Secondary Incentives in Social Entrepreneurship

Today’s young techologists dreaming of a future in social entrepreneurship are more culturally sensitive than ever before, says Manish Bhardwaj, the CEO and co-founder of Innovators in Health. Even undergraduates recognize that their projects in the developing world must be “culturally sensitive, infrastructurally sensitive, and economically sensitive”: they must take into account the values of the local community, not presume the existence of electric power in a village that might have none, not create a product that the local population could never afford.

Innovators in Health biometric demo
Biometric demo. Credit: Innovators in Health.

All the more bewildering for these aspiring technologists, then, when they create clever solutions to urgent problems, being sensitive at every turn—and still their projects flop.

“The intriguing thing is that once you put down all the check marks for sensitive, appropriate technology, even if the customer seems willing and happy, even after that point, a lot of technology doesn’t have the impact you want it to,” says Bhardwaj.

It’s a humbling fact, and if Bhardwaj’s advice has a theme, it is that technologists can afford to be humbler. Your new technology may not be as revolutionary as you think; your customers may not want it; and it may not fix the problem by itself. Bhardwaj delivered these harsh truths—which he means as encouragement—in the form of a talk this month to students at MIT, where he recently earned a doctorate. (MIT’s ten-month-old Dalai Lama Center for Ethics & Transformative Values, where Bhardwaj is a fellow, hosted the event.)

One misunderstanding, says Bhardwaj, is that your creation is bound to be embraced because nothing like it has ever existed before. Perhaps you would like to set up Internet kiosks in villages or reshape farming practices using sophisticated atmospheric equipment. You may think that your competition is another technology company and define your product in relation to that competition, when in fact there may be imperfect but adequate solutions already in force that have history and familiarity on their side. Your Internet kiosks may be competing with a man on a bicycle who relays information from village to village. Your farming technology may be competing with a local sage who has been predicting the weather for years. For your product to succeed, you will not only have to persuade your customers that your technology is better than other technologists’ but better than longstanding local practices.

Even if your product will save lives, you may well have to prove its worth. Bhardwaj mentions a memorable article published in The New Yorker last December describing efforts in Africa to replace soot-producing home stoves with clean-burning ones. The old stoves contribute to various diseases, as well as climate change, but local people thought of the smoke as an annoyance that could be tolerated and were reluctant to make a change. (As Bhardwaj points out, someone can always produce “an 80-year-old grandma who has been cooking over that stove forever.”) This problem is not specific to the developing world, of course: it is the reason that, despite knowing about lung cancer and traffic fatalities, we still smoke cigarettes and text while driving.

The solution is to find new ways to communicate the importance of your product, and also to create what Bhardwaj calls “secondary incentives.” For instance, a major project in the 1980s built free or highly subsidized toilets in India to improve sanitary conditions and clean up the drinking water. But because these new toilets were such a luxury, local people used them to store grains, to store poultry, even for religious rituals. (“Think of a mud hut, and then think of a beautiful new structure,” says Bhardwaj. “Are you going to defecate in the nicest part of your house?”) One strategy that wound up working there was sending NGO workers to local villages, where they would take a glass of water, add a drop of fecal matter to it, then pass the glass around to see if anyone would like to take a drink. When people were aghast, they said, This is what you do every day.

As for secondary incentives, one NGO created a range of options (priced between $7.40 and $74) and hired local people to encourage their neighbors to buy toilets (and offered these “motivators” commissions). This helped people to see toilets as fitting organically into their communities—as status symbols, even. When people were not persuaded by the idea of preserving their own health, they were reminded that their children’s health was at stake, and their community’s. “You have to appeal to people’s idealism and vanity both,” says Bhardwaj.

Innovators in Health smart pillbox
Priyanka Kumari and Shashi Pallwal test the uBox in Dhanarua, Bihar. Credit: Innovators In Health.

In the end, one of the toughest lessons for the technologist is that not all problems can be solved through technology. Bhardwaj’s organization, Innovators in Health, has developed high-tech products that it hopes will combat tuberculosis in India: a fingerprint logger that can reliably establish when patients receive medicine from providers and transmit that information wirelessly (developed with Microsoft Research India); a smart pillbox that reminds patients to take their medicine and keeps track of when they do (developed with Abiogenix). But these innovations would be useless, says Bhardwaj, if their partners in the region (Operation ASHA in Delhi and the Prajnopaya Foundation in Bihar) had not already developed largely successful TB treatment programs.

“We can only make a program that is good, excellent; we can’t make a program that is bad, good. If you go to an area where no programs exist, you have to be honest: in this region, what we need to do is start a treatment program, and if that’s not our primary focus or competency, we need to bring in others,” says Bhardwaj. “If you want to change the world, you have to be very honest about what needs changing.”

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