Archive for August, 2007
You can find just about anything you want in Ahmedabad now, except an sd card reader. I finally found a cord from another Nikon that would get pics off my camera. Here are some of the better ones. Enjoy.
This is from when I visited the first female agricultural collective. This field is for eggplant.
A dog escaping the midday sun.
The people with whom we met. These women helped start the co-operative.
Last week, I visited villages in the Anand District.
In this particular village, SEWA helped rejuvenate the handloom workers’ craft by giving them trainings and purchasing their products at a fair market price.
SEWA then processes and markets whatever is made at the SEWA Trade Facilitation Center (STFC) located in Ahmedabad.
More to come soon.
August 30th, 2007
Most of what I have done thus far seems like it would have promising results, but I can’t too sure. While my meetings usually end with gratifying promises, contact info exchange, and sometimes even a firm follow-up date, I’m not sure how much we discuss will actually translate into implementation. Nevertheless, I feel like there is much potential for the work I am doing, both in ‘evaluating this telemedicine system’ and in ‘optimizing it to maximize benefit to the rural poor’-my two major tasks.
Meetings with SEWA Gram Haat (the rural marketing/distribution organization), the Research office in SEWA Academy (where they conduct action-oriented studies of SEWA activities), and SEWA Health (a part of SEWA’s Social Security) have resulted in identifying datasets that might be useful for evaluation/research purposes. However, I haven’t actually received much of this information yet, as I plan on meeting with SEWA Academy tomorrow, the Gram Haat data is at their processing facility in the Sabarkantha District, and SEWA Health has yet to get back to me.
My meetings outside SEWA have been more interesting. Last Thursday, I went down to Apollo Hospital for a VRC session on tele-consultation for skin diseases to see the expert end of the VRC telemedicine network in action. By the end of the 3-hour-long session, the dermatologist seemed spent. While technical difficulties and poor camera-handling slowed down the session significantly, the biggest problem appeared to be in the Electronic Medical Record (EMR) forms filled out by each district for each patient in advance. For whatever reason, patient description and medical history often did not correlate with what was on paper. This became apparent when a rather large woman was reported to weigh 42 kilos (~92 lbs) when she was clearly at least double that weight, if not moreso. This was corroborated by the male/female mix-up which followed. It was clear that the current telemedicine system was ‘suboptimal,’ and we started discussing ideas for things to change.
At Apollo, I also had the chance to sit down and talk with their director of telemedicine in Gujarat (as Apollo has its own telemedicine network in addition to the VRC system). As we went through their different business models for telemedicine, I found that none were particularly sustainable just yet. A lot of the telemedicine that is currently being used is based on CSR (corporate social responsibility) or the intrinsic motivation of particular doctors. While this may have dented my faith in the concept of telemedicine a little, it made me admire the efforts put forth by Apollo and the specialist doctors a little more.
On Tuesday, I went down to Vadodara (Baroda) to met with the District Health Officer (DHO). We told him about our VRC system, and he seemed incredibly supportive. He lent us the use of his PHC (Public Health Center) in Bodeli, one of the our VRC sites. This opened the door for telemedicine applications from a wide range of specialties. Currently, SEWA’s VRCs don’t have any diagnostic equipment, and thus are confined to teleconsultation for skin diseases alone (as the video camera is enough for diagnosis). With use of blood pressure monitors, ECGs, and blood testing at the PHC, not to mention the doctors and medicine dispensary, much more detailed information can be sent to Apollo for specialty consultation. The DHO asked SEWA to compose a Memorandum of Understanding (MoU) of what it wanted to do exactly.
In the next week or so, we plan to meet with the PHC doctors, a block level health officer, and Apollo Hospital once again to put together some sort of framework for expansion of telemedicine. Hopefully the ideas we are getting from talking to all of these people will not die with just that, all talk.
August 23rd, 2007
A lot has happened at work in the past week and a half. Initially, my direct liaison to SEWA, the VRC Coordinator, had not given me much attention. This led to the ‘excelling’ and the creation of a draft of a pamphlet on the VRC program (for ISRO and potential donors). My attempts to make progress on the other ideas I had were met with seemingly inane roadblocks, such as records in hand-written Gujarati or failure to set up a meeting with someone downstairs. All of this changed last Wednesday.
I met with the Director of Rural Development to discuss what I had thus far completed and what I planned to do for the remainder of my time here. In preparation for this meeting, I had organized my work into separate projects, each with a clearly defined purpose and progress report detailing work completed, steps remaining, and roadblocks. The Director was either impressed or caught off guard and told my liaison to free her schedule completely and give me her full attention.
I was surprised by this commitment, as my liaison had a full plate. The others assigned to the VRC Program were either absent or split their time with other projects. Nevertheless, this eventually translated to less time wastage (hence, me taking so long to make this post). All of the roadblocks I identified were addressed, and I now have a schedule full of meetings with officials and field visits to last me for the next week and a half.
On a side note, last Thursday I had the opportunity to visit the first registered women’s cooperative in Gujarat. Someone from another NGO (Going to School) was doing research for a documentary, and I was allowed to come along.
About twenty years ago, SEWA started one of its agricultural campaigns by leasing unused land from a local government (panchayat) in a village in the Mehesana District. The women in this village then developed this ‘waste’ land into fertile farmland and started an agricultural collective. I got to interact with the women who helped start this collective and hear their stories.
I was amazed at the impact of this project on these women. Cooperative members went from being seasonal workers in large plantations to having the opportunity to generate their own income from their small plot of land. Women who used to be frequent victims of domestic abuse were now managing their family’s finances. They had even started their own savings collectives. Stories of this pilot project’s success reached other villages and SEWA helped create something similar in many other districts in Gujarat.
I took a lot of pictures, which I will upload as soon as I find a way to get them off of my camera. Until then, happy Indian Independence Day!
August 14th, 2007
I pretty much spent this week Excelling, or at least attempting to. I created a database of all of their teleconsultation records with macros that automatically generated useful summaries whenever it was updated with session attendance logs.
After the first day, I was impressed with how I picked up VBA so easily (I had learned some VB 6 back in high school). I had written code to separate parts of a single name, search the total attendance for duplicates, delete the repeats, and display unique names alongside counts and the dates attended. I later learned this was called a filter, and excel had this feature built in.
Two days later, the same thing happened again. Except this time, I had programmed a pivot table. Or actually like 6 different pivot tables. Oh well, at least I know how to program in VB again.
August 4th, 2007
…doesn’t really exist here. But I’m kind of glad. I got to experience the two extremes of India firsthand (hence this really long post)…
I had my first field visit on Saturday. We went to the VRC at Bodeli. It’s about a 4 hour drive from Ahmedabad, so we left at 8 in the morning and came back at around 9. PM. Honestly though, by the end of the day, I had had such a good time I almost didn’t want to leave.
Six of us went-4 from SEWA, and 2 from another NGO (the All India Disaster Mitigation Institute) looking to become a new expert center. When we arrived at the VRC, located in a town of perhaps a couple thousand (but enveloped in ‘tribal area’), we sat down with some of the women in charge and heard their stories. I was amazed at how SEWA has helped transform their lives. I was even more amazed at their spirit – at how, even at the age of 35, having never picked up a pen (much less having learned to read), they were still motivated to educate themselves and attempt to come out of poverty.
The representatives from the other NGO and I asked these people, who had all arrived early for a teleconference session later in the day, questions in order to characterize this system in more detail. In a way, I was already ‘evaluating their teleconference system’ (my assigned task), and I was already getting ideas for things we could possibly change.
My biggest accomplishment for the day (or rather the first actual thing that had something to do with what I have some experience in) came afterwards, when I sat down to talk with the woman in charge of the VRC. She, herself, wasn’t very educated, but she was very eager to help. We began to talk about SEWA at the district level. What started with a conversation about the layout of villages in the district led to a potential goldmine of data. She had detailed records of pretty much every activity that any aspect of SEWA did in all of their villages. The econ major in me was already getting ideas about indicators and difference-in-difference equations in order to quantify the impact of these telemedicine sessions on these villages. I managed to get some electronic copies of monthly summaries in Gujarati (which I read at about, um, 20 minutes a page) for analysis in the future. In short, I finally had some way to possibly go about ‘evaluating their teleconference system.’
We pretty much brought a monsoon storm as we were coming back to Ahmedabad, as the streets in the eastern par of the city were flooding as we entered. However, I was told that always happens when it rains an inch or more.
I saw the other extreme of India on Sunday, when I was out with some of my cousins. We spent half of the day in Gandhinagar at Science City (think the Indian government’s attempt at Epcot). It really turned out to be a rundown museum, where most of the exhibits where either broken or empty, with a large 3D Imax screen, where people lined up half an hour early to enter despite seat numbers written on all their tickets. Nevertheless, it was a valiant attempt at science literacy in India, and I am sure that place can be cleaned up in no time when a high ranking government official or a corporate sponsor visits.
The other half of the day was spent in the rapidly developing Western side of Ahmedabad. Here, I finally saw firsthand the effects of India’s 10% growth rate. My cousins’ new flat was very Western. Looking out of their 4th floor balcony over their complex and more broadly at the multitude of cookie-cutter bungalows taking shape over the landscape, I could almost imagine myself being in Europe. There were evenly spaced streets (many under construction), and (a couple) grassy lawns. It almost seemed like what we would call suburbia. The only giveaway would have been the crazy traffic. And the peacocks chilling on rooftops. And the monkeys, cows,…
Then we went to a mall. Not THE mall, because that’s two streets over (and even bigger one is under construction like ten minutes away). It was the Himalaya Mall, with 4.5 floors, a food court, an arcade, and the enormous Big Bazaar (think Wal-Mart) stacked on top of a three story parking garage. It had attractions, such as a giant climbing rope, and big tubes all around which blew crisp AC air, revitalizing those entering from the torturous heat outside. It even had several stores common to malls in the States, with prices that (although cheap to us) would be pretty expensive for an Indian salary. And it was packed.
India’s culture has changed so much from what I had last remembered it to be. For this rapidly growing (middle?) class, everything is driven by consuming as much (preferably American or Western) as possible, almost mindlessly. Perhaps I get this impression because I usually live with my grandparents in their albeit large, but old-fashioned bungalow in an older part of town, or because I had visited some of the poorest of the poor in this country only the day before. While I want to embrace this dramatic increase in standard of living, I don’t know how I feel about its impact on those on the other side of the spectrum. The existence of stores like Big Bazaar in India takes the Wal-Mart effect to a whole new level. I’m sure I’ll see more in the next seven weeks and eventually get around to making up my mind, which was sufficiently blown by this weekend.
August 2nd, 2007
My first week at SEWA was a lot of things – fun, educational, influential, long. Boring, however, it was not. Whenever I had downtime at work, I would find something cool to read or talk to some of my co-workers, many of whom had interesting back-stories. I spent much of my time going through material and orienting myself to the Village Resource Center (VRC) program, of which telemedicine is a part.
[Some background (very skippable)…
The VRC program is part of the Indian government’s “Mission 2007” to “bridge the technology divide” between urban and rural India. A VRC is a center accessible to those in rural areas linked up via satellite to expert centers in urban areas such as hospitals or agricultural universities. These expert centers hold teleconference sessions on a wide variety of topics practically relevant to rural life in India. These sessions, broadcast simultaneously to all VRC’s in a region, last roughly 2 hours (at least in Gujarat). During this time, one hour is usually spent on prepared material, while the other is for questions answered live via this link. In Gujarat, SEWA has set up 5 VRC’s and another NGO has set up 5 more in the desert-like Kachh region where India meets Pakistan. According to the latest report, the VRC’s in Gujarat are the only ones deemed ‘functioning’ by the Indian government, and SEWA’s VRC’s are the only ones in this state which regularly attract a fair amount of people.]
Our office in Ahmedabad is one of SEWA’s 5 VRC’s, so, on Thursday, I had the opportunity to sit in on a tele-agriculture session by Anand Agricultural University. Overall, I found the setup and the system easily operable and surprisingly interactive. Even uneducated rural women felt comfortable asking any questions they had to these experts. This system facilitated such interaction extremely well, as these women felt like they were face to face with these experts without any sense of intimidation that they would normally feel in their villages. I also witnessed a tele-consultation session for skin diseases with the other NGO in Kachh. This is the essence of telemedicine, where the entire session consisted of a doctor treating patients, writing prescriptions, etc. During this particular session, which happened to be a follow-up from a previous consultation, I could see many cases of successful treatment which would not have been otherwise possible.
Through all of this, I have learned a lot about how NGO’s really function. This being my first experience actually working with one, I am probably over-generalizing. Nevertheless, I do find some truth to many of the things I have heard about in the past, namely much bureaucracy and high staff turnover, ultimately leading to inefficient use of time and resources. Despite all of this, I am surprised by how much SEWA has actually accomplished. I am still trying to gauge whether the people who work here do so because of some intrinsic motivation to impact change (as the money isn’t really that good), or simply because they couldn’t find anything better to do. Right now, I am leaning towards the former, or at least hoping.
August 1st, 2007