Selected publications (.pdf)

"Education Change, Leadership and the Knowledge Society" 
Global e-Schools Initiative (GeSCI)  

Survey of ICT in education in the Caribbean
Volume 1: Regional trends & analysis
Volume 2: Country reports

Using technology to train teachers:
Appropriate uses of ICT for
teacher professional developmen
infoDev (Mary Burns, co-author)

Project evaluation:
Uganda rural school-based telecenters

World Bank Institute
(Sara Nadel, co-author)

The Educational Object Economy:
Alternatives in authoring &
aggregation of educational software 

Interactive Learning Environments
(Purchase or subscription req'd) 

Development of multimedia resources 
UNESCO (Cesar Nunes, co-author)

Real Access/Real Impact
Teresa Peters &
(hosted for reference; RIP TMP) 


Learning, technology & development


Entries in mHealth (2)


Specialized hardware vs SMS, you be the judge

The Neurosynatpic ReMeDi MDAU (Multi-parameter Data Acquisition Unit) telemedicine tool assesses critical diagnostic services measurements and prepares them for transmission back to a clinic or hospital. The diagnoses provided are:

  • Electro-Cardiogram (ECG) 
  • Blood pressure 
  • Oximeter (your blood's oxygen saturation level) 
  • Auscultation (what a stethoscope tells you) 
  • Temperature
  • Heart rate

ReMeDi, the basic version, is designed for use, at least theoretically, in village kiosks such as those provided by nLogue. Cost is about US $250. ReMeDi, plugged into an n-Logue computer or someone else's hardware, is probeware.

By delivering diagnostic services in villages that don't have doctors, ReMeDi at least potentially saves villagers the costs and lost opportunities of traveling to towns or cities when they need to see doctors. (And if you're making the benchmark, $2 per day, you would: a) like to work as many days as possible; b) prefer not spending money when you don't need to.) So ReMeDi has some potential to improve morbidity rates (e.g., general health-related suffering) and cut end-user healthcare costs. ReMeDi also has the potential to increase revenues among early-adopter physicians and, of equal importance, deliver a bit of a revenue stream to the n-Logue. (Prof. Ashok JhunJhunwala, god-father of n-Logue, is also among the guiding lights of NeuroSynaptic.) 

Now, I tend to argue that there's room for all kinds of solutions in the big tent of technology-for-development. (I mean, technology covers a lot, from pencils I suppose to robotic arms.) But in keeping with a flurry of information about telemedicine, it's interesting to compare the NeuroSynaptic approach to the effective use of SMS (Short Messaging Service) by healthcare-related NGOs in Africa, India and elsewhere.

SMS supports cheap one-way and two-way communication among healthcare providers and patients. It's been used to build HIV/AIDS awareness, (Text to Change, Uganda), 
support and track drug-regimen compliance (the SIMpill medical adherence system is one among many), as well as to support diagnostic-and-treatment programs. 

ReMeDi is low-cost, but the ability of Neurosynaptic to continue to offer the product requires 10s of 1,000s of kiosk operators and other providers of rural Internet access to offer the product and service and, critically, make money by doing so. (it's a bit hard for me to grasp the means by which kiosk operators connect to providers of diagnoses and medicines.) ReMeDi is state of the art, but it's only as effective as the training that the kiosk operator receives and his (her) ability to market the ReMeDi service. (In the pilot test supported by IDRC, an initial stream of users shrank to a trickle, possibly because the kiosk operators failed to operate the ReMeDi device effectively.)

ReMeDi, in its state-of-the-art-ness and its robustness, creates challenges in relation to training, asymmetrical partnership-building, and supply chain. (If the patient has to travel to get the prescription, her initial savings in avoiding a doctor visit are lost.)

SMS creates challenges based on the simplicity of the communication medium. Short text, no media. There's a bit of work involved in establishing broad- or narrow-cast message dissemination (although organizations like Frontline SMS are striving to reduce the work involved).

Most critically, ReMeDi requires several layers of inter-mediation, most noticeably by Neurosynaptic, by the kiosk-operating organization (n-Logue) and by the all-too-critical-and-all-too-unlikely-to-be-effective kiosk operator at the village level. 

Again, it's not that these variant approaches exclude each other. But if I had a few dollars to support a scalable, sustainable, effective tool for reducing morbidity and/or mortality rates across a rural region, I would see what I could make happen with SMS and leave the more complex solutions for another player. 

If I were prescription-drug manufacturer Rambaxi, however, I might look into ReMeDi as _part_ of a solution that included druggist-to-villager delivery of my products. That is, if someone else would fund hardware and connection for Internet access. 


mHealth, SMS, and African schools

I stopped in at Wayan Vota's TechSalon on mHealth at inveneo on Tuesday morning. (mHeatlh = "mobile health," essentially the use of phones, handheld computers and other portable devices to meet healthcare needs and improve healthcare systems.)

Karen Coppock, VP of VitalWave Consulting, presented information about their new-ish report culling trends and examples from over 50 mHealth projects. (A project that I worked on in 2003, Teledoc, was among the group they looked at.) 

The VitalWave report shows mHealth used for: 

  • Remote monitoring (6 projects) 
  • Remote data collection (14 projects)
  • Communication and training for healthcare workers (5 projects) 
  • Disease and epidemic outbreak training (7 projects)
  • Diagnostic and treatment support (9 projects -- including the now-defunct but lamented Teledoc!)
  • Education and awareness (6 projects)

Much, much attention was focused on SMS, used for one-to-one communication and used as a broadcast / narrowcast medium to reach mobile-phone users. SMS--because it's cheap, it's nearly ubiquitous (for those who can read), and connects directly to incentives in the form of airtime--is becoming the killer app for health, agriculture and community development in Sub-Saharan Africa. 

But not in education. Sure there are a few initiatives. And teachers have relatively high levels of mobile-phone ownership, (OK, I'm guessing here, prove me wrong). But the primary constituents--kids--don't own phones. And the few mLearning initiatives that target educators and schools, a couple in  Tanzania and South Africa, haven't really taken off. 


Here's an example

Vodacom and Nokia were collaborating to offer mobile based educational content to remote schools. The Project 'BrigeIT' uses a Nokia N95 and a TV set on the client side. A teacher is able to send an SMS to request material and a file is downloaded to the phone on such a request. This multi media file can be played back on the TV set. There are still some issues on energy that the project is grappling with.

Television -- even without broadcast content -- is NOT the killer app for schools in the region. Electricity, toxicity (what happens with those CRTs?) and the high cost of usable content are all barriers. Not to mention the fact that the data-download over Vodacom's GPRS network is going to cost _somebody_, even if that somebody is Vodacom for the purposes of the field test. 

Finally, why not just load ALL the damn content on a DVD and send the thing to the school so the teacher can browse without peering through the tiny aperture of her mobile phone screen at whatever index of, say, social studies content is sent in reply to her SMS? (Sure, portable DVD players cost somewhat more than CRT-based TVs, but they use way more power and release way more toxics at the end of their lifecycles. [Well, not way more, perhaps. But lots of lead...])

Where's the SMS-based teacher-development project that drives teachers to upgrade their subject knowledge and try new approaches in the classroom? Or OUT of the classroom?

(More on SMS and schools, and on the relationship of mHealth & eHealth, soon.)