What I picked up from "The folly of finding what works"

“The impact of information technology on the Global Economy” was the title of my research project last semester. 2 weeks into the project and I was still finding newer things to study. Around the same time, my professor in charge advised me that I better stop searching for more topics and better get to work.

I, on the other hand wanted to make this a comprehensive study on the impact of IT. So I wanted to include Overview of the situation today, the booms and busts, the venture capitalists, web1.0, web 2.0, the long tail, Outsourcing, trickle down effect, ICT for development, mobile communications. Phew. No wait, there's more, e-commerce, e-governance, case studies of famous companies, the semiconductor industry, exports, imports, recession. Relate that to GDP, employment, education, productivity, FDI...

Did I leave out anything?

Clearly, if I did manage to include it all, I'd have a PhD thesis, which I would have sold and made money from.

Just one problem.

This would never get finished. In fact, my project wouldn't even start. I'd be so busy finding newer things to study about that I'd hardly put pen to paper and actually document anything. Instead I would just be reading and researching on every single item that was remotely related to the IT industry.

Moving on,

This May, when I started my summer internship, I was fascinated by the health care industry. In particular, primary health care. The numbers were huge and I was overwhelmed by the scale of their operations. So when I had to pick my project, I didn’t want to leave out anything. I tried to include everything, using variety of economic formulas, different theories. My internship coordinator asked me why I don’t stay for a 6 month fellowship. As flattered as I was, I also got the underlying hint. I understood that given the time frame it was unfeasible to carry out the study with so many parameters. Heck, I wouldn’t be able to make sense of all that data. So I picked one or two core areas and focused on them.

As far as personal experiences go, these were the first two instances that came to my mind while I was reading Ken Banks' blog post titled The folly of "finding what works". He brings up a very valid point:

As with the confusion caused by multiple interpretations of “sustainable development“, the social mobile space is struggling with its own definitions of concepts such as collaboration, empowerment, scale, “enabling environment” and “finding what works”. We hear these terms on a daily basis, yet we never stop to ask what they really mean. What does an “enabling environment” really look like, and do we really need one like people say we do? Who decides what scale really means, and how important scaling really is? We all nod in agreement when people use these terms at conferences, but refrain from questioning them through fear of appearing ignorant.

The “folly of finding what works” strikes particular resonance. Although mobiles for development has only been around for a few short years, surely by now we’ve identified at least a few things that work? Isn’t that the purpose of all these reports, blog posts, tweets, projects, conferences, workshops, barcamps and academic studies?

After six years-or-so of social mobile, we’re surely at the point where we can throw some real resources around at least a few tools? Surely we can pool our collective skills, knowledge and resources into helping at least a few reach their full social change potential? Instead of sitting around talking about our commitment to social mobile, we need to show our true colours and act, regardless of who gets credit for those actions.

Reading this also started another chain of thought in my head, the credit for which has to be given to Stan Thakaekara. In the course of what would turn out to be a vociferous debate on issues relating to the environment, education, caste and equity amongst other things, Stan gave us some gyaan on how he feels that technology hasn't quite lived up to its promise. How technology hasn't quite created an equitable world. How the more answers we try to seek, the farther we seem to move from actually arriving at the truth. And instead we're just making the world worse off.

But then what is the truth anyway?

Coming back, Stan was of firm belief that the divide is getting larger and larger. Technology is giving only a few answers. It's a balloon effect, where squeezing one side of a balloon makes it expand in the other direction. You can't ignore the consequences and certainly can't escape them. So we have to now come up with clean technologies in order to clean up all the mess that we created over the years* **. Jeffrey Sachs also says that it's not that we don't have fossil fuels, we have plenty of it (maybe not oil, but coal surely), its about using it in an optimized manner.

Jeez, I digress again.

When Stan first told me all this, it did strike a chord somewhere but I was still too mesmerized by capitalism. I now realize, I didn't quite understand capitalism. Maybe I still haven't. But after having read works of Jeffrey Sachs, Nassim Nicholas Taleb and Joseph Stiglitz, I have been exposed to a whole new way of thinking. These guys aren't dishing out dung. They all emphasize on the same thing, there's little time.

Bottom line being:
The reforms have to take place now, the access to credit/capital for the poor has to happen now and heck social media for development better deliver now. Because everyday, a kid is losing his life in Africa (and India and Latin America and Bangladesh and...). Like Ken said, we need to stop talking and start doing now.

*Of course there are numerous theories which say that we would have reached this stage anyway even had it not been for the pollution, but lets leave that for another day.

** And then there's yet another theory that says that no matter what you do, we're way past the threshold. So we have to release chemicals in the air such as sulphates to cool our system (remember the TED talk on climate change? No? Here)

First few days at work

Three days into my internship, and I can already get a feel of how hectic it's going to be in the coming 2 months. But maybe that's not how I should've started this post because it might mislead some of you.

So let me go in a systematic order. The work that ICARE is doing is fabulous. Through their pyramidal structure (that includes eye care at Primary, Secondary and Tertiary level) they provide their services to more than 3 crore people (estimated from the brochure and other reference materials). This includes eye check up, referral to a high centre if the problem cannot be cured at a particular centre, spectacle delivery etc. They also have tie ups with companies such as Vision Spring (erstwhile Scojo).

On my first day I went through the paper that started it all, called the Andhra Pradesh Eye Disease Study[APEDS] (The paper can be found here ). The study gave a comprehensive analysis of 4 areas of Andra Pradesh (one urban and 3 rural of which one was well off) and showed the prevalence of blindness there. The results were also presented on the basis of sex, socio economic status, age etc. This study gave rise to the ICARE models which have set up centers in almost all districts of Andhra Pradesh and whose models are being adopted by organisation all over the world (For example Australian Government's "Avoidable Blindness Initiative" recently decided to implement the Vision Centre model of ICARE).

The projects undertaken by the center are also massive. At present they have some 12-13 projects running which include Community Linkage for Integration of Primary Health, Rapid Assessment of Refractive errors, Sight for Kids, Diabetes prevention programmes amongst many others. The projects (a lot of which are CSR initiatives) are funded by some of the biggest organisations in the health as well as financial services.

What I am interested in though is sustainability of these centres since LVPEI is a not for profit organisation. LVPEI has always believed in quality eye care and equity and hence the services provided to the poor and the rich are the same. At the secondary and tertiary level, 50% of the services are paid by patients who have the ability to pay in a three tier fee structure and the remaining 50% services are provided free of cost to under privileged patients. LVPEI claims that the centers can provide services upto 70% to non paying patients and yet be sustainable.

If true, then this is an awesome initiative for they have a revenue model in place but with a philantrophic touch to it. I find this really fascinating and the fact that LVPEI and ICARE have been in existance for so long bears testimony to the fact that this model is sustainable. However, I would like to examine this from a closer level to validate that.

Apart from that, I am also brushing up with a lot of statistical and econometric models to further assist me in the project that I take up. Some pretty exciting projects are lined up for me here, the trouble being I can take up only one due to the time constraint.

ICARE this summer

So another year comes to a halt as the summer beckons.

After a rather uneventful last 2 summers(unless you count the trip to Egypt), I am hoping to become more productive this time around.

This summer I shall be working with a fantastic organization, The International Centre for Advancement of Rural Eye Care (ICARE). Responsible for trying to come up with ways to remove blindness from rural unreachable parts of India and the developing world, ICARE looks at long term solutions at a large scale. They also manage and plan the community health care initiatives of L V Prasad Eye Hospital, another giant in the health care industry.

So what is my work going to be? Broadly I shall be working with a lot of economics related aspects, such as cost-benefit analysis of their Vision Centers vs PHCs as well as bordering over to marketing where I try to analyze various community eye programs and newer & effective ways of spectacle delivery. Apart from this there might be other things in store that I am not yet aware of.

Why did I choose this?

Well mostly because over the past year I have been increasingly becoming attracted to the developmental sector. Its evident by the proportion of social entrepreneurship related items in my feeds.

Seriously speaking, I never thought this sector would excite and it'd be naive of me to think that this is my true calling, but for whatever reasons there might be, right now this is the place I want to be in. Lets see how the gig goes.

P.S: At the same time I have been working on a couple of other ideas in the field of community health and nutrition and am also most probably volunteering for Kiwanja, a champion organization trying to use ICT for development. Check out their product FrontlineSMS.