Recruitment for Baby Monitor is in full swing, and we are almost ready to begin the first mobile screening calls to pregnant women in their third trimester. Our tech partner InSTEDD has made some great improvements to their Verboice interactive voice response platform that will bring Baby Monitor to life. Check out the latest call flow below. InSTEDD makes it easy:
Design your call flow.
Use the web interface to program the flow.
Use the built-in text to speech feature to quickly test and retest your flow.
Go back to the web interface create local language audio recordings for each voice prompt.
The Baby Monitor team is using the Echo Smartpen for our formative qualitative research. The Smartpen is pretty slick. It records audio that is time-linked to your handwritten paper notes. When done writing, just stop the recording and click on your notes to hear the playback. Connect the pen to a computer to transfer the audio and notes to the desktop app and send to third-party apps like Google Docs with one click.
In this short video, Edwin explains how we are using the Smartpen in our research for the Baby Monitor project. Our favorite feature is the ability to print your own Smartpen paper from a regular color printer. The Smartpen uses special paper with thousands of microdots that keep track of the pen’s movement on the paper. Livescribe sells special notebooks, but you can also print your own using the desktop app.
We got smart and realized that we could print our interview guides on regular paper and then stick the paper back into the printer to print the Smartpen background. So we can create our own “smart” interview guides. Interviewers use these smart guides to take field notes and record interviews. Livescribe makes sharing the audio and notes with the rest of the team a breeze.
In 2009, Google Earth showed inaccurate boundaries between Kenya and Uganda, and also between Kenya and Tanzania. I pointed this out in a post published here on Aug 17, 2009 (reproduced below).
A few weeks ago, while preparing for a class on applied informatics and a gis workshop, I fired up Google Earth and navigated to Muhuru Bay, Kenya, the site of the original research that pointed me to the errors.
To my surprise, the errors had been corrected. The boundaries now reflected my 2009 suggestions. Here are my slides:
This slide shows the old and new boundary between Kenya (top) and Tanzania (bottom). Scroll down to the original post to see my notes about standing on the stone marker and plotting the point.
This slide shows the old and new boundary between Uganda (left) and Kenya (right). The red line in the left image shows my estimation of the actual boundary based on historical documents (scroll down to read more). The new Google Earth boundary in the image on the right looks pretty similar…
So, while I have zero proof, I am officially taking credit for changing these international boundaries in Google Earth. Kenya, no need to thank me for stopping Tanzania’s digital encroachment on your southern border. Uganda, you get back some precious Nile perch waters, but Migingo is still Kenyan. Pole Sana.
Original Post:
Kenya and Uganda are in a row over a small island on Lake Victoria that lies near their shared border. Jeffrey Gettleman picked up on the dispute in a recent NY Times article. I have disagreed with Gettleman’s descriptions of African affairs in the past, but I think he got Migingo right:
It’s a slab of rock, not even an acre big, packed with rusty metal shacks, heaps of garbage, glassy-eyed fishermen and squads of prostitutes, essentially a microslum bathing in the middle of Africa’s greatest lake.
I know because I visited Migingo two weeks ago with a group of Duke University students spending the summer at the Women’s Institute for Secondary Education and Research (WISER) in Muhuru Bay, Kenya. There is not much to be found on this less than 2 acre mound of dirt and tin. It is what surrounds the island that has Kenya and Uganda spending nearly $1.7 million USD to determine ownership.
Fish.
Lots of Nile perch to be specific. As Gettleman reported, Uganda needs the exportable fish that swim in the waters around Migingo to prop up its fishing industry that is currently at 25 percent capacity due to a dwindling supply.
The dispute started in 2004 when Ugandan police landed on the island and raised their country’s flag. It escalated in February 2009 when Ugandan officials began requiring Kenyan fishermen to purchase permits to conduct business. The debate over the island got so heated in recent months that Kenya’s President Kibaki had to quiet calls from within his government for military action against the country’s neighbor and fellow East African Community member.
So which country has a rightful claim to Migingo? As explained in Kenya’s Daily Nation newspaper, Uganda may not be interested in the location of the island as much as knowing where Kenyan waters end and Ugandan waters begin. If Google Earth is any guide, Migingo and its sister islands, Usingo Island and Pyramid Island, are within Kenyan territory.
In a report issued to Ugandan officials on July 21, Kenyan surveyors claimed that Migingo lies 510 m inside Kenyan Territory. This is in line with official Kenyan and Ugandan documents dating back to the Kenya Colony and Protectorate (Boundaries) Order in Council, 1926, created when both countries were British protectorates.
A 1973 International Boundary Study conducted by the Office of the Geographer within the U.S. State Department (No. 139) reprinted the boundary demarcation set by the 1926 Order in Council:
…the [580 mile] Kenya?Uganda boundary is delimited in three sectors from south to north: (1) Boundary from 1° south latitude, through Lake Victoria to the Mouth of the Sio River, (2) Boundary from the Mouth of the Sio River to the summit of Mount Elgon, and (3) Boundary from the summit of Mount Elgon to Mount Zulia, on the boundary of the Anglo?Egyptian Sudan [Democratic Republic of the Sudan].
The first sector begins in Lake Victoria at the Tanzania tripoint, which is located on the first parallel south and approximately 33°56′ east longitude.
“Commencing in the waters of Lake Victoria on a parallel 1° south latitude, at a point due south of the westernmost point of Pyramid Island; thence the boundary follows a straight line due north to that point; thence continuing by a straight line northerly to the most westerly point of Ilemba Island…”
This Google Earth image shows the “straight line northerly” from the “westernmost point of Pyramid Island” to the “westernmost point of Ilemba Island” [not pictured].
Since Migingo is located east of Pyramid Island, which forms part of Kenya’s westernmost border, it looks to be clearly within Kenyan territory. As measured in Google Earth, Migingo is 496 m inside Kenya according to the line I drew from Pyramid Island to Ilemba Island. This compares to the Kenyan surveyors’ estimate of 510 m.
Google Earth, however, is not the best tool for settling this dispute. This program puts Migingo 1.76 km inside Kenya. As indicated in the first map above, Google Earth also places the Kenya-Tanzania border 0.74 km into the Kenyan Division of Muhuru Bay where I have spent the last two months working on a participatory mapping project. I know Google’s boundary is off the mark because I stood on the mark — the triangle stone shown below. The GPS coordinate I captured at this boundary marker reflects the boundary as visible on WISER’s high resolution imagery that was recently acquired from the GeoEye-1 satellite launched in September 2008.
And don’t count out Tanzania of this diplomatic tussle. When I visited Migingo, my Blackberry buzzed with a text message from a mobile phone company welcoming me to the former German colony.
I hope this gets resolved soon. I have a map waiting to be delivered to division officials in Muhuru Bay, a new Division in Kenya that is now part of Nyatike DIstrict. This is important because Muhuru Bay was formerly part of Migori District, which, for moment, is in charge of the upcoming census of Migingo. Presumably, if Migingo is determined to be a part of Kenya, it will fall to Muhuru Division in Nyatike District.
So for now our maps sitting quietly on my computer, awaiting a final decision. If it were up to the the Nairobi hotel staff member who just arrived at my door with a delicious steak sandwich, Migingo would be declared a part of Kenya. Good enough for me.
Shortly after arriving in Gulu, northern Uganda in early 2007, I learned about an IDP called Opit about 30km outside of town. My opportunity in the north did not come with my very own white SUV, so I had to get creative. One smart move was deciding to move to Opit to reduce the time I spent traveling back and forth. Another was purchasing Blue Lightning for the necessary trips from Gulu to Opit (and beyond).
With no knowledge of motorcycles or rural roads in the rainy season, I purchased this beast of a machine with the little research support I had.
Then the punishment began. For the scooter that is.
Parts fell off every day. It was only for the short period of time in between the thick mud and the loose sand–what seemed like 20 days max–that I rode without incident. Without the skill of a good mechanic, a friendly guy on the main road into Gulu who saw (well earned) dollar signs every Friday night when I returned from Opit, always dragging some critical part behind me, Blue Lightning would have been finished within months.
Moses, a good friend who began working with me back in 2007, sent me this photo today. That is him cruising around Gulu on Blue Lightning.
Given the mismatch between this little scooter and the roads of rural Uganda, I think this 5-year update rivals anything the Cuban mechanics have achieved since 1962 with the ’57 Chevy.
According to conventional wisdom, the public sector needs to provide the infrastructure that the private sector can exploit. In the case of mobile phones, the private sector is providing the infrastructure that represents a great opportunity for the public sector to exploit for better health of its people.
Tore Godal and Richard Klausner writing in the Lancet (gated) to introduce a new WHO thematic report called Every Woman, Every Child (ungated).
The literature on early life influences can be broken into several strands. One strand examines prenatal, or “fetal origins.” This research has recently been surveyed by Almond and Currie (2011b), and Currie, (2011). A second strand focuses on health conditions in childhood. This literature is surveyed in Elo and Preston (1992), and more recently, in Almond and Currie (2011a). Both strands suggest that health in early life has long term consequences on education, earnings, and on future health. An interesting issue highlighted by Smith (2009) is whether the effects on employment and earnings work mainly through effects on health, or whether there might be direct effects on, for example, education. A third strand of the literature asks whether poor health in the mother can be “transmitted” intergenerationally to the child (c.f. Currie and Moretti, 2007).
New working paper (gated) by Almond, Currie, and Herrmann.
Refs:
Currie, Janet. 2011. “Inequality at Birth: Some Causes and Consequences.” American Economic Review, May.
Almond, Douglas and Janet Currie. 2011b. “Killing Me Softly: The Fetal Origins Hypothesis.” Forthcoming in the Journal of Economics Perspectives.
Elo, Irma and Samuel Preston. “Effects of Early-Life Conditions on Adult Mortality: A Review,” Population Index, 58 #2, Summer 1992, 186-212.
Almond, Douglas and Janet Currie. 2011a. “Human Capital Development Before Age Five,” in Orley Ashenfleter and David Card (Eds.), The Handbook of Labor Economics, 4b. Amsterdam: Elsevier Science B.V.
Smith, James P. “The Impact of Childhood Health on Adult Labor Market Outcomes,” The Review of Economics and Statistics, 2009. 91 #3, 478-489.
Currie, Janet and Enrico Moretti. 2007. “Biology as Destiny? Short- and Long-Run Determinants of Intergenerational Transmission of Birth Weight.” Journal of Labor Economics, 25(2): 231-264.
There is limited empirical evidence on whether unrestricted cash social assistance to poor pregnant women improves children’s birth outcomes. Using program administrative micro-data matched to longitudinal vital statistics on the universe of births in Uruguay, we estimate that participation in a generous cash transfer program led to a sizeable 15% reduction in the incidence of low birthweight. Improvements in mother nutrition and a fall in labor supply, out-of-wedlock births and mother’s smoking all appear to contribute to the effect. We conclude that, by improving child health, unrestricted unconditional cash transfers may help break the cycle of intergenerational poverty.
In resource-limited settings, HIV diagnosis is done with rapid diagnosis tests (RDT) using two or three different RDTs in either a serial or parallel algorithm (according to national guidelines). Rapid tests allow scale up and decentralization of treatment, both of which are essential to saving lives. Yet RDTS…are known to yield false positive results due to serological cross-reactivity…I first came across this unpleasant reality in Bukavu, DRC while working as a medical coordinator for MSF in 2005. We were running the first program offering ART to the province and had tested nearly 6000 people…We came to realize that some people in our program did not have HIV, so we re-tested a number of them—and identified almost 50 who were suspect for false positive HIV diagnosis. This news was devastating, considering the consequences a false diagnosis can have on people’s lives.
…The reaction of those identified as false-positive varied. One woman said that her husband had divorced her, and she had remarried someone from the HIV+ peer support group. A pastor was immensely relieved to hear that he was HIV-negative, since he could never figure out how he got infected. Some felt it was a miracle from God, or evidence that the latest magic potion on the market cured HIV.
I’ve noticed lately that many of my global health and development colleagues tune out when someone uses the labels mHealth, ICT4Anything, e-solutions, or i-gadgets. I can’t blame them. Rhetoric has outpaced reality and evidence (which should not surprise anyone who knows how long it takes to generate rigorous evidence).
Good shorthand has a short shelf-life. Sooner or later abbreviations or acronyms that once helped to communicate an idea are dissected and labeled unhelpful. ICT4D might be the latest victim.
I’ve decided to put the letters m, e, i, c, t, and the number 4 on notice. You are not helping. But you can redeem yourself as verbs.
In our work on Baby Monitor, a mobile phone application for new and expectant mothers in rural areas, ICT takes a different meaning:
Identify – Remote screenings to find women in need
Connect - Using the platform to connect women to care
Treat – Bringing treatment to the doorstep through telemedicine (not a part of our project)
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