Stanford University

Instructors Joshua Cohen Political Science, Philosophy and Law
  Terry Winograd Computer Science
  Zia Yusuf CEO, Streetline Inc.
Course Assistant Eric Mibuari  

In this course at the Stanford, small interdisciplinary project teams worked jointly with students from the University of Nairobi and NGOs in Kenya to design new technologies for promoting development and health. 23 Stanford students participated from a broad range of disciplines, including African Studies, Business, Anthropology, Computer Science, Electrical Engineering, Human Biology, Law, Management Science and Engineering, Microbiology and Immunology, Political Science, Science Technology and Society, and Symbolic Systems

Six of the students traveled with faculty to Nairobi over Spring break to do initial need finding with our partners:  

nairobi university
David Thiru
John Neatherlin
Aidah Binale
Dan Orwa

This week of need finding formed the starting points for the six project teams, which continued to collaborate with our partners throughout the quarter to conduct observations and interviews, identify needs, generate concepts, create prototypes, and test their use. At the end of the quarter, students presented their projects to a panel including the representatives listed above from these organizations, who came to Stanford to review the projects and identify possibilities for further development. As of the beginning of June, four of the teams are planning to send members to Nairobi during the summer to work with the partners to do further testing, pilot studies, and feasibility studies in preparation for project implementation.

The starting brief for the projects was to find innovative ways to use mobile applications in areas of health, education and economic development. Since we are strongly committed to the principles of human-centered design, we encouraged them to adapt their projects to meet needs they encountered as relevant to the people for whom they were designing. As a result, not all of the projects ended up using mobile technology, but all are deeply based on solutions to substantive problems.

In addition to the students and our Nairobi partners, we would like to thank the coaches from local industry who volunteered their time to work with the teams, to the many people who came to class to share their expertise with the students, and to our financial sponsors, Nokia and the Freeman Spogli institute.

2011 Projects

Makmende (MYSA)

Women living in Mathare - one of Nairobi’s largest informal settlements - are commonly the targets of assault, mugging and rape as they go about their daily activities. These threats are greatest outside of daylight hours, but women must often travel very early in the day or late in the evening as they commute to and from work, school, the market or community latrines.

To help address the security problem for residents of Mathare, we are developing Makmende, a system of community foot patrols that will escort women along their daily commute. Using mobile technology to disseminate real-time information about the location of patrols, we seek to coordinate the formation of citizen-led walking groups that will escort women safely to their final destinations.

The project is in its early piloting stage, and our next steps over the summer are to meet with our partners in the Kenyan police force and local citizen safety committees to identify the appropriate people in Mathare to act as patrol leaders. Working with community members, we hope to have an early pilot up and running by later this year.

We believe that this project has great potential not only to improve the physical safety of women in Mathare, but also, by expanding the number of hours that they are able to securely travel outside the home, to improve their freedom of movement and general peace of mind.

-- Clare Bennett, Ray Gilstrap, Margaret Hagan, Nan Zhang - Coach Sunny Jeon, Stanford Political Science

Take Taka (Umande)

In Kibera – a large and poorly resourced suburb of Nairobi, Kenya - there is only one functioning toilet for every 2,000 people. There are no public sewage systems and public latrines serve a tiny percentage of the population. As a result, the majority of the population resorts to the use of ‘flying toilets’ – feces in plastic bags - which creates unhygienic and unsafe conditions for Kibera’s residents. This points to an increasing and urgent need for cost-effective and sustainable solutions of hygienic human waste disposal.

A number of sanitation initiatives and organizations exist in Kibera, but most of them only partially address the needs of the users. Need finding revealed that the most significant family and community needs relating to sanitation are: convenience for all family members, safety, accessibility during day and night hours, hygiene, privacy and sustainability.

As a solution, we propose “Take Taka” (taka is Kiswahili for “waste”), a linked system including a bucket toilet in the homes of residents of Kibera and a daily pickup service. Each family/housing unit is allocated two-bucket toilets. A full bucket is collected from homes each day by a team of two individuals using rickshaw carts and their own labor. At the same time, the team delivers a clean bucket. These individuals then take the full buckets to nearby bio-digesters to be emptied, cleaned, and return them the next day (alternating out with the second bucket). Bio-digesters are sewage treatment plants that convert human waste into biogas, which can be used for cooking and electricity.

“Take taka” will be a non-profit organization, which will serve a consulting and advising function for community group-operated waste removal systems. It will operate primarily through a partnership with the Umande Trust – an NGO focused on water and sanitation in Kibera with whom we have established a strong relationship. It will facilitate the creation of partnerships with existing community organizations already running the bio-centers, and will entail the development of new partnerships as we expand.

-- Davis Albohm, Jess Auerbach , Stephen van Helden, Zach Weiner - Coach Anja Svetina Nabergoj, University of Ljubljana

Kuja Pamoja (Umande)

Kuja Pamoja is a project inspired by the story of Phanice Maiba, a small-scale trader in the informal settlement of Kibera on the outskirts of Nairobi. Phanice struggles to make ends meet as a single mother of seven children, with her only source of income generated by her small fruit and vegetable stall.

Kuja Pamoja targets the many small-scale traders in Kibera who are like Phanice. These traders face high business costs, comprised of stall maintenance fees, bribes, and loans. The most significant of these, however, is the direct cost of buying fruits and vegetables in the central markets in Nairobi each morning. Given these high costs, small-scale traders in Kibera earn small profits of only 200-300kSh a day, the equivalent of US$3-$4.

In partnership with the small business team of Umande Trust, Kuja Pamoja will leverage Umande Trust's already established loans programs to create groups of 4-5 small-scale traders. These groups can negotiate in Nairobi's central markets for bulk-purchases. By buying larger volumes, they achieve bulk discounts and traders can buy more produce without increasing the cost borne individually. The result increases their profits by 15-60% and saves time during the process.

The profits generated from these bulk purchases can be used to expand individual businesses and balance additional responsibilities that prove to be a significant draw on income and time. In the future, we envision that Kuja Pamoja's model will evolve to incorporate financial tools and training, in addition to generating more groups savings, thus become a powerful community force.

-- Chris Anderson, Riah Forbes, Aleema Jamal, Jonathan Kirschner - Coach Sally Madsen, IDEO

Nishauri (MYSA)

Youth are susceptible to risky sexual behavior in the sprawling informal settlement of Mathare in Nairobi, Kenya. Hardworking, single parents, who make up the majority of the population in Mathare, have little or no time to supervise or communicate with their children. This often leaves young people with the critical role of passing on information about health risks, and this can lead to extremely risky behavior if that information is incorrect.

To address this issue, we are developing a project called Nishauri, in close partnership with Mathare Youth Sports Association (MYSA), a youth organization with 25 years of experience of working to educate and empower young people in Mathare. Nishauri (“Please advise me” in Swahili) is a mobile counseling service, which seeks to connect counselors trained in HIV/AIDS and STI prevention to hundreds of youth seeking answers from a safe, private source. By harnessing existing local capacities of community counselors, Nishauri brings confidential, reliable, and timely information on sexual health and other sensitive topics to a broader cross-section of youth at risk, who may otherwise be reluctant to seek in-person advising.

Nishauri employs an Unstructured Supplementary Service Data (USSD) platform, complemented by Short Messaging Service (SMS). On their mobile phones, youth users can browse most commonly sought information on various health topics, or submit their own questions and receive responses from MYSA-trained counselors-- all cost-free and confidential.

-- Pablo Fernandez, Katie Hill, Risa Kitagawa, Eric Ruth - Coach Jofish Kaye, Nokia Research

Lishe (CDC)

Project Lishe (which means nutrition in Swahili) is a food nutrition program designed for a weakened and marginalized HIV positive mother who needs a healthy food program that supplements her family’s carb-heavy diet with vegetable and protein sources. A strong nutrition regimen is necessary for her health care as an HIV positive woman, so therefore, her children and her health absolutely depend on this enhanced nutrition. The program’s goals are twofold: 1) Lower the cost of acquiring healthy food through group purchasing, and 2) Inspire a woman and her family to eat a balanced diet. There are five key players going forward: the CDC and CFK who will help kick-off the program and provide high-level support throughout its lifecycle, agricultural wholesalers with whom we will negotiate in order to achieve discounts, agricultural suppliers who will negotiate the prices and distribute the goods to mothers, the participating mothers who will act as the inspiration and guiding force behind the program, and the Patient Care System, which is an existing IT system run by the CDC which tracks residents of Kibera from the health perspective.

To fund this program, we anticipate collecting a weekly membership fee from mothers which will fund not only the food purchased, but also the salaries of a nutrition assistant who will determine food allocations based on the particular needs of families, a program manager who will handle overall logistics, and dedicated suppliers who will work exclusively with this program. We believe this program will work because of the partnerships we have formed with partners such as Agneta and because of proven models such as that of Positively Africa.

--Jon Elist, Audrie Lin, Min Liu - Coach Arna Ionescu, Proteus Biomedical

ENDesha (CDC)

Childhood diarrhea is one of the leading causes of death for children under five in Kenya. 300,000 die from diarrhea in Kenya alone. Most of these deaths result from dehydration and could be prevented by giving the child a six-cent combination of salt and sugar (called oral rehydration salts or ORS). Presently, however, mothers tending to children with diarrhea don’t view ORS as a “real medical treatment,” they can’t assess the severity of their child’s condition, medical services in Kibera shut down on nights and weekends, and the journey to the nearest hospital is long, costly, and dangerous.

The ENDesha hotline project is designed to drastically reduce childhood deaths form diarrhea by (1) improving access to oral rehydration salts; (2) changing public perceptions around their medical efficacy; (3) providing immediate personalized medical counsel at times when legitimate medical services are closed; and (4) following up with patients to ensure successful outcomes. The initial phase of launching ENDesha in a community will be a one-time distribution of ORS packets with the ENDesha Hotline phone number to households with children. Even where misperceptions around ORS exist, ready access to free ORS is likely to help convince wary mothers to try using it. When their children are ill, mothers can call the ENDesha Hotline free of charge. To keep costs down and increase the scalability of the project, ENDesha Hotline will largely rely on a voice-automated algorithm to handle calls – only patching calls through to an ENDesha-trained medical counselor in cases requiring immediate hospitalization.

When the Hotline calls a mother back it will first ask whether she is calling because her child currently is suffering from diarrhea to make sure that she is calling for the right reason. ENDesha will then proceed with a series of triage questions – three symptoms any one of which indicates that the child should be brought to a hospital immediately. If the child requires immediate hospitalization, the caller will be routed to a live operator who will inform the mother that her child’s condition requires immediate hospitalization and encourage the use of ORS before she leaves. For cases that pass the triage stage, mothers will be asked for the child’s age and five symptomatic questions. Based on their responses, additional cases may be routed to a live operator for immediate referral to a hospital or, for cases that can be deferred, mothers will be recommended to administer ORS and educated about the treatment of diarrhea. For mothers who do not have ORS or need help dosing it correctly, further optional assistance will be provided. Finally, ENDesha will follow up with patients. For hospitalization cases, the medical operator will call back in an hour. For deferral cases, mothers will receive a text message the next day.

Despite the amount of general health information being dispersed in Kibera, the desire for immediate personalized medical counsel was strongly voiced in our need-finding. When medical crises strike, people just want someone who can tell them what they should do. ENDesha can fill that need – providing immediate personalized medical counsel twenty-four hours a day, seven days a week – and save the lives of thousands of children. 

--Belinda Chiang, Jonathan Leland, Daniel Wiesenthal, Sun Ying  - Coach Sam Yen, SAP

class photo

You can see: