at a video clip showing global health professor Hans Rosling* describe perceptions and then facts about the differences between the so-called developed and developing worlds:

First Hans Rosling Lecture

Next, look at Professor Rosling's second lecture:

Second Hans Rosling Lecture

Now visit Rosling's Gapminder site and do the following:

1. Click on the "Explore the World" graphic.
2. Next, select Rwanda from the list of countries.
3. Click "Play" to see how Rwanda compares with the rest of the world on two dimensions -- life expectancy and per capita income.

Results?

In 1997, the average Rwandan could (1) expect to live to 46 and (2) earn less than $1,000 a year. -- this the toll of ignorance, disease, tribalism, colonialism, corruption, genocide and AIDs.

While each year the rest of the world lives longer and earns more, Africa lags far behind, its citizens dying much younger and living much poorer.

But if the history of the rest of the world is any predictor, Africa -- and Rwanda in particular -- is changing for the better.

Although only 6 percent of Rwanda has electricity, the government plans to provide electricity to 16 percent by 2012.

Today I see Kigali planted firmly in the future and rural Rwanda trying to pull away from the mire of the middle ages.

Kigali, Rwanda's capital, is pushing its way to modernity.

When I was a correspondent in Europe, I had a hobby of counting the number of building cranes hovering over a city skyline. The more cranes, I reasoned, the more economic development for the city.

Kigali shows lots of cranes -- new government buildings, a major hotel/conference center, business buildings.

A major project to make use of an estimated $20 billion in natural gas beneath Lake Kivu is underway.

Our little project is one of hundreds in Rwanda, but the cumulative effect is significant.

Over the next decade I hope to see Rwanda move up on Hans Rosling's charts, affording Rwanda's citizens better health, longer lives, and more income.

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* "Even the most worldly and well-traveled among us will have their perspectives shifted by Hans Rosling. A professor of global health at Sweden’s Karolinska Institute, his current work focuses on dispelling common myths about the so-called developing world, which (he points out) is no longer worlds away from the west. In fact, most of the third world is on the same trajectory toward health and prosperity, and many countries are moving twice as fast as the west did." -- TED.com

Practicing their sales pitch

Kigali, Rwanda (Saturday, Feb. 27, 2010) --In the courtyard of Hotel Gorillas, the backpack team is holding its second meeting.

Vani Rajandran, a Rice bio-engineer and the only undergrad on the backpack team, is briefing her MBA teammates on each of component of the lab-in-a-backpack.

The backpack team is one of four teams bringing Rice bio-medical technology to Rwanda. Their job during their stay in Rwanda is to develop a business plan that will interest entrepreneurs.

They have five days to determine if there is a market for their product.

Vani briefs her teammates on backpack-in-a-lab.

Arrived in Kigali

Kigali, Rwanda (Saturday, February 27, 2010) -- It's quiet in Kigali with little traffic and few pedestrians.

It's the last Saturday in February, and everyone in Kigali is supposed to spend the morning cleaning -- trimming bushes, picking up trash, sweeping the road in front of their place. The morning is considered a "day of service."

And the clean up is strictly enforced. Road checks makes sure only cabs and taxi mo-peds are on the road.

We're settled in our rooms at the Hotel Gorillas. Many of the students are walking around the neighborhood.

It's a beautiful day, in the high 60s, breezy. Kigali's thousands hills are lush with fruit and vegetables.

The students are ready to work.

Safe and sound at Heathrow

We arrived without incident at London's Heathrow this morning and cooled our heels for seven-plus hours. Some of use went into town (Brrrr!) and took in the tourist sites. Fish-n-chips and a pint of Guiness on a cold, blustery day. (Yum.)

Next stop, Nairobi.

MBA Class Project Called "Most Innovative" For Launching New Businesses in Rwanda

Houston (February 26, 2010) -- Dale Dawson, entrepreneur and founder of Bridge2Rwanda, told MBA students that their class was "the most innovative and exciting" approach he had ever seen for building businesses in Africa.

The students who left this week for Rwanda to find ways to commercialize Rice medical technology are part of Professor Marc Epstein's Management 747, Technology Commercialization in Developing Countries.

Dawson, an investment banker and entrepreneur, is building schools and businesses in Rwanda.
He serves on President Paul Kagame’s Presidential Advisory Council.

Click movie controller below to see the movie.

"Our goal is to turn this idea into a flood of colleges and universities that will do very similar programs to your," said Dawson.

On the Road Again: Project Rwanda 2010

by Gale Wiley
February 23, 2010

For the second consecutive year, two professors and four teams of Rice MBAs are flying 10,000 miles to Rwanda over spring break to commercialize medical technologies developed and tested by Rice engineering students.

But this year, there's an added twist.

Each team will consist of four MBAs plus a Rice undergraduate engineering student who will serve as technical advisor for the team. The engineers will answer technical questions, observe the devices in the field, and make recommendations for possible product modifications. The MBAs will focus on commercializing their products.

Two-day flight from Houston to London to Nairobi to Kigali.

Product Line Up

The teams will work with Rwanda's health community to develop business plans for four products:

• a lab in a backpack,
• an intravenous therapy (IV) monitor,
• a clamp to regulate syringe dosing, and
  
• a continuous positive airway pressure (CPAP) device for aiding infants' breathing.

Accompanying the teams are Professors Marc Epstein and Maria Oden.

The trip is part of Epstein's course, Technology Commercialization in Developing Countries. Oden is an engineering professor and director of Rice's Oshman Design Kitchen where the medical technologies were developed by Rice undergraduate engineers. (See NPR story below.)

Lab in a Backpack

Backpack (Life Packs, Inc.) Team
Vikas Bahl (MBA), Vani Rajendran (undergrad), Sharad Malhautra (MBA),
Leonard Yowell (EMBA), Tonny Yiu (MBA), Vicki Chang (not pictured; MBA)

The backpack team (aka Life Packs team) will be offering five versions of their backpack: a portable diagnostic lab which can diagnose diseases such as TB and malaria, a dental backpack for routine check-ups and tooth extractions, an OB-GYN backpack that can be used for prenatal and pap smear exams, a vision backpack that includes surgical tools, and a community health backpack that allows health workers to perform first aid and basic disease screening.

Battery-powered IV Monitor

IV Drip (Smartdrip) Team
Faraz Palliwala (MBA), Sachin Agrawal (MBA), Laura Krone (undergrad),
Shelley Cao (MBA), William Yester (MBA)

The SmartDrip IV Monitor is a "low-powered portable device that monitors the drip rate of an IV-infusion and adjusts it accordingly through a motorized clamp." The unit regulates drip rate and volume, features that can help health care workers faced with administering multiple IV's.

Controlled-dose Clamp

Controlled-dose Clamp (Easy-Dose) Team
Karthik Narayanan (MBA), Kristin Anderson (undergrad), Jan Goetgeluk (MBA),
Britt Kennedy (MBA), Lee Willeford (MBA)

The Easy-Dose device fixes to an oral syringe to regulate dosage. According to the team's marketing materials, medication errors can worsen a patient's condition, lengthening treatment and in some cases causing death. In many places in the developing world, caregivers use spoons or cups or unmarked oral syringes.

CPAP

CPAP (infantAIR, Inc.) Team
David Tipps (MBA), Will Pike (MBA), Cynthia Hu (MBA),
Martha Vega (MBA), Jocelyn Brown (undergrad)

The infantAIR team will be introducing Rwandans to "Baby Bubbles," a device that helps babies breath "by gently keeping their lungs inflated, thus increasing oxygenation." The continuous positive aireway pressure (CPAP) device is inexpensive and easy to use.

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Documentary about Project Rwanda 2009

For the inaugural class in 2009, Epstein's MBAs showed four different technologies to Rwandan officials: an incubator for preemies, a hand pump dosing device, a nutrient supplement powder, and an early version of the lab-in-a-backpack.

A three-part documentary reports the experiences of the Incubator Team:

Part I click here.
Part II click here.
Part III click here.

For a short, five-minute version of the documentary, click here.

++++++++++++++++

Houston NPR Affiliate's Lab-in-a-Backpack Story

In January, the local NPR station ran the following radio story by Wendy Siegle about the Rice's Design Kitchen and the Lab-in-a-Backpack:

After the devastating earthquake, the world's eyes are on Haiti. Some say the tragic event reemphasizes the country's need for stronger infrastructure — especially in the medical sector. A group from Rice University spent time in Haiti last year to test a compact medical tool they developed that can increase access to healthcare in Haiti and other developing countries. From the KUHF NewsLab, Wendy Siegle reports.

"All of the materials are contained within this heavy duty hiking backpack. And inside is a microscope and a centrifuge…."

Rice University student Jocelyn Brown is showing me Lab-in-a-Backpack — an ultra-portable diagnostic laboratory she helped design and engineer with about twelve other students. At first glance it resembles a pack an adventurous hiker might take on a trekking expedition through the Himalayas. But after peeking inside, I discover there’s not much room for your socks. Instead, the pack is fitted with general purpose diagnostic tools.

"They diagnose what a physician might want to do in a general physical exam, along with, in specific countries, very specific tests that might work for diseases in those specific countries."

That’s Maria Oden, an engineering professor at Rice. She’s also the director of Rice’s Oshman Engineering Design Kitchen where most of the work on Lab-in-a-Backpack was cooked up. She says the thirty-two-pound pack is custom designed to be used in developing countries, like Haiti, where access to health care is often extremely limited.

"In order to get health care, either the people have to walk a very long way to a health clinic, or for the diagnostic Lab-in-a-Backpack the physician can go to a much more rural location and have the opportunity to do diagnostic tests that they normally would need a laboratory for."

Last summer Brown, who’s a senior bioengineering major at Rice, field-tested the diagnostic Lab-in-a-Backpack in Haiti, a country current facing the tragic effects of one its worst-ever natural disasters.

"It was a very impactful experience; just witnessing the extreme lack of health care in Haiti was quite shocking."

Brown says that the Lab-in-a-Backpack was—and still is—very useful in Haiti, because it can be used on diseases highly prevalent in the region.

"It can diagnose TB, malaria, several very common infectious diseases and provide basic treatment as well."

In addition to the diagnostic Lab-in-a-Backpack, the students have created several other models for various uses. These include an OB/GYN pack, a dental pack and an eye care pack. Because the packs are most effective in providing basic care, Oden says they have many limitations when it comes to treating victims during a crisis situation. But new designs are in the works.

"There’s an opportunity to develop a backpack that would be specific for emergency care which might be even more appropriate for the disaster that's happening right now."

For now, the creators of the two-thousand dollar Lab-in-a-Backpack are fine-tuning the models and figuring out ways to get more packs sent to developing countries. Last month, twenty-four packs were sent to Ecuador. Over the next year, the packs will treat an estimated one-hundred-and-twenty-thousand Ecuadorians.

From the KUHF NewsLab, I’m Wendy Siegle.

Kigali Marketplace

OK, so it's a little late. But here it is anyway -- The Kigali Marketplace.

Enjoy.

http://www.youtube.com/watch?v=elnlaZgS6Ag

Coming Home

Goodbye to Rwanda (Kigali Airport)

(SCROLL DOWN FOR VIDEOS)

Tuesday, March 10, 2009

By Gale Wiley

Kigali, Rwanda – Rice MBAs who came to this African capital to commercialize biomedical technology are returning home this week with more than firsthand knowledge about commercializing biomedical technology in a developing country.

For starters, students have learned that Rwandans are a proud and gentle people who are zooming into the 21st century -- in part through outside aide, in part through dogged determination, education and hard work.

Rwanda is well organized, largely through the efforts of the country’s government, whose leadership is dominated by women who fill the gap left by men killed during the genocide. Fully 80 percent of the legislature is female.

New and Old

Kigali is a bustling, beautiful city of a thousand hills with perfect California climate. The traffic circles contain well-manicured gardens. The views from hilltop to hilltop are breathtaking.

During rush hour, Rwandans wedge themselves into mini-vans that serve as taxis. Braver souls hire mo-ped taxis piloted by helmet-wearing cowboy drivers who lean on their horns as much as their accelerators.

Kigali is booming. Everywhere there is movement. At rush hour in Kigali, throngs crowd the markets and taxi stands where scores of mini vans and mo-peds wait.

Rush hour in Kigali's mass transit hub

The well dressed employed and the ragged jobless – many talking into cell phones -- walk side by side.

In the city center you can buy low quality electronic goods and pirated CDs. A huge, enclosed market on the edge of town is like the Rwandan version of WalMart, except here you get to bargain with vendors.

Rwanda has a long way to go, however, before all of its citizens are afforded the same access as Kigalians have to electricity and clean water and centralized sewage systems. In rural Rwanda, mud brick huts that do not meet minimum standards are being condemned by the government and replaced with higher quality structures.

China has landed big contracts to add and improve roads throughout the country. Germany has built a huge mountain-top solar array.

Everyone here talks of the years before and after 1994, the year of the genocide when as many as 800,000 Tutsis were slaughtered at the hands of Hutus.

The genocide happened 15 years ago, and memorials to the Tutsis are scattered through this tiny country. Hardly a person you meet doesn’t have a story about losing relatives to death during the genocide.

Press Freedom?

Rwanda’s television programming is mostly soccer clips, Rwandan music videos, and rosy interviews with government ministers and President Paul Kagame.

“Government here doesn’t air bad news,” said one young reporter who had been fired from Rwanda’s only government-controlled TV station. “Reporters who want to gather views opposite the government’s are let go.”

Unemployment

The government hires as many as people as it can, but the crush of immigrants from the countryside and neighboring countries puts pressure on an economy that is largely agricultural.
Rwanda, quite simply, needs jobs that bring value to the Rwandan economy.

Thousands of young men walk the streets here looking for work. During the day they sit in groups or prowl the city centers. In the district where huge bags of flour and sugar and consumer goods are unloaded, one thin young man yelled to me, “I’m hungry. Give me money.”

Awash with Churches and “NGO-how”

By some estimates, more than a thousand churches and nearly 300 non-governmental agencies (NGOs) work in Rwanda, providing aid, equipment, training, and what some call “NGO-how.”
Rwanda, not surprisingly, is largely Protestant. Again and again, Rwandans would say to us, “Like us, Americans are Christian.”

Like South Africa, Rwanda used the process of reconciliation to allow Tutsi victims to confront and forgive their tormentors. Although some religious leaders in the 1990’s failed Rwandans during the genocide by falling silent during the persecution and the subsequent slaughter of more than 800,000 Tutsis, still other clerics spoke up for or protected Tutsis.

Tourism

Tourists see gorillas "up close and personal"

Tourists to Rwanda come in several flavors: those who want to see the genocide memorials and the gorillas ($500 cash for a permit), those who are connected with churches and NGOs (you see these folks at the best restaurants or riding in Toyota SUVs with African drivers), and those who are simply travelers curious about Rwanda (by far the smallest group).

“Tom Cruise”

The hope for Rwanda is in the young who put in long hours at school and who pay to hear local rapper Tom Close (Rwandans say “Tom Cruise”) at live concerts.

We met the son of a seamstress who started a business with micro-finance money seeded by an American NGO.

He has big plans to grow Rwanda’s fledgling tourist industry.

“We’re building a Web site for my mother’s shop,” he said speaking perfect American English. “You will be able to order her handmade custom made shirts online. We have big plans.”

Students' route home
Kigali-Nairobi-London-Houston
36 Hours, door-to-door

Five MBAs and a Baby

Friday, March 6, 2009

by Gale Wiley

Kilgali, Rwanda -- A tiny preemie was moved from a $20,000 incubator to a $300 Rwandan-built incubator designed by Rice engineers and marketed for the last week in this tiny country by Rice MBAs.

The child, dubbed "Baby Kigali " by the five-man Rice team, spent the night in the prototype incubator which represents the first of a potential production of as many as 900 incubators for the Rwandan market alone.

"Baby Kigali" in the Rice Incubator

Thousands more incubators -- all made by local manufacturers -- could be sold across Africa and other developing countries.

"But there's lots of work to do yet," said one team member. "The incubator needs to be thoroughly tested by the Rwandan certification agency. Doctors and nurses already asked for design modifications they'd like to see."

Four Teams

The MBA students came to Rwanda as part of Marc Epstein's class to study firsthand how to bring Rice bio-med technology to Rwanda, if possible using Rwanda labor and management to create and sell those products.

The students divided into four five-person teams and were tasked with developing a viable business plan for a specific product.

The students are developing business plans for three prototype products that were tested in African clinics and hospitals last summer by undergraduate interns that were part of Rice’s Beyond Traditional Borders program.

The teams are organized by product -- the low-cost neonatal incubator team, a diagnostic lab-in-a-backpack team, a plastic dosing device for liquid medicines team, and micro-nutrient supplements.

For five days the students worked day and night, meeting with doctors, nurses and Rwandan health officials in clinics and hospitals across Rwanda.

The incubator team spent much of its energy getting their incubator built using Rwandan materials and craftsmen.

The backpack team has a commitment from an NGO for 80 backpacks. Medical officials in Rwanda expressed interest in backpacks that could be tailored for specific needs and diseases.

The 20 students return Stateside next week, many of them flying out Wednesday.

Rwandans Unveil Protoype Incubator

Thursday, March 5, 2009

by Gale Wiley

Kigali, Rwanda -- It was big day for Rwandan carpenters who built a low-cost, wooden incubator following design specs of Rice MBAs who traveled here as part of a technology commercialization class to bring simple, low-cost, bio-med products to developing countries.

Rice MBAs are using their business acumen to develop third world markets, pricing, and distribution channels for products designed by Rice bio engineers.

Rice University Bioengineering Professor Rebecca Richards-Kortum accompanied the incubator team to a furniture co-op where Rwandan workers unveiled their incubator prototype.

Richards-Kortum and Marc Epstein, a professor with the Jesse H. Jones Graduate School of Management, teamed up to give Rice MBAs the chance to promote bio-technology products to Rwanda.

The Rwandans used no electric tools to make the incubator.

Although the incubator is made of wood, it will serve as a demonstration model that students can show to clinics in rural Rwanda.

"This is a low-cost incubator made by Rwandans for Rwandans,," said Rice MBA incubator team member Jess Arnold. "This model is a start. We can always modify the incubator down the line. We wanted to create a product that Rwandans could build themselves."

The incubator team estimates that there is a market for as many as 900 incubators in rural Rwandan clinics.

The Rice MBAs paid the carpenters by collecting $500 in donations during a Super Bowl party.

Backpack team scores

The backpack team met with Access Project, an NGO that could not hide its enthusiasm for the product.

The backpack, called a "lab in a backpack" by Rice students, holds medical diagnostic equipment. Using Rice undergraduates, Richards-Kortum has sent 12 backpacks for testing in third world countries.

Access Project, with the assistance of the Rice MBAs, immediately began work on a proposal to raise funds to purchase 80 backpacks.

The NGO requested that Rice team visit Bugasera, another rural hospital, Thursday to demonstrate the backpack to NGO colleagues.

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Rice MBAs Find Markets for Their Products

Incubators are expensive, requiring expensive repair and maintenance.

by Gale Wiley

Wednesday, March 5, 2009

Teams spread out to the countryside today to see rural Rwandan clinics and hospitals firsthand. Other teams met with government officials, suppliers, contractors, and an agency that certifies medical products and drugs.

As the incubator team learned that its Rwandan-built prototype would be ready Thursday, they bought electrical supplies (four light bulbs, sockets, wiring, and switches) on the local economy to create the incubator's simple heating circuitry. In their hotel, students crafted a crude test circuit (it worked!) and a final circuit for delivery to the Rwandan craftsmen Thursday morning.

Health workers at rural clinics say they need a cheap, easy-to-repair, locally made incubator. Some said they would place orders once they saw a working prototype.

"We hope to create jobs for Rwandans with our product," said an incubator team member. "A locally supplied incubator that's easy to repair has high interest here."

The backpack team faced tough grilling from a government medical official who wanted to know why Rwanda would need a diagnostic lab in a backpack when the country already had lab facilities scattered strategically through Rwanda. The remained confident they would find a market niche for their product, a belief that was supported Wednesday night when two NGOs expressed strong interest in the backpack.

Thursday the backpack team was asked to demo their product.

The dosing device and nutrient powder teams continue to meet with officials and medical experts at every level. Wednesday night the dosing team learned that at least one hospital administrator saw great potential for a device that would give precise doses.

Using Rwandan Labor to Build Incubators

Furniture Makers

It has been a whirlwind from the moment we got here. Feelings awake here: hope, sorrow, fascination, guilt, awe. Rwanda is an amazing and grand place.

Above all are the people — so sweet and kind and alive. They are building a country from the devastation of genocide.

Everywhere the Rice MBA teams go, there are children. Last night as we drove in from the country, it was 5 p.m. when children get out of school. Dressed in blue and yellow uniforms, the children would wave to us, grinning broadly, shouting, “Masungo!” which means "White man." It is a cry of excitement and cheer. There is no derision. The children seem delighted to see us.

I followed the incubator team today.

We began with the furniture makers, a co-op where hundreds of men make furniture and coffins -- among other things -- in the narrow canyons of dressers and beds. They use crude tools -- I saw no electric saws or drills -- to make mortise joints and carved pieces. They are masters with planes and hammers and awls. Young couples buying their first piece of furniture snake their way through down the narrow aisles as workers hammer and saw and carry pieces to the street for customers.

The furniture makers are crafting a model of the Rice incubator, a simple wooden box with a simple electric circuit for standard light bulbs. Although getting a local contractor to make a prototype seems like a minor thing, for the incubator team this is a major victory, the first step in using local craftsmen to produce a product set for sale in Rwanda.

The unit should be ready Thursday. On Wednesday the incubator team will finalize the electronics and deliver the wires, bulbs, and sockets to the furniture makers. On Friday, they hope to have a working model to show hospital administrators.

Rwanda’s medical system is made of local clinics, regional hospitals, and the national King Faisal Hospital. Clinics serve as a form of triage, handling relatively minor medical and nutritional problems -- and births. Cases clinics can’t handle are forwarded to regional hospitals. And what regional hospitals can’t treat is forwarded to King Faisal Hospital.

District hospitals and local clinics appear to be markets for the diagnostic lab in a backpack, the low-cost incubator and bilirubin light, the protein powder, and the dosage metering device.

Two expectant mothers at a rural clinic in Rwanda

Teams have also learned that all products sold to hospitals in Rwanda must be approved by a national certification agency, a process that may take longer than the time students are in country.

Every team is hopeful. Each has found avenues for development. In the short time they are here, it is unlikely they will launch complete businesses. But some teams have already found partners, local builders, and entrepreneurs with the training and expertise to run a business.

Note: Internet bandwidth is poor. Think of thousands of computers trying to suck data through one straw. It's almost impossible to upload videos to you, but I will continue to look for better connections.

The Apprentice Comes to Rwanda

[See newly uploaded video below!]

by Gale Wiley

Well, today (Monday) was the first day of what will be five incredibly busy days for our four MBA teams, each one trying to figure out ways to commercialize its Rice bio-med product in Rwanda.

We began at King Faisal Hospital, the national hospital of Rwanda. We were briefed on how the government makes its buying decisions, how very little is actually manufactured in Rwanda, how distribution to the countryside is a major problem, how building infrastructure (roads, internet, water, electricity) is a top priority in Rwanda's plan to grow the country's economy.

The students toured the hospital and made product pitches to top medical officials.

In the afternoon teams were given free rein to pursue leads, conduct interviews, and find suppliers.

We draw a crowd

I followed the incubator team who decided they needed to build a life-sized model of their product using Rwandan supplies and labor.

Our driver took us to the furniture district where the team located a cooperative that produces bed frames, clothes closets, trunks, and caskets.

Within minutes after we pulled up next to the co-op, scores of Rwandans closed around us, me with my camera videotaping the incubator team as they worked through specifications for the incubator with Rwandan craftsmen.



I felt like a cameraman for the Rwandan version of The Apprentice.

Tomorrow some of the teams venture out to the countryside to visit district hospitals, a key market for the backpack, the incubator, the dosing device, and the protein supplement.

Sunday in Rwanda

Children's Dance Troupe

by Gale Wiley

Sunday was an emotional roller coaster.

We began the day with rain beating on the roof of Cathedrale St. Ettrenne as we watched an Episcopalian (not Anglican as I reported earlier) service. A choir of young people (drum, electric piano, and guitar) sang hymns in African harmonies. The text of hymns were displayed for the congregation in PowerPoint slides high up on a wall behind the priest.

Holiness, holiness is what I long for
Holiness is what I need
Holiness , holiness is what you want to give to me…

Next we visited the Kigali Genocide Museum.

Imagine your neighbor whom you've known for years suddenly knocking on your door. He carries a machete. His intention is to kill you and your family. Imagine this scene and mass killings sprouting up around the country. This was the story in 1994 when the Hutus slaughtered between 800,000 and a million Tutsis.

The genocide museum like the Holocaust Museum in Washington, D.C. is not for the faint of heart. You begin with the early divisions and hatreds between the tribes, the effect of colonialists, the brutal power struggles between the tribes, the slaughter, and now 15 years later and a long period of reconciliation, relative peace.

The museum is well worth the visit.

In the afternoon we dropped in on the Rwamakondera Children’s Dance Troupe where children performed tribal dances, following the tradition of each dancer soloing to hypnotic drums and chants.

In the evening we had dinner with Dan and Campbell Vogel who work with Bridge2Rawanda and who are helping teams make contact with Rwanda government officials.

On Monday teams with Rwanda ministry officials and begin their work, making contact with NGOs, hospitals, manufacturers, and suppliers.