This description of Andrés Randazzo's work was prepared when Andrés Randazzo was elected to the Ashoka Fellowship in 2006.
In rural Mexico, where one in every four children is malnourished, Dr. Andrés Randazzo has stepped outside his medical role to tackle health problems through simple eco-technologies that provide families with basic necessities such as clean water and adequate housing.
The New Idea
Andrés incorporates appropriate technologies for bettering basic living conditions into the existing health infrastructure of Mexico’s poorest rural areas. His organization, SANUT, has created cisterns, ovens, and houses that are 70 percent cheaper than their regular counterparts and can be easily constructed. SANUT is engaged in the continual re-design of products and the development of new products. Results are effective because rather than using simple prototypes to test models, SANUT engages users in the creation process. Andrés is harvesting the potential of these technologies as a tool for community development. Traditional health programs in the Mexico’s rural areas gather women for workshops to preach the importance of clean water and other basic necessities, but Andrés promotes practical, community-based strategies for realizing these ends. In the case of cisterns, for example, a single SANUT molding allows a community to build 100 cistern units; SANUT also provides follow-up mechanisms for continued community involvement. Even with modest pilot projects, SANUT has involved nearly 100,000 people in many rural communities. Andrés is spreading his model through health-related citizen organizations around the country, which have a deep community presence that allows them to integrate appropriate technology into community development efforts. He is also replicating though government agencies such as the Integral Family Development Agency (DIF), and the Ministry for Social Development (SEDESOL) to reach a much broader group with a simpler set of services.
Over half of Mexicans live in poverty, with a disproportionate number of Mexico’s poor residing in rural areas. With poverty comes poor health: rural health indicators fall well below those of their urban counterparts. Fully 25 percent of rural children suffer from malnutrition. Facing deteriorating conditions in rural areas, the health establishment has focused on emergency measures, allocating sparse funding to palliative medicines over preventative efforts with greater long term impact. Often health services don’t reach the poorest communities at all. The Mexican Public Health Ministry continues spending money, only to see health statistics deteriorate.Some efforts have been made to focus on preventative health strategies in Mexico’s poorest areas. Social services agencies such as DIF and SEDESOL, along with some community organizations, have developed networks of “promoters”, typically social workers or local women trained to spread health practices in their communities. This often means gathering women to give talks and workshops on the importance of clean water, adequate housing, proper sanitations, and so on. Yet women are not truly given the tools or sense of empowerment to implement such simple preventative measures. It means little to understand the need for clean water when households lack cisterns. The basic technologies of cisterns, ovens, and improved houses cost far more than community or government agencies have been able to afford. They require specialized labor to install, doubling the ultimate cost, and are seen as the purview of other government agencies that have less extensive community infrastructure. Ultimately, health interventions leave women with new knowledge but little empowerment or motivation to try what seems like the next new idea for relieving their burden. The inertia of continued failure and powerlessness prevents them from pursuing solutions to the health and home problems they face.
Andrés, who is not an engineer, has bypassed the traditional process of product development—design to prototype to product—for a more flexible design process. His seeks not only to make technologies less expensive, but to constantly improve, redesign, and change. Having identified the first key elements to a healthy household, Andrés is using his local community as a testing ground for continued improvement of his eco-technologies. With continued use, innovations and ideas for improved construction processes inevitably come to light. A 12,000 liter capacity cistern that took 10 days for specialized workers to install can now be installed by five local people in six hours. A local factory produces the molds which can be used to construct more than 100 final products. At their current stage of product development, houses will soon be built by local women in three weeks and cisterns—normally requiring significant heavy labor and time—can be built in 6 hours. All of Andrés’ products are designed to foster low-cost community participation in household improvement. Andrés recognized that many technologies were designed to be built by men, but that women often had a greater interest in seeing them through. All products are made to be constructed easily by women, generally by a group of women working together. In 2001, SANUT won first prize in an award issued by the Mexican Health Foundation for the impact of its community development programs on children from zero to five years old. This major success in family health gave Andrés access to the national health organizations in Mexico City, such as DIF and SEDESOL, and to community organizations that recognize SANUT’s work as the missing ingredient to their preventative initiatives. Their pilot projects in six regions throughout Mexico have resulted in nearly 3,000 cisterns, ovens, houses and fish farms installed, impacting nearly 100,000 people.SANUT’s strategy for replication and greater impact includes forming deeper alliances with DIF, SEDESOL and community organizations that are already considering scaling up their purchases. SANUT and the national health authorities together ensure that preventative health knowledge and practices are spread through existing networks of trained social workers and through the community organizations created to install these products.Finally, SANUT is already negotiating the expansion of its new approach to five other countries in Latin America. Andrés is looking for community organizations and national health entities similar to DIF and SEDESOL that can incorporate SANUT’s appropriate technologies and constant community feedback into their existing rural health networks. Operations are planned for Colombia and the Dominican Republic within the next two years.
Andrés was trained as a medical doctor in Argentina during a time of military repression and saw many of his university friends killed for participating in social and political causes. When he left Argentina, Andrés developed a deep indignation as he observed social injustice during many years of work in Latin America and Asia. He witnessed immense poverty and poor health, participated as a doctor working within various health care systems, and observed that simple technology solutions make basic necessities such as food and shelter more affordable. When Andrés came to Mexico 10 years ago, he applied his research techniques and best practices to improve nutritional outcomes in rural Mexico. To achieve this end, he started and ran SANUT, building a network of trained community health workers who offered workshops and training programs to community women. But as Andrés visited these rural communities, he saw that children were malnourished not because their parents didn’t care or understand but because they didn’t have the basic infrastructure for clean, boiled water. He had seen simple solutions in his years of travels, and imported them, only to find them too expensive and labor intensive. He soon saw that this seemed to be the missing ingredient from other prevention oriented health programs. When SANUT won a major health prize in 2001, he used the publicity to approach Mexican government authorities. In the years since, he has traveled throughout Mexico, identifying local representatives of national organizations who could adopt and implement his work locally. This work has since become his passion and the focus of his life. He foresees an overhaul in the Mexican health system, resulting in a stronger and more effective emphasis on prevention.