An innovative component of the Global MBA takes Carey student teams around the globe to find solutions for people living in areas of great need.
By Jennifer Walker
Last January, Global MBA candidate Amanda Creel learned that things don’t always go as planned when one does business in another country.
Creel and her team of three fellow students worked in Kigali, Rwanda, to improve efficiency at a 16-bed health clinic by implementing a series of tracking cards. The idea was that patients would get a tracking card with their check-in time upon arrival, then hand the card to every person who treated them, who would also record their check-in and check-out times.
Once the cards were completed, the Carey School team could see where patients were spending the most time and make recommendations that could improve patient wait times in those departments.
But, Creel says, “it was hard to communicate to the employees the importance of the cards and exactly how they worked. A lot of them came back incomplete.”
The team was prepared for this, though. They had created a work plan for the project before they arrived in Rwanda as part of the Carey Business School’s Innovation for Humanity course, also known as I4H. And Lecturer John Baker Sr., faculty advisor for Rwanda projects, also told them to expect to make adjustments. “There [is] some change when their feet hit the ground,” Baker says. “They have to figure out how to adjust the plan to get the work done and make an impact for these people.”
So the team adapted: Creel spent a few days at the front desk filling out the cards herself while the others did the same in various departments. As a result, the team ended up with 100 cards that they used to find inefficiencies within the entire patient cycle, from entering to exiting the Polyfam Clinic.
The Polyfam project is one of nearly 60 corporate social responsibility projects that 250 Carey students have completed in Ecuador, India, Kenya, Peru, Rwanda, and the U.S. since the I4H course began in 2010. The course, which is a requirement for first-year Global MBA students, begins in the fall with lessons and case studies about social entrepreneurship, various country markets and sectors, and the challenges that businesses encounter in developing countries. As part of the course, students will spend nearly three weeks abroad during the January intersession working with global businesses. So they plan for their trips also by initiating contact with their sponsors and developing work plans.
It is this opportunity to dive into international business projects that sets Carey apart from other business schools.
“Every MBA program has a very strong global component, but a lot of that is going abroad, meeting people, and being briefed as to what they do. It would be a tourist perspective,” says Professor Dipankar Chakravarti, who created the I4H curriculum and directs the course. “We thought an approach where students would have to conceptualize a problem before they had a good understanding of a country’s environment would be very eye-opening. That’s because all of the things that they take for granted in a traditional business environment generally are not true in these countries. If they’re working on an irrigation project that involves using an electric pump, it’s not clear that they’ll have an outlet to plug it in. So students have to be flexible and adaptable in order to deal with the realities on the ground.”
The students also take away an understanding of how to communicate with other cultures. This lesson is learned both within their four- and five-person teams, which are often diverse themselves – Creel’s team included students from China, Vietnam, and the U.S. – and in their assigned countries, where asking a direct question or scheduling a meeting may not produce the expected result because of cultural differences. While taking these factors into account, students have only a short time to develop recommendations intended to strengthen both businesses and communities.
“Inexperienced eyes are actually an advantage because we don’t fall into seeing things the same ways,” Chakravarti says. “Students have gone to these countries and have had a dramatic influence by using their eyes and common sense, supplemented by basic management tools that they have learned in the first semester of their GMBA program.”
India: Increasing Access to Safe Drinking Water
Hyderabad, India’s fourth most populous city with nearly 7 million people – about twice its population from just seven years ago – is a place where drinking the local water can cause stomachaches and diarrhea. Safe drinking water is available from companies like the Naandi Foundation, but it costs a few rupees per month (less than five cents). But in the rural areas surrounding the city, where the daily salary is less than $2, villagers may not understand why they should pay for something they can get for free.
In January 2013, a four-person team from the I4H class went to Hyderabad to help the Naandi Foundation make its water plants sustainable long term and increase its customer base, all while fulfilling its social mission of providing safe and affordable drinking water.
Early on, the team, which included students with experience in engineering and finance – I4H staff match students’ backgrounds with each project’s needs – realized that Naandi was only charging two or three rupees for 20 liters of water. “At that point, you may as well give it away for free because you’re nowhere near covering your overhead costs,” says Michael Digafe, a Global MBA student and the project’s team leader. As a result, some of Naandi’s water plants were in danger of closing. So the group recommended new price points, which varied by village depending on socioeconomics and other factors. To help communities understand the need for the price increase, the team counseled Naandi to share its accounting ledgers, showing the villages how long they had before their plants would be forced to shut down.
Then, to learn how the water pumps work, the team traveled six hours south to Vijayawada (population: 1 million) – sharing the road with “cows and [three-wheeled] autos and buses and trucks and cars and people and lots of bicycles,” says Senior Lecturer Bonnie Robeson, the former faculty advisor for India projects. In Vijayawada, they spent three days visiting seven water plants in seven villages so they could make recommendations that would reduce costs, such as buying energy-efficient pumps. Later, the team combed through the financial data for six of the plants and discovered that Naandi was paying too much for electricity at some pumping stations. Once the billing was corrected, the company could pass that savings on to consumers.
While in each village, the team also talked with the panchayats, a group of community leaders who are in charge of organizing their village’s services. They learned that villagers often collect the Naandi water by walking one or two kilometers one way while carrying a 20-liter jug – a trying task on a daily basis. So the team recommended that Naandi look into offering a water delivery service. “The villagers were willing to pay a couple of extra rupees for that service,” Digafe says. “That would allow Naandi to stabilize their price point while giving more people access to their water.”
This firsthand contact with the villagers is an important component of the I4H course. “Students need to understand how to interact with other cultures, as well as their similarities and differences,” Robeson says.
In Vijayawada, Digafe learned that the villagers are culturally attuned to being agreeable, even if they don’t agree with the information being presented. So the Hopkins team had to change its approach when talking with them. Instead of asking outright if a panchayat agreed with a statement, the team members would be more subtle in their questioning, then interpret facial expressions like the head bob, which equates to a half yes/half no. “When we got that, we kept trying to talk our way through the communication channels,” Digafe says.
Digafe says that his experiences in India will help him better communicate with his future colleagues, who he expects will be all over the world. “I4H helped me understand that different cultures have different ways of approaching problems and coming up with solutions. When you actually do the work in person with people who don’t live in the same area code as you, it makes so much more sense that way.”
Peru: Building a Cohesive Farming Community
For six years, Red de Energía del Perú (REP), the largest electrical power provider in Lima, has been working to enhance the quality of life for urban farmers who live in Villa María del Triunfo, a district just outside the city. These farmers, or huerteros, fled the highlands for Lima in the 1990s, when Peru’s government was at war with two rebel groups. Today, the district has 13 small farms that grow produce like eggplant, lettuce, peppers, tomatoes, and potatoes, the majority of which are kept for personal use. The farmers live very close to one another, and they face the same community issues. But, they don’t speak Spanish fluently – some speak an Andean dialect known as Quechua – or read or write at all, even though Spanish is the primary language. “They don’t yet have the self-skills and resources to think as a whole into the future,” says Silvana Ricalde Lizarzaburu, REP’s Analyst of Corporate Social Responsibility.
Still, there is opportunity here, if the farmers can work together. They could start selling their produce on a larger scale, or solve community problems like the growing piles of trash in the district. So REP wanted to develop a nontraditional curriculum to teach the farmers communication and leadership skills. In January, the company sponsored five I4H students to create this curriculum, which would be known as the leadership academy.
“The leadership academy was designed to engage a small core group of farmer leaders whose influence extends to many other farmers and build them into an organized community that sustains itself,” says Associate Professor James Calvin, faculty advisor for Peru projects. “But it also needed to operate within the cultural context of Peru and the huerteros group that Red de Energía supports. The students were very cognizant early on of making sure they were respectful when doing this work in another culture.”
Once in Peru, the team’s first step was traveling to Villa María del Triunfo to talk to the farmers. With the assistance of a translator – and a good selection of candies to break the ice – the students learned that some of the farmers were afraid they wouldn’t be heard. “They had some clear leaders, so it was hard for others to speak over those people,” says Global MBA student Sarah Grannemann. “Everyone looked to one person as the father of the community and had to do what he said. So helping them learn how to voice their opinions was important.”
The farmers also talked about their community issues, such as disposing of trash, which wasn’t picked up by the municipality of Lima. Instead families would drop their trash, plastics and all, in designated spots, then someone would set the heap on fire, creating toxic fumes.
From these interviews, the Carey School team began to fashion a mission for the course. “The farmers needed better lines of communication so they could then work together to develop group goals,” says Alexander Glogowski, a Global MBA student and the project’s team leader. “That would lead to goal-setting behaviors and strategic planning for how they could achieve those goals as a group.”
The students gained the most insight into how they should organize the course content after listening to two women from two different farms talk about how they lost their sons at a young age. “The conversation really showed us that even though they had communication problems with regards to leadership roles and unmet needs, they really did want to communicate with one another,” Glogowski says. “That helped us think about ways to engage communication that would center around sharing personal experiences.”
After this visit, the team worked in Lima, creating a pyramid-structured leadership academy that emphasizes listening, conflict resolution, negotiation, strategic planning, team building, and proactive behavior. The final curriculum included 11 topics covered in 24 lessons, and a list of resources to solve problems, such as contact information for a local landfill where they could dispose of their trash. One farmer from each farming community – a total of six males and seven females – would meet weekly, and each topic would take two weeks to complete with the final two weeks devoted to presenting individual goals.
As of July, Ricalde Lizarzaburu was planning to implement the leadership academy during the next year with the help of IPES, an NGO. About the students and their work, she says, “What I received from them is more than a project. This academy is going to help [the farmers] create in the future some organization of people.”
Rwanda: Improving the Efficiency of a Private Health Clinic
In Rwanda, the Kigali Memorial Centre was built on a site where more than 250,000 people are buried. This represents only a fraction of the 1 million people – 10 to 15 percent of the population – who were slaughtered during the country’s three-month-long genocide in 1994. Afterward, “the country, by the people’s words, was completely destroyed,” says Baker, the I4H faculty advisor for Rwanda. “There was no infrastructure, no government they trusted, no health care, no public transportation. So they’ve been rebuilding since then.” The Polyfam Clinic is part of that effort.
Founded in 1997 by Dr. Immaculée Mukatete, who owns and manages the clinic and sees patients there, Polyfam is one of the few private clinics in Rwanda, where 95 percent of health care is government-run. It’s located in Kigali, a city that Creel, the I4H student, found to be much cleaner than Baltimore and quite pretty, with views of the green hills and low-lying clouds in the distance. (Rwanda is known as the “land of a thousand hills.”) In the city, the roads are paved and easy to navigate for a while, but eventually visitors will need to drive down a dirt path with gulleys as deep as a foot. This is the route to the Polyfam Clinic that Carey’s students have taken for the last three years – the longest-running partnership that I4H has had with a project site.
In 2011, students began the partnership by looking at Polyfam’s record-keeping system. At the time, the clinic had around 22,000 manila folders organized by patient number. Students helped staff move to an electronic medical records system using the clinic’s resources, which, at the time, were an IBM PC and Microsoft Excel. Today, Polyfam has moved all of its records online.
Then, in 2012, the second wave of I4H students wrote a business plan in preparation for the clinic’s transition from a one-floor operation to a four-story hospital. Earlier this year, the hospital was in the preliminary stages of construction.
But before transferring to a facility that’s eight times the size of the clinic, Mukatete wanted to make sure Polyfam was running smoothly and utilizing current resources. That’s when Creel’s team came onboard to measure the clinic’s efficiency and offer recommendations for improvement.
To make an impact, the team also had to adapt to the way Rwandans do business. For example, the country views time differently: There aren’t any clocks on the wall and people are sometimes late to meetings. “They’re just not in a rush like we are here,” Creel says. “I’m used to being rushed, so it’s hard for me. But I learned I just can’t expect something to be done right away. They work the way they work.”
Communication was another challenge. There was one team member who knew some French – she was able to interview staff members about their responsibilities and issues – but Creel and the other students did not know French or Kinyarwanda, the native language, at all. Short on options, they decided to simply observe the clinic in action, which yielded a wealth of information. “We went in expecting to quantify everything and have our work based on numerical data,” Creel says. “But sitting for a few hours and watching the people work told us a lot about the clinic.”
Observing is exactly what Creel’s team did after analyzing the tracking cards. These cards showed that the time between going to the lab and getting the results from a physician was the bottleneck in the patient processing cycle and the cause of long patient visits. “In America, we go and get our blood drawn and we get a call a couple of days later,” Creel explains. “In Rwanda, they wait for their results.” During this time period, the team noticed that staff members were duplicating some tasks. For example, once the lab results were ready, a technician would handwrite a copy for patients to take home, then enter the same information into the online database. So the team recommended installing an old printer at the technician’s desk, so he could type lab results into the computer system and print out copies for patients.
In all, the team made about 10 recommendations to improve efficiency. Some issues were easier to fix, such as putting signs on doors to help patients navigate through the clinic. Other suggestions took longer to implement. When the team discovered that doctors weren’t always checking out patients in the computer system – an important action that sends the patient’s information to billing – they recommended adding a required checkout box to the online records. But Polyfam’s one IT professional got married and went on his honeymoon around this time, putting this suggestion on hold.
Still, Mukatete says by email that the students’ recommendations over the last three years “have actually improved the performance of the clinic in terms of service delivery and management [and] brought positive impacts to our business in terms of growth and reputation.” She’s even recommended to Baker that they think about coming up with a longer project for students. “Every time [the students] leave, we feel like we still need them,” she adds. “They help us uncover many opportunities in our business.”