Finally! Two years after the ColaLife trial in Zambia came to an end, we are very pleased to confirm that the UK’s Department for International Development (DfID) will be the majority funder of our new project in Zambia. It took a significant effort for us to win this money. The process has taken nearly a year, and involved not only an initial 'Concept Note' and then a fully costed bid, but also a complete review and development of all of our systems.
This is the fully funded project we have been waiting for: we have always known that the key to establishing our ground-breaking diarrhoea kit - Kit Yamoyo - as a sustainable product in Zambia is to work in the biggest market - where the most people live.
That is the capital, Lusaka, where over 2 million of Zambia's 13 million people live - over half of them in 'compounds' - or shanty towns. Our first work was in remote rural areas, because we wanted to prove that a well-designed, desirable and affordable product would get there - based on learning from what Coca-Cola and other corporates do. But for sustainability, a proper market launch, targetting the biggest population is key.
This new project - called KYTS-LUSAKA - will ensure that parents of 100,000 children will be able to buy an affordable diarrhoea kit close to home. It will also train several hundred shop keepers and community health workers - not only in how to use Kit Yamoyo, but also in using safe water, hand-washing and hygiene, and the 6 danger signs to beware of, in a sick child.
So, where do our Global Giving supporters come in? Whilst most of the funding comes from the UK Aid Direct Programme, we have pledged a voucher fund of £16,500 (or $25,000) to offer discount vouchers to mothers and carers in the poorest areas. This is enough to co-fund 30,000 vouchers. We would not have been able to bid for the project without the on-going support of Global Giving supporters! We are also adding co-funding from the GSK and Save the Children Healthcare Innovation Award.
This new project will mean a lot to some of the poorest families in Zambia. Our local project manager, Albert Saka, tells us: "All of our work piloting Kit Yamoyo so far tells us that families really worry about their child dying from dehydration from diarrhoea - or remaining weak because of many recurrences. With so much pressure and crowding in public clinics, they want to be able to find a top quality medicine close to their home. We have waited a long time for this latest plan to come to fruition. Thank you Global Giving!"
Are you in or near London on the evening of 27th July? If you are, please join us at a free event for ColaLife supporters, both existing and new. Come and hear about our future plans yourself, ask questions, and see the ColaLife Film.
Work in Zambia is moving forward – with one new project already underway this year, aiming to reach the most remote areas where under-nutrition is rife, and one set to start in the heavily populated capital, Lusaka, in September.
Both of these projects feature implementation through local agencies: our way of ensuring ownership, alignment to local cultures and people, and long term sustainability. And both will feature vouchers, crowd-sourced through our Global Giving support network! We know how important these vouchers are, as at certain times of the year, before the harvest is in, many communities become low on cash:
Local mother Tilingenji told us: “The first time I tried Kit Yamoyo, I had a voucher, and this helped me as I had not yet sold [my harvest]. My child Kondani got better quickly, and up to now, has not suffered from diarrhoea again. So, my advice to other mothers when a child has diarrhoea is to buy Kit Yamoyo, even if you do not have a voucher, because it will help your child to improve quickly.”
Kit Yamoyo vouchers work in several vital ways. Given out via community health workers for redemption in local shops, they help us to target the poorest mothers and carers who have low incomes, poor educational level, large families – often more than six mouths to feed – or additional burdens to cope with, such as disability or long-term illness like HIV-AIDS.
Secondly, they help to ‘pull’ Kit Yamoyo out into even the most remote areas, in effect putting ‘value’ in the hands of mothers at the end of what distribution experts call ‘the value chain’. We feel this approach is much more sustainable than free products. This can undermine local shops and livelihoods.
Thirdly, local shop-keepers tell us that vouchers give them confidence to buy and bring Kit Yamoyo, when they know these are circulating in the community.
There are still challenges to overcome, but we also have some exciting new partnerships emerging – expanding the ‘channels to market’ for Kit Yamoyo – so that it will soon be available via government clinics and supermarkets.
Hope to see some of our supporters in London soon!
Jane and Simon
This spring, Albert Saka, from our partner Keepers Zambia Foundation (KZF) has been out and about in Lusaka's compounds (townships) finding out what people think of ColaLife's Kit Yamoyo Anti-Diarrhoea Kit.
As well as visiting shop-keepers, and showing round some VIP guests (more below!), Albert was able to interview an enthusiastic customer: Margret. Her daughter Rabecca has been suffering from diarrhoea for a while. In Zambia, diarrhoea is a serious problem for children under five years old: caught in a downward spiral of poor nutrition and chronic diarrhoea that they can't shake off, they can easily fall prey to Zambia's third biggest killer of children under five. Oral Rehydration Salts are often out of stock in clinics, not available in shops, and 1 litre sachets are not well-suited to home use. Zinc in combination with ORS - a simple, affordable, essential medicine - is now the ‘gold standard’ treatment for diarrhoea, but is rarely available. Marget confirms what we already know too well: that many parents have difficulty finding easy-to-use treatment, close to home.
Margret tells Albert: “Kit Yamoyo really helps us a lot. In the past we went to the clinic we used to wait in line and at times we were told that there's no ORS. Now we just go to a shop and buy Kit Yamoyo. Kit Yamoyo is easy to make up. If your child is sick, whenever you go out, to a funeral or to church, working or trading at the market, you can easily buy it and it is so easy to use you can even trust someone else to make it for your child.”
She has already noticed the difference it makes to have zinc in the kit: “The benefit we have found with Kit Yamoyo is that it also has zinc tablets and soap to wash our hands. We don't always have soap at home, but during diarrhoea it is important to use soap. When we give the child zinc tablets it gives them strength and appetite and stops the diarrhoea. Besides Kit Yamoyo, zinc cannot be found at the clinic or shops. So I recommend Kit Yamoyo to my fellow mothers whenever their children have diarrhoea”.
Albert tells us: "Since we finished trialling Kit Yamoyo with ColaLife, at the end of 2013, we've been working to scale-up our work, especially retailer training and community awareness, as well as stimulating production and sales, through our production partner, Pharmanova. KZF is a small organisation and we are proud that the whole world has admired our work. We do need funding to educate shop-keepers and the public on this new product and how to use it. But in spite of the success of the trial, raising new funding has been difficult... "
Until now: 2015 looks like it could be our breakthrough year!
One evening, at the tail-end of 2014, ColaLife got a surprise call: we were joint winners of the GSK and Save The Children Healthcare Innovation Award! We've been lucky to win a lot of recognition up to now. But this award is different: it comes with $370,000 - a share of the Million Dollar prize! These were the VIP guests Albert was show-casing our work to, at the start of the year. By Feb-15, the announcement was official, and the award is in the bank!
This award will go a long way to making our scale-up plans a reality. We will stretch it as far as we can: offering ‘match funding’ can really help pull in government support. We have put some aside to keep our work in Lusaka going, until a new project starts, hopefully later this year. The win has already helped ColaLife and KZF to launch a market development project in 14 of the most remote districts in Zambia – where the majority funder is the Scaling Up Nutrition (SUN) programme. And that has resulted in a first, big, public sector order for our partner, Pharmanova.
Since we met up with Albert in Lusaka, he has been out on the road for 8 weeks, visiting these remote areas. He tells us: “The response from key government institutions and other stakeholders has been great. They can’t wait for the programme to get started. They know it is a big job to reach remote villages. We make sure that health personnel and the community know the product and how to use it. And the trainings we deliver to retailers are vital: apart from bringing the kit and selling it, they can help to educate mothers on how to use the kit.”
And Albert adds a big thank-you to our Global Giving supporters: “I wish to thank all those who contribute to our voucher fund: that’s how we make sure this new product is affordable to people like Margret and her little daughter, and helps us do our job to establish Kit Yamoyo for the future”.
Happy New Year from all at ColaLife and from all the families and their children who have been able to get an award-winning Kit Yamoyo AidPod from their local shop over the past two years. Our aim is to help people help themselves, to combat the world's second biggest child-killer - diarrhoea - by making the very best essential medicines affordable, easy to use, and easy to find in communities all across Zambia - and hopefully beyond!
Our Year End Challenge on GlobalGiving raised an amazing $12,000 plus a $1,000 bonus from GlobalGiving, for qualifying in fifth place, so by the end of December, we'd reached our 2014 target of $40,000.
Thanks to your generosity, around 40% of all the Kit Yamoyo purchases so far have been supported by a discount voucher. For 2015, we plan to offer discount vouchers to at least another 15,000 mothers, so they can get our life-saving kits in a nearby shop to treat their children effectively in the home. To do this, we need raise our GlobalGiving target by another $25,000, helping us reach 65,000 children by the end of our third year in Zambia. We're also expecting to announce new grants very soon, that will support our local partner, Keepers Zambia Foundation, in their education work among communities and small-scale retailers.
The vouchers are a great way you can help a mum or dad try Kit Yamoyo for the first time and learn to use it. Vouchers also give confidence to local small shop-keepers, so they are willing to invest in the new Kit Yamoyo product. We aim to train over 100 shop-keepers in 2015.
So far, most of our work has been in remote rural areas, but in 2015, we will be starting a new project in Zambia's capital, Lusaka, and other urban centres. Although public health services here are closer to people's homes than they are in the rural areas we have been serving so far, our research shows that many of the same problems still exist: over-stretched and poorly-stocked clinics, long queues for treatment, almost no suitable products in the many small shops people use daily, and poor awareness of how to treat children's diarrhoea quickly at home, with Oral Rehydration plus Zinc.
Our 2014 pilot showed that training local shop-keepers in Lusaka's urban 'compounds', to sell Kit Yamoyo and to pass on health messages to their communities, has real potential in urban settings. As Mr Hamwemwe, a newly trained shop-keeper from Lusaka's George Compound told us: "I'm pushing this new product to the community. It will make a big difference, because diarrhoea is always a problem during this season." And these larger markets will provide more customers for our local manufacturing partner, Pharmanova, and help establish Kit Yamoyo as a self-sustaining independent product in Zambia.
Your donations carry on doing good - because for every ten kits Mr Hamwemwe sells, he will earn at least $2.50. That sounds a small amount, but can help send his child to school, or feed his family for a week. So, let's see if we can get to our new target of $65,000 for 65,000 Kit Yamoyo AidPods by the end of 2015!
Thanks again, and Happy New Year!
When ColaLife set out, in 2008, to improve distribution of simple medicines by ‘harnessing’ Coca-Cola’s world-renowned distribution of fizzy drinks, the logic seemed simple:
i) Cola gets everywhere in developing countries – especially Coca-Cola
ii) Simple life-saving medicines, like Oral Rehydration Salts and Zinc for diarrhoea, don’t
iii) Within most developing countries, Coca-Cola arrives – even in remote villages - in the world-famous red plastic crates.
So: design an anti-diarrhoea kit - or 'AidPod' - that fits into a Coca-Cola crate and it can ‘hitch a ride’. Simple. Clever. Sustainable.
But the real world is never that simple, as we were to find out.
Some things, we did right: we began by sharing our idea with as many people as possible, both professionals and people living and working in Africa, to see if it really was a good idea, if it could be improved, changed – or should simply be thrown out. We began our research in earnest in 2008. We took advice from experts in logistics, from specialist staff at Coca-Cola, and most importantly, from people on the front line, such as mothers, carers and - in Tanzania - small distribution businesses, called MDCs (Micro Distribution Centres). Our first ideas included removing a bottle from the cola crate, and putting a tube in its place, or putting a wedge-shaped pack in the space between the crated bottles. Generously, Coca-Cola itself made no objection. But what did the frontline think? Simon visited several MDCs in Tanzania to find out.
Removing even one bottle was our first fail, immediately seen by small retailers as a potential lost sale. But the ‘wedge’ idea fascinated people: “It’s a good idea,” Benito, an area sales manager, tells us in this video clip. “Coca-Cola gets everywhere but medicines don’t. It would be good if we could be doing something to help with people’s health.” We also spoke to mothers in Uganda and Zambia, as well as health professionals, Ministries of Health and even UNICEF and WHO. Emboldened by wide-ranging support, we went ahead to work on prototypes of an aspirational new anti-diarrhoea kit that fitted into cola crates. So far, so good.
Failure number two was a communications conundrum, which, despite our best efforts, persists to this day. This first raised its head as The Coca-Cola Distribution Myth. Many people imagine that this powerful global giant owns and controls its channels to market. People thought we were proposing international distribution: inserting anti-diarrhoea kits into crates in factories in America or Europe, and then shipping the entire crate into Africa. What a powerful myth that is!
In fact, Coca-Cola is manufactured locally, in over 200 countries in the world. Amazingly, they are one of the biggest employers in Africa. Lorries may carry crates between major towns, but Coca-Cola owns no mules, bicycles, oxcarts or buses, and this is how a myriad of products is carried into villages. Anywhere a lorry can go is fairly straightforward - we were interested in those carts and bicycles: the 'last mile'. On top of this myth, the fact that we ‘dared’ to work with Coca-Cola returned to haunt us again and again. We regularly receive heavy criticism for proposing distribution ‘dependent’ on a global giant that ‘peddles’ unhealthy sugar-water. But, in fact, people everywhere make their own choices on what to eat and drink, and what to buy – and this includes the poor in Africa. The ‘magic’ of Coca-Cola distribution is conjured by millions of humble, independent shopkeepers like Shadrick (pictured) who make their own decisions on purchases, and on Shadrick’s customers, who make choices on how to spend their money. The lesson here: understand the complexity, but keep your messaging simple, and keep repeating it, again and again. Be patient. The world has many pre-conceptions, and you cannot change those overnight. Were we wrong to work with and learn from producers of an unhealthy commodity? We think not. But choose your battles – you can’t fight them all.
In spite of these recurring challenges, the idea of the anti-diarrhoea kit in the crate took off. Journalists contacted us; awards rolled in. Almost without our realising it, the photo of the 'clever packaging' that fits snuggly between bottles of Coca-Cola went viral, and quickly came to represent our work: a classic case of the 'double edged sword'.
By early 2013, we knew that the ‘Kit Yamoyo’ (Kit of Life) and the distribution trial was a huge success. Before we began, less than 1% of children in our trial areas were getting the world-recommendation of ORS and Zinc for diarrhoea. Within 12 months, we had increased that to nearly half of all children in our trial areas: 45%. We had set up the trial to measure, observe and learn - and we soon found that, in spite of astounding successes, it contained at its very heart our biggest failure to date: only 4% of kits were actually carried back to the village in cola crates. Yes, retailers bought them, and carried them on bicycles, carts and buses; but in cartons and bags, not slotted into crates. Coca-Cola was losing out to cheaper sodas in rural areas; and in any case, demand for Kit Yamoyo was higher than could be accommodated in the crates going out to villages. Could we have found this out before design work started? Sometimes the only way to find something out is to try it in practice. Innovation is unpredictable. You end up in places you didn't expect.
So, we were back to managing the communications conundrum: even one of our kindest commentators, Peter Day of the BBC, asked if our award-winning design was ‘a bit of a con’.
Some of the criticism was a lot worse.
What to do? We had to face up to the fact that fitting the kit into cola crates wasn’t important after all. The easiest route would have been to keep that finding under wraps, to stick to our story, hang on to our now-famous photo of the kits in the crate, and defend our award-winning design. But how would that have helped our beneficiaries? Most of the 25,000 mothers and carers we had helped had no idea that the kit was designed to fit into a cola crate – but we had listened and learnt from them: we had introduced many benefits they really did want: smaller sachets for the Oral Rehydration Salts (200ml instead of the traditional 1 Litre); an easy way to measure the water needed; better tasting medicine; easy to understand instructions; and, as well as the vital Zinc tablets, a small bar of soap for hand-washing.
So, we publically announced we were ditching the award-winning packaging design – but were keeping all of the benefits that mothers, carers and retailers value. We’d learnt it was the space in the market, not the space in the crate, that was important. And the space in the market was a much more complex story, about how to design with the poor, for the poor – to better meet their needs. So we went back to the drawing board, to unpick what we had really learnt, and bring in cost reductions as well as more design improvements. We now have two designs: cheaper, better and more fit for purpose.
This change of direction could have been a huge embarrassment. But amazingly, by ‘coming clean’ straight away about the failure, we have won more praise, more friends, and more understanding. One of our award-givers even asked us back to the presitgious event we had won the year before, to hear more about our failure.
What the journey so far has shown us, is that it is OK to fail, as long as you are prepared to learn. Find the parts that do succeed and build on those. More than that: if at least some elements of your innovation don’t fail, perhaps you have not been brave enough. And unless you are equally proud of your failures as your successes, no-one will learn. But most important of all: listen to those you set out to help, what they want and need. If you stick to that, you can’t go far wrong.
Project Reports on GlobalGiving are posted directly to globalgiving.org by Project Leaders as they are completed, generally every 3-4 months. To protect the integrity of these documents, GlobalGiving does not alter them; therefore you may find some language or formatting issues.
If you donate to this project or have donated to this project, you will get an e-mail when this project posts a report. You can also subscribe for reports via e-mail without donating or by subscribing to this project's RSS feed.