As technology rapidly advances the way we interconnect, the gap in accessibility by poor communities increases. This gap widens because these communities are already challenged by ineffective systems and structures which reduce their meaningful use of technology.
Too often the power to make decisions does not shift to where implementation takes place. Also technologies introduced top down often impose unsustainable solutions.
Thus, how technology is implemented is just as important as what is implemented.
Creating capacity on the ground
Eﬀective and sustainable action requires a convergence of technology, human and social capital and the core values of equity. Implementation must be supported by local decision-making. It also requires bottom-up approaches, respectful partnerships, long-term commitment, trust and local ownership.
There are a number of examples of this kind of approach that have proved effective across diverse disciplines.
Local training and implementation of new techniques for infectious diseases is one. A project initiated by the Sustainable Sciences Institute, an international NGO that focuses on building on-the-ground capacity, provides a good example.
It has successfully trained more than 1900 scientists in more than 27 developing countries. This has strengthened the capacity of these countries to respond to infections including dengue, inﬂuenza, and chikungunya.
Innovative technologies have enabled countries such as Nicaragua to have locally developed capacity to respond to outbreaks and pandemics. Locally relevant research on infectious diseases has also been enabled. Technologies include low cost diagnostics, adaptation of molecular typing methods and laboratory based surveillance systems.
The power of a ground up approach
A second example is mobilising local populations for widespread impact. BRAC, a Bangladeshi organisation dedicated to alleviating poverty, exempliﬁes this approach.
In the 1970s, it scaled up a oral rehydration therapy, a simple solution that can be prepared at home to treat diarrhoea. The success of the project showed how implementing interventions from the ground up can catalyse widespread uptake and behavioural change.
The project involved educating 13 million illiterate rural mothers in Bangladesh about using oral rehydration therapy for their children’s diarrhoea. Men and other community leaders were also educated on the therapy.
The education campaign resulted in signiﬁcant reductions in child mortality from diarrhoea. UNICEF estimates that child deaths from diarrhoea related diseases dropped from 1.2 million in 2000 to 0.6 million in 2013.
BRAC now integrates community engagement throughout its numerous health, education, and social entrepreneurship programmes.
Local inputs help adapt technology
Then there is the development and testing of information and communication technologies (ICT). This is done by involving local end-users to help create cost-effective tools that can streamline information in response to public health challenges.
For example, the institute has developed tools for research, surveillance and laboratory management of infectious disease. These were developed over time by integrating the input of stakeholders at each stage.
Responding to user demand, tools that extend past the laboratory were then developed to track primary health measures such as pregnancies. These were also used to provide health education and collection of data by community health workers using mobile apps.
Another illustration is Hesperian Health Guides’ HealthWiki and mobile app for safe pregnancy and birth. The HealthWiki connects communities with online resources developed in conjunction with local populations. Between March 2014 to March this year the HealthWiki reached 3.6 million users in places where there would otherwise be no doctor.
Approach applies across the board
Beyond health, there are similar success stories of engaging local communities to implement sustainable change. In agriculture, the development of ecologically sustainable farming methods relies on empowering local farmers who know their land. These farmers use farming techniques improved over centuries.
Supporting sustainable farming provides alternatives to industrial monoculture farming. It also helps diverse ecosystems ﬂourish and strengthens local food production systems.
Similarly, microﬁnance and grassroots entrepreneurship provide essential ﬁnancial services to those who otherwise cannot access or aﬀord them. Organisations such as Ashoka, BRAC and Kiva provide crucial support for small businesses that lift households out of poverty.
Tensions can underlie the implementation of new technologies in communities that have limited resources. But lessons from real life scenarios show that to address systemic and structural failures, bottom-up approaches are required.
Creating and sharing technology using a long term collaborative approach ensures a meaningful convergence on a number of fronts: between high tech and low tech, North and South as well as novel and traditional approaches.
This article is an edited extract from, Yes we can! The Raffles Dialogue on Human Wellbeing and Security, published in the August 2015 edition of The Lancet. The authors are: Dr Tikki Pang, Yap Seng Chong, Hildy Fong, Eva Harris, Richard Horton, Kelley Lee, Eugene Liu, Kishore Mahbubani, Mari Pangestu, Khay Guan Yeoh, John Eu-Li Wong.