Health Education & Technology

In South Africa, 1 in every 9 people is infected with HIV, resulting in a population of infected individuals larger than in any other country in the world. Approximately 1,400,000 of the orphans in South Africa were orphaned as a direct consequence of HIV/AIDS.[1]

Public perception of the disease is still increasingly negative, and public awareness campaigns are becoming increasingly important in reducing the stigma and misinformation about the disease.

South Africa has four major HIV/AIDS awareness campaigns: Khomanani (government funded), LoveLife (funded privately), Soul City (a TV drama for adults), and Soul Buddyz (a TV series for teens).

Soul Buddyz, for example, is considered “edutainment;” it uses information and communication technologies such as television and radio to provide entertaining, educational programming that provides information about HIV/AIDS. Each episode, the young characters encounter various issues that face young South Africans in real life such as bullying, racism, abuse, smoking, love, sex, and HIV/AIDS.[2]

UNICEF has written, “initial research suggests that Soul Buddyz and similar interventions might be helping to delay the age at which young South Africans first have sex, a trend that could have an enormous impact in helping to release HIV’s grip on the country and the rest of African continent” (UNICEF). Not only does the show inform about safe sex practices that can reduce the transmission of AIDS, but also stresses the importance of caring for infected individuals and not discriminating against them. There is a great deal of misinformation that non-infected individuals can be infected with the virus just by touching an infected individual; this program has worked to alter this public perception.

The Kenyan Minister of Education said, “education is vital to ensure that people understand what HIV/AIDS is”, so the government is actively promoting large-scale public awareness campaigns about the virus and disease.[3] I believe that the by choosing television and radio as the major methods of information sharing, the government has chosen an important niche to reach out to the most important people. These entertaining programs provide important topics for discussion among teenagers and adults, by providing potentially life changing information.

Along the same lines as Soul Buddyz, Takalani Sesame (South Africa’s Sesame Street) introduced Kami, an HIV-infected character created at the urging of the government to reduce stigma about the disease, at an early age. Kami, whose name means “acceptance” in the Tswana language (one of the country’s 11 official languages), teaches viewers about coping with illness and loss, as well as “create a culture of acceptance.”

According to Muppet Central, Kami will “challenge the stereotype of the HIV-infected sickly child and focus instead on fun and friendliness.” She will also “introduce basic information and promote discussion about such uncuddly issues as death and social ostracism.”[4]

Kami was also incorporated in a powerful advertisement with former US President Clinton, in the run up to World AIDS Day in 2006:

South Africa’s progressive decision to incorporate an HIV-infected character on Takalani Sesame, a show targeted for children aged three to seven is very exciting to me. If this were to be introduced in the United States, I think there would be serious uproar against it. American culture, although seemingly “open,” has real issues with publically discussing sensitive issues such as HIV/AIDS. I commend the South African government for working to find alternative, effective methods of communicating issues of public health concern.

This is a great start to introducing children and young adults to sensitive topics, and I hope that maybe this type of programming can be implemented in the United States, perhaps in the form of LBGTQ education. South Africa is successfully tackling the issue of HIV/AIDS without focusing on the “sex” aspect of transmission, so I think similar programming could be used for other supposedly taboo subjects.

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[1] http://www.avert.org/aids-orphans.htm

[2] http://www.unicef.org/infobycountry/southafrica_21368.html

[3] http://www.time.com/time/magazine/article/0,9171,353521,00.html

[4] http://www.muppetcentral.com/news/2002/091702.shtml

Insurance, Weather Permitting

Given the recent drought plaguing the Horn of Africa, I began researching the impact of these dangerous weather patterns on the livelihood of farmers and small-scale producers in the developing world, particularly in Kenya.

According to CIA World Factbook, 78% of Kenya’s population lives in rural, agricultural region, 22% of its GDP is accounted for by agriculture, and 75% of its labor force works in agriculture.[1]

From these statistics, it is clearly evident that the Kenyan people and economy are heavily dependent upon the nation’s agricultural sector, and subsequently incredibly vulnerable to erratic weather conditions.

In attempt to mitigate the costs of lost capital and poor crop yields due to fickle weather conditions, NGOs and private companies have teamed up to develop innovative solutions to protect the average Kenyan farmer. Agricultural micro insurance, such as Kilimo Salama, literally means “safe agriculture” for farmers who can ensure food security, even in the event of a drought.

Farmers in rural regions around the world generally do not have access to insurance for their farms because they often lack the capital and other resources needed to acquire such protective services from banks or private companies. The insurance offered through Kilimo Salama is called “weather based index insurance.” Weather stations are used to measure the rainfall in given areas, and then these values are compared to predetermined standards specifying the rainfall needs of various crops.  If the crop rainfall needs are not met, all insured farmers receive a payout, and if the needs are met payouts are not distributed.[2]  

The weather systems themselves are powered with solar energy, which adds a sustainable, “green” component to the insurance process as well.

The registration process for the program as well as the delivery of payments is done through paperless transfer using mobile phone technology—proving another innovate application of information and communication technology for the betterment of the third world.

Not only are these farmers insured against the impacts of severe weather, they are also incentivized to purchase better quality seed and fertilizer for their farms. This leads to healthier products for the consumer, because it limits the usage of cheaper, more harmful chemicals.  By using better quality seed, they are also guaranteed better yields than from those generated from seed leftover from the previous harvest.

Another great feature is that farmers, through their mobile phones, received tailor agricultural information about the specific crops they grow. These messages can be used to enhance the growth and productivity of their products.

Here is a video about the program: 

The program seems like a great concept and safety blanket for poor farmers. However, I do have a few issues with it. The program thus far has had difficulty reaching a sustainable scale. Micro insurance programs have only been introduced as pilot programs in numerous countries around the world (India, Rwanda, Malawi to name a few).  This may be because insurance programs are different than offering subsidies. It is difficult to offer insurance plans that are cheap enough for farmers to see the benefit of paying the premium. Additionally, the physical weather monitoring system can be considered a costly investment.

Kenyan society in particular has a negative reputation in Kenya, most likely stemming from the rampant corruption that occurs at even the highest level of the state bureaucracy. The program first needs to improve the reputation of insurance plans for these farmers by providing better marketing strategies in rural communities. The unique “pay as you plant” system offered in Kenya allows farmers to try out insurance for a small period of time, so they can learn to trust insurance. The pilot program has proved successful, so the expansion process in other districts across the nation seems promising.

In the wake of the unfortunate droughts currently facing East Africa, I hope the insurance programs already in effect are providing some sort of protection to the farmers experiencing not only starvation, but limited crop yields as well.

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[1] https://www.cia.gov/library/publications/the-world-factbook/geos/ke.html

[2] http://www.syngentafoundation.org/index.cfm?pageID=562

Social Media and Crisis Management

At 6:54 pm on Wednesday, July 13 the first of three explosions erupted in Mumbai—with the explosions targeting the city’s Opera House district, its Zaveri bazaar, and the central Dadar area in a series of coordinated terrorist attacks. Amidst the confusion, social media sites such as Facebook and Twitter saw statuses and tweets providing real-time updates for concerned citizens.

By 7:30 pm, a series of useful phone numbers for contacting hard to reach friends was posted to the Mumbai Help blog and links to an editable Google Docs spreadsheet was circulated on Twitter with information of “names, addresses ad phone numbers of people offering their houses as a refuge to those left stranded.”[1]

These online forums allowed individuals from all over India to set up information sites in a collective and organized location to provide some order to the crisis situation. Nitin Sagar, an IT engineer in Delhi 720 miles away from Mumbai, created the Google Doc said much of the information begain getting lost in the “Twitter timeline,” so “he aggregated some of the names and phone numbers of people volunteering to help in a spreadsheet [and] re-tweeted to help funnel missed phone numbers from Twitter messages into a single page”[2] He was able to use the quick updates provided by Twitter and Facebook, and organize them in a user friendly and helpful manner.

Similarly, Ajay Kumar, a software engineer in Luknow (also 720 miles away from Mumbai) created a disaster tracker map that provided links to “useful reports such as traffic updates, death toll, blood donors, [and] hospital phone numbers”[3] based on where you clicked the color-coded dots on the map, on Ushahidi a website that allows users to crowdsource crisis information. He aggregated information from Twitter based on hashtags such as #here2help, #needhelp, and #MumbaiBlasts, where he sifted through to find the most timely and accurate information to include in his updates. The power of Twitter in the aftermath of the explosions is visually evident on this map compiled by The Guardian newspaper. It tracks the tweets from the Mumbai area using the #Mumbaiblasts hashtag.[4]

I personally checked Facebook multiple times in the day, just to read the updates posted by my family members in Mumbai. My family in America had a difficult time contacting people via telephone because of the increased usage, so we turned to social media sites to get in touch with them. My cousins and friends in India posted statuses such as “Sab theek hai ghar pe” (everything is okay at home) and “we’re safe” as the quickest way of relaying their safety.  

I think this efficient use of social media sites is truly powerful; this situation showed that social media is an important tool for crisis management in its most rapid form. Before information and communication technologies, the real time relay of information to people around the world was convoluted and nearly impossible. In the age of instant communication, information is spread across the globe in seconds. Although this rapid-fire form of communication is more easily open to the spread of rumors and lies that can heighten crisis, I still believe the use of social media is effective. Kumar and Sagar showed their commitment to spreading accurate information for help amidst the confusion, and I believe that social media was one of the best tools for providing some clarity to the situation.

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[1] "Online Crisis Management: A Web of Support | The Economist." The Economist. The Economist, 14 July 2011. Web. 16 July 2011. <http://www.economist.com/blogs/babbage/2011/07/online-crisis-management?fsrc=scn/tw/te/bl/awebofsupport>.

[2] “Online Crisis Management: A Web of Support”

[3] “Online Crisis Management: A Web of Support”

[4] "Mumbai Blasts - Wednesday 13 July 2011 | World News | Guardian.co.uk." The Guardian. 13 July 2011. Web. 17 July 2011. <http://www.guardian.co.uk/world/blog/2011/jul/13/mumbai-blasts>.

Pharmaceutical Companies as the Good Guys

Jody Ranck, Director of Thought Leadership, Policy and Advocacy at MHealthAlliance brought up an interesting point about private sector involvement and interest in the mobile health (mhealth) ecosystem being limited to the mobile operator. He stated that companies selling mobile telephones and charging for phone service are the only ones with private stake in the mobile health technologies industry.

I found the sole involvement of mobile companies interesting because I see mhealth technology as an interesting market for other private actors, such as individual medical professionals and pharmaceutical companies to tap into, especially in the developing world.

Public/Private collaboration is necessary, especially when lack of effective financial resources at the public level is often the major cause of poverty and health issues. With this in mind, the Tanzanian Ministry of Health in collaboration with Novartis, a pharmaceutical company and Vodafone, a mobile service provider, have developed “SMS for Life,” a program that ensures patients have access to malaria medicine by using mobile phones to track antimalarial drug supplies. 

Here is a video by Vodafone about the pilot program in Tanzania: 

Another great program “Text4Baby, developed by Johnson and Johnson, for mothers in the United States, has the opportunity to make a great impact on natal health in the developing world. The program is “the first ever free mobile health service in the United States that provides timely and expert health information via SMS text messages to pregnant women and new moms through their baby’s first year” (http://www.jnj.com/connect/caring/patient-stories/reaching-moms-one-text-at-a-time).

Here is the promotional video for Text4Baby: 

Text4Baby focuses on women in underserved communities, sending them direct text messages that provide critical health information to expecting and new mothers. By Texting “BABY” or “BEBE” (for Spanish speakers) to 511411, women sign themselves up for three free text messages a week, timed to the baby’s due date or date of birth. The program sends messages pertaining to birth defects prevention, immunization, nutrition, disease, and mental and physical health.

The program is a great concept, but there are still many issues in terms of communicating the benefits of the service and actually registering women for the program. My mom works for Johnson and Johnson, and she wasn’t aware of the program. Therefore, I think Johnson and Johnson should introduce a wider, large-scale marketing program to spread the word to women in underprivileged areas of the United States. They should invest more financial resources for public service announcements and advertisements that promote Text4Baby. Women may not necessarily follow all the advice provided, but at least something will be done to close the information gap. This has the opportunity to help women in one of the most critical times of their lives—they just need to be made aware of it!

A program like this, if marketed effectively, could make a great impact in the developing world, where infant mortality rates remain extremely high. When I was in Kenya, talking to rural village communities about nutrition and general health education, I noticed a great deal of misinformation amongst the women (and men) in regards to pregnancy and birth. The community members were not aware that rest, proper nutrition, and care were just as important for the woman prenatally as it was after birth. For example, many of the women said they often worked in the fields until quite late into their pregnancies because their husbands didn’t understand the effect of childbearing on their bodies.

All of these women had access to a mobile telephone in some way (usually through their husbands), so if a program like Text4Baby was expanded to rural regions of Kenya, BOTH men and women would be informed about the appropriate care required for women pre and post pregnancy. The problems of misinformation, and even gender inequality that perpetuate poverty and health diseases could be solved!

I honestly believe more programs like this should be implemented in locations where medical attention and resources are often hard to reach. What we need is more action from the drug companies themselves; they should work to be socially responsible as they are the ones with the medical resources and financial weight to develop innovative ideas for healthcare through technology.

Corruption (noun) – perversion of integrity; depravity

The rampant corruption that prevails in governments around the world is becoming more and more public each day, and for good reason.

Billions of dollars, shillings, rupees, pesos (etc) of fraud and laundering are exposed daily, as money meant for numerous government programs are found filling the coffers of top government officials. Recently, millions of foreign aid from Great Britain meant for Kenya’s Department of Education was stolen by government officials—depravity of the lowest form which took money meant for educational necessities and was used for personal excesses.

I firmly believe that corruption is one of the leading causes and perpetuators of poverty and conflict. Money is abused and manipulated as governments choose to do more for themselves than their people, and the poverty cycle becomes something impossible to break from. Transparency is thus necessary for the alleviation of the corruption that perpetuates poverty, and therefore for the betterment of society.

In numerous cases, information and communication technologies have proven effective means of combating corruption and improving the transparency of governments worldwide. In the Philippines, for example, the President there has implemented a page of the government website entitled “Transparent Government—What the People Want.” On the site, individual citizens can provide commentary or issue complaints about the way in which the government of the Philippines is run. It is an effective web-based tool through which ordinary citizens can voice opinions and press for increased transparency from their government.

You can read the comments posted here: http://www.president.gov.ph/government/default.aspx

 Grassroots anti-corruption movements have also burst all over the Internet. India-based “India Against Corruption” has started an online movement to ensure the passing of a strong anti-corruption bill in Parliament. Members of the movement regularly market meeting times, events, and goals on social media sites such as Facebook, Twitter, and Orkut. The movement has gained a lot of press in the last few weeks, and its leaders have been able to garner support from numerous members of parliament. You can find the website here: http://www.indiaagainstcorruption.org/

The online anti-corruption movement is only just getting started. With time and creative application the Internet and other technologies will hopefully continue to broaden the degree of transparency in some of the most corrupt nations of the world.

Climate of Communication

There is an old adage that a chain is only as strong as its weakest link, and this holds particularly true for a society suffering from a deficit of accurate information and knowledge.

Dr. Matthew Nisbet noted that public skepticism derives from public ignorance or irrationality. In terms of climate change, the urgency of environmental degradation has been framed incompletely, leading to public ignorance and ambivalence. The issues of climate change must be communicated more effectively in order to overcome the debilitating ignorance that is creating serious environmental consequences.

Movements such as www.350.org have begun the communication revolution on climate action, and are beginning to make a significant impact. Bill McKibben, cofounder of 350.org, realized the importance of a global crusade to reduce carbon dioxide to 350 ppm, a value scientifically determined as the safe upper limit for carbon dioxide in the atmosphere. He created the website to effectively, and creatively communicate the message of strong climate action, and has been able to make a significant dent in the armor of global public ignorance.

On October 24, 2009, the organization organized and supported over 5,200 events with people in 181 countries, who gathered to call for strong action and leadership on the climate crisis. The website has found a way to publically communicate the urgency of the climate crisis, and by framing the issue in terms of the harm generated worldwide, climate change was made relevant in the public mind. By demonstrating visual solidarity with the number “350,” the issue captured media attention without alarmism or fear mongering, that are off-putting to the public. 

The following is a video compilation of the global day of action in October hosted by 350.org:

Basically, the world needs more creative public campaigns that spread important social messages to the masses and promote grassroots mobilization. I honestly believe that creative communication is the key to overcoming the ignorance barrier, and making a real global difference. 

 

Internet Anonymous

In a world of the 24-hour news cycle, people are increasingly putting down their newspapers and opening up their laptops, mobile phones, and tablets to remain connected with the rapidly changing face of journalism. Newsreaders are ever more reliant on Internet communications in the form of blogs, tweets, and Facebook posts as the primary source of information.

Although these online sources provide the most rapid form of news and information sharing, one must question the reliance of Internet communication as completely factual sources of information. The recent scandal over the narrator of the blog “A Gay Girl in Damascus,” displays the ease with which authenticity can be feigned online.

The blog, “A Gay Girl in Damascus,” claimed to be written by Amina Arraf, a gay Syrian female, but was revealed to have actually been authored by a straight American man. The blog was wildly popular in the blogging community throughout the world, and the hoax has raised questions about what “reality” means for the Internet.

I understand that creative license on the Internet is important, however I am not sure how to identify when creative fiction becomes flat-out lies. The blogging community is in uproar about Amina Arraf, but I’m not really surprised that she proved to be a character of fiction.

The Internet has long provided individuals with a forum of anonymity—

A place where you can provide commentary on news articles and pick fights with people about a video on YouTube. The Internet will always be a location for identity construction, and then reconstruction. We shouldn’t read too much into any particular opinion or editorial, we just need to understand that the Internet provides everybody a voice, even if it is not their real one.

Mobile Potential

This is James. He lives in a little village outside of Bungoma, a small town located in Kenya’s Western Province.  He walks an hour and a half to work each day because he is too poor to afford the relatively economical forms of public transportation—boda-boda (bicycle taxi), piki piki (motorcycle taxi), or matatu (minibus)—and has no savings, so he cannot even invest in a bicycle. He barely has enough to feed and clothe his family, let alone send his two daughters to school.  However, there is one thing James does have, and it’s a cell phone.

While I was volunteering at the NGO James serves as the caretaker for, the directors of the program suggested we pay James a few Kenyan Shillings in exchange for doing our laundry. We were told he would truly appreciate the gesture, as he was struggling to support his family.

James, a deeply caring and kind man, was immensely grateful. However, rather than spend the laundry money on food and clothing for his wife and children, he purchased a brand new mobile telephone. He has no one to call, no one to SMS, and no one to call him. He just has a phone, an asset he cannot even afford to charge at one of the local phone charging shops.

While I was initially dismayed by the news of James’s self-indulgent purchase, I know of the opportunities the phone can open to James’s family and village if social entrepreneurship is actively promoted. James could become the center of information for his village, if he uses his mobile device to attain information about crop prices for the village farmers, to search for employment and business opportunities for the latent capitalist, and to access educational resources for the community youth. 

The governments of poor, developing countries must understand the potential of information and communication technologies in the rural villages, and must actively promote the social and economic benefits these technologies can provide. Although offering government resources through free telephone hotline numbers and SMS services may not be feasible in the short term, governments should develop practical ways to make this kind of electronic information more accessible to the rural poor.

In this globalized technological revolution, if new information and technology services aren’t given life in the most rural regions in the world, individuals like James will continue to flaunt their effectively dead phones to no avail.