Charlene’s blog

All in all, I have really enjoyed taking this class, which has been my first course outside of the Haas curriculum. We have heard from a wide variety of practitioners who have worked on technology projects that are truly making a positive impact in developing countries. Most of the topics covered were related to public health, with a few around agriculture and education. I would have loved to have heard about more projects related to economic development.

In terms of the structure of the class, I think we would all agree that there was a desire for more class/small group discussion. It is so rare that you have students from such diverse disciplines (I-Schoolers, Computer Science PhDs, MBAs) in one room, and I enjoyed hearing people different perspectives on the loaded term that is “development.” I know that in the Microfinance Speaker Series that I help run at Haas, the lecturer leads a discussion for the first half of class, and then the guest speaker gives his/her presentation. This seems to help students prime and engage their minds to discuss the topic before the speaker shares an example application related to said topic. Someone in the class suggested that we have assigned, or at least optional, reading for each week that would serve the same purpose of preparation.

In terms of the future, this class has inspired me to contribute to some sort of ICTD project during my last semester of school. Ideally, I would love to work on a project related to the field of microfinance, for example, mobile applications that decrease transaction costs (e.g. mobile payments for loan officers to send disbursements and for borrowers to send payments) or back-office management information systems that allow MFIs to accurately store and analyze all the data that is necessary for operations.

Sonesh Surana opened up his presentation on the Aravind Eye Hospital Telemedicine Project with a beautiful video demonstrating how Aravind is essentially a rural eye clinic with no eye doctors on-site where patients come in for basic vision tests and then engage in a 5-minute teleconference with a remote eye doctor. I think this is an amazing example of what ICTD can do to bring improved health services to developing countries. Sonesh did a great job of facilitating an interactive discussion around some of the challenges he faced while he was working on this project:

Tower Challenges:

-Location… Where do you put the tower? You need land, need location for best range of coverage

-Cost… about $3000 to construct a tower for wireless network

-Difficulties in finding a site that works for everyone

-Lack of expertise in building a tower

 Sonesh’s team came up with creative solutions to address these challenges – they dentified an existing client of the Eye Hospital who had the skills to build and maintain the tower. The team also made an agreement with a manufacturing company to tack equipment onto its chimney, in exchange for connectivity between its two factories. These challenges related to building a tower and setting up the radio equipment really resonated with me because this past summer I worked at an ISP (internet services provider) in Ghana. One of BusyInternet’s challenges was to build and maintain the minimum number of base stations  and AP stations (which are also quite expensive) to cover the maximum market of potential radio clients.

Training Issues:

Sonesh also highlighted the ever-present issue of human capital – there is limited technical expertise available locally, and even then, many will gain technical skills and then leave. He shared some of the creative ways that he encouraged interactive, sustainable training. For example, he used the same verbiage when communicating, and also would purposefully sabotage the link to force the team to learn how to troubleshoot.

Power Challenges:

Finally, Sonesh discussed the common challenge around a constant source of power. The network was subject to frequent outages related to spikes and swells, low voltages, and frequent fluctuations. It is very costly to pay for backup electricity.

Results:

Fortuntely, despite many challenges, the telemedicine project has been a huge success. About 90,000 eye patients have been screened and vision has been restored for nearly 16,000! Sonesh displayed a bar chart that showed how thousands of these patients were served through the expansion of 5 additional clinic links. Furthermore, the TIER group has moved from doing all maintenance, management, installation, and equipment supply to doing only some equipment supply with Aravind (a local vendor handles installation and Aravind handles maintenance and management). It is clear to me that the positive impact of this telemedicine project will only increase exponentially!

 Today Neil Patel gave a talk on some of his experiences designing information systems in rural India.  

Jatan Certification System
One of the difficulties with organic certification is that “organic” does not necessarily mean the same thing worldwide. Secondly, small farmers may be left out since certification is usually for large scale, industrial enterprises. So, Jatan created an organic certification system “for farmers, by farmers”.  Instead of evaluating farms on a binary scale (organic or not), the Jatan system uses a more inclusive, scalar scorecard based on three categories: 1) environment/sustainability – what’s the water source? (well, dam?), 2) social – how many people visit the farm?, and 3) health. This certification system is particularly unique for several reasons. For one thing, the scorecard is in Gujarat, so farmers can actually read their own certifications, and some of the farmers have given feedback that has been incorporated into revising the scoring system. What’s more, the appraisers are volunteer farmers.

When prompted to elaborate on the economic value of the Jatan certification, Neil explained that farmers receive certification stickers to put on their produce, and when consumers see the certifications, they will be willing to pay a premium price. They believe that the “Jatan” brand will be strong enough to command this premium because Jatan is running the most well-known organic retailer and conducts farmer’s markets and other events to educate consumers.

Brian DeRenzi gave an interesting presentation on “Automating Routine Tasks for Community Health Workers”. I appreciated that he was very upfront about some of the challenges he faced in helping different organizations to develop these mobile applications. For one thing, it’s important to create a feedback loop to engage community health workers in improving the data flow (e.g. What questions don’t make sense? What questions aren’t being asked?). Secondly, Brian brought up the point that applications can serve two very different functions: data collection (information gathering) vs. service delivery (providing healthcare by selling basic medication). But Brian insightfully pointed out that service delivery can also serve as a method for gathering data (how much medication was distributed? may be just as good a way (if not better) to ask how many people report having headaches. Finally, he mentioned the importance of the order in which one asks questions. One drawback to mobile apps is that they are sequential (only present one question at a time), whereas paper applications allow healthcare workers the flexibility to jump around.

Next, I gave a presentation on my summer internship in Ghana. Since I implemented a CRM system for one of Ghana’s largest internet service providers, I named my presentation “Designing Urban Computing Applications.” I first shared how I ended up working in Ghana, introduced my client BusyInternet, and shared the main objective of my project. I next described the process by which I approached the implementation and some of the data analysis I conducted during my 10-week internship. I wrapped up by sharing some of the lessons I learned: 1) Change is hard… get local buy-in!, 2) Technology by itself isn’t enough!, and 3) Implementation sustainability – leave a legacy! I know that the system I implemented this past summer may not educate or save lives, but I do believe that it enables employees to be more efficient and to improve customer service, and then BusyInternet as a company will be able to increase sales, grow and expand, and create additional jobs.

Today Deepti presented her experience with the MILLEE project, the goal of which is to design mobile phone-based software and games to help children in rural India to learn English. I particularly enjoyed the insight she shared into how cultural differences can affect the learning experience. Some of the things that Deepti mentioned were:

• The caste system (poorer people in lower caste, richer people in higher caste)
• If given a choice, poor families will send boys to school instead of girls, who marry by 17-19 years old
• Parents do not give boys and girls equal access to food, education, mobile phones. “If girl is educated, then it will be more difficult to find boys who are equally, if not more, educated.”

I found the results of Deepti’s study to be interesting. For one thing, girls shared more and fought less than boys (larger groups of girls gathered than boys), and boys fought over hitting buttons whereas girls took turns. Furthermore, the ease of access to a cellphone (in terms of both physical availability and social acceptability) was driven first by caste and then by gender (UC Boy > UC Girl > LC Boy > LC Girl), and degree of parental approval/acceptance was driven first by gender and then by caste (UC Boy > LC Boy, UC Girl > LC Girl).

Someone asked a question about whether adults (who may not have owned a cell phone), were jealous that their childrens when they did not. Deepti replied that the adults did not play mobile games, but also were not envious b/c they were perceived as toy phones. And besides, these phones weren’t connected to any sort of functional network.

I really enjoyed this week’s class on establishing relationships for designing rural computing applications because I have faced similar challenges and experiences through volunteer work in La Perla (a remote village in the Ixcan region of Guatemala) and during my internship in Accra, Ghana this past summer. In terms of establishing rapport, I agree in the importance of demonstrating a commitment, rather than “just flying in for 3 days and then flying out”. In La Perla, our volunteer team was only there for one week, but we partnered with a local church as well as dentists from Guatemala City who were committed to returning to the village once every month. We also worked hard to “be local” and “show you care” by eating home-cooked meals with villagers and playing with the countless children who were hanging around the dental clinic while they waited for their parents to be seen.

I also found it fascinating that many of the best practices for designing rural computing applications apply to designing urban computing applications in developing countries:

1) Setting clear goals – When I first arrived at BusyInternet, they wanted me to solve a very general problem: improve their ISP (internet services provider) business unit in terms of both internal operations and external performance. So, one of the first things I did once I arrived in Accra was to conduct a two-day brainstorming workshop with Busy’s management team to identify their greatest pain points and prioritize solutions to these issues using a 2×2 matrix (level of positive impact/value vs. ease of implementation). This exercise really helped the team build a roadmap and tangible action items to work toward a goal as broad as “strengthening and growing the ISP business”.

2) Listen (and observe) – One of my main tasks at BusyInternet was to customize and implement an open-source CRM application to manage sales leads, store client information, and track customer service issues. I found extremely beneficial to work closely with the future users to design a CRM system that was user-friendly and effective in capturing/storing the data they needed to perform their jobs more efficiently and effectively. Although in my IT consulting days, it was best practice to separate the design phase from development phase from testing phase, it was much more practical to blend all three tasks together. Therefore, I would design and configure SugarCRM one day, have the sales and customer support teams use the new functionality in production, and then provide me with feedback (“technology probing”?).

3) Identify local champions – One of my greatest concerns was whether this CRM system would live on past my 10-week internship. Therefore, I spent a lot of time training BusyInternet employees not only how to use the system, but why it was so important to do so. I found that the more that employees  used BusyCRM, the better their understanding of benefits and value of the CRM system. Suddenly, I started hearing managers encouraging their respective teams to use the system, and asking me for more advanced functionality (including weekly and monthly reports).

Neal’s example of Electronic Medical Record (EMR) reminded me of an experience I had prior to business school, when I traveled to a remote village in rural Guatemala to set up a weeklong dental clinic with several dental students/residents. Having no medical background, I assisted with designing and implementing an Access database to store the medical records of each patient. One question I didn’t get a chance to ask Neal was whether the Patient ID was the only unique ID (he mentioned issues related to mistyped IDs and data integrity). When we designed the database, we intended to pull up medical records using a combination of Patient ID and date of birth, but we discovered that most of our patients had no idea when they were born!

Neal’s acknowledgement of some of the uglier sides or negative impacts of international development really resonated with me. I spent this past summer in Ghana working for BusyInternet, an ISP based in Accra. Although I was not working in a rural area, I was exposed to the proliferation of international aid agencies and NGOs based in Accra. Although many of these organizations do tremendous social impact, it was clear to me that there is simultaneously a great amount of inefficiency, wasting of resources, and even corruption. I definitely feel inspired to pursue a career in international development (particularly interested in technology solutions to poverty and social entrepreneurship in developing countries), but I feel convicted that I need to be very careful about who I work for.