Rather than tightly controlled industrial scale projects, in the developing world at least, some of the more interesting, impactful healthcare innovations are coming from lone innovators working at the "long tail" of problems. Not only are few multinationals present in these developing markets, many just don't understand them - or even worse they don't understand why they need to be in them.
It's innovation in this long tail that is most interesting - a place where people innovate out of necessity, not luxury, and as a matter of survival or ethics, not profit or markets. Often it is a brutal environment but one that would-be social entrepreneurs must acknowledge before setting out.
'Reluctant' health innovation
More often than not, innovators in the developing world end up fixing something they never realised was a problem but were suddenly compelled to tackle. This is especially evident in the field of healthcare.
While researching a new book on innovation, it became apparent to me that six of the 10 chapters would cover health. The issues they address include data collection, genetic disorders, communications between community health workers, patents, access to medicines, and solar energy as a lighting solution for maternity wards. The range of examples shows how broad and complex an issue health is, as well as the sheer scale of the need for improvement in the developing world.
The story of obstetrician Laura Stachel is a fantastic example of unplanned innovation. Stachel's organisation - We Care Solar - designs portable solar lighting kits for maternity wards in developing countries. When she first arrived in Nigeria she planned to work on a different problem altogether, but quickly realised that a simple lack of lighting in rural areas was responsible for an unacceptable number of mother and child deaths. Maternal mortality rates in Nigeria are among the highest in the world, with a ratio of 1,100 maternal deaths occurring for every 100,000 live births, so she turned her attention to helping design, build and distribute solar-powered lighting kits to help solve it. Solar suitcases are now saving the lives of thousands of mothers and babies throughout the developing world.
Some would call what Laura did accidental innovation. But an accident implies that luck played a major part - a suggestion that fails to do justice to a difficult journey with many sacrifices and obstacles to be overcome.
This is the side of social entrepreneurship that many don't see. The years of solitude spent pushing others towards your goal, the decision to place yourself in harm's way (as in Stachel's case), and the constant threat of failure. Most social innovation ventures run out of money, time, or willpower. Although the rewards of a successful career as a social entrepreneur can be significant, for all the romance of the discipline it is often a difficult, frustrating and lonely journey. Few people in the world of social entrepreneurship ever set out with the aim of becoming rich, and as I discovered, some start out through serendipity.
Serendipity is all very well but we cannot rely on it. Governments, organisations and businesses can play their part in encouraging the opportunities and core values that foster social entrepreneurship. In the social innovation world we talk a lot about project sustainability, but little about human sustainability. If we're to have any chance of ongoing success in our battle against the many problems facing society then we need to attract the brightest young minds to the field, and then give them all the support they need to keep them there.
Establishing university or after-work courses on social innovation helps, but we are in danger of institutionalising social entrepreneurship. Social change isn't a well thought-out, orderly process. The key is helping driven people fulfil their ideas. By encouraging cultural awareness, teaching current affairs and running travel-based initiatives such as student placements abroad will help the right people find the problems they are best able to solve. You wouldn't get to experience developing world maternal care in London, Paris or New York but you will by following Stachel's lead and by spending time on the ground in west Africa.
The innovator's code
Although social entrepreneurship can't be boxed-up, shelved and sold, certain advice can be offered to help others tread a successful path to impactful innovation: