I’ve been in Rwanda for a little over a week now. Its my first time here and so far I really do love this country. Its quite beautiful, much more lush and green than I had imagined. The people are quite friendly and always offer up a smile. I am here to start a new project that will involve using hand-helds to collect health data (more on this in a later post). To that end I’ve been working closely with the folks at the Twubakane project. Its great to be here and see some of these bigger projects working outside of the context of my comfortable office at home. There is a lot of great work going on here.
After meeting with the folks I will be working with at Twubakane, I was taken to the Ikigo health center in Kicukiro. Its a small facility that seems to be handling a great number of folks in a densely populated area. We had a surreal experience riding out to the center as we were bumping along the pothole-filled dirt road only to run into a film crew in the middle of a shoot - camera on rails, mic booms, the works. I’m still left confused by it. Nonetheless we met with some of the community health workers who go door to door in their villages to collect data. I learned that they are elected by their peers in the villages to do the job - there is a great deal of trust there. Twubakane should be praised for these kinda of approaches as it brings a sense of honor to these important tasks. We talked at length (with much translation) about what has worked and what has been difficult with the paper-based system we hope to replace or enhance. There are some very important steps in the paper system we’ve got to think on. The current system allows all of the workers and the program supervisors to review the data together as they compile it. This lets them figure out if changes in the numbers are due to a growing health problem, or mistakes in collection. If we have the data in our system doing the compilation for them we might skip this step and that would be bad for the communities. We must keep this in the program itself.
Meeting with the health workers was worth the trip for me on its on, but of course I’ve done more than that while here. We hope to be able to hire a local developer to join the team, but only have a couple days left to get that done. It is possible though. I’m excited about this project and being here in Rwanda has brought home to me the importance of certain aspects of our approach at IntraHealth. The use of open source hit me in the head as I was asked very pointedly about it (unprompted, I promise!) It seems the idea of having to fly someone in to work on a couple of extra proprietary systems has grown old. But more than that, the true ownership of these projects in terms of Stakeholder Leadership Groups, or the elected health workers, or hiring local talent seems to be the right approach for this kind of work.
Posted by
David Mason on 3/3/2008 • Tags: Africa, Cellphones, Data Collection, Digital Divide, Mobile Technology, Open Source, Public Health, Technology, Volunteers
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In reading this article from BBC News on “The Invisible Computer Revolution,” a number of points seemed worth taking notice of. The article posits that a computer revolution is taking place in the developing world without attracting much notice from those of us in the development community. In the industrialized world, we are so used to interacting with our desktops and laptops (like the one I am writing this on right now) that we are ignoring the computer that has already penetrated the developing world: the cell phone. Because we don’t typically use the cell phone for computing tasks, we don’t recognize what a powerful and cheap device it is.
I have written about this before, but I wanted to highlight a couple of other points made by this article. First is the point that demand for cell phones in the developing world is driven by the user, not by nonprofits or aid agencies trying to put cell phones into their hands. We already know that for adoption of technology to be sucessful, it must be demand-driven. Rather than trying to sell a government on a cheap laptop, we should take advantage of the technology that is already in the pockets of so many people. It makes sense, doesn’t it?
Of course, even in sub-Saharan Africa, the fastest growing cell phone market in the world, many people still don’t have access to a cell phone. But the article points out that access has grown much more rapidly in certain sub-groups, such as health care workers–exactly the population we are trying to reach. One application the article proposed was continuing education software for health workers, delivered by text message straight to their cell phones. Why isn’t anyone writing this software? Why aren’t we?
I think those of us working in ICT for development need to start using our cell phones the way our target customers use theirs: to retrieve and transmit information (rather than make voice calls). Then we might stand a better chance of coming up with ideas for technology-based solutions that work in their world, not ours.
For further reading, here is a terrific overview from MobileActive on a variety of ways cell phones and text messaging are being used to solve problems in the developing world.
Posted by
Shannon Turlington on 2/13/2008 • Tags: Cellphones, Development, ICT4d, Mobile Technology, Technology
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With the start of the new year, it is traditional to predict trends for the coming months. So I thought I’d take a look at our ICT work and identify what I see as trends for our work moving forward and for ICT for development in general. I don’t think any of these predictions are earth-shattering, but they should be helpful as guides for our work and areas for further discussion.
Generally, I see two strong trends and then one I’m not so confident about:
- Greater focus on using cell phones and text messaging to connect systems to users
- Broader acceptance of Open Source technologies in nonprofits and in the developing world
- Increased use of social networking tools to improve communications among people doing this work and people using our systems (this trend is “iffy” because I don’t know if this is something that will really take off in 2008, at least in our organization)
Cell phones and text messaging
It is clear that cell phones are the fastest growing and probably most accessible technology for two-way communication in the developing world. Text messaging, in particular, has become an efficient way to send and receive necessary information, more ubiquitous than email. People in the developing world are more likely to have access to a cell phone than to an Internet-connected computer, they are familiar with the technology, and it is generally cheaper for them. Some unique uses of the technology I’ve seen recently are texting locations of mobile HIV clinics in South Africa and tracking epidemics in Rwanda.
We will need to take advantage of this trend to make our Web-based systems, such as iHRIS, easier for our clients to use, particularly in areas where there is no Internet access. The cell phone may even be a solution for accessing just-in-time information from online repositories, such as the HRH Global Resource Center.
Open Source technologies
I see a promising trend for Open Source technologies becoming more widespread in both the sectors that we work in–nonprofit and public health–and the countries where we work. As Open Source becomes more familiar and thus more trustworthy, the advantages will become too clear to deny. The costs are significantly lower, and the potential for turning over systems to local developers to maintain and grow is much higher.
For our part, we’ll be using such technologies as the Asterisk telephony system and possibly Open Source software on cell phones in addition to the standard LAMP (Linux-Apache-MySQL-PHP) set of development technologies, as well as releasing all of our software developed in-house under Open Source licenses and actively encouraging outside developers to improve them. I expect we will expect our partners to also leverage Open Source technologies. Most importantly, though, I am hearing from the country level that strategic technology plans are being made based on adopting Open Source software for everything from servers to desktops. .
What about social networking?
I think the surge of social networking tools, such as blogs, wikis, podcasts and more, is a very exciting development for those of us who live with always-on, high-speed Internet connectivity. But how does that translate to our work in low-resource settings? I’m not sure, but many nonprofits are exploring that question now and sharing their ideas.
Social networking tools are so powerful and so popular because they tap into our very basic human desire to connect and share with one another. Last year we dipped our toe in the water through this blog and virtual learning environments, which were essentially online communities for sharing information. Perhaps this year we can use them more thoughtfully as a way to better connect with dispersed employees, volunteers and even our clients who are using the technologies we develop. We can exchange ideas, get feedback and work collaboratively faster and more effeciently than we have before.
But for that to happen, the tools have to be accessible, easy to use and compelling. We should start with a few small, targeted projects and see what happens. Instead of trying to reinvent the wheel, we should harness those free tools that have already been developed for us, tools like Twitter and YouTube. Tapping into the power of these tools will require creative thinking and a willingness to experiment, as well as time to see what works best for us and our community.
Does anyone have any ideas or predictions for 2008? Please share them in the comments.
Posted by
Shannon Turlington on 1/21/2008 • Tags: Cellphones, FOSS, ICT4d, Mobile Technology, NPtech, Open Source, Public Health, Social Networking
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Shannon recently wrote about mobile technologies and the possibilities that are open to us with the influx of mobile usage in the countries in which we work. What’s equally exciting is what has happened since in the development of open mobile technologies.
Here in the United States we have the worst situation in the world when it comes to openness in our mobile technologies. Our phones are “locked” to particular carriers so that we cannot use them on another provider. This is mostly an historical problem as the carriers originally thought the money would be in selling the devices. While there is some money to make there, the real money comes in selling the service. Nonetheless, we are left with the old model. In the rest of the world the two are separated. One buys a phone then decides which network to go use it on. While most US phones can be unlocked to work with other networks, its not something easy enough for everyone to be able to take advantage of. The disturbing trend set in place by Apple’s iPhone takes the locking another step further to the point where Apple is trying all they can to keep its users from using anything but AT&T.
Enter Google. Google has launched the Open Handset Alliance which has the weight of many companies behind it with the goal of developing an open platform for mobile devices called Android. While they were not the first to start such a task (beaten to it by the OpenMoko folks, they have the name recognition to make a very big splash.
So what does all this news mean for us and our work? I suppose to answer this I go back to IntraHealth’s mission which is to “mobilize local talent to create sustainable and accessible health care.” With an open platform we can more easily introduce the people we are working with in-country to the technologies in which we have developed applications and processes to deliver health care. In this case, applications that can take advantage of the enormous use of mobile technologies in the countries in which we work.
With proper funding the ideas for these application are endless. Imagine a district health care facility with a system that can send a text-message to a patient to let them know a follow-up appointment is needed. Texting is cheaper and easier for most folks in developing countries. Imagine a member of the Nomadic Somali people in North-Eastern Kenya using a mobile phone to schedule an appointment with the health care facility they happen to be closest to on a given day - and then using that same phone to let the provider access their medical history. Imagine a district health office in a very rural area accessing their Ministry of Health’s system via a mobile device when their power goes out. What once was a break in access to communication is now just a switch to another technology. The possibilities are endless, and with an open source platform, they are cheaper to implement and easier to develop on.
Half the fun of accessing these new technologies is coming up with new ways of applying them to old problems. How would you use it?
Posted by
David Mason on 11/13/2007 • Tags: Cellphones, Development, Digital Divide, FOSS, Mobile Technology, Open Source, Technology
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I admit it: I have a love-hate relationship with my cell phone.
I don’t like phones in general, but I consider my cell phone to be more necessary than other phones. It has helped me out in some sticky situations, like when I had a flat tire or needed advice on a difficult buying decision while at the mall. But I don’t like the thought of other people being able to find me no matter where I am, so I am stingy with giving out my cell phone number. And I am rather passive-agressive toward my cell phone, often leaving it uncharged until it starts that annoying “low battery” beeping, usually at 2 a.m.
Still, I must be alone in disliking my cell phone, because everywhere I look, people are talking on them. Cell phones aren’t just popular here in the U.S. They are becoming ubiquitous all over the world. Worldwide there are over 2.7 billion mobile phone users, far surpassing Internet users, TV watchers or even car drivers. In the developing world, especially, mobile phones are leapfrogging conventional wired technologies like landlines and Internet to become a primary communications and information resource.
Last week I was in a meeting with a co-worker who had just returned from a workshop the Capacity Project was hosting in Africa. He shared an interesting learning — that his African colleagues rarely read email as part of their daily work. (What a shock that is to those of us working in an email-addicted culture!) Rather, they would prefer to be notified via an SMS (text message) on their cell phones when an important email message was waiting for them because they were much more likely to check their cell phone messages than their email. Reading the text message would prompt them to go read their email. (Why not skip the middle man and send the email straight to their phone?)
In fact, the developing world is way ahead of us in finding creative ways to use text messaging and mobile phone applications. Here, we still largely use our cell phones to talk. In the developing world, cell phones are used to look for jobs, check daily prices for crops, and get timely health information and services, among many other applications.
In the U.S., we are so used to our daily routine of email and web surfing that we forget that the rest of the world is different. We put content or services on a website, point people to the URL and expect them to just go. We expect our audience to get updates via “pull” methods like RSS feeds and email lists that they subscribe to themselves. But everything comes back to the Web link.
Our audience and clients in the developing world don’t have reliable access to the Internet, and they aren’t in the habit of checking these resources daily or using them as primary sources of information. What they do have is a cell phone in their pocket. The technology already exists for converting email messages and website updates to text messages and vice versa. But those of us who are providing the content have to remember that it’s a mobile world and make our content available in multiple formats, including SMS.
This raises some questions and challenges, of course. Receiving text messages costs money, so any messages we send have to be timely and critical to have value. Text messages have to be short and to the point, which changes the way we write content as well as how we deliver it. Does that mean we should start delivering messages a la Twitter, but with meaning? How do we promote two-way conversation, and more importantly, interactivity — with web-based applications, like iHRIS, for instance — given the constraints of the cell phone? How do we reach people who may use multiple phones or change phones frequently?
MobileActive.org may be a resource that can help. Their mission is to help nonprofits use mobile technology more effectively in their development efforts. Their website provides useful news about mobile technology used in various initiatives, as well as international mobile usage statistics, including number of subscribers, cell phone costs and providers for each country. Another good resource is the Mobile Applications Database, a database of projects using mobile technology to make a difference.
Here we’re also planning to take our iHRIS software mobile and to build a mobile telecommunications-based community health information system as part of the Last Mile Initiative. Stay tuned for developments!
Looks like I’m going to have to learn how to love my cell phone…
Posted by
Shannon Turlington on 11/5/2007 • Tags: Cellphones, Development, ICT4d, Information Systems, Mobile Technology, NPtech, Resources, Telephony
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