Revolution

You all know that the world is flat. If you don’t, you need to read Thomas Friedman’s book, “The World Is Flat.” Basically he says that cheap communication (i.e. the Internet) has “flattened” the world; barriers of space, geography and culture are becoming irrelevant because of the ease of communication.

So the world is flat. But what does that matter to a Kenyan farmer? To someone making $1 a day, even a $400 computer is far beyond feasibility. And that’s not even considering the lack of electricity and computer knowledge which seem as endemic as malaria.

If you’re a computer nerd (or you know any), you know they’ve been talking about ‘think clients’ for about forever. We nerds have long dreamed of getting access to computer horsepower far beyond what we could afford using a “thin,” cheap computer whose only purpose was connecting to a big, powerful one, one where all the real work was done and big data was stored. But computers got so cheap so fast that this never really worked out. Cheap, at least, for the developed world.

But there are billions for which a computer is completely inaccessible. Even the $1 per hour for computer use is unreasonable. Enter: cell phone. It’s the thin-client that we nerds have been yearning for. And the internet is just now getting mature enough to simultaneously handle the big tasks and to present it to the kinds of processors found on cell phones. So what do we have? We’ll have, within a decade, poor people across the world accessing the fullness of the internet.

Who should care? Everybody. Do you have something to sell? You’ll have a billion customers within a decade who have phones, internet access, and the ability to send money over phone networks (in Kenya, it’s called M-PESA and you use local businesses as ATMs; you can deposit and withdraw money from your phone at almost any shop or stand). Do you want to distribute Bibles? For the cost of a few Bibles, you could give a person access to the Bible in every language and every piece of Christian scholarship ever written. Do you want to communicate your message? There is an entire generation of the poor that will soon discover it can read whatever ideas that interest them, be they democratic, communistic, consumerist, atheistic, Christian, Muslim, patriotic, or racist. A billion potential readers. A billion sets of eyeballs. A billion wallets. A billion hearts. Gutenberg’s printing press gave millions access to the printed word within a century of its invention. The cell phone will reach exceedingly more people in its second decade than the printing press did in a century.

So where does Nuru fit in? How are we positioning ourselves in this revolution? We are planning to accelerate it. We want our people to be on this cutting edge. We have purchased and will soon be issuing internet-enabled cell phones to all our staff within a few weeks. We’ll teach them the basics of how to use the phones to communicate, how to use email, and how to use the internet. And then, we’ll use some of the newly matured internet tools to do Nuru stuff better.

Google Forms provides an incredible platform for collecting data. We can design forms, send out the relevant URL, and then get people to submit data by phone and have it compiled onto a safe, secure, shared server in San Jose . That means that all of our operation can, with a few thousand dollars of phones, become completely digital. No more paper attendance forms. No more written ledgers recording contributions to savings accounts. No more survey sheets. No more lost home visit forms. No more paper. All digital.

But this won’t just let us do what we used to do better. It will let us do what’s never been done before. Do we need to make an announcement to all 60 Nuru staff members? Now we just need to send out an email. What about taking a staff-wide vote on a course of action? It’s as simple as emailing out a Google Form.

I talked before about the Disease Intelligence Network, a system for monitoring and rapidly responding to outbreaks. But now it’s actually possible. We can do continuous surveillance (i.e. taking temperatures), uploading this data to a server as it is collected. The instant certain conditions are met (e.g. fever prevalence >10%), we can have the computer alert the healthcare team of an outbreak of disease.

There is a multitude of other things that we can do but don’t realize we can do. An entire universe of possibilities will open up in three weeks. I just need to keep my head on straight and make sure we master the basics first.

Turnover

So it begins. I am now officially a Research Officer. I’m on a special assignment the next seven weeks to get a data collection system set up for the Poverty Intelligence Network (a revision of the Disease Intelligence Network… all this is in the blogosphere if you’re really interested). I’m going to work on data: how to use it, how to gather it, how to teach others to use it.

So today I started a new job. But in the same place. It feels somehow like I’m leaving, but without going anywhere. I’ve officially handed over my position to the wonderful Janine Dzuba. After the break in April (all Western staff out for a few weeks allowing the Kenyans to run the project alone for a while), I’ll be taking back up the healthcare reigns.

This last week, I’ve been spending all of my time transitioning with Janine, the now Healthcare Program Manager. This was quite challenging. Simply in terms of information, there is very much which needs to be communicated in a very short time. We had only 3 days; most transitions happen over the course of 3 weeks. But Janine had been staying in the loop by weekly calls with me for the last few months (isn’t the flat world wonderful?).

Nevertheless, it’s impossible to communicate the situation here over the phone. Or at least I wasn’t able to. So in coming here, even though she was here just six months ago, she had much to learn and adjust to. She’s been drinking from a fire hose the last few days, and doing a great job of it. Visiting the clinic, meetings, conversations, lunches… and so on… and so on.

And for me, it has been hard for me to remember all the things I’ve been doing so that I can tell her about them. You, my faithful blog readers, have only gotten to read of a few of the things that have been happening. There are a million little details of the program: which forms I use, how I run meetings, the where/when/why/how/who about meetings.

The turnover was hard in another way as well. We didn’t agree on everything. Janine thought some of the things I prioritized weren’t as important. Some of the things I had ignored, she thinks should be emphasized. So what is there to do? The thing to do is to give it up; that’s what a turnover is about. There is no room for ego; I have had to give up my programs faithfully and fully to Janine. Then she can lead them forward with her strengths and weaknesses, complimenting my own. It’s wonderful to have another critical mind working on this project. It has been wonderful (though sometime painful) to have Janine’s keen mind asking keen questions about the way things have been going. And this is exactly how we get better.

She’s going to do (and doing) things differently from me, and that’s a good thing. It shows the Kenyan staff a different style of management, allowing them to hold on to the gems of each program manager and throw out the rest (there are plenty of habits and styles which I would not want emulated). It also makes the CDC the constant ones. The only relationships which really last are those with Nuru Kenya, not Nuru USA. This rapid rotation and frequent turnover forces independence.

I’m really excited to see what she does with the program over the next few months. There are some really exciting things in the pipeline for sure! We have a child’s health day, a mobile clinic and the initiation of the Community Health Worker training, just to name a few. I’m a bit jealous of her, but not so much that I’d give up nerd-ing out with the research team. I can console myself with being able to reap where I haven’t sown, so to speak; I get to come in with all these things set up and make them better still when I come back in May.

David