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ENDesha

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. 

Our Team

Belinda Chiang is a Master’s student in Management Science and Engineering concentrating in Finance with an undergraduate at Stanford in Community Development and Social Entrepreneurship. She’s particularly interested in for-profit social impact with experience in microfinance, entrepreneurship-training, public health, cleantech, technology strategy, and philanthropy. She also studied at Oxford University and University of Cape Town, taught a course on “Women & Entrepreneurship,” was director of a startup nonprofit called Gumball Capital, and will be starting a design consulting firm in Taiwan.

Jonathan Leland is a second year law student at Stanford. He attended public school in Washington, D.C. and graduated from Wesleyan University in 2005 with a degree in Psychology. After college, Jonathan was a founding director of Thanda (www.thanda.org) - an NGO in South Africa that provides guidance, education and advancement programs for high school students and in rural communities.

Daniel Wiesenthal is a Masters candidate in Computer Science at Stanford, where he majored in Symbolic Systems as an undergrad. His CS studies focus on Human Computer Interaction and Natural Language Processing. He is also fascinated by East African culture and language, and passionate about the role mobile technology can play in HIV education. He speaks fluent Swahili, and recently spent 6 months researching HIV education on the coast of Kenya. These studies culminated in Dan leading a pilot marine-environment multimedia HIV education+VCT (voluntary counseling and testing) project exploring the feasibility of sending doctors and educators throughout the Lamu Archipelago on ships to host health festivals focused on HIV. Dan is currently founding an internet startup in Palo Alto.

Ying Sun is an MBA student at the Graduate School of Business and an MPA/ID student at Harvard Kennedy School. She graduated from Harvard College in 2006 with a degree in Applied Mathematics. After college, Ying worked as a management consultant at McKinsey and Company, where she worked on strategic and operational consulting projects for International Aid Agencies, developing country governments, and NGOs. She has also worked in business development and advisory roles for social ventures, such as Click Diagnostics, a mobile health company.