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there when they worked for the Bri­tish Aid Pro­gramme in the coun­try years be­fore, and the steep in­fant-mor­tal­ity rate for un­der fives at 145 per 1,000* il­lus­trated the need for it.

A killer ill­ness

In Zam­bia, 40 chil­dren die ev­ery day from di­ar­rhoea. It’s the coun­try’s third big­gest killer be­hind malaria and pneu­mo­nia. On top of that, Zam­bia has some of the high­est rates for food in­se­cu­rity in the re­gion, with Unicef not­ing that 45 per cent of chil­dren un­der five are stunted due to mal­nu­tri­tion.

In many ar­eas of this vast land, ac­cess to health­care is al­most non-ex­is­tent, with dev­as­tat­ing con­se­quences for even the sim­plest of ill­nesses. Di­ar­rhoea to a western par­ent is rarely cause for con­cern, eas­ily treat­able with a visit to a lo­cal GP. In Africa, how­ever, it’s an en­tirely dif­fer­ent story, with mothers of­ten faced with no al­ter­na­tive to watch­ing their de­fence­less chil­dren die. Even when mothers like Brenda walk long dis­tances in the sun to their near­est med­i­cal out­posts, there is of­ten lit­tle that can be done there.

The coun­try’s small, spo­radic health clin­ics are fre­quently run sin­gle-hand­edly by a clin­i­cal of­fi­cer, who serves as many as 8,000 vil­lagers – com­mon prac­tice in a coun­try where re­search sug­gests that shock­ingly, there is only one doc­tor for ev­ery 10,000 peo­ple.

With just one treat­ment room, th­ese clin­ics of­ten have no wa­ter con­nec­tion and no means of com­mu­ni­ca­tion other than the of­fi­cer’s per­sonal mo­bile phone. Even more dis­turb­ing, they fre­quently have no med­i­cal sup­plies.

The vast dis­tances be­tween med­i­cal posts and the vil­lage com­mu­ni­ties they serve make them an im­prac­ti­cal op­tion for many ru­ral pa­tients, and the Ber­rys knew ac­cess to af­ford­able medicine needed to be im­proved.

The plan to blan­ket com­mu­ni­ties with the Kit Yamoyo was rolled out across one-third of two of Zam­bia’s 80 dis­tricts ini­tially.

Co­laLife aimed to con­vince ru­ral shop­keep­ers that the kit was as valu­able to them as a can of Coca-Cola. If shops agreed to stock it, mothers could cut their travel time for life-sav­ing medicine in half. “Be­fore we started, in one of our dis­tricts women had to travel on aver­age 9km to their lo­cal health cen­tre, and that may not have had stock when they got there. Now those women have to travel on aver­age only 4km to get to a shop that stocks our Kit Yamoyo,” says Si­mon. Al­though orig­i­nally pack­aged with the in­ten­tion of be­ing fit­ted into crates of Coca-Cola, over the past few months the Kit Yamoyo has come into a life of its own and is mov­ing away from the crates as a means of trans­porta­tion. Co­laLife has re­cently dis­cov­ered that retailers are keen to pick up the kits from whole­salers at the same time they are col­lect­ing other stock for their shops.

Now only 8 per cent of its retailers use the Coca-Cola trans­port method. As Si­mon is keen to point out, rather than the ac­tual dis­tri­bu­tion, the most valu­able les­son they have learnt from Coca-Cola is the im­por­tance of a prod­uct’s value chain. In other words, if you make it valu­able and de­sir­able, it will work.

Si­mon is also re­al­is­tic that in or­der for the Kit Yamoyo to catch on, it has to be af­ford­able at com­mu­nity level. It retails at just less than Dh4 a pack – the price of five ba­nanas – but that could de­crease when its contents be­come lo­cally sourced. At the mo­ment the zinc comes from Tan­za­nia and the soap from In­dia, but al­ready Zam­bia’s only lo­cal soap man­u­fac­turer is pro­duc­ing a small bar of soap for the kits.

There is also the pos­si­bil­ity of a 35 per cent sav­ing on costs by mov­ing away from pack­ag­ing that fits into Coca-Cola crates.

“We started with the space in the crate,” says Si­mon. “But much more im­por­tant for the long term is the space in the mar­ket.”

Hit­ting the mark

It would seem the af­ford­able and med­i­cally ef­fec­tive de­sign strat­egy was right on the mark, be­cause ru­ral Zam­bian fam­i­lies – 80 per cent of who live in poverty, ac­cord­ing to The United States Agency for In­ter­na­tional De­vel­op­ment (Usaid) – are will­ing to make the pur­chase.

Re­cent sur­veys con­ducted in Kalomo and Katete dis­tricts show 100 per cent pos­i­tive feed­back from com­mu­ni­ties.

Talise, a 25-year-old mother of three says, “The ad­vice I can give to my fel­low mothers is to use Kit Yamoyo straight away when you no­tice di­ar­rhoea symp­toms. Your child heals very fast and you will not risk the sit­u­a­tion es­ca­lat­ing.”

The suc­cess of the Kit Yamoyo can be at­trib­uted to many things, but it’s im­por­tant to note that the peo­ple who in­spired the idea are those who are us­ing the prod­uct.

It was the mothers, grand­moth­ers and car­ers of sick chil­dren who put for­ward their re­quire­ments and shaped the de­sign be­fore it was even on pa­per.

Dur­ing the re­search stages, the Co­laLife team dis­cov­ered some­thing as sim­ple as mea­sur­ing the cor­rect amount of oral re­hy­dra­tion salts

(ORS) to wa­ter was pre­vent­ing mothers from treat­ing their sick chil­dren. The prob­lem they faced was that ORS is pro­duced for use in hos­pi­tals and is there­fore pack­aged in onelitre sa­chets. How­ever, a sick child re­quires just 400ml of ORS, mean­ing mothers should, if fol­low­ing in­struc­tions on the pack, throw away the re­main­ing 600ml af­ter 24 hours – some­thing Si­mon says is un­re­al­is­tic.

“Of course they don’t do that be­cause they are poor, so what hap­pens is they take a ran­dom amount of wa­ter and sprin­kle in a bit of ORS. They usu­ally get the con­cen­tra­tion wrong so it’s less ef­fec­tive.’’

And so the kit was tai­lored to re­solve the is­sue of mea­sure­ment and has been de­signed as an all-in-one mea­sur­ing, mix­ing and stor­age de­vice, while also serv­ing as the cup that chil­dren drink from.

And the win­ner is…

The great de­sign of the kit has been recog­nised, as it picked up the 2013 Prod­uct De­sign of the Year award in Lon­don. “It’s fan­tas­tic that some­thing de­signed with the poor and for the poor, and with the word ‘di­ar­rhoea’ in it, has won a main­stream, in­ter­na­tional de­sign award,” says Si­mon. “I con­grat­u­late the judges for be­ing so brave.”

Im­por­tant to the kit’s suc­cess is also the fact that, un­like most medicines on the mar­ket, it has been de­signed not only to help the sick but also to as­sist lo­cal retailers. Con­se­quently, in its first six months alone, 20,000 kits were snapped up by ru­ral shop­keep­ers in trial dis­tricts and as a re­sult of its avail­abil­ity at an af­ford­able price, the team be­lieves around 60 lives have been saved al­ready.

Now the Ber­rys know it’s time to start rolling out the ini­tia­tive na­tion­wide, and they have

It’s a grand scheme for a sim­ple but bril­liant idea

been push­ing ahead keenly with the Zam­bia trial to com­pile cred­i­ble ev­i­dence that the kits suc­cess­fully de­crease the num­ber of di­ar­rhoeare­lated deaths. They have part­nered with the es­teemed not-for-profit pri­vate re­search Univer­sity in the US, Johns Hop­kins, to gen­er­ate pos­i­tive hard facts to this end.

It’s a grand scheme for a sim­ple but bril­liant idea, to have ru­ral shops across Sub-Sa­ha­ran Africa stock­ing the kits in the same way they stock Coca-Cola. And what a co­in­ci­dence that in 1886, un­der the be­lief that car­bon­ated wa­ter was good for the health, the world’s big­gest soft drink brand ac­tu­ally started out as a phar­ma­ceu­ti­cal drink for the sick.

The kit con­tains zinc tablets, oral re­hy­dra­tion salts and soap

The smartly de­signed kits fit neatly in Coca-Cola crates, which are dis­trib­uted across Sub-Sa­ha­ran Africa

De­mand for the kits is so high that retailers are now col­lect­ing them from the whole­salers to sell in their lo­cal shops

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