News Releases for 2014
2013 Annual Report
Our 2013 Annual Report is here! Take a look at our accomplishments and impact last year, stories from the field, and plans for next year!
Feature on our partner, D-Rev in the New York Times!
Light-Bulb Moments for a Nonprofit
By CHRISTINE LARSONJAN. 11, 2014
View Full Article Here
Krista Donaldson, center, is chief executive of D-Rev, a nonprofit group that designs medical equipment for use in developing countries and licenses it to distributors. Jim Wilson/The New York Times
No baby should die or be disabled because a light bulb can’t be replaced. Yet during visits to hospitals in India and other countries, Krista Donaldson often saw lifesaving phototherapy systems, used to treat infant jaundice, languishing in dusty corners because of burned-out bulbs and other seemingly simple problems.
Often, the real issue was that these donated Western systems weren’t designed for local conditions.
As chief executive of a nonprofit organization called D-Rev, Ms. Donaldson had a mission: to design first-rate medical equipment better suited to developing countries, then license it to for-profit distributors in those areas. That way, she reasoned, the market would allow sales and production to grow to meet full demand.
Or that was the plan. It hasn’t exactly worked out that way. “We thought if you design a good product, it will scale on its own,” Ms. Donaldson said. “That works in efficient markets, but most developing communities don’t have efficient markets.”
Ms. Donaldson examined a D-Rev phototherapy unit at a hospital in Tamil Nadu, India. Peter R. Russo
In the case of the jaundice treatment, the first part of D-Rev’s plan worked well. Designers and engineers came up with an inexpensive light therapy system, called Brilliance, that was rugged enough to roll smoothly across dusty, rural hospital floors, and able to cope with erratic power supplies.
But the second part of the plan — relying on markets rather than equipment donations to spur growth — has been another matter. D-Rev’s commercial distributor in India, for example, found that cronyism or corruption sometimes led hospitals to select higher-cost, lower-quality products, according to Randy Schwemmin, D-Rev’s director of technical operations.
D-Rev is one of dozens of small Silicon Valley start-ups aiming to use market dynamics to solve social problems. But seven years after its founding — and a decade into the rise of “social entrepreneurism”— D-Rev and its peers have found that the marriage of nonprofit motives to for-profit markets can be rocky.
D-Rev has had to become far more involved than it expected in financial models, licensing deals, consulting services and manufacturing arrangements. In essence, it is redesigning not only high-tech products but also supply chains and procurement systems.
“What D-Rev is doing hasn’t been done before,” said Kevin Starr, managing director of the Mulago Foundation, which is one of D-Rev’s donors. “They’re combining ways of designing equipment by focusing on the user and the user’s context, while also thinking about how to get it to people, about strategies for distribution and the market.”
One day last fall, the sounds of a chop saw broke the hush of D-Rev’s offices, housed in a bright loft space in the Dogpatch district of San Francisco.
“We’re building a table,” Ms. Donaldson said. The office needed more serving space for a party the next week that would celebrate a milestone for another D-Rev project, a low-cost prosthetic knee. After the party, the table — more of a bar, really — would give the staff more space for stand-up meetings, brainstorming sessions and a complicated board game then in vogue at the office.
Why not just buy a table at Office Max? “We’re on a shoestring,” Ms. Donaldson said. “Plus, we like making things.” And why not build it yourself when you’ve got saws, screwdrivers and safety goggles dangling from a pegboard in the corner? The tools are normally used for mocking up products from foam or wood, but they offer a tempting distraction in an office that employs about a dozen engineers, designers and tinkerers. Several of them trained at Stanford’s Hasso Plattner Institute of Design — better known as the “d.school” — which encourages the early and rapid building of prototypes.
Ms. Donaldson, 40, has plenty of hands-on design experience. Originally from Nova Scotia, she earned an engineering degree from Vanderbilt University, then two master’s degrees and a Ph.D. from Stanford in engineering and product design. She worked on reconstruction in Iraq for the State Department and served as a design engineer for the nonprofit KickStart International, which provides low-cost irrigation pumps to farmers in Africa.
She is still pretty good with tools herself, although it has been a few years since her days as a teaching assistant in the Product Realization Lab, a high-tech machine shop at Stanford used primarily by engineering and design students.
In setting out to solve health problems, D-Rev adopts the “design thinking” approach associated with both the d.school and the design firm Ideo, where Ms. Donaldson also once worked. The approach requires intensive study of users and their surroundings — what they need, why they need it, and all details of a product’s use.
Since D-Rev was founded in 2007, its employees have visited close to 300 medical facilities, whether urban hospitals in Africa, roadside “microhospitals” in India or birthing centers in Nepal that are accessible only by foot. They’ve talked with doctors, nurses, administrators, policy makers and maintenance people to understand the barriers that might keep a machine from helping a patient.
But that has not been enough. To make sure that end prices remain low, D-Rev has needed to find manufacturing and distribution partners willing to cap prices and forgo substantial markups. In the case of the Brilliance lighting system, D-Rev asked hospitals about reputable equipment makers and then approached Phoenix Medical Systems, a neonatal equipment distributor based in India.
D-Rev proposed a deal: Phoenix would manufacture and distribute the Brilliance lighting system and cap its price at $400, or $500 with a warranty (Western systems can run $3,500). In turn, D-Rev would structure licensing fees so that Phoenix made more money selling to poorer clinics than to wealthier ones.
But D-Rev realized early on that in India, the purchasing process wasn’t working in Brilliance’s favor. Hospital systems still sometimes chose higher-price systems because of bribery or cronyism, or because they didn’t understand Brilliance’s technical innovations, Mr. Schwemmin said. To help make Phoenix’s bids more persuasive, D-Rev realized that it needed to coach the company from the sidelines, especially in explaining technical features — say, why Brilliance doesn’t need cooling fans or filters.
Plans to expand beyond India, meanwhile, hit serious bumps. One distributor in the Philippines ordered eight units from Phoenix for $500 each but then resold them for $2,400, Mr. Schwemmin said. When D-Rev asked for the reason behind the drastic markup, the company said it needed to budget money for kickbacks, he said. Because of these and other experiences, “we feel the need to be a lot more involved in picking distributors and managing relationships, because we’re afraid of corruption,” he said.
To that end, D-Rev sent an analyst to the Philippines for eight weeks last year, to vet potential partners. It sent another associate to South America for three months to assess markets in Argentina, Brazil, Columbia and Peru. D-Rev shares its market studies with Phoenix, consults on potential new markets and stays involved as Phoenix develops new relationships with foreign distributors.
“We always expected to be a little bit involved with building markets, but it was more work than we anticipated,” Ms. Donaldson said. Fortunately, that work has paid off. Since the Brilliance lighting system hit the market a year ago, nearly 300 units have been installed in India, Malawi, Myanmar, the Philippines, Tanzania and Uganda. It has treated nearly 15,000 babies in six countries and prevented 300 deaths or disabilities, D-Rev estimates.
Though social entrepreneurship has been in vogue for many years, D-Rev’s model — nonprofit product development combined with third-party, for-profit distribution — is unusual. And it might be unfamiliar to some foundations.
“It shouldn’t be surprising that a foundation that spent its whole history solving social problems through grant-making is not going to turn on a dime and learn the different skills required for solving problems through market solutions,” said Paul Brest, former head of the William and Flora Hewlett Foundation and an emeritus law professor at Stanford. This may well change over the next decade, he added.
Some foundations are already embracing the new emphasis, and they are pressing organizations like D-Rev for specific figures on impact, such as the number of patients treated. “We design for impact measurement from the beginning,” Ms. Donaldson said. Having “specific numbers about where products go, the number of babies treated, the number of deaths and disabilities averted, has really helped us talk to funders more effectively.”
D-Rev’s operating budget grew to about $1.4 million in 2013 from $880,000 in 2012. Donors include the Mulago Foundation, the Greenbaum Foundation and Focusing Philanthropy. Individual donors contributed 38 percent of D-Rev’s budget in 2012.
The early success of Brilliance has led the company to tackle an even more challenging market for jaundice treatment: microclinics and remote birthing centers. In September, a D-Rev product manager, Garrett Spiegel, carried a prototype of a compact treatment system called Comet to three rural birthing centers in Nepal that were accessible only by hiking two to five hours. After trekking up mountain trails in pouring rain and smothering humidity, Mr. Spiegel said, “I definitely came back saying that weight, as well as size, should be a priority” in developing the product.
To find and communicate with the clinics, D-Rev relied on One Heart World-Wide, another small nonprofit based in San Francisco, whose work has reduced infant and mother mortality in the Baglung district of Nepal by 50 percent in three years. Such interdependence of organizations has become more crucial Both One Heart World-Wide and D-Rev work with another San Francisco venture, Medic Mobile, to coordinate far-flung volunteers and health assistants via mobile texting.
Yet enormous hurdles remain. While the organization has learned much about jaundice treatment and medical facilities in developing countries, specific experience with one condition may not apply to another. Ms. Donaldson appears undeterred. “There have been a lot of unexpected challenges,” she said, “but we really like solving complex problems.”
News Releases for 2013
View Our 2013 Newsletter
Our 2013 Newsletter is here. Please take a look to learn more about what we have been up to this year and what we
have to look forward to in 2014!
OHW Board Chair Receives Recognition from the LCA
One Heart World-Wide Board Chair, Jay Blumenkopf, of Gonzalez, Saggio, and Harlan LLP, has been selected as a recipient of the Litigation Counsel of America’s inaugural Peter Perlman Service Awards. The first class of 25 Peter Perlman Service Award recognizes LCA Fellows and others within the legal profession who have contributed in meaningful ways to society by giving their time and resources in an effort to improve the lives of others. The award is supported and sponsored by Peter Perlman, the LCA’s 2013 president.
Dining for Women and OHW in People Magazine!
It’s the birthday celebration that keeps on going – and continues to change the lives of hundreds of women and children around the world.
On Jan. 20, 2003, Marsha Wallace wanted to celebrate her 42nd birthday differently than the usual dinner out with friends. She wanted it to mean something more, and for longer. She invited 25 friends over to her Simpsonville, S.C. home, asking each of them to bring a dish to share and $30 to donate to a worthy cause.
“I knew that if we helped only one, it would make a difference,” says Wallace. “You never know what the ripple effect will be.”
Ten years and countless casseroles later, Wallace’s Dining for Women (DFW) has grown to 425 chapters and 9,200 members around the U.S., raising more than $2.78 million to aid women and girls living in poverty in 30 countries.
“I feel compelled to help women,” says Wallace, 52, a nurse who was raised by a single mother and was a single mother herself before marrying husband, Jim, a family physician. “I have been a single mother. I wanted to be self sufficient, independent and have a sense of achievement. I want them to have the same.”
Members of the dining club learn about each of the organizations they fund, giving grants of up to $50,000 to 21 organizations around the world per year – funding efforts like obstetrical care, safe havens and job training for sex-trafficking victims, literacy programs and job training.
“In developing countries, women are not only often deprived their basic rights,” says Wallace. “They are brutalized. We work in teams to vet organizations and make a decision [to fund] striving for different types of programs that solve different issues in different parts of the world. Then, we follow-up.”
Arlene Samen, founder of One Heart World-Wide, a nonprofit that provides obstetrical care to impoverished women in countries like Nepal and Mexico, says DFW’s funding has helped create clean birth kits: a sterile drape, gloves, a clean razor for cutting an umbilical cord and string to tie it.
“Women deliver their babies alone in the garden, the jungle or a shed,” says Samen. “They often know nothing about pregnancy, prenatal care or delivery. Marsha has such great compassion for others. She is driven and unstoppable.”
For Wallace, growing the organization and helping more women is the goal. On a recent trip to India to visit a health clinic DFW was funding, she says she was overcome with the magnitude of the suffering of the women and children there.
“As a nurse and mother of four, I have a different perspective from most,” she says. “We were in a three-sided cinder block building packed with women and children sitting on the floor. Some had acute sores, infections, illnesses. There were lots of young girls with much younger siblings on their hips. When we left, I sobbed and sobbed, overcome with the level of need. How could we address it all?”
To Colleen Clines, who launched the nonprofit Anchal Project to help provide alternative careers to women exploited in India, supported by DFW, Wallace is a mentor.
“She has helped me as we continue to grow and try to help women,” says Clines. “She has such a warm heart.”
Network of Safety: Decreasing maternal and neonatal mortality
(original post on Midwife International’s Blog)
Healthcare, education, running water and electricity are nearly non-existent in some of Nepal’s most remote regions, places like Dolpa, located near the Tibet border and nearly ten days by foot from the nearest road. Consequently, maternal and neonatal mortality is common, and getting assistance or maternal healthcare is nearly impossible. Yet one organization, One Heart World-Wide has developed a care model, which they call the Network of Safety, that has proved successful in remote regions such as these.
Dolpa is one of the largest and least developed districts in Nepal, located at the border of Tibet. The nearest road is ten days away on foot. Because of its remote location and difficult terrain, and elevation of up to 25,000 feet, Dolpa lacks some of the most basic amenities such as health services, education, running water and electricity.
Maternal health services are nonexistent in this extraordinarily remote region. Before One Heart World-Wide (OHW) began working in Dolpa, there were no functional birthing centers in the entire district. OHW renovates existing health posts’ infrastructure, trains the local staff, and provides necessary equipment and supplies to upgrade them into certified birthing centers. Today, there are two certified birth centers in Dolpa, the first was opened in 2011 in Dunai (lower Dolpa), and the second, in 2012 in Dho Tarap (upper Dolpa).
Wangmo Thapa is the Skilled Birth Attendant (SBA) who works in Dho Tarap. She lost her own mother in childbirth when her brother was born. Though she was just eleven years old, it was then that she decided to become a nurse to help other mothers survive childbirth. Once she graduated from nursing school, Wangmo went back to work in the small health post of Dho Tarap. At that time, she was frustrated because she felt that she did not have the resources necessary to help the women of her community. Then she met a member of the OHW team who decided to sponsor Wangmo to participate in midwife training to become a certified Skilled Birth Attendant for the new birthing center.
Now 23 years old and a certified SBA in a new birthing center, Wangmo is thrilled. She tells us that at the beginning, women were reluctant to reach out to her for assistance, because of her age. Then she met Nyima Lama, who was pregnant for the second time, 17 years after the birth of her first child. Nyima had experienced complications with her first pregnancy and was anticipating another complicated birth, leading her to reach out to Wangmo. They stayed in close contact until her eighth month of pregnancy, then lost contact for a month during the harvest season. One evening in July, a villager informed Wangmo that Nyima was in labor and needed her help. Wangmo rushed to Nyima’s house with her delivery kit, where she found her already in the second stage of labor with severe contractions. Nyima had been in that state since the morning, but there had been no progress. Upon examination, Wangmo discovered that the baby was in a breech presentation, with his feet first. These cases can be very difficult to deliver, and in the United States are almost always delivered by Caesarean section. However, this was not an option in rural Nepal. Instead, Wangmo remembered her training and safely delivered a baby boy. The new baby was having difficulty breathing so Wangmo stimulated him by rubbing his back and used suction to clear his airways. When he was breathing normally, Wangmo helped the mother through the final stages of labor and in the end, both mother and baby were healthy.
Nyima and her baby are alive today because of Wangmo’s ability to recognize the proper actions to take. Wangmo says “I was able to perform all the necessary procedures and help to both the mother and the baby smoothly and with confidence because of the One Heart World Wide SBA training I got to take.” After this incident, the women of the community gained respect for Wangmo and they now see her as a hero in their community.
Wangmo’s story demonstrates the multidimensional structure of the OHW Network of Safety model. The organization works to create functional birthing facilities within reach of women in remote areas who would otherwise have to travel for hours or even days to reach a health facility. They run midwifery education programs to train nurses in midwifery skills, enabling them to handle complicated deliveries with confidence, and educate women and their community members on how to recognize dangers signs and to know where to reach community health volunteers or Skilled Birth Attendants who can aid in deliveries and evacuations to referral hospitals. These simple interventions are raising awareness, changing behaviors, and reducing preventable deaths related to pregnancy and childbirth.
One Heart World-Wide’s life-saving programs were initially established in the late 1990s in the Tibetan Autonomous Region where the founders experienced a number of significant successes in collaboration with the Lhasa Prefecture Health Bureau and the Women’s Federation. Over ten years, the organization was able to decrease unattended home births from 85% to 20%, by ensuring the presence of a skilled attendant at delivery. In 2008, in the two counties where OHW was working, the Lhasa Prefecture Health Bureau reported no maternal deaths and newborn death rates dropped from 10% to 3%. One Heart World-Wide (OHW) developed an effective, replicable, and sustainable model to reduce preventable deaths related to pregnancy and delivery among vulnerable, rural populations. Simply put, OHW works with local communities and health providers to develop a culturally appropriate Network of Safety around mothers and infants by raising awareness, teaching good practices, and distributing essential supplies to ensure that mothers and infants survive delivery and the first months of life. The demonstrated success of this model has led OHW to expand operations to other sites in need including the Baglung and Dolpa Districts in Western Nepal, and the Copper Canyon in the state of Chihuahua, Mexico. Learn more at http://www.oneheartworld-wide.org.
We are very excited to announce that OHW will be Dining for Women's featured project for July 2013!
Dining for Women is a dinner giving circle. Chapter members “dine in” together as a chapter once a month, each bringing a dish to share, and then pooling “dining out” dollars (what would have been spent if they had eaten at a restaurant) to send to programs empowering women worldwide. All of the donations from hundreds of chapters are then combined to support carefully selected international programs each month. Dining for Women funds grass-roots programs in education, healthcare, vocational training, micro-credit loans and economic development. The programs they support are aimed to improve the living situations for women and their families, by providing the tools they need to make changes.
One Heart World-Wide is very excited to announce that we have been chosen to be the lucky recipient of July 2013’s “dining out” dollars! This funding will be used to expand the Network of Safety in Western Nepal by funding four master trainers’ salaries and benefits for one year, training expenses and supplies for 800 trainees, and 2,000 birthing kits which include gloves, plastic sheeting, razor blade, string, soap. Our goal is to empower Female Community Health Volunteers as efficient maternal and neonatal health outreach providers for both Baglung and Dolpa districts. By strengthening the maternal and neonatal knowledge and skills of local FCHV who care for women and their newborns at the village level, we will in turn increase the access to skilled birth attendants, essential resources, and safe motherhood messages for vulnerable pregnant women, leading to better birth outcomes across our program areas.
We could not be more grateful for this opportunity. The support of Dining for Women will allow us to save many lives, one birth at a time.
Stay tuned for updates!
To learn more about Dining for Women and the project they are funding, visit www.diningforwomen.org
New Blog Post from the Maternal Health Task Force's Blog Series on Respectful Maternal Care
Cultural sensitivity training for maternal health providers
POSTED ON APRIL 23, 2013 BY SARAH BLAKE
Guest post by Arlene Samen APRN, Founder and CEO, One Heart World-Wide
The integration of modern medicine into traditional systems can be challenging. One Heart World-Wide (OHW) works with the Tarahumara populations of the Canyon in Northern Mexico. The Tarahumara are among the indigenous groups farthest removed from mainstream society, and as a result suffer from many barriers to care. Discrimination against indigenous groups in Mexico creates one such barrier. Many Tarahumara people fear that medical providers will disrespect them, violate their right to make informed medical/family planning choices, or otherwise mistreat them. Language barriers further exacerbate these issues, as many Tarahumara do not speak Spanish and many providers do not take the time to make sure indigenous patients have understood them.
Many Tarahumara women feel that providers make little effort to understand their practices or beliefs, and often act with an air of superiority by telling women that there is no place for their use of traditional parteras (midwives). They often leave the clinics feeling patronized and without an understanding of the care or advice they have received. This is due to the complicated medical language that the providers use, which even a well-educated, native Spanish speaker might have trouble with.
These circumstances, coupled with the difficult travel and long distances that many women face in order to reach a clinic, lead to almost 90% of Tarahumara women delivering without a skilled birth attendant. This in turn results in dismal maternal and neonatal survival outcomes.
OHW is seeking to improve this situation through our Network of Safety model. The Network of Safety is an intervention aimed simultaneously at several levels, from the mothers to the referral hospital. Providers are trained, health facilities are upgraded and outreach programs on safe motherhood target community members.
In order to encourage facility-based deliveries, we have found it necessary not only to inform women of services available and advise them on their use, but also to work with clinical staff to ensure they provide culturally appropriate, quality care to indigenous patients. We want the Tarahumara women to feel comfortable in the clinics so that they will be willing to return.
We recently began including a new cultural sensitivity training module in all of our trainings for providers. Our trainers focus on raising awareness on the effects of communication on patient relations by discussing intercultural communication theories and dynamics and by practicing techniques to increase clarity and understanding by both parties. Through the exploration of different viewpoints, we invite trainees to recognize beliefs held by the Tarahumara, even if they are not aligned with their own, so long as they do not cause harm to the mother or newborn.
It is our hope that behavioral changes among health care providers that lead to more respectful provision of care will allow for greater changes among the Tarahumara as well, ultimately resulting in increased numbers of facility-based/attended births and therefore healthier birth outcomes for Tarahumara women.
For more in the respectful maternity care blog series, click here.
For more on Maternal Health Task Force, visit their website
Women Deliver: Celebrate Solutions
Celebrate Solutions: “Foot Soldiers of Change” Bring Healthcare to Rural Women
January 14th, 2013
By: Joanna Hoffman, Women Deliver
Throughout the world, rural women are particularly disadvantaged in their access to quality maternal health care. Distance to health facilities, lack of trained health workers, and supply shortages are some of the most prominent barriers preventing women from reaching the care they need to be healthy. In the Copper Canyon, it can take residents four hours by foot to reach the nearest clinic and another six or eight by truck to reach a hospital. The situation is not much better in much of Nepal, where seven out of ten babies are born at home without a skilled health worker, and a young mother dies every four hours.
One Heart World-Wide began operations in Nepal and Mexico operating under the motto, “To work in places where no one else dares to, but where the need is the greatest.” On a local level, volunteers are trained as “Foot Soldiers of Change” who hike through remote areas, bringing safe motherhood tips, clean birth kits and prenatal vitamins to pregnant women in their communities. They are also trained to recognize signs of dangerous complications, and how to safely evacuate women in life-threatening situations. For many, these Foot Soldiers serve as the much-needed link between rural pregnant women and essential health care.
As of March 2012, One Heart World-Wide had trained 70 volunteers in Mexico and another 500 in Western Nepal. For the 2,000 pregnant women they have helped, these volunteers truly are “Foot Soldiers of Change”, bringing hope to those in the most remote corners of the planet. As distant as they may feel from the rest of the world, these women now have someone looking out for them, crossing canyons and mountains through the day and night to ensure a world with fewer tragic statistics and more healthy mothers.
To support One Heart World-wide, check out their projects on Catapult here.
Flickr photo via Gates Foundation.
Catch up on One Heart's work during 2012