“A weak ICT ecosystem,” I replied.
“ICT Ecosystem? What does that mean?” said a man across the room.
I took an extra second to gather my thoughts before deciding how to respond. A few moments prior, this man had asked the goliath of all questions,
“What do you think is the greatest challenge to implementing Project Kiramama?”
Simply speaking, I find the biggest challenge to Project Kiramama – a RapidPRO (SMS-based) project designed to reduce maternal and infant mortality rates in a province of the central African nation of Burundi – to be a weak ICT ecosystem throughout the country.
As a New Yorker, when I have a question I look up the answer on Google. If I want to try to a new restaurant, I have three mobile apps to consult. If I need to communicate with someone, I can phone them on their mobile, email them, send them an SMS/iMessage or find them on an upwards of ten different social media platforms.
With low mobile penetration rates, a very low electrification rate, and extreme poverty throughout the country, this same mode of thinking, of turning to technology for a solution is not pervasive in Burundi. This lack of thinking has both yielded and is the result of a weak ICT ecosystem of software developers, computer programmers, graphic artists, even basic Internet users in the country. So how then does one implement a technology-based project when the common user does not intuitively know how to use technology to solve their problem?
The answer is: by demonstration.
A few months ago, I did a field visit to a health center that will be directly part of Project Kiramama. As with most health centers in the province, supplies, electricity and personnel are lacking, though the willingness to learn new techniques is strong.
After answering a series of questions, the head of the health center showed me around the different rooms. In the corner, a drawing one of his staff had done caught my eye.
It was a simple flowchart to help health workers determine the correct diagnosis for respiratory problems in patients. He was perplexed I found the drawing so fascinating; little did he realize that I had just found a very simple solution to a very large problem. I whipped out my phone and showed the head of the health center a picture generated from RapidPRO.
I explained to him that we also create flowcharts to help health workers diagnose patients. The only difference is that we use SMS’s to guide health workers through the flowcharts and computers to automate the process and store the data.
As we continued on the tour of the health center, I pointed out other examples in which Project Kiramama uses computers to better existing processes. For instance, converting paper records to electronic spreadsheets and databases:
And turning maps into something interactive and easy to modify:
As I continued to show him specific examples of how phones and computers could better the day-to-day and emergency operations of the health center, I slowly saw a look of recognition take root in his face. Though he had personally never seen such a computer-based system at work, a verbal explanation of how a computer could transform what he already had in place piqued his interest. By the end of the visit, I knew I had a technology-based solutions believer before my eyes.
Of course, to do this same set of demonstrations in every health center that will be part of Project Kiramama is not possible without a massive team. Alas, ideas are not finite, and I knew as I left the health center that this new believer would soon spread his newfound knowledge to other team members in the health center. This one believer could soon turn into two, which turns into four, and so on. To overcome a weak ICT ecosystem in the country, Project Kiramama will need to create a chain reaction of knowledge.
Project Kiramama is just one of many solutions to lowering rates of maternal and infant mortality in Burundi. Working with other initiatives, Project Kiramama will help health workers better diagnose patients, better use and dispatch existing equipment, and better determine what is needed where, when and why. Through continual support and real-life examples, projects like Kiramam work alongside health workers of Burundi to introduce health workers to a new approach. Projects like Kiramama help introduce a new way of thinking.