I had a good conversation last night with Dr. Vikram Kumar, the founder of Dimagi, a very cool project that’s using handheld devices, phones and smartcards to provide health care services in the developing world. Smartcare, deployed in Zambia by the national health ministry and the US Center for Disease Control, is a ood example of how their systems work. Patients are given smart cards which contain an encoded version of their health records and history. This allows patients to bring their medical histories with them if they move, or if they travel to a city to see a specialist. These systems are extremely complex to deploy – they’ve got to work for doctors, nurses, patients as well as for the funders and public health professionals studying the spread of disease and the effectiveness of care.
Kumar and his team have been admirably open in their willingness to try different technical and social approaches to the problems of storing and disseminating medical records in the developing world. While they’re committed to open source solutions, they’ve worked on a variety of platforms and with a wide range of partners – for the most part, they’re refreshingly free of technical ideology. As the corporate motto – “We do things here” – reminds me, they’re a for-profit social venture that’s focused first and foremost on getting things done.
So I was slightly surprised to hear Kumar tell me that he and his team are thinking about launching a new campaign – “Coded in Country”. Dimagi is one of five finalists for the Legatum FORTUNE Technology Prize, a million dollar prize “awarded yearly to honor individuals and organizations whose application of technology solutions has demonstrably improved the quality of life among impoverished populations.” (Voxiva, a company I admire and have invested in is another one of the finalists.) Should Dimagi win the prize, they’ll be in the media spotlight and well-positioned to advance a social change agenda, like “Coded in Country”.
(Vikram clarifies that Dimagi is only one partner in a Coded in Country effort. The idea is being pioneered by joel Selanikio and others with non-profit consultancy DataDyne.)
There’s an enormous amount of software developed for use in developing nations. It’s easy to miss this fact if you think only about shrink-wrap software – the software Dimagi is generally focused on are things like hospital management systems and medical record systems. More broadly, there’s an enormous amount of custom code used to manage government agencies, factories, universities and school systems, payroll systems and so on. In developing nations, lots of this code is paid for under government tender or by international aid agencies. And lots of the coding contracts go to US and European firms, who’ve got experience designing and implementing these projects.
There’s lots of problems in handing these contracts out to people outside the countries in which projects are deployed. Systems often don’t meet local needs. Maintenance and changes to the system often requires programmers to travel internationally, which is extremely expensive. Most critically, deploying these systems doesn’t help contribute to building a base of technical expertise in country. Lots of us who work on technical projects in the developing world feel like it would be smarter to give projects to local contractors, encourage them to train and employ local geeks, rather than exporting hard currency to developed nations without building domestic technical talent.
This was the logic behind Geekcorps, though we came at the problem ass-backwards, focusing first and foremost on geeks in the developed world. After a couple of years, we figured out that building software firms that could compete internationally for contracts involved more than improving their geekery – it likely involved management consulting, as well as training firms how to bid succesfully for these pieces of work. It’s possible to get tripped up on details like accounting standards – ultimately, the reason Geekcorps merged with another firm (disastrously) was because we couldn’t comply with USAID accounting standards by ourselves – getting a Ghanaian software firm to a place where they can apply for these contracts can be a major challenge.
I like how Kumar is thinking about the problem. If the international development community starts challenging the idea that software has to be built in countries like the US or India, and insists that a majority of development on projects is done in-country, we’ll generate a mass of possible projects and funding that will allow local developers to train and grow. And Kumar is exploring some simple and practical ideas to help improve the local talent base, including funding internships to allow recent university and training school graduates to spend months at a software company, picking up skills until they’re able to contribute to projects. (In working on Geekcorps, we used to talk about software as one of the last apprenticeship industries, where academic training could only take you so far…)
Something that Vikram said to me late in our conversation has been rattling around in my brain today. He pointed out that life expectancy in Zambia – one of the companies where Dimagi has worked extensively – is roughly half what it is in the US. “For those of us lucky enough to get the equivalent of two lives, we really should make sure we put that extra life to good use.” Helping figure out how to build a thriving IT sector in Africa would certainly be one worthwhile thing to do with an extra life you have.
While on the subject of cool Africa-focused software projects, let me point you to the recent Forbes story on Ushahidi, the remarkable Kenyan software project that’s helping people around the world engage in distributed citizen journalism in response to crises. The article focuses on the brilliant Ory Okolloh, who put forward the initial idea for Ushahidi, perhaps at the expense of Erik, Juliana, David and the other amazing folks who’ve worked hard to bring the project to life, but it’s great to see the project getting such widespread media attention.