futurechat

Further to my earlier post, Health on her fingertips, where I explored the need of Sumita, a poor young woman to find out more information on basic health care, I have built up my thoughts on the need for universal, transparent health information accessible by phone.

• A Central repository of health information + local health information is added in to make it more relevant
• People can access the information through a Call desk and through SMS
• A national health number is created that is manned by people who speak the local language. SMS menu is readily available that gives basic information (in language of choice to subscribers)

Public health services in India are woefully short of reaching the urban poor let alone the vast rural population. While institutional health frameworks for urban poor and rural poor exist, they could greatly be strengthened though this simple mechanism.

A. There are 5 dimensions of access to health services (Obrist et al. 2007: 0002)

1. AVAILABILITY: The existing health services and goods meet client’s needs - What types of services exist? Which organizations offer these services? Is there enough skilled personnel? Do the offered products and services correspond with the needs of the poor? Do the supplies suffice to cover the demand?
2. ACCESSIBILITY: The location of supply is in line with the location of the clients - What is the geographical distance between services and homes of the intended users? By what means of transport can they be reached? How much time does it take?
3. AFFORDABILITY: The prices of services fit the client’s income and ability to pay - What are the direct costs of the services and the products delivered through the services? What are the indirect costs in terms of transportation, lost time and income, bribes, and other “unofficial charges”
4. ADEQUACY: The organization of health care meets the clients’ expectations - How are the services organised? Does the organizational setup meet the patients’ expectations? Do the opening hours match with the schedules of the clients, e.g. daily schedule of workers? Are the facilities clean and well kept?
5. ACCEPTABILITY: The characteristics of providers match with those of the clients - Does the information, explanation and treatment provided take local illness concepts and social values into account? Do the patients feel welcome and cared for? Do the patients trust in the competence and personality of the health care providers?

In India none of the above parameters are remotely met when it comes to the poor. Health services have poor availability, are seldom accessible due to absence of doctors, medication, infrastructure. Most poor people are illiterate and unaware of what to demand from the government health centers, therefore even inadequate and unacceptable services are accepted with gratitude.

B. Mobile phones could serve as a simple, cost effective empowerment tool. Information on the phone could help people empower themselves and solve basic issues that occur due to paucity of information and availability. At a basic level Mobile phones could give relevant information on the following:

1. Methods of identifying, preventing & controling health problems
2. Appropriate treatment of common diseases & injuries
3. Maternity & child health (including family planning)
4. Prevention and control of locally endemic diseases
5. Immunization
6. Availability and sourcing information of essential drugs
7. Health education

C. This in itself is a large body of information. This would need to be converted into a simple information architecture which is accessible on voice call as well as SMS.

To simplify this further, information could also be broken up into information by need.

I. Questions on personal and family Health and wellness

• Personal & Family Hygiene
• Prevention – Malaria, TB
• What will keep my children healthy?
• Protection

II. Questions on Cost of care

• for emergencies
• for doctor visits
• for medicine
• for surgery
• for tests and medical needs and insurance cover for each

III. Questions on Treatment

• Diseases
• Types of treatments
• Caring for chronic illnesses
• Doctor details
• Hospital information
• Types of tests
• Complaint numbers
• Blood banks
• Organ donors

D. The above method of information access would help the government by reducing the burden of health care in some ways by increasing transparency and empowering the bottom of the pyramid people who are frequently short changed because they know no better.

The information dissemination would of course need to be in multiple Indian Languages to ensure penetration and access..

Going back to the 5 dimensions, mobile services would solve some of the issues outlined above:

1. AVAILABILITY: The poor can know what is available, how they can help themselves
2. ACCESSIBILITY: Instant information increases the ability to access health services as patients can now know who to contact and where.
3. AFFORDABILITY: Overcharging and corrupt practices can be curtailed to some extent.
4. and 5. ADEQUACY and ACCEPTABILITY: Better information, means more knowledge of what to expect and therefore a bottom up pressure on service providers to give better care.

E. The issue of funding also needs to be looked at critically. Funds will be required fundamentally for the following:

1. Seed capital to establish the information databases and technology infrastructure as well as hookups to the various telco’s
2. Ongoing costs to update information, services, staff costs and technology

While a simple model would be to make this government funded, I believe that for this service to be sustainable a public private partnership would be a better idea. The revenue generation from incoming calls, SMS interactions alone could be substantial. Other revenue streams could also be explored. For example a rating system for doctors, hospitals, nurses could be set up. Doctor and hospital references could be given on the basis of their track record and customer / patient feedback.

Organic cotton is generally understood as cotton, from non genetically modified plants, that is certified to be grown without the use of any synthetic agricultural chemicals such as fertilizers or pesticides. Its production also promotes and enhances biodiversity and biological cycles. In the United States cotton plantations must also meet the requirements enforced by the National Organic Program (NOP), from the USDA, in order to be considered organic. This institution determines the allowed practices for pest control, growing, fertilizing, and handling of organic crops. As of 2007, 265,517 bales of organic cotton were produced in 24 countries and worldwide production was growing at a rate of more than 50% per year. (Wikipedia)

India is the world leader producer of organic cotton. It’s the second largest producer of cotton and second largest exporter. The demand for organic cotton over the world increases every year, especially in US, Europe.

The organic cotton industry in India has been growing since past five years and has caught the attention mostly of farmers and manufacturers. What is interesting is that the domestic market for organic cotton is virtually untapped due to low domestic demand. Most Indian customers don’t buy organic cotton clothes or organic food. While the West shows an increasing trend towards moving away from fertilizers and chemicals, the Indian consumer is largely unaware of the many benefits of organic products. Awareness and purchase of organic products is a limited trend only amongst high net worth customers in Delhi, Bangalore and Mumbai.

While branded organic food stores exist (in a small way) branded organic clothes are not readily available. Products from international apparel brands that retail in India are a blend of pure organic cotton along with other fabric like polyester, etc. Usually the percentage of organic cotton ranges from 50 to 80 percent mixed with other fabrics. To develop the domestic market for organic cotton targeted marketing activities that drive both, awareness and behavior change are necessary.

The first barrier that needs to be overcome is that of explaining the concept of ‘Organic Cotton’ to the average Indian consumer and how it differs from the ubiquitous cotton that we are all used to.

While Organic Cotton and Fair Trade products are a fantastic example of buying for a cause. the larger challenge is one of behavior change. The fashion industry survives on the philosophy of ‘Change’. New trends for every season and new clothes for every social event are the norm. Even if we move towards these more sustainable fabrics, we will not be able to make a significant dent unless we impact fashion mindsets that dictate over consumption and excess at every point.

The big question then is – Do we sell Sustainability to the Indian consumer ? or Do we talk about Organic Cotton as a new fashion trend?

‘No, its not as easy as popping a pill!’ Thats what I was told when I hurt my shoulder last year. It took long for the painful realization to sink in that I had months of painful physiotherapy ahead, if I wanted back complete use of my arm. A friend referred me to Navtej Johar, a famous dancer and yoga guru. A full year and several yoga therapy sessions later, while my arm is back to normal, this painful journey has taught me a lot.

While I can start making a long list of all that I learnt, what lies at the core is the realization that one needs to lead a balanced lifestyle. I often remember Navtej saying ‘ Be aware of what you are doing’. That statement has many layers – it could mean, ‘Think about the consequences’ or it could mean ‘ Dont be selfish ‘ or ‘Be considerate’.

I cant help but link it back to the debate on climate change. Awareness in the corporate world about the consequences of our actions is woefully lacking. Being aware of the long term impact towards environment and people is almost an alien concept as we try to maximize impact to achieve our quarterly goals. Don’t we already know right from wrong? After all the media coverage on climate change do we really need laws drafted in Copenhagen to enforce consideration towards environment and people? or Are we waiting for a crisis to happen that will force change upon us?

What do we do when someone falls ill? I asked a few friends and it was no surprise when each one of them answered ‘ask a friend / family member’ about who to go to. The interesting bit that I want to draw your attention to is that no one said that they would call a particular number. Unlike what we see in most American Soaps – India does not really have a concept of 911. We rely on friends and family to help us in our hour of need.

While information exists in silos in our vast health infrastructure most people dont know

• the emergency services numbers,
• details of hospitals and doctors
• numbers of blood banks

In some locations people dont even know whether the medicine they have purchased is genuine or spurious? If they are doubtful they dont know who to contact.

The list is endless. A simple application that makes health information universally accessible on the mobile phone could go a long way in solving many of our information related needs around healthcare.

It was interesting to read Future trends 2010 for UK but the talking points in India are likely to be substantially different, from this list, in 2010. A list that is likely to be collated soon.

In our context, some points that seemed interesting to deliberate on are listed here.

1. Food and Eating out – The writer talks about a trend towards genetically modified food, eating at home being considered by more people. The affluent Indian customer though is increasingly exploring more options for entertainment and eating out. Meanwhile the debate on genetically modified foods here rages on. Most people , likely are not sure about the pros and cons. The food challenge that must be addressed is about food purity and to a much larger sense food security to a large part of our country.

2. Music consumption moving from download to streaming – Streaming music may be something that is being talked about there but there is much more potential in a digital delivery model that allows a user to play music irrespective of internet connectivity. In our case, broadband speeds and pricing are not exactly conducive to streaming music for the near term. Today there was an article that talks about music delivery in India on pen drives and sd cards . While interesting, it seems another wasted opportunity by the music industry while at the same time increasing digital waste that have still no clear recycle processes. The music shopping experience needs to improve dramatically and consider innovative options to deliver legal music to the customer. It is interesting that digital delivery of music has only recently launched in India with Nokia Music’s offer on selected phones. I will write a more detailed view on music delivery in another post.

What , in your view, are some of the topics and trends that India will be talking about in 2010.

Once upon a time mobiles were considered to be a status symbol. Soon after they became a necessity – every person had one – people cycling on the road, the dhaba wala, the domestic help – everyone!

• Did it ever occur to any of us that it could still be considered a matter of status symbol in some remote corners- maybe it did
• Did it ever occur to anyone that this again can become a feminist thing to fight for maybe it didn’t!

Actually that is a fact.

In small villages in the south, women aren’t allowed mobiles. Its not the cost involved – the mobile is a status symbol. Only a few men can own it and the woman can occasionally use it.

Why and how a mobile can become more than a communicating tool can only be discovered once you see the usage in these areas. The local villagers use the mobile to communicate . The need came from younger college going youth traveling to cities, being influenced into having the luxury of having one and then the worried parents wanting to keep in touch.

The need also arose from the middlemen who constantly commuted between the small villages to the cities to sell.

The need then gave way to the luxury of talking at home and at will.

But the need never became a necessity to use it beyond the regular wanting to stay in touch or to inform. Women who are considered home makers everywhere regardless still aren’t allowed the luxury of the mobile. There are innumerable plans for women, remunerative scheme to help woman becoming independent and earn of her own – there is no plan or an intention to provide these  woman to  have a voice and communicate.

If this mobile is an empowering tool and can make a difference in each of the rural homes it can only be made by having the woman to use it.

I am not a feminist but I was actually shocked at the thought why a woman is deprived of such a simple tool

• We have given her a smokeless chulha,
• We have given her health programs to take care of her family,
• We have given her and her children affordable education programs
• Then why not a mobile

Why hasn’t anyone thought that empowering  woman with mobiles is actual empowerment. Why hasn’t anyone thought that lets not think that this mobile is just to communicate its to build community support systems, its to enhance our fragile sense of security and most importantly it can be used to learn and share information.

Dina’s post on Mobile Innovations in India inspired a thought in me and I wrote about Indian Crafts and Mobiles. I have been since keenly following the discussion that seems to have developed there.

When we talk of real people we dont talk stories any more. We talk of what is actually happening in real time.

Let’s see what Dastkar has really been successful in doing. It has tried to organise thousands of artisans part of 100 diffrent craft groups and helped them come under one umbrella of Dastkar where they can sell to contemporary india.

Dastkari Haat Samiti on the other hand has created informative craft maps of different parts of the country, which gives the information about handicrafts, and handlooms of India! They have had over 70 bazaars providing strategic marketing linkages to hundreds of artisans.

What if we were to get these organizations a support  network in REAL TIME – Many organisations have helped the artisan externally but how can they help themsleves.

• Can they be empowered with information in their language and make decisions of thier own. Maybe
• Can they be empowered with information about different SHG’s (self help groups ) Maybe
• Can they be empowered with information about grameen banks and schemes. Maybe
• Can they be empowered with information about their craft and the related materials. Maybe
• Can they they be empowered with information about other artisans in their vicinity. Maybe
• Can they they be empowered – YES – what they do with the information and how they use it in the subsequent years is for all of us to see – but why should we be afraid to empower them

We all need to understand that we live with history. Our crafts people are living that history and reinventing ancient methods to suit our daily needs. Lets evolve in a scientific manner to help that kaarigar who has toiled for several years and give them the independence they deserve through information.

The handicraft sector is the largest decentralised and unorganised sector of the Indian economy, and is amongst India’s largest foreign exchange earners.

• Craftspeople form the second largest employment sector in India, second only to agriculture.
• Handicrafts are rightly described as the craft of the people: there are twenty-three million craftspeople in India today (Jaitly, 2001).
• No Indian craft is ever purely decorative. While handicrafts, be it metal ware, pottery, mats, wood-work or weaving, fulfil a positive need in the daily life of people, they also act as a vehicle of self-expression, and of a conscious aesthetic approach.
• The change in consumer buying trends and the entry of various new, aggressively promoted factory produced commodities into the rural and urban market, has meant that craft producers need more support than ever if they are to become viable and competitive. This will help them to generate a surplus and a higher standard of living.

While I have been hearing about mobile phones turning into – ‘Hand held devices’ – the term has been a mystery to me. Dina Mehta’s post is actually an eye opener for me. Especially the bit on Nokia is very interesting.

Since I work with craftsmen in rural India, the applicability of mobile innovation, and the changes it could bring in my field about seem almost limitless. Mobiles could impact

• Craft services
• NGO services
• Artisans

1. Craft services – this service could actually tie up with either a Dastkar, Dastkari haat – these are NGO’s that work with several groups of craftswomen across India. These NGO’s could be providers of information on the different products available in their regions. A mapping device associated with this service could be used by the network of entrepreneurs, buyers and artisans to update product availability and nature of skill.

2. NGO services – this could go beyond just remunerative work – but area wise give updates on different NGOS working in the region, the dev. work ongoing their links and contacts

• Textile services
• Updates of yarn prices – cotton,wool, silk,
• Textile activities in different areas
• Information on the NGO’s involved as well

3. Now a thought on how a phone could help the artisans -

• Information about different fairs happening in different parts of india and information on how to participate in them
• Information on how to take loans from banks – special Grameen banks and schemes
• List of NGO’s that were working in the area and he could join them
• Information on to free education for his kids, skill based learning institutions / workshops for his wife to learn a few skills, help in design development
• Information of other groups doing similar craft and how to join them

It is important for us to understand that in order to help people ‘at the bottom of the pyramid’ they need to be pushed to the first rung of the business ladder and then be made to help them selves. The dependency of funds from Government should cease and give way to self sustained activity. The mobile phone could give them the most important tools to face the world – timely information and the ability to connect.

Life has changed – the climate change, the environment issues, the rapidly increasing pollution every thing points towards changing the way we live. But is this pointer to everyone – maybe not – the people in more remote areas aren’t touched by the city life – the way of living there is still as simple as it used to be. We all did migrate in some decade for a need to make a ‘ better living’.

What happened to better living as it evolved to living in such polluted times. Should we go back– we cannot – we don’t know how to but at least lets encourage living the way people have been since centuries – recycling – creating – innovating – living simply….

In search of Navalgund durries

Located in Dharwad District of Karnataka, Navalgund village is popular for its durrees (also known as Jamkhans) that are highly patterned. Navalagunda Jain Temple, a famous Jain heritage center, is another prime attraction of the place.

We sped into the dusty bylanes of Dharwad and reached the small village of Navalgund by late noon. Most homes had the vertical looms, that were lying empty, built in the front courtyard of their small houses. The home we went to a vibrant durrie was being woven and was near finishing.

The durry was woven using vibrant recycled yarns purchased from the nearby industrial city of Hubli. The waste yarn was easily available and very cheap.

With the popular temple in the village and Hubli being a major Industrial town we learnt that the art of weaving the Navalgund durries was dying slowly. There were only 12 families still weaving this durry. Most of the families involved had found lucrative business by selling flowers. Durries were only made to order.

We bought this durry which was ceremoniously cut off the loom and handed over to us. Armed with my new durry and determined to revive the navalgund durry one day I left for the Jesuit hostel I was staying in.

We were only an hour away from our destination when out dilapidated, overworked jeep broke down. It was already twilight and there were no villages in sight – we took a lift from the first vehicle that passed us – a milk van!

The small village too had several power looms weaving beautiful ilkal sarees. There was a loom in every corner – sarees being woven for mostly local retail.

The jeep was back soon (about a couple of hours after seeing the looms we spent waiting in front of the local akhada!)

We were approaching our centre (about 20 km. we were stranded again – our jeep just gave up) Under the moonless sky with ancient tree looming in on us it wasn’t the best nights to be stranded out in the wild.

A truck finally stopped and took us closer to our destination. I was staying in one of the Jesuit hostels was relived to be back now closer to midnight thanking that we were still alive to narrate our story.

Having had the opportunity to go to various remote areas in India I feel fortunate to have living history around to see and understand the traditional systems. Unfortunately some traditions have already become stories only found in history books While some like the Navalgund durries would soon be a thing of the past unless we do something about it.

Why don’t we make it our responsibility to take areas like these and make a small change that would effect lives of many and sustain a culture that is decades old. An art of living we can all believe in!

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