Thai Organic Supermarkets Seek to Improve Health

A Thai business is working hard to expand access to organic food in the country. It sees this as part of a wider campaign to improve health in the country – and its success has caught the attention of the government, which wants to turn Thailand into a global health destination.

The Lemon Farm chain run by Suwanna Langnamsank (http://www.lemonfarm.com/lmf/) was started 13 years ago and has grown to nine organic supermarkets in the capital, Bangkok. Lemon Farm works with 200 organic farms in Thailand and employs 160 people.

Organic food (http://en.wikipedia.org/wiki/Organic_food) – grown without chemicals and artificial fertilizers and not irradiated or subjected to other tampering – is believed by many to be healthier because it avoids the harmful effects of accumulating chemicals. It is also thought to be richer in vitamins and minerals because of the use of non-chemical fertilizers on the soil.

Lemon Farm sells made-in-Thailand organic vegetables and fruit, natural gift sets, soap and tea. There are also macrobiotic cafes in the supermarkets called Be Organic.  A macrobiotic diet avoids foods containing toxins (http://www.cancerresearchuk.org/cancer-help/about-cancer/treatment/complementary-alternative/therapies/macrobiotic-diet).

The supermarkets use eye-pleasing modern design to set themselves apart from more conventional supermarkets.

According to Lemon Farm’s website, it is a social enterprise and practices fair trade. It is using market-driven solutions to increase the availability of healthy food in the country. It seeks to support small-scale farmers and champion change in farming methods, encouraging a move away from dependence on harmful chemicals that damage human health and the environment and promoting “agricultural and economic self-sufficiency”.

The macrobiotic restaurant operates to six values, among them using fresh vegetables and only using produce from associated farms. The restaurants do not use added sugar, they cook using a pressure cooker, and use natural ingredients such as sea salt, ginger, fermented soy sauce and natural miso. They do not use any artificial preservatives or flavour enhancers such as monosodium glutamate (MSG), a common practice in Asian cooking.

Lemon Farm’s success as an organic food pioneer has caught the attention of the Thai government. The Ministry of Commerce (http://www2.moc.go.th/main.php?filename=index_design4_en) has contracted Lemon Farm to join its campaign to offer organic food in schools and hospitals.

By promoting organic food, the government is hoping to boost farmers’ incomes while improving health in the country and bolstering the country’s thriving medical services industry serving foreign patients.

“We need to promote healthy food and a healthy environment,” Piramol Charoenpao, deputy permanent secretary at the Ministry of Commerce, told Monocle magazine. “Thailand is a medical hub. The idea is to have retreat-style hospitals serving organic food. We’re increasing organic food production and educating people about it.”

Thailand has already built a good reputation with its medical and health services. More than 1.6 million non-Thais are treated in Thai hospitals annually, with an estimated 500,000 travelling specifically for medical treatment (The Guardian).

Former Thai Prime Minister Thaksin Shinawatra mooted the idea of making the country an international leader in medical tourism in 2003. It is expected providing medical services to overseas patients will make the country US $3.3 billion by 2015 (The Guardian).
 
It is hoped that offering organic food in hospitals and health facilities will boost the attractiveness and effectiveness of using health services in Thailand.

Medical tourism is considered one of the fastest-growing sectors in the world. Estimates place it as a market worth US $100 billion. Three countries that compete in this market by offering medical services in the English language include India, Singapore and Thailand. They compete by offering services comparable to wealthier countries but at considerably less cost.

Lemon Farm says it is on a mission to develop the marketplace for organic food in Thailand by educating consumers and producing “innovative natural food”.  It looks like it has already made a big impact.

By David South, Development Challenges, South-South Solutions

Published: February 2013

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP's South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South's innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.  

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South Africa Innovates Healthcare with Prepay Phone Vouchers

Pioneers in Africa are experimenting with new ways to fund the delivery of healthcare that is affordable and sustainable and not dependent on foreign aid and donations. A South African company is prototyping the selling of pre-payment healthcare services through mobile phones with a range of vouchers that can be bought and downloaded at the tap of a keypad. They are priced at between US $12 and US $49 and cover medical and dental check-ups, tests, treatments, chronic care and medicines. They are flexible and can also be sent to friends and family who need help.

In South Africa, poverty is still widespread. The majority black population has a median income of US $2,000 a year (New Internationalist) and many still live in crowded townships and poor rural communities. Poverty has also increased for many white Afrikaner South Africans (http://en.wikipedia.org/wiki/Afrikaner). A study by the Standard Bank of South Africa found the number of whites earning less than US $80 a month grew from 2000 to 2004 by more than 50 per cent. In the government capital of Pretoria, 50 Afrikaner squatter camps have emerged in recent years. For many, affordable healthcare is a critical issue.

The story of healthcare in Africa is not a linear one of constant progress. The continent as whole achieved its lowest child mortality rates in the 1970s. But after that, the quality of healthcare declined as a result of various factors including economic crises and the HIV/AIDS crisis – both of which overwhelmed public systems. In sub-Saharan Africa, health systems reached rock bottom in the late 1990s.

“Few people could afford annual check-ups, medicines or user fees at hospitals,” wrote Dr. Ebrahim Malick Samba in the paper “African health care systems: what went wrong?” for News Medical (www.news-medical.net). “One result was the resurgence of infectious diseases such as malaria, tuberculosis and cholera.

“Prior to the 1980s, the district hospitals, community health centres and other outreach health posts provided medical services and essential drugs free of charge. With reforms, user fees and cost recovery were introduced, and the sale of drugs was liberalized.

“Many governments discontinued budget support to the health sector which paralysed the public health system. There was no money for medical equipment and maintenance; salaries and working conditions declined.”

Things have been steadily improving from this low base through the 2000s, the result of increased aid funding for public health systems and greater national investments in staff, facilities and equipment. There is still a long way to go, but Africa is becoming a world leader in developing and deploying mobile phone applications for health and healthcare.

Despite dramatic improvements to the quality of hospitals and the number of qualified doctors, the continent’s healthcare services are still a patchwork, with rural and slum dwellers poorly served and the stresses of treating patients with contagious diseases like HIV/AIDS and malaria pushing resources to the limit.

Research has shown it is better and fairer to develop pre-payment mechanisms for healthcare than to just hit patients with fees when they are ill. With pre-payment, a person can buy care services when they are financially able to and bank up care for when they become ill and not able to work and save.

This is a crucial issue for people with low incomes who can quickly be devastated by their illness or that of loved one or family member.

The World Health Organization (WHO) has taken a firm stand against so-called out-of-pocket payments and encourages the growth in pre-payment methods. The World Health Report 2000 found that “Fairness of financial risk protection requires the highest possible degree of separation between contributions and utilization.”

South Africa’s Yarona Care (www.yaronacare.co.za/prepaid.html) – a health insurance provider network – is rolling out prepaid mobile phone vouchers, allowing patients to see doctors or dentists and even traditional healers for treatment. When a patient visits, the healthcare worker redeems the mobile phone voucher to get paid. One product, Impilo Go, allows people to pay for one visit to a doctor and seven days of medicine for R230 (US $34). For people on a tighter budget, there is Impilo Care for R80 (US$12). A patient can visit a nurse practitioner for a medical check-up and receive tests.

Impilo One offers medicines alone for R100, while Impilo Plus for R195 (US $29) is aimed at people with chronic conditions. They can get a prescription from the doctor and then go to a pharmacy participating in the scheme to receive medicines.

Dental work is also covered by the vouchers.

An online demonstration shows how the mobile phone process works (www.yaronacare.co.za/cellphonedemo.html).

The service is marketed at a mix of customers, from individuals to corporate clients looking to cover large numbers of people to government and NGOs. They can purchase services by voucher, payroll schemes or mobile phones.

Prepaid by mobile phone as a concept is already well established across Africa. It is a simple way to make payments and sell services. In the case of Yarona’s offering, the customer or patient uses their mobile phone to dial a code to pay for a service. When at the doctor or dentist’s office, he or she spends the voucher for the service by giving a unique code to the healthcare professional. Once this is done, Yarona Care pays the healthcare provider for the service.

The voucher approach allows customers to buy health services for family members for a defined period of time. Vouchers can also be sent to family members for emergencies.

By David South, Development Challenges, South-South Solutions

Published: April 2011

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP's South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South's innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.  

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African Health Data Revolution

A pioneering tool for gathering health data now being used in Kenya could herald a revolution in the way diseases are tracked and defeated around the world. It uses mobile phones to better connect patients with medical and health personnel, and allows data to be gathered in real-time and used to track health and improve the delivery of services, especially to remote and under-serviced areas.

In the past couple of years, Kenya has become a hotbed of mobile phone and information technology innovation. The now-famous Ushahidi crisis-mapping platform (www.ushahidi.com) is just one example. Social enterprise Data Dyne (www.datadyne.org) – with offices in Washington DC and Nairobi, Kenya – is offering its EpiSurveyor application (www.episurveyor.org) free to all to aid health data collection. It bills itself as “the first cloud-computing application for international development and global health … Think of it as like Gmail, but for data collection!”

EpiSurveyor claims to have more than 2,600 users around the world and is currently being upgraded to a second version.

“With the touch of a button I can see what’s going on across the country in real time,” Kenyan civil servant Yusuf Ibrahim told Britain’s Daily Telegraph newspaper. “It is amazing.”

Ibrahim works in Nairobi as the Kenyan Ministry of Health liaison to Data Dyne.

He uses maps and charts on mobile phones to track deadly disease outbreaks and vulnerable pregnancies.

The EpiSurveyor application works simply: A user logs into the website and builds and creates the sort of form they want. They then download it to a phone and start collecting data straight away.

Ibrahim gathers this data from mobile phones used by health care workers across the country.

“It used to take days, weeks or even a couple of months to find out about an outbreak of polio on the other side of the country,” he said. “Now we know almost instantly. The speed with which we can now collect information has catapulted healthcare and prevention to another level. It has completely changed healthcare and saved countless lives.”

He proudly points out Kenya’s mobile phone data collection system is “probably better than what they’ve got in the West.”

“Although we are a third world country, I’m pretty sure we’ve done this before

Western countries. While they are still collecting information in hard copy on clipboards, we are getting it instantly.”

Packed with data processing power, mobile phones are capable of an immense range of tasks and applications. Some see phones as key to a revolution in how healthcare is provided: the mobile phone becomes one-part clinic, another part mobile hospital dispensing advice and transmitting vital information back to healthcare professionals and scientists in hospitals and labs.

Despite dramatic improvements to the quality of hospitals in Africa and the number of qualified doctors, the continent’s healthcare services are still a patchwork, with rural and slum dwellers poorly served and the stresses of treating patients with contagious diseases like HIV/AIDS and malaria pushing resources to the limit.

The United Nations has a number of initiatives partnering with mobile phone manufacturers, networks and software developers as part of a global campaign to reduce HIV/AIDS, malaria and deaths in childbirth.

EpiSurveyor is being used by more than 15 countries’ ministries of health and is the adopted standard for the World Health Organization (www.who.int) (WHO) for electronic health data collection.

It began as a partnership with the United Nations Foundation, The Vodafone Group Foundation, WHO and the ministries of health of Kenya and Zambia in 2006 to pilot test the software for EpiSurveyor.

At the United Nations Foundation (www.unfoundation.org), chief executive Kathy Calvin equates the impact of mobile phones on global healthcare to the discovery of the antibiotic penicillin.

“Instead of building clinics and roads to remote towns and villages so that people can access healthcare, we are bringing healthcare directly to the people via mobile phones. You get a lot more healthcare for your money,” Calvin told the Telegraph.

By David South, Development Challenges, South-South Solutions

Published: November 2010

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP's South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South's innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.  

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African Technology Tackles Health Needs

Africa is becoming a world leader in mobile phone applications for health and healthcare. Despite dramatic improvements to the quality of hospitals and the number of qualified doctors, the continent’s healthcare services are still a patchwork, with rural and slum dwellers poorly served and the stresses of treating patients with contagious diseases like HIV/AIDS and malaria pushing resources to the limit.

But innovative inventions are coming along to provide new tools to doctors and medical personnel and to better engage patients with remote services.

South Africa’s Afridoctor (http://twitter.com/afridoctor) mobile phone application claims to be Africa’s first personal mobile health clinic. It lets patients use its “SnapDiagnosis” system to submit photos of their ailments and in turn receive advice from a panel of medical professionals, or use the mapping feature to find doctors, clinics and health industry-related services nearby.

Afridoctor was conceived to fill the gap across Africa for basic health information that is reliable and trustworthy.

There is an emergency feature to notify next of kin during a medical emergency and provide a location. Other features include symptom checkers, first-aid information, health calculators and quizzes.

Expert feedback comes within 48 hours after submission of a request.

A winner of a Nokia competition, Afridoctor was developed by the labs of media company 24.com (http://20fourlabs.com) of Cape Town, South Africa.

“It is more for external use – like dermatology – for things like a bee sting or a snake bite and you don’t know what to do or how to diagnose it,” Werner Erasmus, who created the app, told the BBC.

The “find a doctor” system uses Google Maps to geo-locate local health services including doctors, hospitals and emergency clinics.

The distress feature enables users to contact a family member or friend at the touch of a button. It does this by storing the mobile phone number of a selected relative. When the distress button is pressed, they are notified of the phone’s location.

Developed in just three weeks, to enter mobile phone company Nokia’s contest (http://www.callingallinnovators.com) for mobile phone applications, Afridoctor went on to win the competition in 2009. It is now being expanded to be usable on most, if not all, smart phones.

As in the rest of Africa, mobile phone use in South Africa has dramatically increased in the past 10 years. It is estimated that over 70 percent of South Africans now have access to one.

Another application getting attention is Ghana’s mPedigree (http://mpedigree.net). Designed to combat the damage done by counterfeit drugs in Africa and across the South, mPedigree works by letting a person send a text message by mobile phone to the mPedigree service to check a drug’s authenticity. A message comes back confirming whether the medicine is authentic or not.

The World Health Organization (WHO) has estimated that 25 percent of medicines sold around the developing world are counterfeit. Some contain no active ingredients, and others are even harmful.

MPedigree is a Ghanian start-up headed by social entrepreneur Bright Simons (http://www.worldpress.org/freelancers/index.cfm/hurl/page=freelancerDetails/id=7). Like Afridoctor, it is ambitious and hopes to expand around the world. So far, the mPedigree Network has expanded its work to East Africa.

By David South, Development Challenges, South-South Solutions

Published: September 2010

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP's South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South's innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.  

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Cool Food for the Poor

A whole wave of hi-tech, innovative products are now being developed and marketed for the world’s poor. These products are designed to raise the quality of life of poor people and treat them as a market with real needs, rather than a mass of people to be ignored.

One of the major challenges of the 21st century is finding ways to make these products affordable for the poor – bringing significant development gains in health and quality of life – without increasing the burden on the world’s environment. In India, this vast new market is rapidly coming alive, with new marketing channels reaching deep into the country’s slums and aided by a lively media scene turning people on to new products.

India is turning its large number of well-trained engineers and product designers to the task of making relevant products for the country’s millions of rural poor.

An Indian refrigerator – the ChotuKool fridge (http://www.new.godrej.com/godrej/godrej/index.aspx?id=1) – is designed to stay cool for hours without electricity and to use half the power of conventional refrigerators. Priced at US $69, it is targeted at India’s poor – a population of over 456 million, almost half the total Indian population (World Bank).

Manufactured by Godrej and Boyce and weighing just 7.8 kilograms, it is designed around the stated needs of the poor, who wanted a fridge capable of cooling 5 to 6 bottles of water and 3 to 4 kilograms of vegetables. Portability was crucial as well, since it needed to be moved when large family gatherings take place in small rooms.

As a video shows (http://www.youtube.com/watch?v=dtCRlynp0bM), the fridge looks more like a drinks cooler than the typical large refrigerator. It works by replacing the standard compressor motor found in most fridges with a battery-powered heat exchanger.

A group of village women was involved in the design process from the beginning. The fridges are being distributed by a microfinance group.

While people in developed countries take it for granted they will have both a refrigerator and a steady supply of electricity, the world’s poor have few options for keeping food cool.

There is a strong economic advantage to refrigeration: many farmers have to throw away vegetables or sell at high discounts because they are quickly spoiling in the heat. By refrigerating, they can keep them fresh and get the higher price. For somebody living on less than US $2 a day, this is a big economic boost.

Keeping food cool also comes with health advantages: it slows bacterial (http://en.wikipedia.org/wiki/Bacteria) growth, which happens at temperatures between 4.4 degrees Celsius and 60 degrees Celsius. This is called ‘the danger zone’, when some bacteria double in just 20 minutes. But when a refrigerator is set below 4 degrees Celsius, most foods will be protected from bacteria growth (USDA).

Through refrigeration, the poor not only can avoid food poisoning, but also benefit from better quality foods, more dietary variety, and better take advantage of buying and storing food when prices are lower. For example, eggs in a refrigerator can last for up to five weeks. Fresh fish can be stored unfrozen for up to two days.

The quality of life improvements from refrigeration are obvious. But with conventional refrigerators costly and dependent on a steady supply of electricity, the poor will not buy them.

An Indian government survey in 2007/08 found daily pay in rural areas ranged from 45 rupees a day (US $1) to 110 rupees a day (US $2.40). This means the ChotuKool fridge costs between one and two month’s wages for a rural worker.

Some argue even the cost of the ChotuKool is still too prohibitive to many poor people. And there are other initiatives out there to offer low-tech solutions to cooling food.

In Nigeria, grassroots inventor Mohammed Bah Abba has designed a cooler called the Zeer (http://practicalaction.org/?id=zeerpots). It works like this: two ceramic earthenware pots of different sizes are arranged one inside the other. The space between the pots is filled with wet sand and kept moist. The user then places their drinks or vegetables inside and covers with a damp cloth. As the water from the moist sand evaporates (http://en.wikipedia.org/wiki/Evaporation), the air inside the centre pot is cooled several degrees, enough to preserve some foods and drinks.

Another Indian innovation is also targeting the rural poor consumer: a water filter. Called the Swach water purifier (http://www.tata.com/article.aspx?artid=TtOdcdNuSRk=), it is aimed at households and stands just less than 1 metre (just over 3 feet) in height. The filter is designed to do bulk water purification and is the result of 10 years’ research. It is aimed at the one billion people in the world who do not have access to clean water. It will sell for 1,000 rupees (US $21.50).

It is very slick and modern in design, with a mix of white and clear plastic, resembling the commonly used Brita (http://www.brita.net/) water filters found in many homes. It works by using ash from rice milling to filter out bacteria. The ash is impregnated with silver particles to kill germs that cause diarrhoea, cholera and typhoid. It is able to purify 3,000 litres of water before the cartridge needs to be replaced.

It is manufactured by the Indian industrial giant Tata.

“It was the pressing need of people trapped by the effects of natural disasters such as the (2004 Indian Ocean) tsunami that saw the deployment of one of the earliest versions of this product,” said Tata vice chairman S. Ramadorai. “A key part was the insight that a natural material like rice husk can be processed to significantly reduce water-borne germs and odours when impure water is passed through it.”

By David South, Development Challenges, South-South Solutions

Published: January 2010

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP's South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South's innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.  

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