Final Thoughts

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This course has served as a wonderful opportunity for me to learn about some of the current ICTD projects throughout the world.  Having had very little exposure to these types of projects before now, I feel like I have gained a great deal of perspective regarding what’s out there, and how my skill set might best be leveraged in a useful way.

I have a background as a programmer, writing software for various state agencies to help them manage, store, and query geo-spatial data over the web.   I am particularly familiar with some of the types of activities and issues that are associated with land use, environmental data, and vector-based disease, and have worked on a number of software projects with the Florida Departments of Transportation, Agriculture, Environmental Protection, and Health that addressed problems within the environmental and epidemiological domains.  That being said, I realize – especially after learning about the research presented in this class – that implementing similar systems in the developing world would involve, in most cases, an entirely different approach.  I do not have any “development experience” per se, but am nonetheless fascinated with the enormous potential that technology has to assist the developing world in solving problems by making information systems more efficient and facilitating a heightened understanding of the problems and potential solutions through data collection and processing.

My research interests are pretty general and flexible.  There are so many wonderful applications for technology – facilitating micro-loans, certifying coffee cooperatives as organic, widening the availability of healthcare, educating children, helping struggling businesses survive – and I would be happy to support any of these spheres.  I feel like I am a flexible generalist (who also happens to be a programmer), and I would love to use my skills to help support really any development project.  I feel like in order to be a researcher, I need an initial question and a sense of what I hope to accomplish, but to be honest, I’d like to help support someone else’s research while learning more about ICTD from the field (like an apprentice).  Though perhaps someday when I’ve acquired more perspective, I would indeed like to conduct my own research, but in the meantime, I’d like to support an existing project.

If I were to explicitly choose an arena, though, I did find that the agricultural certification projects and the Sustainable Sciences Institute work (disease research, control, and prevention) to be most in line with my past experiences and interests.  In addition, I would also like to explore ecosystem health and the ways in which a healthy, sustainable balance between local people and their surrounding environment can be best promoted (similar to Neil Patel’s organic farm certification project that gave people credit for their sustainable practices).  I’d also be interested in working on a project that protects biodiversity – perhaps from an eco-tourism angle.

Lecture 10 – Using Line-Of-Sight Technology at Arvin Clinics (India)

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On Tuesday, November 4th, Sonesh from UC Berkeley’s TIER Group talked about his experiences in setting up WiFi networks for Arvin Eye Clinics in India using Line-Of-Sight technology via a series of steel towers.  Sonesh was such an interesting and engaging speaker, and had many candid anecdotes for the class.  His presentation style really allowed me to envision some of the challenges he faced from his own perspective.  Some highlights:

  • “I didn’t know anything about installing 20 meter towers!  What if they fell down?  Where do we put them?”
  • “When troubleshooting connectivity problems, I learned to speak about the hardware and the concepts in the language that the techs at the Arvin clinic used.  It’s important to bridge the language barrier.”

Sonesh also described the negotiation process that was needed to make things happen: from negotiating with an off-duty cell phone company worker to build cell phone towers, to finding land for the towers themselves, the problems that Sonesh tackled were far broader than simply IT issues.  Sonesh’s natural teaching abilities also seem to account for – at least in part – the fact that the telemedicine project with Arvin was able to become scalable and self-sufficient.   He shared with the class that people at the clinic learned best when they figured things out for themselves, rather than being instructed.  He would intentionally break something, and then let the technicians figure out how to fix it.  His team also partnered with local IT professionals in the villages that were served, which further enabled the telemedicine operations to become sustainable after the US team went home.  The Arvin telemedicine project seems to be a shining example of a sustainable, useful, economically self-reliant development project that provides an important service to the community.

Lecture 9 – Information Systems for Rural Gujarat

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On October 28th, Neil Patel, a CS student at Stanford, presented his work in using technology to facilitate the promotion and adoption of a grassroots certification system for organic farmers.  He gave us some background on the current “top down approach” to organic certification in India, and how it was mostly geared towards certifying large-scale providers of agricultural products for international export.  Since this system doesn’t meet the needs of the majority of Indian farmers, who are small-scale producers would also like to be certified for organic, the Jatan Certification System (JCS) was created to bring smaller farmers into the organic market.   By providing a way for small farmers to certify their farming practices as organic, JCS enables small-scale producers to command higher prices for their agricultural products, while promoting sustainable and environmentally friendly agricultural practices. This new certification approach is also novel in that it gives each farmer credit for the percentage of organic practices that s/he does employ (on a graduated scale), rather than simply certifying a farmer on a “yes/no” basis (i.e., whether or not a farm meets the minimum standards for organic production). 

 It is exciting to see how two seemingly unrelated domains – computer technology and agriculture – can be linked.  By digitizing these paper organic scorecards (in the community’s native language), Neil and his team have automated the certification process and implemented an alternate, bottom-up approach to quantifying the “organic-ness” of a farm.  This is an obvious statement, but it seems like the magic of all of the development projects we’ve heard about this semester has been the great ideas that aimed to fill niches where health, poverty, and the environment needed a little assistance.  Creative technological solutions, when done smartly, simply make certain tasks of these organizations easier – namely information organization & retrieval, and communication.   Of course, I enjoy hearing about new mobile technology implementation strategies and asynchronous communication strategies, but it’s more interesting to hear about the projects themselves.  Development projects that credit farmers for treating laborers and animals well and re-using rainwater; provide rural healthcare; enable communication and knowledge-sharing; and enable small-scale business owners to gain access micro-loans are wonderful and exciting applications of information technology.

Lecture 8 – More Students Present Their Work!

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On October 21, we heard about three more student projects.  I am absolutely blown away by how many Berkeley grad students have gone abroad over the summer to do ICTD work!  It’s really remarkable and inspiring.

Brian
The first speaker, Brian, presented his work on mobile healthcare applications for data collection and service delivery in Africa.  He described his methodology for creating and implementing data collection and screening tools to help community health workers (CHWs) deliver better care and improve reporting.  A few things I found particularly interesting:

  • That depending on the organization, some CHWs were “well paid” while others were volunteers.  I remember hearing in another seminar (on developing economies) that there were often issues when a new NGO establishes itself in an area and pays local employees to provide a service that has traditionally been provided on a volunteer basis.  The new NGO, even though its intention to pay its employees was a good one, inadvertently disrupted the traditional order of things.  Since these two models are quite different, and I wondered if these differences were typical among NGOs in Africa that are providing healthcare (volunteer versus paid CHWs), and if one model were much more successful than the other. 
  • That Brian observed a CHW leverage a patient’s lack of understanding about the mission of the NGO to ‘scare’ the patient into complying with health recommendations.    That is, when the patient asked the CHW if he would be arrested for poor sanitation (assuming that the CHW was a regulatory official), the CHW simply replied “yes,” to scare the patient into compliance.  It’s interesting to observe the ways in which people improvise with technology, and use it in ways that may not be intended or anticipated.  This is yet another example of how complex the process of application development can be – especially within a completely different cultural context.

Charlene
The second speaker, Charlene, spoke of her experiences in Ghana as an intern for “BusyInternet.”  OK, so, I really loved this presentation because I could relate to certain aspects of her project (insofar as I have had experience in configuring and extending COTS business software for organizations and trying to get everyone switched over).  Of course, I have no idea what it’s like to do that in Africa, but it made me realize that I currently possess a skill that could help another organization somewhere on the other side of the globe. 

I was really impressed by Charlene because she was able to accomplish so much in her 10 week stay in Ghana.  She was able to gain buy-in from the employees in the organization, wrote up manuals and configuration instructions, and even observed the employees extending the application for themselves.  Not easy! And, Charlene’s still getting emails from BusyInternet to see that the application’s still running smoothly.  The question was asked in class if Charlene thought that BusyInternet would be able to continue to maintain the application over time.  It sounds to me like this is likely, especially since new functionality has been added since she left by internal staff.  I think that if the tool is valuable to the business and that if the business knows what is possible, it will figure out a way to keep the technology going. 

Roxanne and Allison
The final speakers, Roxanne and Allison, presented their work in creating Bodas for Life in Uganda, sponsored by the Blum Center for Economic Development.  What a great presentation – while exploring opportunities for integrating technology into healthcare in Africa (their original mission) the group realized that it would be more useful to leverage existing technologies to improve healthcare delivery.  They observed that the need for transportation to healthcare facilities was not adequately being met, so they created a moped-based EMT-like service to provide both transportation and initial emergency response for the community.  It was nice hearing that Bodas for Life received accolades from the health minister for making a program that was totally sustainable and that used existing tools.  It was also great to hear about how the program essentially created a new type of job (moped EMTs) that gave people status and a sense of pride – what a great indirect benefit to the community!  That’s a bonus above and beyond the already-important feature of providing for much needed medical transport service.

Lecture 7 – Students Present Their Work

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On October 14, three students presented their work in Developing countries. Kuang presented his work and experiences in developing mobile data collection applications and resources for community health workers for CommCare using Openll. It was interesting hearing him talk about how he was able to utilize a variety of resources to fund his research interests, and learning about his iterative process of conceptualizing useful solutions, given his research interests.

Kurtis, the second speaker, spoke on his project on asynchronous telephone communication. The project focuses on optimizing an existing cost structure with respect to cellular phone service in order to serve more communication needs in rural Uganda (i.e., only sending messages during low-traffic times when it is cheapest to do so). I liked that his project viewed the communications problem using economic, technical, and accessibility lenses and was able to blend all of the benefits from each of these angles to create a really useful product – and asynchronous cell phone service. Though Kurtis and his team did test his concept with potential phone users with demonstrated success, it seems that when it comes time to convince providers to support asynchronous phone messaging, it shouldn’t be a hard sell. Though still in its early phases, the project seems really practical, pragmatic, useful, and rooted in a sound economic model.

Heather, the third speaker, also talked about ICTD initiatives for health in South America. Like Kuang, Heather’s projects also relied heavily on mobile computing devices, lat/long and GPS capabilities, and designing ways to get clean data at the point of entry. Also like Kuang’s project, Heather’s project also used various visualization strategies (GIS and Spatio-temporal analysis) – in her context to track epidemiological patterns and disease outbreaks. I really enjoyed Heather’s presentation, and was interested to hear her insights on how different ICTD project are often silos, even though there are many project around the world that are doing very similar things. I also found it interesting when she said that too often, ICTD work stops at “the pilot” and that not enough happens after pilot testing in some cases. I wonder how hard it is to develop a successful pilot into a full blown implementation, given that pilots are often conducted by researchers and grad student types. Interesting things to think about.

Lecture 6 – Testing Children’s Educational Games in Uttar Pradesh

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On October 7, 2008, we had the pleasure of hearing one of the iSchool students, Deepti , present her work in piloting children’s educational games in the Indian state of Uttar Pradesh. During her two week trip, Deepti and her team’s goal was to try to understand the potential of cell phone games as learning tools. Her presentation was just fascinating. I was very interested to learn about just how big a factor caste played in the lives of the children, and how prominently this cultural construct factored into the effectiveness of their particular pilot study and the assumptions that they made. Several observations that she and her team made that were very interesting to me:

  • That the study had to almost be stratified by gender and by caste, since their free time, autonomy, and parental support of educational aims varied so much.
  • That the school selected for the pilot study was seen as a high caste school, which in turn negatively affected low caste participation.
  • That the tension between low caste and high caste girls was so blatant, as seen by the high caste girls trying to trick the low caste girls into thinking that there was no school that day.

Deepti also told an interesting story about one of the games, “Pick a Word,” where children had to find objects that represented English words that were displayed and take pictures of them. She and her team observed that the lower caste girls didn’t have the freedom or autonomy to wander through the village to find certain objects, so they would pretend that one object (say, a pile of leaves) represented another object (say, a mango) and take pictures of the “proxy” object. Had one of the team members not observed this, the conclusion might have been drawn that the girls weren’t learning from the game, but in fact the girls were just improvising, given their social constraints. What an interesting lesson.

After listening to Deepti’s talk, it really seemed that she and her team’s educational game pilot was as much of a vehicle for understanding cultural and social norms as it was a technology project! She noted that her take-away lessons were all socio-cultural, rather than technical. Week after week, this seems to continually be the case. What an interesting talk!

Lecture 5 – Designing Appropriate Computing Technologies for Rural Development

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In Tuesday’s lecture, we began by discussing the format of the class as well as the format for potential future classes like the Designing Rural Computing Applications class.  Just to reiterate some things that were said in class, I really think that it would be great to incorporate field work into the classroom so that we can really get some practice and perspective into the types of information and communication issues that a small NGO or non-profit faces.  The prospect of having a class like that really excites me.  Also, I’ve been thinking about some of the ways in which the blogs could more readily facilitate dialogue among students: as I’ve been reading other people’s blogs (which have been fascinating!!), I’ve noticed that we really haven’t been commenting on each other’s thoughts.  So, even though many of the blogs post questions or share really relevant anecdotes, I wonder if we’re all getting the full benefit of this collective introspection.  Perhaps instead we could alternate each week so that half the class could blog, and the other half of the class could comment on the blogs.  Or, another format that I’ve liked is something we’ve been doing in my Visualization class, where we each post a comment to a Wiki for each class – when everyone’s comments are in one place, it seems easier to comment on one another’s thoughts and questions.  Okay, now moving on from administrative details to the content of the lecture… 

What I found (and what everyone else seems to have found) to be fascinating about Professor Parikh’s lecture was how humble, interesting, and candid he was when describing his experiences in rural India.  Having never been abroad myself, hearing about a rural computing experience from the perspective of a recent graduate of a Masters program looking for perspective and meaning was both refreshing and encouraging.  I really enjoyed Professor Parikh talking about what his day to day experiences were like – hanging out with his cousins, New Years Eve, speaking a different language, etc.  It was also nice to hear about the iterative the process of creating a reasonable scope for the rural village resource coordination project, which involved reconciling the grand vision of the program director with the time, budget, and technological constraints in place.  Finally it was interesting to hear about Professor Parikh’s evaluation of the successes and failures of the project.  It really gave us the impression that getting a particular idea, project, or implementation “right” takes diligence, constant self-evaluation, and a few failures.  All of these were great lessons to share with the class.  The lecture was very inspiring.

 

Lecture 4 – Telemedicine In Rural India

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BACKGROUND

In class on September 23 (2008), Terry Lo came to speak on a telemedicine franchising program in Rural Uttar Pradesh, India, that aimed to (1) improve access to public health care and (2) provide more access to family planning options.  After first giving some background about the unmet needs in the area…

–  There are 1,700 people for every one doctor
– There is little incentive for urban-situated doctors to move to rural areas
– 54% of the population have no government healthcare services nearby, and people prefer private centers anyway
– Providing public health care is not profitable for private centers
– The quality of care in rural healthcare providers (RHPs) wasn’t always consistent
– 24% unmet need for family planning, and that 43% of those women had sought

…Terry Lo explained how World Health Partners (WHP), a New Delhi NGO, went about trying to solve these problems by implemented a number of telemedicine clinics (TPCs) throughout the state.  TCPs were placed near main roads where no other clinics or hospitals existed, but where there were RHPs and pharmacies nearby.  One TPC would serve ~ 10 villages.  The TPCs were each privately owned (with an initial $3,000 investment), but WHP would provide training, equipments, and support.  As part of the standard operating procedure, the TPCs were required to offer family planning.

SOME REMARKS

First, I want to say that I think it’s great that NGOs and innovators are trying to create and implement sustainable models of providing much needed healthcare to underserved areas of Uttar Pradesh.  I am sure that such complicated problems are very difficult to tackle and solve.  This being said, after thinking about Lo’s presentation and reading some of the other student blogs, I had a few questions about the business model, and also about cultural perception:

– If TPCs are being set up near RHPs, and if they will soon be prescribing medication (in direct competition to the neighboring pharmacies), is it possible that the TPCs are actually financially undercutting the local healthcare networks?  Will the RHPs still be able to function as the scope of the TPC’s mission continues to expand, especially if TCPs are being subsidized in part by WHP?

–  Might the continuity of care be disrupted when a different telemedicine specialist evaluates a person at each visit?  Even though the RHP providers aren’t necessarily doctors and some may not be ‘competent’ healthcare practitioners, perhaps the quality and consistency of care isn’t necessarily enhanced by the newer TCP system.  It would be nice to see the results of some sort of evaluation study to truly grasp the benefits of the TCP system.

– On family planning:  how big of a cultural and religious issue is the topic of family planning?  In the U.S., family planning can be controversial, and is not condoned because of the religious beliefs that people hold – especially in certain areas of the country.  If a clinic opened up in a small town in the Deep South (US) which said, “Everyone who comes to this clinic must be educated about family planning,” there would definitely be some outcry from the community.  Is that an issue in India at all?

I’d be interested in seeing a third-party evaluation of the TCP system – pros and cons – just to have some perspective.  I really have no background knowledge on such things soming into this class, but am anxious to learn more.

Lecture 3 – The Work of Jhai Foundation

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On Tuesday, September 16, Lee Thorn, founder of Jhai Foundation, volunteered his time to speak with our class about the work of his organization.  Jhai, which means “hearts and minds working together,” facilitates third world development (mostly in the technology arena) by (1) mentoring local entrepreneurs and people “who want change” and (2) providing them with low-cost technology resources which can be powered and maintained in even the most remote of places.  The mission of the organization can be easily understood from the quote below (taken from Jhai’s website):

“We like self-help. We insist on financial sustainability. We design for impact. We are most interested in relationships. We have demonstrated how, after such a devastating war, people from opposite sides can reconcile by working side-by-side. We call this the ‘reconciliation process of development.’ We are now taking this very respectful way of doing things into rural villages through sustainable computer-aided efforts in the areas of health, education, and increased livelihood.”

This is such a powerful and inspiring concept, envisioned by a former Vietnam veteran (Thorn) who wanted to make a difference in the region where he served during wartime.  He shared with the class how his organization’s creative and clever “bottom up” approach was able to provide a number of self-sustaining services.   What stood out about Thorn’s presentation was the truly grassroots nature of his approach, which were evident in a number of arenas.

ACTING FROM “BEHIND THE SCENES”
Thorn said a few interesting things regarding the role he felt the international community should play in development efforts, including:

–  “I try to show my white face as little as possible,” and
–  “If there is to be lasting change, people have to do it for themselves.”

This philosophy that aid should simply facilitate the ideas of the community seems wise and intuitive:  a project should only proceed if the community stands behind it and sees it as serving a valuable need.  As I continue to learn about development issues, this sentiment seems to be echoed over and over again.  In addition, much like Schwartzman and Parikh’s article stated last week, Thorn also emphasized the fact that rapport must be established with the community, and that the aid organization needs to ensure the community that they will always be there to support the project (permanence).  Thorn suggested to “go out and have a beer” with the people who may be potential allies.  In addition, it was interesting to see a model where the community runs the organizations.  By minimizing reliance on outside support, the individuals who are most closely related to the problem – the community members – can decide themselves how the technology can best be used.  Thorn showed that in Laos, technology was being leveraged to serve a variety of pragmatic and money-making functions: remote healthcare services, internet cafes, education, and even outsourcing work (after hours).

HARDWARE
Another interesting thing about Jhai was that rather than importing state-of-the-art laptops from first-world donors, Jhai facilitated the construction of a sustainable PC, which could be powered by a bicycle generator, connected to the larger world through Wi-Fi-to-phone connectivity, run using a fraction of the energy requirements needed for an average PC, and maintained using locally available hardware.  Right off the bat, local Laotian communities are given a tool that they can maintain without extensive external dependencies on power, hardware, or network infrastructure.

APPLICATIONS
Finally, I found it fascinating that Jhai was even able to serve illiterate community members (who used the remote healthcare services) by using graphics-based software and audio tools.  It was nice to see that absolutely anyone at any literacy level could use technology to help make their lives better.  It broadened my horizons as to the power of ICT in even the remotest of areas.

Lecture 2 – Establishing Relationships

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This week in class, we read about and discussed a basic set of steps that should be followed by “outsiders” who are providing technology services (or any services, really) for customers in rural regions. By following the interpersonal best practices listed below, the working relationship between foreign consultants and local clients can be strengthened.

– Establish a Rapport: embracing the local culture, being professional, helping out in a variety of capacities, demonstrating commitment, employing those who know the language and culture whenever possible, and defining precise roles.
– Design Relevant Solutions: listening to the customer and finding local allies (or “natural champions”) who understand the concept and will help you.
– Adjust Evaluation Procedures: convincing users that the testing is relevant to the project, integrating testing into everyday activities (un-invasive), and developing tests that mirror the users’ work environments.

The guidelines described in Schwartzman and Parikh’s article are not emphasized enough in technology consulting work! Though I have no experience working with third-world rural clients, my experiences in working with clients in general have taught me that being helpful, professional, capable, and willing to embrace the local culture – even if it’s simply the office culture – is essential in establishing trust and rapport and being an effective consultant. Stopping to catch up with a client about their weekend, joining the office’s knitting club (even if you know nothing about knitting!), trading recipes, helping support staff open email attachments, listening to people’s frustrations when performing business processes, etc. are all invaluable in designing relevant solutions and getting “buy in” and cooperation from all participants. Without a foundation of trust, respect, and open communication, it is very difficult to be helpful in any capacity.

It was interesting hearing these similar principles being applied to rural Guatemala during Dr. Parikh’s lecture. Though the differences between the consultant and the customer were much greater both culturally and economically, the principles used are essentially universal. A few points that stood out during the lecture:

– Having one of the technology consultants teach salsa dance lessons!
– Listening to the story about the “cell phone man” who would climb to the tallest peak and correspond with the outside world on behalf of the local people.
– Explaining vegetarianism to people who were unfamiliar with it.

I found the lecture to be interesting and relevant to a variety of contexts, and the annecdotal stories were priceless.  I mentioned this in my last blog, but I just wanted to say again — I would be really interesting to learn about how an organization — such as the Asobagri coffee cooperative — can eventually become self-reliant in terms of having in-house technical expertise (at least at some level), rather than relying exclusively on foreign experts.


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