Archive for November 2007
Tomorrow is World AIDS Day and instead of “barraging you with [another set of] statistics, gruesome photos, or heart-wrenching stories” (quote credit to Mr. Casnocaha), I want to alert you to something we prefer here – solutions, problem solving, technology, and creative thinking. Piya Sorcar, a doctoral student in Stanford’s Learning, Sciences & Technology Design program has used her considerable skills to figure out how to reach the minds of children in devleoping countries when it comes to HIV/AIDS education.
Incorporating a variety of techniques from several disciplines Piya has generated an animation based educational technique and curriculum, the first of its kind in this area. The first results from this groundbreaking technique are in and they have been outstanding. The indefatigable Sorcar has plans to disseminate the educational curriculum free to schools and other organizations. She also has plans to launch the animation on social networking sites such as Orkut (very popular in some developing countries) and Facebook.
This educational technique and curriculum has taken over 2 years to develop and as far as we know no one else is using this animation based method. This work is truly inspirational, overcomes various methodological barriers and just as importantly political barriers (especailly in countries where sex education is banned). The early results indicate tremendous success. I highly encourage you to read the full story below and visit the website where the animation can be viewed:
We previously covered Piya Sorcar’s work in a post last year and it has been the most read post on this blog with over 1700 visits. You can view that here for further background information.
Lasly, there is much more to say about Piya’s work which we will save for another post. I have placed some links about World AIDS Day below this entry and as a side note – even rock group Queen is getting into the action with their first new recording in a decade to mark the event.
Doctoral student creates groundbreaking animation to teach HIV/AIDS prevention in developing countries
To combat the stigma associated with discussing HIV/AIDS and sexual practices in India and other developing countries, doctoral student Piya Sorcar has developed a groundbreaking animation-based curriculum to teach HIV/AIDS awareness and prevention in a culturally sensitive manner to young adults around the world.
Sorcar’s project, Interactive Teaching AIDS, is already being used in several countries…The animation emphasizes the biology of HIV/AIDS, presenting a storyline with a dialogue between a curious student and a friendly yet authoritative cartoon “doctor” on the biological facts about HIV,its spread, and its prevention.
“What’s groundbreaking is that she’s shown that we can inform people about AIDS while respecting the culture,” said Communications Prof. Clifford Nass, an advisor to Sorcar’s Ph.D. project. “That’s an enormous accomplishment.”
“The result was Interactive Teaching AIDS, an animation-based tutorial featuring a friendly cartoon doctor and patient who guide participants through the biological aspects of AIDS transmission. The tutorial is available online and on a CD.”
A recent study of the application in India by Sorcar with 423 students in private schools and colleges in North India, showed significant gains in learning and retention levels after interacting with the 20-minute animated tutorial. Prior to testing, only 65% knew that HIV was not spread through coughing; after the tutorial, this percentage increased to 94%. Students stated that they were comfortable learning from the tool, and more than 90% said they learned more about HIV/AIDS through the animated tutorial than any other communication method such as television or school. One month after initial exposure to the tutorial, students were rapidly seeking and educating others about HIV/AIDS prevention through their networks, with nearly 90% sharing information they learned from the tutorial with someone else.
One of the Millennium Villages is just down the road from Mbarara. I have known this, kind of, since my first visit to western Uganda in 2005. But this past Sunday several of us, led by a friend working for the UN in Mbarara, drove the hour or so up a tortured dirt road into the highlands of Isingiro district where residents with assistance from various local and regional governments and international funding, are working to improve their way of life.
The drive through hilly farm country was striking – deep green banana farms planted to the base of lighter green grass hills; wattle and cement homesteads dotting the red dirt roadside. Near the Millennium Villages pilot, the road rose quickly, I had to shift into low gear and creep up to the ridge road that took us to Ruhiima. The air was cool along the ridge road and the views of distant gray storm clouds, green valley farms, and everywhere cultivated land was impressive. Small farms of banana, cabbage, potatoes, beans, and other produce were planted on the hillsides. Homes were often located on hilltops, requiring someone to do a lot of climbing when fetching water. Well kept, graded dirt roads connected villages and farms.
We visited a tree nursery, an improved water spring, a recently constructed health clinic, a telecommunications center, and a renovated primary school. The core ‘village’, referred to as MV1 by the UN staff, has about 5000 residents and a prospective cohort of 300 volunteer households enrolled in rather intense observation. The intervention area surrounding MV1 is called, well, MV2 with roughly 45,000 residents and subject to less frequent research efforts.
We were clearly on the visiting dignitaries loop but it was great to finally see the place. I was struck by what I heard about the community involvement in each of the projects – the Millennium Village felt like the Peace Corps on a serious funding kick. The requirement for some level of community contribution, the community members’ planning meetings, and the focus on incremental but important improvements to the agricultural economy were familiar in tenor (though far larger in scale and scope) to what Peace Corps volunteers have attempted with neighbors and friends in many places (check out the PC Partnerships grant program). There have been multi-year integrated rural projects coordinated by Peace Corps volunteers in the past with mixed results.
The project is premised on making large-scale changes in social behavior. The primary school, for instance, has a new feeding program. In the first year, the MVP procures beans and rice with an agreement from parents and perhaps other residents (in our quick visit it wasn’t clear who was involved) that in each succeeding year, local farmers will contribute increasing percentages of food until they shoulder the full responsibility by the end of the program’s fifth year. The assumption that the local residents would take on greater involvement over time was built into every improvement we visited. This can be a weak assumption largely conditional on a culture of effective leadership.
From where I stood in the village, the development efforts looked like what we would expect from any good government investing in the common weal. [Also brought to mind this JAMA article ("Informing Resource-Poor Populations...") on the health effects of simply educating villagers about existing government programs.] The inevitable question followed – how long will it all continue after external funding ended? The answer passed by then in the form of a flatbed truck heavily loaded with green bananas. There is a good deal of local commercial agriculture. “Matooke” banana are cultivated everywhere and sold to middle-men who truck the green fruit to urban centers (Kampala for the most part) in drier eastern Uganda where less bountiful rains inhibit matooke production. You can see where a broad-spectrum but geographically focused investment in the inputs of development has the potential to strengthen long-term economic links like the matooke trade and dairy production far beyond the borders of the Millennium Village.
There were a couple of other threads that came to mind during the visit.
1. Vertical versus horizontal programs. For a great discussion on this in the context of global health, see the CGD blog (“Should All Vertical Programs Just Lie Down?“). Standing at the improved water source with locals proudly telling us the water was now clean while children harvested huge cabbages on the drainage slopes downstream, it was clear what it means to have functional water systems, a school with a teacher and involved parents, and a newly hired doctor at a renovated health clinic all at once.
2. Policy makers have been drawn to ‘clusters-as-catalysts’ in other settings including ‘village-based’ counterinsurgency strategies. Bad metaphor for the MV effort… but does this cluster strategy work in security or development?
BBC reports that “a study published in the Public Library of Science journal by researchers from the Harvard School of Public Health suggests the policy has saved Brazil around $1bn between 2001 and 2005.” The article itself is available freely online as a part of the open access policy of PLoS.
From the Harvard School of Public Health press release:
The results showed that, although costs for Brazil’s locally produced generic antiretroviral drugs (ARVs) increased from 2001 to 2005, the country still saved approximately $1 billion in that time period through controversial price negotiations with multinational pharmaceutical companies for patented ARVs. Since 2001, Brazil has been able to obtain lower prices for patented ARVs by threatening to produce AIDS drugs locally. Though these negotiations initially prompted major declines in AIDS drug spending, HAART costs in Brazil more than doubled from 2004 to 2005. The steep increase reflects the fact that more people living with HIV/AIDS began treatment and are living longer. The increase also reflects the challenges associated with providing complex, costly second- and third-line treatments as people develop resistance to first-line drugs, live longer and require more complex treatment regimens.
Figure 6 from the article – Impact of Alternative Price and Quantity Scenarios on Total ARV Costs, 2001–2005 – shows how the increase in spending is primarily related to increases in quantities rather than costs (Figure 6.A). This figure also shows how much would have been spent if there were no price changes (6.B) and the theoretical minimum that could have been spent by buying the lowest-priced generics on the market (6.C).
Beyond Good Intentions:
What Really Works In International Aid?
“The Beyond Good Intentions film will document effective examples of international aid and inspirational humanitarians who are making the world a better place through their work. This is a rough cut trailer for the documentary film that is taking us around the world to ten different countries over the course of a year including Colombia, Peru, Argentina, India, Cambodia, Laos, Indonesia, Madagascar, Mozambique, and South Africa.” See trailer below, actual story profiles begin at the 3:15 minute mark (via Change the World blog):
AIDG is a wonderful organization and they are having an event tomorrow in NYC. Please pass this onto your networks:
“The Appropriate Infrastructure Development Group (AIDG) helps individuals and communities get affordable and environmentally sound access to electricity, sanitation and clean water. Through a combination of business incubation, education, and outreach, we help people get technology that will better their health and improve their lives.”