NB Health Care
Forget the Sexy ‘Innovations’: Build (and Monitor) More Water Pipes
Editor’s note: mWater is a monitoring and evaluation (M&E) and data management platform that is used in 147 countries to track water sources. NextBillion first interviewed the nonprofit’s CEO, Annie Feighery, two years ago. In the interview below – part of NB’s focus on water, sanitation and hygiene from the month of August – Feighery talks about some of mWater’s aspirations and how safe water systems might ultimately be achieved worldwide. But first, she describes mWater’s evolution since that first interview:
“We began with a focus on the water and sanitation sectors of aid, but users from all sectors have taken up the platform. Increasingly, we were asked why our name has the word ‘water’ in it since we are applicable across all of aid. So, this year, mWater has created a duplicate brand, Solstice, to be more accessible to a user base beyond water and sanitation to adjacent SDGs (Sustainable Development Goals), especially agriculture and nutrition, but also energy, education, maternal survival and emergency response.
“Much of what we do is help organizations and governments decide what to measure and then advise them how to analyze their results in terms of meaningful policy. Three examples of how I have led mWater to accomplish sustainable management capacity are:
- The Global Indicator Library: a wikipedia-like record of indicators and their recommended question sets developed by high-budget institutions and made available to the world for free. It has a democratic ranking system with upvotes and use-based presence in the search results, so that the most useful indicators get used more. The library has the impact of bottlenecking the many ways to measure the same things over time, place and organization. The library began with a focus only on WASH but is growing to all SDGs.
- Console templates: Once a user comes to us and asks, ‘What do I measure?,’ and creates a monitoring system with our existing question sets or their own, the next question is, ‘What does this data mean?’ Consoles are MIS interfaces comprising dashboards, maps, spreadsheets and other important visualization tools. We provide console templates at the per-indicator set level. The flagship console template is the global water quality template. This is a console that allows a user to see their data in terms of national and WHO standards for SDG6.
- WASHFIT: an MIS platform for managing water, sanitation and hygiene in health facilities. This was built for WHO as a means of moving what was already a global, paper-based monitoring system into a digital interface. Users can design surveys, deploy them and then analyze their results against standardized indicators that themselves prescribe next steps.”
Kyle Poplin: What’s the status of the worldwide effort to eliminate waterborne (diarrheal) disease?
Annie Feighery: The most recent report updating global safe water access came out a few months ago, the WHO found that “Some 3 in 10 people worldwide, or 2.1 billion, lack access to safe, readily available water at home.” The worldwide effort is guided by the UN Sustainable Development Goals, which, for water, has the target of achieving safe and sustainably managed water systems for everyone by 2030. The target’s wording implies a few great shifts in the way people are thinking about diarrheal disease. First, the word, “safe”: People didn’t used to believe achieving safe water sources was possible, they worked instead on “near” or “safer.” But water treatment with chlorination and piped infrastructure is now the priority over unsafe water sources like shallow wells. Our technology is part of this advance, as we have made it possible to map water points networks of water systems and monitor them, which is to say manage them for ongoing safety.
Too many NGOs are still limiting their expectations for functioning, nearby water sources. We urge them to stop building the cheaper, more dangerous shallow wells. But the early adopters have made the turn and are monitoring water for safety. My colleague, John Oldfield, testified to Congress on this point, and said: “People are not dying from walking for water, they are dying from (feces) in their water.” A water point in a low-resource region of the planet has the same burden for being safe for a young child to drink as a water point in New York City.
KP: Is WASH success achievable worldwide and, if so, what would that look like?
AF: The second part of the new SDG target is the word “systems.” The thought leaders on this took under consideration that the pattern of NGOs dropping a well and leaving, the so-called “dig and ditch” strategy, is not sustainably safe. These NGOs like to set up volunteers to watch over the water point and say it’s local ownership. But … it is actually irresponsible to work without being part of the local government and having a long-term strategy for a funded position, be it the NGO or the water utility or the paid government worker checking on that water point and reporting its safety and function.
The only way it is feasible to achieve global access to safe water is through systems. Water systems are often piped infrastructure, but they can also be small-scale water treatment and distribution units, a borehole that pipes directly into a neighborhood of homes, or a kiosk that filters and treats an otherwise unsafe water source. The majority of the water-stressed (people) on the planet live within a kilometer of a piped network. They don’t need wells, they need to be part of the infrastructure. One thing mapping water access makes possible is for that water NGO to ask themselves: Before I build a well that is alone and not part of anything, is there a piped network I could extend to this neighborhood for the same cost?
Helping people have access to the infrastructure alone is not enough. Achieving safe water systems will be the next great challenge. Many cities’ water utilities do not have maps of their pipes so when one breaks, they simply build another one and leave the leak ongoing. Broken pipes allow piped networks to become contaminated. Mapping pipes and monitoring their networks for breaks will be the next big task to achieve for safe water access at high scale.
KP: How has mWater grown in the past two years?
AF: Our growth has been really wonderful. Two years ago we were just about to top 5,000 users for the year and we were receiving a few thousand submissions a month from 59 countries. We began this year at 10,000 users in 100 countries and this month we are topping over 15,000 users. We have a user base in 147 countries mapping about 40,000 sites and submitting over 60,000 surveys. We have a very broad grassroots reach. Most of our users are small government offices, local community water user committees, small and medium-sized NGOs, and academic researchers for whom we have dramatically reduced the cost of research.
KP: In our interview two years ago, you said, “Technology is the solution.” Do you still feel that way?
AF: Technology is the paradigm for work. In any industry, from shipping to commerce to health care and, yes, to governance, technology is how work gets done. So achieving sustainable governance foundations at the local to national levels that can build and maintain infrastructure like water systems and sanitation services has to begin with technology. Our approach has evolved from merely mapping and monitoring to more of an operating system with a focus on real-time data management. Every node in the network of people, organizations, governments and stakeholders can play their part in the same data ecosystem, whether it is the health worker collecting a survey at a water point; a utility worker responding to the outage that survey recorded; the NGO funding and training the utility; or the central government deciding on needed resources and managing their assets. The end result is a sort of mesh network of actors that can begin collaborating and catalyzing each other’s work and achieve progress faster.
KP: mWater was built to run lean and agile, like a for-profit tech startup. Are you still operating that way? Has it served you well?
AF: I am a strong believer that “lean and agile” management is an evolution of management. “Lean and agile” continues to be the approach we take to management. On the lean side, we have to keep the discipline of staying as small as we can. The tendency with nonprofits is to bring in as many people as you can, from volunteers to low-wage employees. But layers of people to manage slow you down and dilute your impact. Often, an A-list player can do the work of three or four people who are less qualified and cheaper. On the agile side, we manage our schedule in short sprints so that we have the freedom to try out a direction with all our effort and, if it fails, we find out quickly and can change directions within a week or two. (Note: The mWater team currently consists of seven people based in four countries.)
KP: Here’s a quote that stuck with me after our last interview. “Over the course of the next five years, we need to have generated advances in the field of water and sanitation that result in a significant advance in diarrheal disease. Or we need to go out of business.” How’s that going?
AF: We ask ourselves ongoingly: Are we taking enough risks, what is slowing us down, how can we grow faster to have more of an impact? We hold ourselves to that startup thought that five years is the entire universe of time. If we cannot make visible, lasting impacts within that timeframe, we should go out of business.
(Last) week (was) the largest global conference for our industry, World Water Week in Stockholm, Sweden, with thousands of participants talking about their work in water and sanitation. One way I know we have made an impact is that, walking down the halls, you (could) hear people presenting from our platform in various session rooms. Presenters (had) mWater maps and charts and our name (was) said out loud as the way many presenters collected data, analyzed their data and shared their data. Two years ago at that conference, almost no one knew our name.
So far, our best impact is shifting the paradigm among NGOs to one of sharing data with each other, and especially with the local governments they serve. One way we did this was by our business model that charges upstream in the system, keeping data collection free. We never charge per datapoint or per data collector. When people see that the data they collect is not a commodity, they are more likely to a) collect a lot more of it, but b) drop their guard against sharing it with everyone.
The mWater platform is unique in that it includes a frontline data collection app alongside a relational database of real-time, updatable data. There are many competitors in the aid industry for where to share your data, but they almost all create repositories of CSV files or maps of points that cannot be updated. They make governments lose faith in monitoring because the data they work so hard to get is quickly out of date. This is our competitive advantage. As a result, our growth curve has been very steep – and our biggest champions are the governments we are working to serve.
KP: I know you’re a deep thinker on such matters so I’ll ask a tough question: What are the major holdups in the effort to achieve the Sustainable Development Goals?
AF: The aid industry has been in existence in its mature form for 70 years now. And in 70 years, they have not achieved enough progress yet, by anyone’s measurement. I think a big reason is that part of the work of the industry is to secure itself as an industry. They are not actively trying to make systems that can exist without them. We call this the missing goal: There should be an exit strategy. The benefit of managing your aid projects with mWater is that there is no dependency cycle that is ongoing after your aid project leaves because using the system is free. You can leave and the government or local community can continue to manage a data-driven system.
The second thing the aid industry, especially at the donor level, is not doing to achieve faster impact is taking risks. Donors’ job should be to absorb the risk in a new market model failing. They should be happier to lose money going after ambitious infrastructure. Often, they add risk by introducing silly ideas under the veil of innovation so that they can try to go cheaper paths. Pipes are not as sexy as a backpack filter, but that is the kind of infrastructure they need to be looking at rather than short-term “innovations.” We encourage donors and aid agencies to not use developing countries as trial grounds for innovation. Let a new approach to safe water prove itself in London or Hong Kong; use what we know to build safe water systems for poor regions.
Kyle Poplin is a journalist and former editor of NextBillion Health Care.
Photo courtesy of mWater