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[Opinion] Change World, Wrong Way Around
Climate Change and eHealth should be grassroots issues
Bright B. Simons (baronsimon)     Print Article 
Published 2009-12-22 01:26 (KST)   
Trust me, beloved friends, when I say that the past few days have afforded me the opportunity to link, somewhat intricately, my impressions of the ongoing climate change summit in Copenhagen with my long-running musings about mHealth and the 쐁loud.

I wished though that I could also say that this intricately forged link is a positive one. Alas, negativity seems to prevail.

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The whole tortuous process began last month when I began preparations to participate in a series of workshops and seminars about the course of eHealth in Africa.

I read up on the travails of telemedicine in Southern Africa in the 1980s and pondered the fact that for most African practitioners and patients, what counts for telemedicine most of the time is the house officer (junior doctor) using his mobile phone to communicate between wards and to deliver dosage instructions to support staff because the official land line has long ago ceased to function.

All while the climate change conference was building its crescendo.

Then Bush House wrote.

So between collecting my thoughts about whether there are any lessons to learn in Africa from South Asia셲 communal approach to telehealth, I assembled my thoughts about how, in their aggressive pursuit of a legally defined consensus and global regulatory regime for climate change mitigation and adaptation, global leaders were missing insights about local peculiarities, stifling spontaneity, and over-focusing resources on a top-down approach that will surely fail to find full resonance at the grassroots (listen to the BBC program here.)

As I proceeded, the similarities between the challenges confronting the two nascent industries -- eHealth and climate redesign, that is -- began to take on an interesting clarity. It is simple: the powers that be are putting the cart before the horse.

And how sweet was my vindication when, eventually, the wrangling at the Copenhagen summit got into full swing and in perfect alignment the fierce debates at the eHealth summit started to gather momentum.

In the field of eHealth, the cart-positioning is mishandled through the misallocation of resources to so-called "regulatory structure development, 쐏olicy framework construction, 쐓tandards setting agenda, 쐒ole definition, 쐓takeholder strategizing etc. etc. Let us face it, eHealth (or mHealth, my own cup of tea) cannot be better conceived than AS an 쐇ndustry. Never in the economic history of this planet, however, has an industry been created by the process of social conformation.

All industries begin as providers of goods and services, many times in a clear breach of the social consensus about how the target need is or ought to be met. The regulation, policy thinking, standards setting, normative narration, and the whatnots and whatnots follow on the heels of such goods and services. Indeed, sometimes the social conformation never really keeps pace.

It is therefore extremely puzzling that in Africa, my primary sphere of interest, so much energy and resources are being dedicated to all this para-cerebral activity when there are few notable, genuinely marketable, goods and services in the mHealth applications arena.

No doubt your initial reaction would be: but should we not create an 쐃nabling environment for the emergence of these goods and services you so passionately crave? Well, the truth is that if there is anything 5,000 years of recorded economic history has thought us it is that 쐌idwifing innovation is more often than not a thoroughly elusive quest.

It is extremely hard to predict in advance the conditions under which embryonic innovation would flourish and any attempt to consolidate a pseudo-consensus around some smartass prescience often leads to leakage and arbitrage, which are rarely ever helpful.

In the absence of support for entrepreneurs and producers to brave the torrents of the marketplace; to boldly experiment and proudly fail; to learn from failure and refine their practical intellect; and to learn to ride the unruly horse that is popular taste, it seems to me a thoroughly unrewarding approach to use the African marketplace as some sort of giant colloquium. Rarely in the days that I spent wading through the story of eHealth쁲 three decades in Africa did I sense an awareness that the fickle bazaars of popular utility are where the seeds for growing comprehensive social systems around eHealth would be found. It seemed to me as if the game in town is one of experts designing how the vast majority of ordinary Africans -- who to be frank couldn셳 give a hoot about a 쐒egressive analysis -- would spend their precious time and resources examining the eHealth 쐏roposition.

But there was another depressing thought that kept bobbing up and down my fatigued brain. Perhaps this warped way of looking at innovation might flourish for a bit longer than even your worst fears anticipate, given how the process is dominated by the same actors who have been long vilified for turning Africa into an Aid junkie (See, for example, this BBC News article).

And then, of course, I had to endure another optimism killer in the form of the ongoing hysteria about clinching a 쐂eal at Copenhagen.

The analogous question, when it comes to the climate change acrimony unfolding in that pretty Scandinavian city, is whether we intend to abide by whatever 쐁onsensus emerge out of this process at all seeing how busy we are howling about who has to 쐌ake sacrifices and who deserves some slack (and who needs wads of cash on account of historical victimhood -- sounds familiar, ye Aid-talk savvy observers?).

My honest, depressing, view is that there is too little evidence, even clarity, of what really works in reducing the output of harmful greenhouse gasses for us to be growling and howling at each other in an overworked effort to "induce consensus." There are so many little grassroots ideas that we could help to grow, fail, pick up, flourish, and percolate our consciousness in quicker time than we can develop and ENFORCE a grand treaty of national behavior about systematically reducing greenhouse gasses.

To cite but one example, I have always wondered what an electronic menu at a restaurant that in a subtle and pleasant way demonstrated, by animation and likewise, the 쐁arbon pedigree of listed items might do to what I consider 쐅ood, honest, food. Maybe such a "product" might contribute tremendously to the carbon reduction objective. Maybe it will be a grand flop. But that, precisely, is the point. We need to let a whole range of possibilities play out in the place where our most impacting decisions are made - the consumer and producer marketplace.

What I am almost completely convinced about is that for a wide variety of systemic change causes -- of which mHealth and climate change are our immediate concerns -- we are throwing in our energies and resources to promote change the wrong way around. Always better, I would venture, to allow the grassroots to supply us with the seeds for use in nurturing the grand and complex gardens of regulation and all-encompassing policy frameworks.
This article first appeared on the Ashoka Tech blog (tech.ashoka.org).
©2009 OhmyNews
Other articles by reporter Bright B. Simons

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