East Bali Cashews: Empowering East Balinese women and farmers one cashew at a time

Nadia Putri - University of Michigan Ross School of Business

In 2012, Aaron Fishman travelled to rural East Bali as a healthcare volunteer and was amazed by the beauty of this region. But, he soon discovered that behind the beauty, East Bali is an impoverished region of farmers. 98% of people who live in Desa Ban (Ban Village), Karangasem Region, East Bali are cashew farmers. Farmers sold raw cashews to traders who shipped them overseas for processing. Aaron saw an opportunity to create a sustainable economic solution for these farmers and their families through agriculture and food processing. That’s how East Bali Cashews (EBC) was born in Desa Ban. Now, EBC employs more than 400 people with the majority being women from local area.

Factory employee carries a bucket of cashews to the splitting machine

The company has touched many lives of people in Desa Ban, as beautifully expressed by Ibu Lasmi, “I’m only a high school graduate, yet, the company believes in me and my potential. Never would I have imagined moving up from a daily worker to managing more than 50 workers myself.”

 

Nadia Putri - Ross School of Business

In addition, not only focusing on its social impact, EBC also puts high importance on its product quality. Boasting a wide variety of unique ingredients from East Bali, the company is aiming to deliver tropical indulgence from Desa Ban to consumers worldwide.

This summer, I’m honored to be chosen as one of WDI Global Impact Fellows to work at EBC as a business development intern. As a rapidly growing social enterprise, one person at this company wears many hats and so do I. My role in the company is divided into two: while I’m at Desa Ban factory, I’ll be working on quality improvement projects and also summarizing the company’s impact on women employees. In comparison, while I’m at Bali/Jakarta office, I’ll be looking into US market entry strategy. I'm very excited to be back in home country, working at a company that delivers real social impact to the community.

My first couple of weeks at EBC factory has been quite eventful. While in Desa Ban, I’m staying at EBC’s campsite (called East Bali Immersion) where I get to sleep in a tipi. As a city girl myself, it’s an amazing feeling to wake up to rooster crows, sleep to cricket’s sound, and shower under the open sky.

My bed and belongings inside East Bali Immersion's tipi

At the factory, everyone is very welcoming and open to share their stories. It’s especially humbling to see such high curiosity and willingness to learn from the factory employees. This serves as my daily reminder that situation you grew up or lived in does not define who you could be. More stories to come!

Improving maternal health in Kenya - Jacaranda Maternity

Andrea Arathoon – University of Michigan School of Public Health

Jacaranda Health is an organization that “aims to make pregnancy and childbirth safer for women and newborns by transforming maternity care in East Africa”¹. They started operations in 2011 with a mobile clinic that provided prenatal care to women in Kenya. It has now grown into two distinct arms that still work towards the same goal but cover two different aspects of maternal health.  Jacaranda Health’s NGO arm focuses on research and healthcare innovations. In 2017 they worked with 15 public/mission hospitals in two counties and this year they are expanding to three counties and more facilities. Jacaranda’s other arm, Jacaranda Maternity, is an 18-bed private hospital located in the outskirts of Nairobi. The hospital conducts over 25,000 outpatient visits per year and delivers an average of 115 babies every month. I have the privilege of working as a summer intern with Jacaranda Maternity.  

Jacaranda Maternity, located in Kahawa West

Jacaranda Maternity focuses on delivering high-quality, affordable healthcare to women and children. Quality care is based on three pillars: accessibility, excellent outcomes and continuous improvement. Jacaranda provides outpatient services every day of the week and is open for deliveries and emergencies 24 hours a day. In terms of outcomes, the hospital has not had a maternal death in over 4,000 deliveries, which is a testament to the highly qualified staff in the institution. Continuous improvement is also an essential part of the care provided. The staff has daily huddles, during which the previous day’s activities are discussed, and where opportunities for learning constantly arise. They also attend weekly educational workshops that allow them to be up-to-date on a variety of topics related to patient care.

Jacaranda Maternity’s target population is primarily low-income women and children around Kahawa West, a peri-urban area located north-east of Nairobi. Most of the hospital’s patients are women receiving pre and post-natal care in the facilities. These women also deliver their babies in the hospital and return for their child’s immunizations and wellness checks. The hospital also offers general medical outpatient consultations for adults and children, and includes a pharmacy and laboratory where patients can purchase their medications and receive a wide variety of tests, respectively.

The biggest challenge for an organization like Jacaranda Maternity that provides high-quality care while serving mostly low-income populations is financial sustainability. Over the past few months, there have been many efforts by Jacaranda Maternity to reduce costs and to increase patient volumes, while at the same time maintaining the high quality of care that Jacaranda is known for. One potential intervention that can have a positive impact on profitability is the improvement of patient flow in the facility. If patient flow is streamlined, waiting times can be reduced and consultations can be more efficient, which in turn, increases patient volumes and reduces costs. As part of my summer internship project, I have been tasked with mapping and optimizing the processes for outpatient visits and inpatient stays.  These improvements in patient flow include the rollout of an outpatient care checklist, which will simplify the current medical record and will ensure that the organization complies with World Health Organization and Kenyan Ministry of Health guidelines for patient care. This checklist will also serve as a decision-support tool that can aid providers in their clinical decision-making process, promoting high quality care.

I am very excited about my summer project and the impact that it can have in improving maternity care for women and children in the country.  

References

1.     Jacaranda Health. (n.d.). Retrieved June 12, 2018, from http://jacarandahealth.org/

Realizing Solar's Potential in Rural Nepal

Matthew Carney - UM Ross School of Business & SEAS

This summer I'm working with the solar startup Ecoprise to help bring solar-powered agricultural services to subsistence farmers in the Terai region of Nepal. As I write this, farmers in rural Nepal are preparing for the approaching monsoon season. Nearly two thirds of Nepal’s working population is made up of farmers, who rely extensively on the rainy summer season for irrigation given Nepal’s isolating topography and lack of infrastructure. Even with significant rainfall, rural farmers have difficulty maintaining their farms due to the high costs associated with pumping groundwater. This loss of productivity often prevents farmers from breaking out of a cycle of poverty. Thankfully, the emergence of solar- powered agricultural services could help reverse this trend and ensure that rural farmers can cultivate their land year-round.

In Nepal, only 40% of the country’s population - mostly in urban areas - has reliable access to electricity. In rural areas, that falls to a staggeringly low 5%. Despite this, Nepal benefits from more than 300 days of sun per year. The combination of Nepal’s natural solar capacity, plus its lack of electrical infrastructure in rural areas, makes it a prime target for solar-powered agricultural services.

In 2015, Ecoprise partnered with the International Center for Integrated Mountain Development (ICIMOD) and SunFarmer - two nonprofits operating in Nepal - to provide photovoltaic (PV) panels water pump infrastructure projects in the Terai region district of Nepal. The sites were monitored over the course of the following year, with increasingly positive results. By using the solar-powered water pumps these farmers were able to irrigate 24% more land during the winter months and 29% more land during the monsoon season. It also reduced the use of diesel- powered water pumps by 75% - saving the average farmer ~$500 per year.

Despite these encouraging signs, there is quite a distance yet to go. The farmers that participated in this pilot program tended to have more land, better access to irrigation, and own more pumps than the average Nepali farmer. In order to ensure equity of access, it will be critical for private enterprises and non-profits to work together to ensure solar-powered agricultural solutions can be made affordable for the farmers that could benefit most from the technology. Solar-powered agriculture presents an opportunity to raise the living standards of millions of rural Nepali farmers in a sustainable fashion - it would be a shame to waste it.