Let's Get Lifted

Alice Liu came to our class to preach the benefits of information and communication technologies in the world of banking, particularly in e- and m-banking for those in the developing world. While the benefits and possibilities of e- and m-banking in the developing world are many, perhaps most fundamentally important is the potential for women in often rural communities to experience a greater deal of control over their own lives, and garner greater respect and ultimately equality within their community. Along with allowing those poor in the developing world to lift themselves out of poverty and maintain safe and legitimate banking accounts, electronic banking gives women a power and responsibility that would perhaps otherwise remain predominantly within the family and home.

Banks are not found in many rural areas of the developing world. Banks tend to be unwilling to offer accounts to the poor as they can be unable to maintain a mandatory minimum amount in their account, lacking a steady stream of income to ensure the bank’s borrowing capability. As we read in Wyeth’s 2010 blog/report from the Mobile Money Summit, while corporations may understand they need to market to the “base of the pyramid” few understand how to do so effectively, and regulators (particularly in the world of finance) care first about stability, and only then about inclusion. Banks therefore continue their reluctance in providing services to the poor in the developing world.

Without banks, the options are few and risky for poor people in the developing world to store or send their own money. Individuals need to find trustworthy couriers to take their money elsewhere (who may want a fee, turn out not to be so trustworthy after all, etc.). Or they can take the funds individually via personal travel (often on foot) but this can take time – and in so doing decrease the individual’s earning potential for the hours, or days that they are in transit. Also, as always, the possibilities that an individual could be robbed or otherwise lose their funds in transit is a distinct possibility, especially in relatively rural and off-the-grid areas.

With the rapid spread of electronic finance, somewhat safer options have emerged. In Latin America particularly, correspondent agents who work at a local shop like a gas or bus station are able to provide the service of depositing and withdrawing money as a bank would. These agents are hooked up to mobile operators or to actual banks in other locations, and such operations are multiplying, as they are less risky for the operators than opening a traditional bank branch.

Mobile phones and m-finance have also allowed for breakthroughs in not only how banking is done by the relatively poor in the developing world, but also in how they do business. Montez and Goldstein remark in their 2010 article on Tanzania for the Africa Development Research Project that most users of m-finance are recent adaptors (3) and that by far the top reason for not using m-finance services was simply a lack of knowledge about how to do so – not a lack of desire (4). These are promising signs for mobile finance in Tanzania in particular, and the developing world as a whole. As the poor and relatively disconnected become more familiar with m-finance through the explosion of mobile-phone availability in the last few years, surely this trend will increase.

As Heeks et al. make clear in The impact of mobile telephony, reducing the presence of intermediaries in small business operations is fundamentally essential to better functioning on both the supply end of things as well as for the eventual producers. Using the case study of the aso oke weavers in Nigeria, this report showed that while intermediaries still remain powerful within the trade (and perhaps more necessary due simply to the geographic distances often separating suppliers from small business people), mobile phones have saved a massive amount of time and money by substituting for personal travel that used to be required of large suppliers, merchants, and the artisans themselves (57).

While the mobile network may have actually entrenched the role of intermediaries and middle-men, m-finance has allowed a new type of intermediary to emerge – the “coordinator weaver” who builds a larger network of weavers and can connect them to a broader array of suppliers and sources of material (58). While middlemen continue to be a drain on the fundamental supply-demand chain of the aso oke weavers, there is also a great deal of hope for how m-finance in particular can be taken advantage of to benefit the suppliers and artisans.

At this point in time, through programs like M-PESA in Kenya, G-Cash in the Philippines or EasyPaisa in Pakistan, billions of dollars have been transferred electronically, with millions of participants in the developing world alone. From relatively simple uses such as depositing and withdrawing money from separate locations, or sending it to family and friends geographically separated from the source, electronic finance has grown to include some very hopeful trends. Among these new uses for electronic finance in the developing world are opportunities to safely pay bills (avoiding the utility cost of lost time), send international remittances in Kenya and Pakistan, and receive one’s government salary and social welfare payments in India and Brazil amongst other countries. Also life and weather insurance have been provided via electronic financing through M-PESA and other programs in developing nations.

However before traditional banks and banking services get entirely involved with e-finance in many particularly rural and underdeveloped villages and regions of the developing world, the basic money exchanges and withdrawals as well as transport will still need to be done with a great deal of support and participation from local people.

Utilizing an already-trusted person in the community to provide leadership, responsibility, and oversight to the processes is essential to a well-functioning financial hub in any village or small town. And throughout much of the developing world, the respect and cultural importance of women offers an intriguing opportunity to broaden the social, political, and especially financial roles and responsibilities of women. Uplifting the status of women is possible through e-finance, and as Liu made clear, once a woman became the central financial hub of her community (operating a trading kiosk of sorts) her status was automatically lifted. As the great John Legend says, Let’s get lifted.

Obama's Open Government Directive & Technological Citizenry

To paraphrase this week's class section subtitle, today I hope to explore the potential of new technologies to strengthen America's democracy, government transparency and accountability.

There seems to be a growing body of evidence to suggest that citizen participation and knowledge of government programs (essential for a participatory citizenry) is growing, and technologies like the Internet and mobile phones have improved true transparency and accountability. President Obama's noble pledge in the Open Government Directive on his first day in office defines the transparency, participation and collaboration of and with government as the cornerstone principles of an open government. Through promoting accountability by providing more information, allowing citizens to have a larger eVoice in the process of government, and encouraging partnerships across the levels of government and with private institutions, the President is making good on his word.

Our new friend Aaron Smith from PEW compiled two studies from last year that help to support the idea that participatory democracy is enabled and enhanced through new technologies. Compared with the 64% of the general population who reported voting in the 2010 elections, 71% of mobile phone owners did so (Politics Goes Mobile 2010). While the data itself (as opposed to self-reporting by citizens) suggests that the overall population turnout was closer to 40%, it is unclear whether mobile phone owners are simply more adept or inclined to lie to pollsters or whether they did actually vote more, but I am willing to give them the benefit of the doubt on this one. Access to government information and program activities is a bit less controversial to chart, and increasing public knowledge should ideally lead to greater political involvement, including voting.

As such, Smith reveals that 82% of Internet users (representing 61% of all American adults) looked for information or completed a transaction on a government website in the twelve months preceding the next PEW survey (Government online 2010). While this is certainly encouraging in and of itself, Americans are not simply using the Internet to process bureaucratic forms or pay taxes but are also tuning in on specific policies and legislation. For example, 48% of Americans have looked for information on a particular public policy or issue online, and 46% have looked up what services a given government agency provides to the public (Ibid.). While all of this increased knowledge and access to policy goals and agency benefits is a sure victory for informing, educating, and inspiring citizens, what is most impressive is that according to the survey Americans generally accomplish most or all of what they want to do on government sites.

On a participatory level, new technologies have enabled everyday citizens to have another life-line to their elected officials, whether through electronic mail or SMS and social media communication with officials, candidates, or political campaigns. Additionally, Americans are not ceasing their activities after simply gaining more information on government activities - increasingly they are voicing their opinions on what they've learned. Of Internet users, 23% participate in the online debate about government policies and issues, and much of of this discussion occurs outside the official and traditional government channels (Government Online 2010). What Smith terms, "online government participators" are a growing and vocal group of Americans, and are going a long way to realizing Obama's goals of ensuring a seat at the electronic table for citizens to provide feedback on government's activity.

While it is not as easy to see the immediate effects of Obama's planned collaboration between federal, state and local governments as well as with private institutions and its direct impact on American citizens, Obama's stimulus bill is a prescient example of such interconnectedness. Whether a certain segment of the American people believe that this arguable expansion of "big government" into the lives of citizens is a positive or a negative (and I would argue the former over the latter), Smith makes clear that 40% of online Americans have sought out data on the business of government, and 23% have explored the government's use of the stimulus money in particular (Government online 2010). This increasing skepticism and inquiry into the expansion of government - especially at the state and local levels - is an important indicator that American citizens are getting involved in the business of government at the source and the periphery and ultimately ensuring a more informed and impassioned voting populace.

While the Obama administration - and subsequent ones - certainly have a long way to go towards reaping the benefits of a technologically connected and collaborating American public, the Open Government Directive has been a good start. As government makes itself more transparent and contactable, citizens' interest and participation will only continue to increase, and as Smith and PEW make clear, this trend is on the rise election cycle to election cycle. With more Americans online than ever before - and many getting in touch with government via social media and SMS as well - we are becoming a more knowledgeable, engaged, and ultimately effective democracy.

When more voices are heard and responded to, a truly representative government can result and as long as Washington remains open to criticism and suggestion, this government can realize the goals that Lincoln so eloquently expressed at Gettysburg in 1863, one "of the people, by the people, for the people..."

Doctors truly without borders (or plane tickets)

Mobile health (mHealth) expert Jody Ranck made some excellent points this week, and with time comes internalization and synthesis - so hopefully this week's blog can organize some of his thoughts with my own and produce a new idea for medical services in the developing world. Or at the very least spruce up an old idea.

In an age when a smart phone's camera can send a digital image clear enough for a doctor on the other side of the world to accurately diagnose skin conditions, or an eye scanning device for under $100 attached to the same smart phone can give any patient an accurate prescription (thanks MIT) without necessitating the purchase of a $100,000 phoropter, many wonder if we still need doctors in the traditional sense.

Is this a better choice in the developing world than an iPhone?

Many of the most needed and life saving surgeries in the developing world require only modest training a few years past high school, and nurses and their associates can be supremely useful and priceless when and where doctors are decidedly lacking. Particularly in the developing world, where medical training in general - and doctors in particular - are in low supply and high demand, it makes a great deal of sense to abandon the West's rigid interpretation that to be a "doctor" one must have spent a decade (or more) and up to hundreds of thousands of dollars in the Academy. Yet to devalue doctors, whether in the first or the third world (and everywhere in between) is to do not only the profession and its practitioners, but also the societies they practice in a grave disservice.

Coming from a major medical family - my Dad is an MD and my Mom, among other things, a registered nurse - might give me a pro-doctor bias. However it also gives me a window into the world of the classically trained health professional. I know firsthand the wild and profound knowledge great health care professionals (and perhaps especially MDs) have at their disposal at all times. Countless times I have made use of just such knowledge for my own selfish aims. My parents are generally able to quickly - and accurately - answer my health related questions and even on occasion diagnose my woes. A relatively unromantic bout of likely food poisoning comes to mind as the latest example (thanks Bonnaroo 2010!).

Make sure to adequately cook all raw meat.
Refrigerating it is also a plus.

While the years and dollars spent acquiring such knowledge (and degrees) may be more worth it to some than others - however they define that "worth" - the knowledge and skills that doctors and other medical professionals learn and practice over years are profoundly important and irreplaceable. At the end of the day I don't know a single person who would prefer we lived without such vital human resources, or would rather diagnose themselves or a loved one than get the best medical advice they could from a professional.

However, as with many elements of this, our New World, technology and the increasing interconnectedness of people across vast distances and economic barriers must elicit changes in how we view the medical profession - and doctors in particular.

Perhaps gone are the days when the only people to turn to are women and men in long white lab-coats with stethoscopes hanging around their necks. Instead of referring only to the MDs - especially in the developing world where they are too few and far between - people must seek other alternatives, but I would argue they must be connected to and communicating with doctors. This is where the future lies - doctors as references and ideal resources for those with less experience, or ability to get the same education that the top-notch university systems provide. Instead of either relying on outdated and incomplete medical information or turning patients away due to a lack of material and experience-based resources, we must connect classically trained doctors with those aspiring to provide fundamental medical treatments where doctors are not available.

Global technology and communication systems provide an intriguing and elemental connection here - we must encourage and ideally incentivize doctors to reach out and give their time and knowledge to those in the developing world who are eager to learn and help the sick in their own communities. Whether this means having doctors send SMS messages from hospitals and universities to health care providers across the globe or instituting web-based platforms whereby medical questions and problems can be quickly asked and answered seems relatively unimportant. In fact that has been a profound lesson of this class - the specific technology used is less important than the fact that technology is merely a means to the end of meaningfully connecting people throughout the world. Whether medical instructors and practicing doctors spend their weekends communicating with those in need of assistance or retired MDs take some time out of their post-career lives to do the same is also relatively inconsequential. The fundamental medical skills and knowledge that so many doctors possess does not fade with time - nor does their interest in helping others be well.

We must encourage any and all doctors to get involved and - with or without discernible reward or recognition - to get in touch with a program or an individual community in need of guidance and inspiration. While programs like Doctors Without Borders are wonderful, if troubled, realizations providing medical resources and doctors to the developing world, they seem a somewhat misguided solution. Instead of merely exporting medical talent and aspiration abroad, we must actively encourage its growth at the source. By providing information and medical skills remotely, home-grown medical professionals and semi-professionals can increase their own skill sets and desire to continue the everlasting quest of profound medical knowledge. This is not to degrade such programs or to suggest that only by "providing" medical insight and knowledge will a developing nation develop its own medical infrastructure - I am extremely uncomfortable hearing the post-colonial alarm bells ringing in my own head. This is only to say that classically trained doctors can be useful beyond their small locales and borders - they can provide meaningful benefits to people throughout the world. Western medicine may be no better or productive than local remedies (although I would say it is - but that's the seed for another, somewhat more controversial, blog), but in a field like medicine don't we need all the knowledge and training we can muster to help individuals in need of attention and health?

You know you like them.

Ultimately then this is a call to arms - for doctors and nurses, medical teachers and students alike - to get involved beyond their own hospitals or universities. Whether they travel bodily to a developing nation to help the sick and heal the injured is not as important as that they do get involved and communicate with interested parties abroad. We can no longer afford to heal our own at the expense of the global sick - and thanks to advances in communications technologies, perhaps we won't ever have to again. One doctor's medical knowledge belongs not to that individual, her/his practice or clinic, nor even to their nation.

Medical knowledge and above all health is a public and global good - and it is morally indefensible not to treat it as such.

For the Love of Teachers

The notion of providing every child in the world - particularly the developing world - with a laptop at low cost or ideally free of charge through national and international initiatives is a wonderful one. 

But I break with Nicholas Negroponte and his One Laptop per Child program on a few key issues. 

The Man Himself

The first is that while children can inevitably "teach themselves" when given a computer, and are of course highly curious and adventurous with new technologies, there will never be a profound replacement for a well-trained, and well-motivated teacher. Teachers provide personal and technological support, answer questions, and inspire children to use these machines in different and effective ways. Ideally, teachers can themselves use the new technologies to provide individualized lesson plans and either teach old material in newly effective ways or revolutionize their own teaching methods and lessons to symbiotically support the technology itself.

 OLpC Program in Nigeria

Secondly, when these laptops break down physically or their software malfunctions, children need teachers who have training on computer repair and maintenance. Too often these One Laptop per Child machines seem to be abandoned when they no longer perform adequately - which both robs the student of a machine that inspires and enables creativity and technological learning as well as shows inter/national organizations that their often extensive funding for such a project is misplaced. The only way that the OLpC program can work is for teachers to become computer mechanics, and pass this newfound knowledge onto their students.

Ultimately the issue at the forefront of improving education - especially in the tech world - is what it has always been: discovering how to inspire teachers to become more involved and effective, more knowledgeable and motivated to continue to learn and improve their own teaching methods. As such, Trucano was right to say that "the introduction and use of ICTs in education can be a useful tool to help promote and enable educational reform" (Knowledge Maps 2005) but that reform must be the end we seek in improving education in the developing world and throughout the globe.

To say that simply providing a new piece of technology is the end-all-be-all solution to the problems of the international education systems is to disregard the fact that without guidance and a network of support, technology will only prove as effective as children make it for themselves. Without discounting the wild - and often astonishingly inspirational - learning that students can do for and by themselves, why propose an educational world where teachers lose their place as guides along the trail of learning? Quite cynically, even if only to inspire students that they themselves can be better, more effective communicators and guides than their teachers are, isn't this enough of a reason to provide students with ever-learning and ever-improving teachers in the classrooms of the world?

So, in the end, the conversation over Negroponte's One Laptop per Child program and others of the sort rests with the fate of teachers, not students or children, and not even so much technology. Children will use whatever technology is at their disposal - and increasingly cell phones are bridging the gaps between those in the developing world and the rest. But to simply use a cell phone, or a laptop, is not enough of a victory for those truly passionate about educational reform. We must strive to use these technologies effectively to harness each child's natural fascination with and motivation towards learning. And not necessarily just for the sake of learning itself - when we see farmers using cell phones to make sure they are not cheated at the local market for their goods, or when we see children reading full-length novels and texts on the tiny screens, we are seeing evidence of technology's ability to improve the standard of living and the standard of imagination the world over.

But we can not be satisfied with simply giving a child a laptop and walking away. We must stand with that child and help them, encourage them, and ultimately learn from them. 

The world needs great teachers - and local ones at that. 

This is a good start - how about evident electricity and local teachers next?