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The backdrop

We have just returned from our first boldly MAD journey to Make A Difference; working alongside UN Youth Representative for SDG 6, Samuel Malinga, to address Clean Water and Sanitation in Uganda.


And what an insightful and exhilarating journey it has been so far. Over the last three months a ridiculously ambitious group of doctors, philanthropists, engineers, researchers, business consultants, impact investors, entrepreneurs, health practitioners, students, data scientists, environmental activists, design professors, social innovators  and strategists from 17 countries have delved deeply into the topic of sanitation.

This unlikely combination of individuals doesn’t even have a love for sanitation in common. In fact, while some people in the group have dedicated their careers to the topic, others have barely considered the fact the 2.4 billion people around the world do not have access to adequate sanitation facilities. What brought these inquisitive problem-solvers together was what we affectionately call their MADness. Their shared, deep desire to Make a Difference.

And that’s where we come in. We invite MAD people with diverse perspectives and interdisciplinary backgrounds to work together to address those big daunting challenges that demand a bolder, more explorative and collaborative approach. And through this case we aim to illustrate how the varied insights and experiences of the group have pushed us to explore solutions that seem so MAD they may actually work.

In this article we will whisk you through our 3-month journey of thought-provoking questions and unexpected insights that have led us to a MAD idea that we feel deserves to be tested.

The role of MAD 

And this is where we bring in our disclaimer; our role at MAD is to catalyse exponential leaps in development. This article is written to provide a little insight into how we bring people together today, to Make A Difference for tomorrow. We write these articles with courageous vulnerability, acknowledging that we don’t have answers, but we are asking the thought-provoking questions that enable us to learn with every leap, sharing our half-thought-thoughts with the community so that together we can crack the big challenges.


So in this article you will find the series of questions we have asked so far, and where they have led us. And a spoiler alert: at the end is a question we are inviting/challenging you to explore further with us.


AN 8 min journey into an Alternative Reality


So take the next 8 minutes to read this series of articles, step out of your current reality and join us in an alternative reality, where there is a fundamental belief that the big problems are solvable.


Welcome to a journey of explorative questions and MAD ideas :) We start with an overview of the problem(s): According to the World Health Organisation 842 000 people in low- and middle-income countries die as a result of inadequate water, sanitation, and hygiene each year.


Traditional flush systems are simply not viable as municipalities in these markets do not have the budget for sewerage infrastructure and even if the money was available, piping clean water to flush down a toilet is a waste of a precious resource.


Pit latrines are a common alternative, but not only are they often unsanitary, they can be fatal as rotting floors have led to many children falling through to the pit and drowning. On top of this, if the pits are not properly maintained they can even exacerbate the problem as they overflow or infiltrate the water table.


Well-intentioned aid programs in the past have donated public toilet blocks, but as local communities were not involved in the design, decision-making, construction or long term planning for the facility, the block may be built in the wrong area, contextually inappropriate, misused, incorrectly maintained or even padlocked by a member who takes private occupation of the facility.


Introducing the MAD Explorative Approach

The first, (unsurprising) insight, is that the situation is always way more complex than it seems; the problem you think you are solving, is not really the problem that needs to be solved. And although you know this going in, you need to start somewhere.

So, where to start?

With the expert; Samuel Malinga, a Ugandan engineer, social innovator, MAD entrepreneur and founder of Sanitation Africa, who has developed affordable toilets and emptying services for Ugandans living in slums and rural areas. Sam’s work is so highly regarded that he has been invited to participate in accelerator programs across the world, is an experienced sanitation advisor and has been selected by the UN as their global youth ambassador for SDG 6: Clean Water & Sanitation.


And although Sanitation Africa’s 16 technically innovative and affordable sanitation solutions are addressing the technical needs of the local context, they are not being adopted by the community at the rapid rate initially anticipated. The reason for this provides great insight into how we should think about solving sanitation challenges globally.


The Insight

Even toilets designed for low income markets cost money. They cost money to install, and they cost money to maintain and they cost money to empty. The lack of government provision for toilets and unsustainable aid models places the economic and logistical burden of sanitation on the poorest members of society, who simply don’t have the economic means to invest in quality sanitation.


Sanitation Africa’s biggest problem is not a technical problem, but rather a market demand problem; people who have not had a toilet before do not see the value in buying one. Individuals would rather spend money on a motorbike or a goat than on the toilet “money-pit”.

It is with this insight, we saw an opportunity to invite our broad community of innovative problem-solvers across different sectors, industries, cultures and interests to come together to contribute their skills, knowledge, experience and networks to tackle a challenge, that if solved, could dramatically decrease the devastating number of illnesses and deaths caused by waterborne diseases globally.



>> LEAP 1 - Explorative Question: 

“How do we encourage people living in slum are to prioritise buying a toilet when the alternative is free?” 

In collaboration with Seeding Impact, we hosted a hackathon with students from KTH and Karolinska Institutet (with Sam and his business developer, Joseph on whatsapp to answer questions.) The students went back to the root cause - why is it important to buy a toilet? To stop the spread of diseases. And that was the first “aha!” moment; Sanitation Africa’s individual selling approach will not address community-wide health issues, because if one person buys a toilet but their neighbour doesn’t, their neighbour’s poor sanitation habits will still lead to them contracting waterborne diseases. And so, the challenge evolved into...

>> LEAP 2 - Explorative Question 2:

“How do we create a resilient and cholera free community?” 

In collaboration with Cordial Business Advisors, we hosted a Think Tank where we presented the community-focussed question to a carefully selected group of executives, researchers, philanthropists, investors and business model innovation experts, that hailed from Uganda, Nigeria, South Africa, India, Argentina and Sweden.

Together the leapfrog hypothesis emerged... Just as markets like Uganda, leapt from “no phone” directly to mobile phones (skipping landline telephones), they can leap from “no toilet” to an onsite biomass producer (skipping the need for heavy sewerage infrastructure or even digging a hole and extracting). Meaning if we could develop local market demand from farmers for fertiliser and biogas, we could turn a toilet into a value-creating asset -  the second “aha!” moment; people could be paid to pooh! Which pushed the challenge one step further...


>> LEAP 3 - Explorative Question 3:

“How can human waste power the creation of resilient communities?” 

It was time to take this question to the market, and so we gathered a team of MAD adventurers (a data scientist from Italy, an environmental activist from Germany, a doctor from Egypt and the two MAD women from Sweden and South Africa), we packed our backpacks and headed to Uganda to join the Sanitation Africa team, meet with the local community, immerse ourselves in their current reality and explore how human waste could drive economic growth at a local level and propel communities out of poverty.


There is a whole article dedicated to the insights from the journey (see next chapter beneath), but amongst all the possibilities that emerged, one struck us as especially powerful; If we could flip the “money pit” toilet into a “renewable source of economic and social prosperity”, it could be the catalyst that radically transforms the health and wealth of this community.


But we feel there is an opportunity to take at least one more leap. Our ambition is for schools to financially benefit from the closing of the sanitation loop, by pioneering a self-funding schools model. The premise being that schools can invest in and maintain the biofertilizer-producing toilets, the revenue generated from fertilizer sales can cover the salaries for teachers - covering school fees and providing free education for the poorest communities around the world!


The ultimate goal is to propel communities out of poverty by providing pioneering sanitation solutions, stimulating economic development and providing free education to the world’s poorest communities. Which brings us to explorative question number 4.



>> LEAP 4 - Explorative Question:

“How can we develop a resilient self-funding school model that enables the scaling of waterless 

sanitation systems across low-income markets globally?”

And this is where you come in, we are forming a global team of MAD people who are ready to join the next big leap and get involved in the self-funding schools pilot. So before this article ends and you return to your current reality, we are asking you to adopt the MAD mindset, and connect us to the innovators, manufacturers, entrepreneurs, visionaries, doers and funders who are MAD enough to give it a shot.  

​These catalytic leaps do not happen in a vacuum, we left the plush offices of Stockholm and spent a week living with an amazing community of innovators in Uganda, and although running water was lacking, the insights and ideas were abundant. 


Bustling with ideas from the hackathon and think tank hosted in Stockholm earlier in the month, our team of MAD adventurers (a data scientist from Italy, an environmental activist from Germany, a doctor from Egypt and the two MAD women from Sweden and South Africa) arrived in Uganda eager to explore the MAD question “How can human waste power the creation of resilient communities?”


During the week of 30th of July - 3rd of Aug, in a small town outside Kampala, we gathered community members, government representatives, health care professionals, social entrepreneurs, students and business innovation experts to identify the key challenges and innovation components needed to catalyse the creation of a resilient and healthy community.


Planning for the Unpredictable. 

The beauty of adventure and innovation, is that the exact path and outcome cannot be pre-defined. However to ensure the week’s activities focussed on addressing the challenge, we adopted an explorative process that provided structure whilst allowed flexibility for learning and iteration. For each of us this was also a personal development journey, so every day started with a check in and closed with a reflection and some pretty big questions (but that’s another article).


>> STEP 1: Mapping Reality 

The first step was to map the community’s current reality and it was then that the magnitude of the institutional voids became clear. Inadequate sanitation was not the only problem this community was facing. There were gaping holes in the provision of clean water, energy, health, finance, education and agricultural support too.


>> STEP 2: The Cost of Inaction 

Together with community members and local leaders, we explored the cost of inaction; what would happen if these voids were not addressed. The stark realisation was that like many communities in Uganda, as the population continues to outgrow the currently inadequate sanitation facilities, health issues would continue to escalate, education levels and productivity would further decrease and poverty and mortality rates would continue to rise.


We literally sketched out a poverty-stricken village with a polluted water source, dead livestock, a hospital with depleted medical supplies, an abandoned school and an overflowing cemetery. With a horrifying picture of what will happen if we continue do nothing, there was a strong motivation to take corrective action.

>> STEP 3: An Alternative Reality 

In contrast to the stark picture of inaction, together we painted an alternative reality, a positive one, where the community harvested rainwater, water for animals and humans was separated, simple biosand water filters were installed, women’s groups made soap, handwashing stations were situated next to toilets, sanitation curriculum was taught in schools, girls could go to school even during their periods and toilets produced biofertilizer that resulted in stronger yields for the farmers.

With a vision of the above “model village” in mind, we spent the week working and exploring at SINA (Social Innovation Academy), a phenomenal innovation village that educates former orphans, street children, refugees and other disadvantaged youth in Uganda to become social entrepreneurs.


SINA is a place where you can truly go MAD. Innovation is embedded in every aspect of the village - even our workshop rooms weren’t made of traditional bricks and mortar, but rather upcycled bottles filled with sand - solid structures, with experimental roofs made of used car tyres or old jerry cans. We were even able to drink water straight from the tap (which is uncommon in Uganda) thanks to the biosand filter company Tusafishe based at SINA. (The Tusafishe team actually became an integral part of the MAD adventurers team - working with us in the community, participating in all the workshops that week and are continuing to drive the project forward today).

>> STEP 4: The MAD Collaboration

As we started to explore how to make that positive village painting a reality, we delved deeply into the MAD models; turning everything on it’s head, seeing the overlooked opportunities, identifying the components needed to catalyse sustainable and scalable development (and madifying them), and connecting the local change agents & leaders.


And when we combined the abundance of resources of all the MAD people; the community, the SINA entrepreneurs, local leaders, Sanitation Africa and health workers, and participants from the Hackathon and Think Tank, collectively we had all the components needed to build the resilient model village.

By the end of the week, we had gone way beyond the issue of sanitation provision. We had collectively developed a resilient ecosystem of local partners that through collaboration would stimulate local economic activity and address the institutional voids. Moreover, selected social entrepreneurs from SINA and community leaders formed a joint leadership team that will drive this initiative forward at a local level.


Through the MAD Approach, together these local innovative leaders will continue to collaborate, explore, break new ground and stimulate economic activity at a community level. Having seen the energy unleashed through this week, and the continuous dialogues since – we have great hope and deep trust that they will push the frontiers for how resilient communities are defined - in ways we all can be inspired by. The progress made in this short week was underpinned by months of deep thought, extensive reading and notebooks full of sketches, diagrams and models. Read more about the method behind the madness in the MAD Models.. 









The MAD EQUATION is a way to play with which variables that needs to come together to catalyze and continuously drive exponential development and impact. The different components can be unlocked through exploring beneath questions:

MAD Base - What would be the game changer? This speaks about the notion of turning everything on its head - flipping institutional voids to clusters of entrepreneurial opportunities - from scarcity to abundance.

MAD Catalyst - What would ignite the change? Play with the idea and paradigm of 10X the impact, rather than 10%, to approach the challenges with a different mindset geared to uncover powerful catalysts.  

MAD Factor - What would ensure the exponential development and scalability? E.g. What are the partnerships and collaboration between "unholy alliances"; overlooked collaboration opportunities between different stakeholders and high impact nodes that can trigger dynamics that fuels further development and expansion?




The MAD APPROACH departs from the center and the least common denominator of MADness - that deep shared desire to make a difference - between the different stakeholders, the MAD approach explores how each void can be turned into clusters of entrepreneurial opportunities - and how the synergies between the clusters can build a strong mutual foundation for a resilient community.

Step by step we revisited the institutional voids, exploring ways of turning scarcity into abundance - for each cluster respectively, and then leveraging the synergies that could be created if combined. In above illustration of the MAD approach, you can see each identified institutional void that was turned into a cluster of entrepreneurial opportunities illustrated by the interrelated spheres. Like puzzle pieces, the development in one area feed into the other. The synergies between them makes the total value greater than the sum of its separate parts.


The spiral outwards illustrate that this is not a linear process, but one of continuous exploration. Beneath you'll find a short overview of the key aspects for each phase of exploration for the Model Village.









PHASE 1: The MAD Journey week, moving through step 1-4, from mapping current reality, understanding the cost of inaction, exploring alternative realities and the MAD collaboration.


This week focused a lot at the MAD base, i.e. what would be the game changer that turns each void into an entrepreneurial opportunity. Phase 1 also includes initial identification of the MAD factors, i.e. what can ensure continuous scaling and development. You'll find some of these examples in the overview of social entrepreneurial interventions and innovation beneath.

The MAD catalyst for the collective efforts was the MAD week’s work of identifying the costs of inaction (creating a productive sense of urgency), identifying and securing partnerships between all key actors, as well as the creation of a local leadership team, to take all aspects of the MAD approach and ideas forward. This is a clear example of MAD's role as a catalyst.


Examples of actions to catalyse from phase 1 to 3 (also illustrated in beneath table):

  • Sanitation Africa to construct the toilets

  • The Swedish Startup inventor from the Think Tank could provide waterless toilet technology

  • SINA entrepreneurs have existing businesses that could e.g.:

    • process the biofertilizer,

    • provide water filters, initiate collection of water harvesting and distribution

    • upskill the local women’s groups in soap manufacturing and

    • provide solar drying services to farmers to increase the yield for excess produce

  • The local farmer consortium could buy the bio fertilizer for non-edible crops such as eucalyptus trees

  • Local farmers could plant the herbs for the soaps

  • A local student organisation could provide WASH sensitisation courses for schools

  • School children could do projects on sanitation and take information home,

  • The local clinic could host the sensitisation courses for the community and provide explain the direct relationship between poor sanitation habits and poor health.

PHASE 2: Continuously play - manifest, explore, learn and madify each Institutional void and entrepreneurial cluster (represented by each sphere in the MAD approach, and columns in beneath table). Through this, spiraling out, continuously incorporating new learnings, thus creating stronger synergies between the areas, and hence a more resilient foundation that can be leveraged for further scalability.

PHASE 3 and beyond: Explore further!

The local expansion of the ecosystem can come from both the development of current actors, and addition of new. This including of a "second layer" of local social entrepreneurial initiatives furthers the prosperity and resilience of the community's development. Examples of entrepreneurs to add in this phase are SINA Entrepreneurs working with refugees, mental illnesses and prostitution.

The national and international scaling can be targeting further communities across Uganda, East Africa and beyond. For this expansion, both the "individual innovation clusters" and the collective approach can be of interest. In areas with great lack of institutional functions, i.e. many institutional voids - the overall MAD approach approach can be of great value to test. In "developed markets" there can still be  great value in trying some of the components and innovations.


We would like to express our deepest thanks to the following people who have embraced their inner MADness on this project so far: 

MAD Adventurers: Ian (Uganda), Carlos (Italy), Lena (Germany), Essam (Egypt)

MAD Sanitation & Community Team: Sam, Joseph, Henry, Tony, Augustine, Joanna, Gejja team (Uganda)

MAD Thinkers:  Daniel (Uganda), Anjali (India), Kabe (Nigeria), Ann (Sweden), Martin (Argentina), Johan (Sweden), Peter (Tanzania)

MAD Hackers: Laura (Spain), Oscar (Spain), Siva (India)

MAD Collaborators: David (China), JJK (China), Shelpi (China), Shapari (Norway), Asa (Sweden), Karin (Sweden), John (Kenya), Rosy (Switzerland), Mike (Sweden), Nick (Sweden), Lise (Sweden)

MAD Ambassadors: Hermine (Sweden), Songul (Turkey), Oscar (Sweden) Olutosin (Nigeria), Petya (Bulgaria), Svitlana (Ukraine) Mathias (Sweden), Gregg (Canada) Cliff (South Africa)  

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