November 2014
asia
Safe Cities How are social entrepreneurs reviving the dialogue around the important issue of public safety?
Contents
fc | CONTENTS
Changing Behaviours For Safer Roads
01
Anusha Jaishankar
Transforming the World through Education
03
Ashoka Bangladesh
Noise: A Silent Assasin
05
Natya Tatineni
Securing Health, Fighting Fake Drugs
07
Rae Winborn
Piyush Tewari's Six Word Story: 'Saving Road Accident Victims Through Bystander Care'
09
Sachin Malhan
Activating the Ashoka Network for Safer Social Change
11
David Nahmias
When organized crime seduces the young: How to ensure social impact in a shattered society
13
Lourdes Zamanillo
The Road to Safety
15
Nikhil Saigal
Medical Kit Reduces Maternal Mortality by 35% in Guatemala
17
Ashoka Spain
More business? Aye Safety!
19
Sunish Jauhari
Editorial VISHNU SWAMINATHAN MEERA VIJAYANN Contributors Anusha Jaishankar Dr. Ibrahim Sohan Natya Tatineni Rae Winborn Sachin Malhan David Nahmias Lourdes Zamanillo Nikhil Saigal Ashoka Spain Sunish Jauhari Design SAMYAK JAIN Talk to us mvijayann@ashoka.org Website www.india.ashoka.org Address 54, 1st Cross, Domlur Layout Bangalore 560071 India Telephone 080-4274-5777 Disclaimer The views and comments mentioned in the articles of fellowconnect are that of the respective authors and do not reflect the position of ashoka on these issues. Cover Photo Courtesy: Flickr/Creative Commons Correction notice - In the August 2014 issue, the photo credits on pages 15 and 16 were given to Amba Salelkar. This was actually taken from a shareable license photograph on Flickr Commons. We regret the error.
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Photo Courtesy: Flickr/Creative Commons
fc | EDITORIAL
We need to develop the core skill of empathy to survive in this changing world
Photo Courtesy: Flickr/Creative Commons
D Dear Fellows,
Public spaces are not owned by individuals. And rightly so, they should not be. We were brought up to think that we only own those spaces that belong to us. There is no issue with such an approach, only that this takes away our basic responsibility towards spaces as well. In spite of the fact that this attitude affects us and others, we seldom accept that we play a great role in defining these spaces. So given that we tend to use these spaces a lot, what is our accountability and responsibility toward them? Are we completely conditioned to think that only when we have absolute authority that we will accept responsibility?
These are some of the core issues Ashoka have been addressing about public spaces. To start with, we explored ‘roads’ as a starting point. This is clearly one of the largest spaces we use. Yet, as a society we abuse roads. To take ownership and represent a space, we need to become empathetic, responsible and considerate. And if we need to develop the core skill of empathy to survive in this changing world, empathy in public spaces becomes more relevant than before. To introduce the importance of empathy, we launched the “Safe Roads, Safer India” campaign with Ashoka changemakers and UL. This attracted over a hundred innovative ideas from Changemakers to change our public spaces. At the end of this campaign, we selected four winners who had clear scope of impact. This issue of FellowConnect Asia is a celebration of citizenship and Changemaking in public spaces.
Safety and apathy are two sides of a coin when it comes to behaviour on the road. If we are empathetic towards fellow citizens who are using the road alongside with us, it creates a very safe environment for everyone. Apathy, on the other side, leads to disasters on the road. By discussing intangible problems such as noise pollution and changing the conversation about safety as being an important business function, this issue challenges perspectives of safety. Following the culture of FellowConnect Asia, we also explore global themes around safety from Bangladesh, the United States and Spain. We are sure that this is just the beginning of the conversation in how we deal with our public spaces. At Ashoka, we hope to alter the paradigm towards our ultimate goal of Framework Change. In today’s world, there is every opportunity to become more empathetic and offer new leadership towards safer public spaces. An idea begins with a thought and we are happy that we are consistently supported from across the world for these ideas. All we need to do now is to give ourselves the culture of self permission to do something about problems that we face. It is time that we encourage a culture of Changemaking specifically in public spaces to create a very safe environment for everyone. Sincerely, Vishnu Swaminathan
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Photo Courtesy: cmcaindia.org
Changing Behaviours For Safer Roads By ANUSHA JAISHANKAR
Road accidents are a leading cause of preventable death and disability worldwide. They are the single largest public health issue, reaching epidemic levels among children and youth in developing nations such as India.
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The current scenario
Studies and reports on road safety by the Government of India focus largely on planning engineering improvements to existing road infrastructure, advancing public mobility options, introducing use of technology in data collection and centralizing data and crash data, improvements in vehicle safety, enforcement and emergency response. Interestingly, European studies on road safety typically include ‘Behavior’ as an important factor in achieving
safe roads. Indian road safety experts have indeed acknowledged the role of behavior in road safety but there are no significant efforts to effect such behavior change. At best, the idea of training and raising awareness is given some support.
These goals have met with varied levels of success. However, these efforts do not address a major traffic issue caused by indiscipline. The result of this behavior is a traffic scenario that is extremely dynamic, unpredictable and quite dangerous.
India signed its support for the UN Decade of Action for Road Safety with a charter to reduce road deaths by 50 percent between 2011 and 2020. To this end, there have been targeted drives to improve helmet and seatbelt usage, reduce incidents of driving under the influence of alcohol etc.
This indiscipline is a direct result of the culture on the roads. People tend to follow the prevalent culture. For eg., in India, it is quite common to see people crowding around a service counter instead of forming a queue and waiting to be served. Similarly, road users often ignore posted speed
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The correlation between behavior change and accident reduction may not be direct, but it is implicit. limits or road signs prohibiting a turn and instead follow the lead of other vehicles in the vicinity.
change themselves, thereby making the problem of enforcement an issue that can be managed.
With a large number of drivers including young newcomers imitating existing road behavior, there is little chance for large-scale change unless there is some intervention to improve attitudes and behavior among current road users, using ways that go beyond classroom training and book-based learning.
Just as positive reinforcement can be used to mould a child’s behavior and a corporate employee can be incentivized to perform better in a meritocracy, positive reinforcement can be employed to maintain and improve road behavior. Positive reinforcement works across social strata, age and geography. Initially, tangible rewards may be required to reinforce good behavior. Eventually, the reduction of the factors causing bad behavior could itself become the reward.
The correlation between behavior change and accident reduction may not be direct, but it is implicit. There may not (yet) be evidence of reduction in the number of accidents by improving road user behavior but intuitively it is clear that when a majority of road users follow expected behavior, it will help to reduce accidents, make driving less stressful, safer and maybe even a pleasant experience.
Reinforcement of good behavior From time immemorial, penalization has been used with the expectation that mistakes can be rectified. By its very definition, punishment can only be exacted after a rule has been broken. This requires immense levels of monitoring. Such enforcement is humanly impossible to scale up when the disparity between the number of law enforcers and those laws are enforced upon are massive and ever growing. For example, in Bangalore there is one traffic policeman for approximately every 3500 people and each policeman attempts to monitor a multitude of broken laws. Positive reinforcement is a proactive method that has the advantage of engaging an individual early on. Unlike punishment, which could have detrimental effects, positive reinforcement is capable of producing longterm positive effects. By acknowledging a good behavior, not only is that behavior strengthened, but this also makes one become self aware and self-monitoring. These empowered individuals become agents of positive
In the case of traffic, when most road users follow a certain road discipline, newcomers are more likely to follow suit. This will also set the stage for introducing new rules with a reasonable expectation that rules will be followed.
Positive Strokes The Positive Strokes program is based on this tendency of newcomers to follow the lead of existing road users. The aim of Positive Strokes is to nudge each individual into becoming more aware of their own safety and the safety of other road users. The novelty of the program lies in the fact that volunteers can watch vehicle movement in the city through a live streaming feed at the Traffic Management Centre (TMC) from cameras located at more than 175 traffic junctions in Bangalore. Watching this from the comfort and safety of the TMC gives one a different perspective of traffic than if one were present on the road. Often, volunteers come away with a greater understanding of the issues playing out on the roads and the challenges that our enforcement mechanisms have to grapple with. Many of them realize that they can make simple behavioral changes to become safer road users. All good road users identified by volunteers, have their traffic viola-
tion record scrutinized by the traffic police. Those who have a violation free record for a certain period of time are awarded a vehicle sticker and a letter of commendation from the chief of Bangalore Traffic Police. The prominently displayed sticker lets one know that their good behavior has been noticed and is encouraged. It also serves as a motivator for others on the road. In addition, this marks a minor but important shift in the perception of the traffic department from an enforcer to an authority that is cognizant and appreciative of those people who are disciplined on the road. This bridge between the traffic department and the common man marks the beginning of an important partnership. Positive Strokes encompasses elements of training, awareness building and positive reinforcement towards the greater goal of behavior and attitudinal change. Without a radical change in the behavior and attitude of road users, the best of infrastructure will still be misused and the most stringent enforcement will still fall short. Behavior change is not immediate and may not be measurable in the short term. Even so, it is important for organizations and institutions working in road safety to acknowledge the role of behavior and attitude among road users, to develop ways to address this issue and to find ways to track progress.
Anusha Jaishankar is the Founder of Positive Strokes, a civic initiative that looks at driving behaviour change towards safer roads.
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Ashoka Fellow Mohammad Ibrahim Sobhan, who was Ashoka Bangladesh's first fellow elected in 1988, passed away earlier this month. We offer our condolences to Ibrahim’s family, friends and community in Bangladesh. Ashoka deeply mourns his loss.
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Transforming the World through Education A Contribution by the STAFF of ASHOKA BANGLADESH
Since her independence in 1971, Bangladesh constitutionally advocated free, compulsory education for all children. Yet in 1980, the adult literacy rate was only 32 percent. Troubled by this, Dr. Ibrahim Sobhan set out to identify the reasons for low literacy in Bangladesh. It was a natural point of interest for Dr. Sobhan, as he was interested in promoting a knowledge culture since his school years. At the age of just 16, he edited and published the first monthly science magazine in Bangladesh called ‘বিজ্ঞান সাময়িকী’ (Science Journal), which is still running successfully after five decades. This magazine created a rich popular science literature in the Bangla language and inspired a vibrant science club movement around the country including the rural areas. The science periodical became the core of Dr. Sobhan’s Centre for Mass Education in Science (CMES). Founded in 1978, CMES has grown into one of the major NGOs of the country. He has also been a regular television personality since the inception of Television in Bangladesh in 1965. Most of the programs he designed and took part in, focus on popular science and technology. Dr. Sobhan observed that the Bangladeshi educational system placed the primary burdens of education on families who had neither the time nor the money properly to invest in their children’s education. Most of the students, especially in the rural areas, were dropping out when they reached adolescence. In order to solve these problems, Dr. Sobhan founded a small school in Dhaka to pilot his idea for a novel education program. He encouraged children living on the streets, or working as domestic help, to enroll. He supplied free textbooks by going door-to-door asking rich households to contribute used ones.
“This was very difficult for me,” he said. “Sometimes people wouldn’t open the door, and hide. Some treated me like a beggar, and they would say as they do ‘মাফ করেন চলে যান’ (Forgive me, go away).” Sobhan’s school children searched for old notebooks for blank lines and empty spaces to write in. To pay his teachers’ salaries, Sobhan cut his own food spending.
The responsibility for giving children a basic primary education must rest with the schools, and happen at school. Through four years of research at his model school, Sobhan designed his own alternative “School - Based Education and Teaching Method” for primary schools. The guiding principle is that the responsibility for giving children a basic primary education must rest with the schools, and happen at school – and there must be no homework. Sobhan used the official primary curriculum, but introduced innovations that optimized the use of time and allowed teachers and students to complete lessons. He extended the class periods from 35 minutes to one hour; in the old system, too much time
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was spent on changing classes, roll call and review of homework – rather than on new lessons. Sobhan organized a systematic weekly lesson plan for teachers to complete the yearly syllabus. Because grading was cumulative, there were no quarterly, half-yearly and annual examinations. It helped teachers monitor weak students and cut down on cheating. To make learning fun and keep students eager to attend school, Sobhan introduced group-learning techniques, which work better in crowded classrooms. In groups of ten, with bright students as leaders, children spent a part of each period studying and using learning aids. In 1983, the Ministry of Education enlisted Sobhan to train teachers and introduce SBE at 50 government primary schools in rural Tangail district. A year later the government gave him 110 schools, and Sobhan obtained funds from UNESCO for expansion. By 1986, SBE had been introduced to more than 1,000 rural government schools nationwide, out of a total of 60,000. Another area Dr. Sobhan focused on was adolescent dropouts. He developed an alternative education system called Basic School System (BSS) to provide them with essential competencies along with technology skills for income, simultaneously practiced at the market level. Each unit of the system works through several Basic Schools and a Rural Technology Centre (RTC) and more than 20 thousand learners could be served at a time. The campuses have arrangements for the training and practice of a variety of appropriate and profitable technologies. BSS also delivers these technologies to youth in rural areas so that they could use it for their microenterprises.
T RI BU T E fc | BANGLADESH
Sobhan used the official primary curriculum, but introduced innovations that optimized the use of time and allowed teachers and students to complete lessons.
Photo Courtesy: Asian Development Bank (usage rights)
The livelihood activities of the graduates are assisted through the microcredit and business development scheme. The central theme of the program is to bring the world of education closer to the world of work, enriched with appropriate and emerging technologies. Dr. Sobhan also designed a separate program specifically for adolescent girls called Adolescent Girls’ Program (AGP). This is a gender empowerment program,which tries to overcome the oppression and discrimination of girls in a traditional society. A major strategy followed is to provide the girls technological knowledge, which promotes economic self reliance. This program trains them in life-skills and appropriate technol-
ogies, and encouraging them towards non-stereotypical livelihood activities. Because of AGP, thousands of girls vulnerable to child-marriage and without rights within even their own family, continued to study. Many of them are now working professionally, for example, as photographers; cultivating mushroom, honey-bees, intensive poultry or pond-fishes; running machineries; managing pharmacies either in remote villages and on their own. The program is being replicated by UNICEF and the Population Council. Dr. Sobhan’s long term goal is for all primary school students in Bangladesh to keep their books in school, learn to learn, add to contribute to the overall economic development of the country.
This article is a contribution by the staff of Ashoka Bangladesh.
Ashoka Fellow Dr. Sobhan is the founder of Association for School Based Education (ASBE), an organisation that improves rural primary education in Bangladesh.
FELLOWCONNECT NOVEMBER 2014 | 04
Noise: A Silent Assasin By NATYA TATINENI
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On January 3, 1998, a thirteen year old girl was raped in Mumbai, Her cries for help went unheard because of the blaring loudspeakers in the neighbourhood. Later that evening, the girl set herself ablaze and died of severe burn injuries. Citing this incident and a number of other cases, an engineer, Anil Mittal, filed a case in the Supreme Court for
Photos courtesy: Wikimedia Commons
the ban on use of loudspeakers and high volume audio systems. This set in motion a series of petitions that led the Government of India to frame and publish the Noise Pollution Control and Regulation Rules, 1999 (NPCR rules). The NPCR rules define permitted noise levels, silence zones, restrictions and the role of state governments and other development authorities in controlling noise pollution.
Noise pollution: The invisible effects Most of us understand the health and environmental concerns that arise from noise pollution but we fail to see and acknowledge the threat it poses to our safety. Noise pollution is an invisible hazard and is often underestimated because of its intangible nature. It goes undetected sometimes due to general insensitivity on the part of the public as a result of high exposure to noise. Noise pollution also drowns various sounds including cries of distress and obstructs emergency care. Loud noise from processions, events and construction sites not only affects our health but also affects urban structures such as buildings. Sumaira Abdulali, Convenor of Awaaz Foundation points out, “In the distant future when the buildings collapse, nobody will relate it to construction noise.�
Photos courtesy: http://api.ning.com
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Interestingly, although construction noise is addressed in the NPCR rules,
information is minimal. The document covers noise limits for basic construction equipment and rules advocating the use of acoustic barriers and sand bunding. But when you look around the management of most construction sites seldom abide by the law. The lack of public awareness has also worsened this situation.
from these countries can help create better implementation structures and showcase the government’s intent, and reduce the activities that add to the problem such as the manufacture of loud horns etc.
Besides the fact that the NPCR rules are simplistic, they are also obsolete. Drafted from the (1990) WHO recommendations, the NPCR rules have failed to keep up with the latest recommendations reducing the acceptable noise levels. The Indian government has had little success in implementing the existing rules, partly due to the vested interests of politicians who frequently organise festivals and events.
In the last decade, citizens have actively pursued stricter implementation of the NPCR rules. Ashoka Fellow Sumaira Abdulali leads a citizen movement involving local police and citizens in recording decibel levels. Through Noise Watch, a free mobile app, she has successfully developed a Citizens’ Noise Map spurring the Government of Maharashtra to conduct a formal noise map of Mumbai for the upcoming Mumbai Development Plan.
Awaaz Foundation filed a number of public interest litigations advocating against noise pollution in the Bombay High Court and simultaneously presented field data to the Ministry of Environment and Forests (MoEF). This impelled the MoEF to accept all recommendations by the Foundation in 2010 following which a new notification implementing stricter noise laws in the country was issued. While these laws have been made harsher, implementation still poses multiple challenges. Globally, many countries have found it difficult to implement laws due to the involvement of multiple authorities at the local and national level responsible for environment, law enforcement, road transport and railways and private contractors. India too, is lost because of a complicated governance structure. For instance, recently the Maharashtra Pollution Control Board strengthened the rules against noise pollution but failed to issue the directions allowing the Nagpur Municipality Corporation to ear-mark no-honking zones. This, in turn, restricted the local police and the RTO from effectively implementing the law. Few countries have found solutions. Both the Netherlands and France have successfully integrated efforts of involved authorities. Perhaps, learning
It only takes citizen voices to start a revolution.
Awaaz Foundation’s support in aiding individuals filing complaints and cases has prompted action from other citizen groups in Banaras, Pune, Madhya Pradesh and Bangalore. To spread awareness about noise pollution, state education and environment departments are now employing various methods. While the Telangana Pollution Control Board recently decided to introduce display boards revealing the noise levels in the city, Sumaira mentions that the Department of Education in Maharashtra has been conducting campaigns in schools to develop awareness at an early age since 2010. Ultimately, innovative and focussed interventions will help tackle challenges. What if the MoEF included noise pollution and the growing 2,48,000 crore construction industry in the National Award for Prevention of Pollution, which currently covers land, water and air pollution? What if interventions involve the stakeholders necessary to design infrastructure and equipment that respect silence? What if we promote silence for tourism to create incentives for people to redefine our perceptions of noise? Adopting best practices from other countries to create a network for experience exchange or providing public information and guidance to address noise problems will strengthen our approach.
Most of us understand the health and environmental concerns that arise from noise pollution but we fail to see and acknowledge the threat it poses to our safety.
Natya Tatineni is a consultant with the Venture and Fellowship team at Ashoka India and focuses on developing and strengthening the fellowship.
FELLOWCONNECT NOVEMBER 2014 | 06
Photos courtesy: Wikimedia Commons
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Securing Health, Fighting Fake Drugs
It was a fairly standard malaria diagnosis for Juma, a five-year-old boy from Kumkwanamaja, Africa. His mother took him to the doctor and was given a prescription for antimalarial. She bought the drug from the local pharmacy and made sure Juma took the medicine every day. But despite strict adherence to the treatment schedule, after only a few weeks Juma fell into a coma and died. The reason: counterfeit drugs. This tragedy is not limited to a single incident, or even to rural Africa. In Kashmir, hundreds of babies admitted into the Sher-i-Kashmir Institute of Medical Sciences died from defunct antibiotics. In 2008, fake heparin, a blood-thinning drug, killed 149 Americans.
By RAE WINBORN
When someone is sick the last thing they want to do is worry about the source of their prescription drugs. However, around the world consumers must now protect themselves from the very thing that was suppose to save them. In recent years, counterfeit medicine has become a lucrative trade. Drugs can be made cheaply and are at least as profitable as narcotics but with a lower risk, especially in developing countries where regulation and enforcement is scarce. This problem is only increasing with the globalization of the pharmaceutical production, affecting both developing and developed countries alike. According to the World Health Organization (WHO), between 1 to 10 percent percent of the drugs sold
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around the world are fake, topping 50 percent in some countries. Estimate deaths range from a minimum 100,000 to up to 700,000 deaths per year; WHO estimates around 200,000 people a year die from imitation malaria drugs alone. India and China are the largest exporter of pharmaceuticals and also the largest source of bogus and low-quality pills. While most exports end up in Africa, many are sent to developed countries. India is US’s second largest importer. Currently, the most innovative solutions to this problem are tackling the end of the value chain and providing safety checks to consumers. PharmaCheck—a device that can detect counterfeit and substandard pills—and liquid barcoding—colored dyes that
can provide information about the drug—can help stores ensure they are stocking quality products. mPedigree Network, a mobile technology company founded by Ashoka Fellow Bright Simmons, has also provided a solution for consumers. Buyers simply scratch off a protected label to reveal a code. They then text the code to a free number that sends them back a verification of the medicine’s authenticity. mPedigree has collaborated with government regulators such as The National Agency for Food and Drug Administration and Control (NAFDAC) in Nigeria and other businesses to establish this network. In the last several years, mPedigree has spread their operations to almost 10 countries, including India. Selorm Branttie, mPedigree’s strategic director discussed why it is important to have a consumer-focused solution: “Because of poor consumer knowledge it is very hard to distinguish which is original and which is fake. Based on that decision people can take life-ending decisions. Usually, in our part of the world when people buy medicine they are already at a very critical stage.
Medicine is expensive and hard to come by. So they need a solution that is cheap and addresses what they are buying… It is very difficult for markets to regulate, there are so many diverse political factors…empowering consumers to be able to check their medicine is the best bet to survival.” Though emerging safety checks such as these help customers ensure the authenticity of some drugs, it is not a complete solution. For one, all drug production companies must implement these safety devices and measures, something that will take time. The fact that many solutions are vying for marketplace may slow down a market-wide adaptation. Second, ensuring the source of the medicine is not the only problem. Many legitimate companies are the culprits producing low quality drugs, especially in India. Though some of these substandard drugs may have genuinely been due to production error, new evidence is leaning more towards intentional cutbacks. In a recent National Bureau of Economic Research study, researchers surveyed nearly 1500 drug samples made by legitimate Indian pharmaceutical
What are counterfeit drugs? Many countries have differing definitions of what constitutes counterfeit drugs. However, the World Health Organization (WHO) defines it as: “A counterfeit medicine is one which is deliberately and fraudulently mislabeled with respect to identity and/ or source. Counterfeiting can apply to both branded and generic products and counterfeit products may include products with the correct ingredients or with the wrong ingredients, without active ingredients, with insufficient active ingredients or with fake packaging.” This definition includes not only fakes made in basements, but also drugs with deficient ingredients made from legitimate pharmaceutical manufactures. Benign fakes and low quality pills may not directly harm people, but they give whatever ailment they were suppose to cure a chance to do harm. Furthermore, lower-doses of some antibiotics help strengthen the bacterial strain to resist established antibiotics.
Drugs can be made cheaply and are at least as profitable as narcotics but with a lower risk, especially in developing countries. companies. Around 10 percent of antibiotic and anti-tuberculosis lacked sufficient amounts of the active ingredient. Some market solutions try to factor these substandard medicines into their solution. mPedigree works closely with regulation authorities who test batches and can then flag substandard batches, but this system only works if the regulators are also up to standard. If companies themselves are not consistently held accountable, validating the source would not help. Third, this is an international problem that requires cross-border solutions. Counterfeit drugs need to be stopped at all levels of the value chain, not just at the end. Lack of regulation and laws in the local and international level only encourage forgeries. Of course, passing laws and enforcing standards will be a long and arduous process. Market-based solutions will assist consumers in the meantime. In the end, solutions must originate within all sectors, from market-based innovations to government advocators, and requires multi-sector collaboration from businesses, governments and consumers alike.
Rae Winborn is a recent Dartmouth College graduate and Ashoka Volunteer and is currently stationed in Hyderabad, India for a social entrepreneurship fellowship.
FELLOWCONNECT NOVEMBER 2014 | 08
fc | SPECIAL
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Piyush Tewari's Six Word Story: 'Saving Road Accident Victims Through Bystander Care'
It was a traumatic sense of helplessness and loss—rather than academic expertise or domain knowledge—that gave Ashoka Fellow Piyush Tewari insight about how to address the issue of road safety. His 17-year-old cousin lay on the road after an accident, unattended for 45 minutes before he died. This incident led Tewari to launch the SaveLife Foundation, an organization that tackles the problem of deaths and serious injuries on Indian roads by focusing on the most likely candidate for life-saving action: the bystander. Tewari believes that improving road safety is not a matter that can be addressed through policy, education, or behavior alone. He’s adopting a holistic approach, which requires working with all the different moving parts and innovating, not on just one thing but with the entire system. Early on, Tewari learned that truly empowering bystanders—who are mostly citizens and police personnel— would require him to make various changes, including: Adjusting hospital and police practice that essentially intimidates responsive bystanders with the threat of being associated with the accident. Under current practice a “medico-legal case” is registered in every accident—despite there being no legal requirement for this—and, at the very least, responding bystanders are asked awkward and probing questions similar to those asked of suspects. Tewari is championing a law called the Good Samaritan Law to encourage and protect the rights of bystanders in such situations.
By SACHIN MALHAN
Training bystanders to engage in emergency response, including first aid and CPR. Tewari has built relationships with leading hospitals and trauma centers to offer emergency response training in several states in India. He has partnered with leaders within the medical community—including Dr. Mahesh Joshi of Apollo Hospitals, one of India’s largest hospital chains— who are deeply committed to scaling emergency response both through hospitals and bystanders.
Improving road safety is not a matter that can be addressed through policy, education, or behavior alone.
Addressing overarching issues that cause accidents, including driver filtration (in other words, who is and is not permitted to drive), road design, and emergency trauma care. For this part, Tewari is working closely with other road safety activists to ensure that the recommendations of the Sundar Committee on Road Safety and Traffic Management constituted by the Government of India are implemented.
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Much of Tewari’s work has been about breaking down walls and enabling the formation of consensus around these issues because different ministries, departments, and stakeholders own each of these issues. In an environment where finger pointing is more common than handholding, Tewari has, over time, built relationships with all the stakeholders. His work with training police personnel in emergency response has made the police leadership a partner in his efforts. In the parliament, he has identified and engaged with those most inclined to champion road safety. Rather than pointing out the shortcomings of various stakeholders, Piyush has shown a way forward. Through this painstaking approach, SaveLife is evolving working models for how to engage the different stakeholders in win-win situations, understand the real behaviors and solutions to bystander training and mobilization, and advocate for the kind of legal or regulatory changes that are not just desired but will be well received and enforced by stakeholders. These models and lessons learned, which can often look like unscalable “products” when viewed through conventional lenses, are in fact the workable solutions that truly change systems once and for all. Rather than one clear-cut innovation, they represent a combination of innovations in aligning interests, pushing through legal change and creating scalable partnership-led services that can be successfully replicated in other contexts by committed changemakers.
Photos courtesy: Yourstory.com
Tewari is championing a law called the Good Samaritan Law to encourage and protect the rights of bystanders in such situations. Recalling the moments when he could see his model making a big impact, Tewari remembers receiving a letter from the office of the Delhi Police Commissioner telling him that two policemen—part of a force that is often perceived as brutal in India—saved an unconscious victim with emergency CPR that they learned through Tewari’s foundation. During the last five years, SaveLife Foundation has achieved impressive results—it has convinced India’s Supreme Court to create an expert committee to plug the gaps in legal protection and enable bystanders; it has trained more than 6,000 bystanders to provide emergency response; and, most important, more than 175,000 victims have reached hospitals and emergency care thanks to the efforts of empowered bystanders.
At a recent meeting of road safety leaders in New Delhi convened by the global safety company UL (formerly Underwriters Laboratories), Tewari described his vision for creating a coalition of organizations for the final push that will be required to bring a proposed road safety law into reality. If he succeeds, Tewari will have gone a long way toward achieving his simple goal—saving the one million lives that are predicted to be lost on the road this decade. Tewari, formerly the CEO of a midsized private equity fund who left the company in search of a mission in life, has found it. And like all great social entrepreneurs, Tewari is generating changemakers by the millions. Once a trained bystander has saved a life, there is no looking back.
Sachin Malhan is Executive Partner at Ashoka Changemakers, an Ashoka program that seeks to rapidly accelerate change by finding and convening high potential changemakers and igniting communities of practice. This article first appeared in Forbes on December 2013 and has been re-published in FellowConnect Asia.
FELLOWCONNECT NOVEMBER 2014 | 10
Activating the Ashoka Network for Safer Social Change By DAVID NAHMIAS
Security has become a widely debated issue among changemakers around the world. What are the measures that Ashoka fellows have taken to confront these challenges?
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By their nature, changemakers are disruptive. Yet shaking up the status quo comes at a price, and tragically in many places around the world, promoting innovative and positive social change can pose physical risk. Though they often go unrecognized, security and stability are fundamental considerations for any social impact activity, and they form the crucial basis for any society to thrive. Such a crosscutting issue demands a crosscutting approach, and through networks, social entrepreneurs are mitigating risks and overcoming vulnerabilities in order to ensure that the world is a safer place to be a changemaker. Ashoka Fellow Sumaira Abdulali experienced this firsthand. Elected as a Fellow in 2008 for leading a citizen movement against noise pollution and its dangerous effects on health and wellbeing in Mumbai, Sumaira came to recognize that another consequence of rapid urbanization is the illegal sand mining industry. With demand for construction materials skyrocketing in India, the corrupt cartels that run the industry frequently employ children to excavate huge quantities of sand, often from open pits or beaches. Such grueling labor causes severe erosion, irrevocably damaging the delicate ecosystems along the shore and causing near irreparable harm to the soil underneath fast growing coastal cities. With her organization, the Awaaz Foundation, Sumaira started to vocally denounce this unexposed practice, taking the issue to the Indian and foreign press and building coalitions with international environmental organizations.
Yet her pursuits have not gone without arousing negative attention. Driving away one afternoon in 2010 after visiting an illegal sand mining site with a journalist, a pair of trucks chased their vehicle and crashed into it, forcing Sumaira and her passenger off the road and down a cliff. Fortunately, they escaped relatively unscathed physically, but with the fear and stress rendered by their attempted murder. The incident made international headlines, and Sumaira turned to the Ashoka network for help to overcome it and return to her advocacy. Ashoka connected Sumaira with its global partner the Urgent Action Fund for Women, a U.S.-based human rights organization. Urgent Action Fund provided Sumaira with some money to implement personal security protocols and later invited her to join their advisory board for three years. The organization published a report describing her and many other women human rights defenders’ stories of security threats; as a result, many international journalists profiled Sumaira in the media, and she helped raise awareness of the safety risks that social entrepreneurs and advocates face. Sumaira appreciates the value of the Ashoka network, especially in the most difficult personal crises. “Ashoka has always been there,” she says. “It’s very good to feel like you’re part of a larger system to feel that you are supported in various ways and you have other people you can reach out to. The network makes it easier for you to reach out to them and to also know whom to reach out to.” By tapping into connections on a local, region-
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al and global level, like Sumaira did, changemakers of all types and ages can quickly find the support and resources to continue their work—and to prevent threats from arising in the first place. A trusted safety network acts as a “barometer,” carefully gauging events on the ground that increase your vulnerability, and as a “shield,” safeguarding you from pressing risks. The most effective networks are cross-sector and global: an entrepreneur in Bangalore or an international organization in San Francisco with the right contacts among the authorities can offer more to a changemaker in crisis than a well-meaning but limited neighborhood organization in the same area. “Even if I have my own local networks there is often a need to have an international network because the local network on its own is not always effective. It’s only when there is pressure internationally as well as locally that it is effective,” Sumaira remarks. The key, though, is developing this trusted network and knowing who your allies are. As Ashoka grows its global network, maintaining the peerto-peer quality and high ethical caliber is paramount. Sumaira observes, “I think that one very important thing for people when they are threatened is to know who their bona fide is. Ashoka network helps provide that.” Now equipped with the experience of facing risks and the knowhow to mitigate and overcome them, Sumaira is contributing back to the Ashoka network in India and South Asia, providing her counsel and connections for other Fellows facing crisis.
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Photos courtesy: Akshay Mahajan/ Flickr Commons
In neighboring Pakistan, Tahir Khilji is also leading an effort among human rights advocates and social entrepreneurs to make a society safer for changemakers. A pioneer in the field of sexual orientation and gender identity rights, Tahir faced his own security threats in the past. After learning basic security protocols for human rights defenders, Tahir and other Ashoka Fellows have organized workshops for other Pakistani Ashoka Fellows and human rights organizations to help them craft their own security plan and strengthen their networks in times of threat. One Fellow who helped co-lead the workshops, Mohammad Ali, had to rely on the security plan he devised when violence erupted in the Swat province in 2009. He activated Ashoka’s network to help evacuate on foot the young students at his school for underprivileged children, set up his school in Islamabad, and keep his education initiative growing. He later returned and continued his work, reinforced by the power of the network. Their story epitomizes how networks and connections can contribute to making a safer world. Tahir notes that this is an effort that requires more than just Ashoka Fellows: “Efforts to protect social entrepreneurs must happen on a larger scale. And not just with Ashoka Fellows – it needs to be done for everybody looking to create positive change in difficult environments.”
New instances of social unrest seem to erupt every day, and dangers to changemakers are accelerating, not abating. To achieve a world that values and enables positive social change, everyone must commit to guaranteeing its safety. Consider how you can contribute your own professional and personal networks to support a changemaker at risk. One contact might make the difference by providing a safe haven, legal or psychological counsel, or rapid response for a changemaker under threat, or prevent a threat from occurring in the first place. Your network could mean the world to—and save the life of—a changemaker.
David Nahmias leads Ashoka’s global Changemaker Security program, which supports Ashoka Fellows and other changemakers facing crises or threats. To learn more and get involved, contact him and the Ashoka India office.
Though they often go unrecognized, security and stability are fundamental considerations for any social impact activity, and they form the crucial basis for any society to thrive.
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When organized crime seduces the young: How to ensure social impact in a shattered society
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By LOURDES ZAMANILLO
Social entrepreneurship might be on the brink of failure. If the social fabric unweaves itself under the weight of crime, social impact will be the first to suffer its disheveling effects. Young people are key actors that determine the structure of the society of the future. Regretfully, they are one of the most vulnerable groups for delinquency. Crime prevention and youth protection, therefore, is one of the key themes that social entrepreneurship needs to address to see a change in the world.
Where are we standing: An insight from Cauce Ciudadano According to the UN’s Youth Report from 2003, worldwide rates in youth crime have risen since the 1980’s. In Mexico, the leading cause of deaths among young people is now homicide. This is why Carlos Cruz has dedicated himself to preventing crime in vulnerable youth groups and reinserting past offenders into society. Carlos, an Ashoka Fellow, is the founder of Cauce Ciudadano, a community center that promotes a model of violence prevention by identifying influential gang leaders and helping them become nonviolent role models in their schools. Carlos’ vision is unique: instead of working
against young perpetrators of violence, he works with them and tackles the problem of youth violence from the inside. If young perpetrators can become gang leaders, they have a great potential to become social leaders. But what bends the scale one-way or the other? According to Carlos, two main factors determine the outcome:
1. Psychosocial factors: Integrity
is determined by a series of variables around a person’s upbringing: education and family guidance plays a key role in establishing the core of one’s values. If both of these are absent, a big gap opens up and serves as an invitation for crime. “Since economic hardship has obliged parents to work double shifts in order to bring food back home and most schools haven’t incorporated empathy, teamwork, respect and solidarity into their curriculim, we can easily identify one of the main factors underlying the growing statistics of youth crime in the world”, says Carlos. Furthermore, most crime prevention policies require citizens to act as vigilantes. “If we base our social structure in distrust, we can only expect the social fabric to unravel. We must base
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our culture on justice instead of legality. Legality is empty without justice”, he adds.
2. Economic factors: Every absence in a person’s life needs to be covered one way or another. When the minimum wage does not provide for a dignified life, people will seek commodities and even food through illegal methods for recreation. Even a well-meaning individual will fall into corruption if he cannot even buy a movie for his family to watch on an idle Sunday. Corruption fills the gaps of a system that doesn’t work for everyone; but for it to be sustainable, it needs everyone to contribute. Government, enterprises and citizens are all contributors to corruption. It can easily be replaced and the employee knows it. In countries like Mexico, organized crime has a much better offer”, explains Carlos.
“Young people turn to corruption and illegality when the jobs offered to them do not satisfy their needs and expectations. A lot of companies hire them to do meaningless operative work that will not provide them with any knowledge or personal growth. The person can easily be replaced and the employee knows it. In countries like Mexico, organized crime has a much better offer.” explains Carlos.
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Photos courtesy: Cauce Ciudadano
How can we prevent and eradicate youth delinquency? One of the main reasons for delinquent behavior is a focus on proposed goals coupled with insufficient means to achieve them. In organized crime, young people find all the missing pieces of the puzzle: recognition, belonging, affection and economic resources. Ironically, that is precisely what we need to prevent it.
1. Recognition: If we want to prevent young people from falling into crime, we must make better offers. Community Centers such as Cauce Ciudadano need to ensure participation, protection and personal development. In the end, young people are seeking for a full package: one that lets them grow and become a part of something bigger without having to worry about having enough money to eat for the day.
2. Belonging: If a strategy to prevent and combat youth crime wants to be successful, it must be implemented at all levels of society. Centralized methods will not adapt to every community and must therefore be adjusted. NGOs have a great insight on these topics, but the State has a broader
reach that NGOs will never be able to obtain. They must work together to attack the problem. Crime is a global issue, and as such, it can’t be treated or solved by individual countries. What happens in one country affects its neighbors and allies. We do not know what rippling effects a particular crime issue might have worldwide, and so, we must understand that one country’s problem is everyone’s problem. Transparency should be guaranteed even at an international level so that investments reach its recipients and do not finance corruption and crime.
Carlos Cruz recognized the great potential in gang leaders instead of focusing in their wrongdoings. “Piracy dealers are great at business. Instead of shutting down their venues and pushing them into crime, why not exploit their talent and show them the way to the formal market?” asks Carlos. Underneath the atrocities, Carlos found that the core values of organized crime are the same ones that society applauds. Young people involved in delinquency are just filling the gaps that the system is refusing them. Today, organized crime is the highest bidder. What will we do to change the scales?
3. Affection: Victims and offenders must be provided with the right attention to prevent recidivism. Psychological and reinsertion methods must be a priority in any strategy implemented.
4. Economy: As mentioned before, corruption is a systematic problem: if it exists, it is impregnated in all sectors of society. To eradicate youth involvement one must cleanse the system first: economic transparency at all levels is a great way to trace the main crime investors and to delete their participation.
Lourdes Zamanillo is a communications coordinator at Ashoka Mexico and Central America.
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The Road to Safety
In the early hours of October 13, while most of the residents of Chennai’s Velacherry neighborhood lay asleep, 29year old Sivakumar drove his car over a pavement, tragically ending the lives of a ragpicker, his pregnant wife, and an elderly woman. Two weeks prior, in an incident in Mumbai, a driver ran over two cops who were returning from their duty at a drunk-driving check, killing one and injuring the other. The drivers in both cases were found to be driving under the influence of alcohol. In a country that ranks number one in cases of fatal road accidents, with about 16 deaths per hour, cases like these are shamefully all too frequent. Historically in India, the attitude towards road safety and correspondingly, the response to road accidents has
By NIKHIL SAIGAL
been largely apathetic. For decades now, the spate of road accidents, deaths, and injuries have been accepted as unfortunate, yet unavoidable consequences of a rapidly motorizing society; a price to be paid for increasing mobility. A recent assessment by the Center for Science and Environment (CSE) indicates that the number of people killed in road accidents in India has increased at eight per cent annually in the past decade, nearly the rate at which car sales have grown. The Global Status Report on Road Safety published by the World Health Organization (WHO) identified the major causes of traffic collisions as driving over the speed limit, driving under the influence, and not using helmets and seat belts.
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Road accidents, currently the eighth leading cause of death, are predicted to become the fifth leading cause of death by 2030. Moreover, WHO now classifies disability, unproductive years, and premature deaths related to road injuries as a significant health impact of motorization. According to the Global Burden of Disease (GBD) when combined, deaths due to road injuries and air pollution exceed the total deaths caused by HIV/AIDS, tuberculosis, or malaria. In an attempt to address and curb the problem, the United Nations General Assembly in March 2010 named 2011-2020 as the Decade of Action for Road Safety. While the announcement of the Decade of Action for Road Safety resulted in minimal response from author-
Photos courtesy: Ash and James/ Flickr Commons
Historically in India, the attitude towards road safety and correspondingly, the response to road accidents has been largely apathetic.
ities in India, the recent unfortunate death of Rural Development Minister Gopinath Munde’s in a road accident has triggered the Ministry of Road Transport and Highways to take the bold and necessary step of drafting a Road Transport and Safety Bill. Drafted with the best practices of six advanced nations - US, Canada, Singapore, Japan, Germany, and the UK in mind, the Bill is aimed at bringing down fatalities in road accidents by two lakh in the first five years. The Bill, which penalizes rash and illegal road behavior by slapping heavy fines and jail-terms on offenders, proposes the introduction of digital systems for intelligent speed adaptation, driver alert controls, and eye drowsiness detectors, amongst other things and is currently receiving recommendations, criticism, and comments from road safety experts and the general public, nationwide. While the final Bill is likely to contain many changes, what is important to note at this point is the historic feat that the Bill has already achieved by bringing road safety to the forefront. The fact that the issue has been recognized as a priority, and has sparked multiple public debates and conversations is truly commendable and a definite positive sign, especially in light of the UN Post-2015 Sustainable Development Goals’ focus on reducing road fatalities worldwide
by 50% (source). Additionally, it has helped instill faith in the public about the government’s seriousness and commitment to road safety, enabling civil society to also take ownership and responsibility. Out of the 1,37,572 fatal accidents in the past decade, 6,463 deaths were due to drunken driving. These sobering statistics necessitate prompt and effective action. While policy change and stricter laws constitute one part of the solution, education, awareness, and better infrastructure comprise the other. The latter is where I believe the role of organizations like Home Safe comes in. We began Home Safe in 2009 with the motive of reducing the number of drunken driving incidents in the Delhi NCR region by increasing awareness and providing alternatives. Over the years, Home Safe has been able to raise awareness by bridging the gap between public and private sectors and engaging local citizens to work towards road safety collectively. One of our most successful campaigns, Respect the Road, is run in collaboration with the Gurgaon traffic police and a private organization has made use of a public mascot, “Traffic Tau” who conveys road safety messages at red lights, schools, and soon, in across all movie theaters in Gurgaon. On the other hand, through a nationwide network of trained chauffeurs, Home Safe
provides a safe, reliable, and convenient alternative to driving your vehicle when you are too tired or under the influence of alcohol. Such solutions have a direct impact on the root cause, but are unfortunately nonexistent or rare. While we currently provide chauffeurs in Delhi, we are working to scale the model to other metros in India over the next few years. The use of technology to maintain quality, ease of usage, transparency, and low cost scalability is a key priority for us at this point. While the public and private sector’s commitment to road safety will aid a significant push, the final way forward will certainly be paved by an empowered civil society willing and able to make changes to their local environments and behavior.
Nikhil Saigal is the Founder of Home Safe, a premier chauffeur service in Delhi established with the intention of making the process of driving in the city hassle free and completely safe.
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Medical Kit Reduces Maternal Mortality by 35% in Guatemala A Contribution by the STAFF of ASHOKA SPAIN
In 2013, almost 300,000 women died from the complications related to pregnancy or giving birth, according to the World Health Organization. The organization calculates that 99 percent of these deaths occur in underdeveloped regions and that in most cases could be avoided if patients had had access to quality healthcare during and after birth. With the objective of reducing these figures, Ashoka fellow Andrés Martínez has developed improved communications and technology systems for communities in remote areas of Latin America, promoted by the NGO Hispano-American Health Link (EHAS). More specifically, the Healthy Pregnancy initiative was launched to avoid unnecessary deaths among pregnant women in Guatemala and other countries in the region. In order to achieve this and detect complications associated with pregnancy in areas where medical resources aren’t sufficient, the initiative uses a portable medical kit able to perform ultrasound scans as well as urine and blood tests. The latter was made possible thanks to another Spanish Ashoka fellow, Jordi Martí, who is implementing the “DBS
Screening system” for blood testing, without needles or cold chains. The backpack’s weight, 3 kilos, simplifies its transport and accessibility. It also includes a solar panel that guarantees its use in remote areas without electricity. The experimental phase of the Healthy Pregnancy project was carried out on a total of 1,000 patients, and saved the lives of 5 women and 31 infants. During its expansion in Guatemala, the kit was used on 762 pregnant women and reduced the rate of maternal mortality by 25 percent. A 60 percent decrease was also registered in emergency transfers and in the costs of treating patients that suffer from postbirth side effects. One kit can be used on up to 400 patients a year. EHAS offers rural healthcare institutions the option of renting the kits or rucksacks, along with a user training and quality control. EHAS is also responsible for the maintenance, including insurance on theft and accidents. The spectacular results achieved have encouraged public and private investors to support the initiative in order
Equipment from the “Healthy Pregnancy” kit for ultrasound scans in a rural environment. Photo courtesy: EHAS
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In 2013, almost 300,000 women died from the complications related to pregnancy or giving birth. to increase the sample to 100,000 women. For example, Pedro Moneo, founder of Opinno consultancy firm, is a mentor of the project, and has supported the initiative from the start. EHAS foresees that 1,000 lives could be saved when the project is up and running in Guatemala, and another 2,500 when it is expanded to other four countries of the region. This will also save approximately 5 million US Dollars for the institutions responsible for rural healthcare. This article first appeared in Opinno, a global innovation consultancy and has been reproduced with permission. It is a contribution from Ashoka Spain.
The rural health workers perform an ultrasound kit with the material to a pregnant woman. Photo courtesy: EHAS
The experimental phase of the Healthy Pregnancy Project was carried out on a total of 1,000 patients, and saved the lives of 5 women and 31 infants
Photos courtesy: WadeandMelanie.wordpress.com
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Lack of safety in public spaces accounts for more than three percent of the country’s GDP
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Photos courtesy: Wikimedia commons
More business? Aye Safety!
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By SUNISH JAUHARI
Is safety becoming a function of business and business growth in India? Historically, this seems to be the case, as safety in public places like roads has made minimal progress, while it is a must-have for large business campuses or IT parks. However, even the emphasis on safety within these businesses is a relatively new concept. Circa 2002: India emerged as a low cost haven and a dream-come-true for cash strapped transnationals. Everything from polishing diamonds to automotive forgings to writing codes for software, was commissioned to Indian sweatshops. With complete disregard for workplace safety and human rights, business leaders across the globe, including key economists declared sweatshop destinations as a smart strategy. Circa 2012: McKinsey reports Indian companies are becoming smarter, creating clean and safe workplaces to remain the low cost destination of choice for large global corporations. Global value chains particularly recognised the importance of safety and it became a key criteria for awarding contracts. The civil aviation sector exemplifies these incentives. When the sector first opened up, new low-cost airlines attracted huge foreign direct investments and ordered an ambitious number of aircrafts. New precision engineering companies vying for Boeing and Airbus’s business changed their safety procedures to meet the "approved" status. Low-cost manufacturing, while important, took the back seat, while workplace safety and ethical manufacturing practices became as important as the AS9001 certification (cer-
Photos courtesy: Meena Kadri/ Flickr Commons
tification needed to supply to large aerospace OEMs). A similar pattern emerged slightly earlier in IT and IT Enabling Services, but most of the businesses were 'greenfield' export oriented units and therefore had the opportunity (and the need) to invest in safe workplaces afresh. Safety has clearly become business enabler rather than being a norm. However, a person working in one of these safest work environments is often exposed to the worst of occupational safety hazards in public places. Sadly, safety providers in public spaces do not necessarily derive the same economic value as businesses. The construction industry is a clear case where economic incentives failed. The construction industry employs over 9mn people in India. It is the second largest employer in India, and the industry is growing way above the GDP average. Incidentally, it is also one of the contributors to fairly large number of accidents that cause disabilities and deaths in India, a large number of which goes unreported because of the nature of the migratory workforce. For example, in 2013, deaths due to falls and electrocution were close to 24,000. According to a report published by International Journal of Biomedical and Advance Research, over 67 percent of deaths among various occupations are those involved in manual construction. Interestingly, this grew significantly in the years of boom and came down during the global crisis period, presumably reflecting decline in the construction activity. Even the most acclaimed construction companies are not up to the mark. For example, the Peoples Union for Democratic Rights claims that there have
been 109 deaths in the multi-million dollar Delhi Metro Rail Corporation construction sites, during their years of construction. But this does not deter people from using the Metro services, or buying and renting property. There is no correlation between the construction practices adopted by the builder and the 'attractiveness' of their product. Ultimately, it comes down to whether the buyer or the consumer is demanding safety as a practice from the provider. As consumers, we have the power. Regardless of whether it is safety in public places or workplaces, or safety buried underneath the finished product, we need to demand minimal standards of safety to create an equitable world. Lack of safety in public spaces accounts for more than three percent of the country’s GDP. When we view safety in this light, we create an economic incentive for everyone, not just businesses, to invest in public safety. Unless providers of safe environments realise that they are stakeholders in some form, we will not be able to able to achieve a safe environment for all.
Sunish Jauhari is Director, South Asia, at Ashoka India. He is a safety advocate who is working toward bridging the gap between government and citizens to create safe cities.
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