By Durba Ghosh
India as a country has made constant endeavors to include the other face of the country—rural India—in the technological boom. However, most efforts have failed to bear results, often due to lack of participation and interest from the private sector. But with an estimated 25% of the market believed to be in rural area, corporates are now taking measured steps to develop ICT solutions for technology inclusion. Here we take a look at a couple of such initiatives, especially in the field of healthcare and education.
Companies like Cisco India and ThoughtWorks believe the time is now right for the convergence of technological capability, economic opportunity and societal needs. These companies are developing user-friendly and affordable technology solutions for general as well as niche problems of rural India. Inexpensive and basic technology solutions like videoconferencing over cloud and virtual storage systems are being used to facilitate communication between urban and rural regions.
Over the years, several voluntary organizations have been engaged in developing technologies for rural areas, but those have barely managed to scratch the surface.
Healthcare goes rural
According to the draft of the Planning Commission’s report on healthcare, there is a 76% shortfall in doctors, which indicates a grim picture of access to medical expertise. As per the Rural Health statistics of 2011 of the 12th Plan draft, the actual availability of doctors in the rural areas is 26,329 against an estimated requirement of 1,09,484.
To deal with different medical expertise challenges in rural and semi-rural areas, Cisco India has made use of technology as a vital tool. The company feels that technology is the right vehicle to virtually “transfer” doctors to the rural areas. The company has already started projects to use the internet in an affordable, scalable and resilient manner.
For starters, Cisco has set up a community kiosk for videoconferencing in Raichur, Karnataka, where patients can walk in to communicate with a doctor in a Bangalore hospital. The doctor can examine the patient in real-time through videoconferencing. For instance, a stethoscope placed on a patient’s heart 300 km away can be heard by the doctor sitting in a distant hospital, or a throat infection can be diagnosed by simply placing a camera in front of the patient’s mouth, which can be magnified by the doctor. Cisco has completed over 20,000 consultancies in less than 11 months and targets to double it by the year end. The company hopes that it will be able to extend its services to at least 10 more villages and towns by the year end.
The vendor has tied up with the governments of Karnataka and Madhya Pradesh to offer the services in rural areas of the states. Cisco is currently in talks with other state governments. For network infrastructure, the company is leveraging BSNL’s nation-wide fiber and copper network.
Currently, nearly 70% of India’s population lives in rural areas, but 80% of the total available doctors are in urban areas, and patients often have to travel long distances at great cost to get quality healthcare. This gap, coupled with the shortage of local doctors, poses a huge challenge for delivery of healthcare. “Therefore, we see a large-scale global opportunity where governments would adopt our solution in a phased manner to deliver healthcare facilities in rural areas,” says Sitaraman.
The country has made several experiments with telemedicine in India. There were 65 such solutions which were launched over the years but most of them shut down due to inappropriateor expensive technologies and methodologies being used to reach large populations. Dependence on satellite-based delivery mechanisms, for instance, had inherent issues like transmission latency, resulting in flawed user experience.
While Cisco is using videoconferencing to take medical help to rural areas, another firm, ThoughtWorks, is working on healthcare in a different way. The company is recruiting software developers to build an open, global medical records standard supporting OpenMRS for developing nations on a voluntary basis. OpenMRS is a community-driven, open-source platform that was created by two US philanthropic organizations in 2004 to facilitate the exchange of medical information between clinical and research organizations
“We will explore its use in rural treatment facilities. We need a whole new movement around things like electronic medical records,” says Singham.
Addressing education
In education, while there have been numerous efforts to bring children in rural areas under the literacy net, it has not borne the desired results, primarily due to lack of proper implementation, accountability and adequate teacher training. The rural education system till date has also been marred by huge absenteeism. Among others, Cisco and ThoughtWorks believe that focused training at low logistical costs will improve the quality of teachers and education levels of children.
One way to get around the problem of absenteeism and lack of qualified teachers is to use technologies such as videoconferencing. With the advent of real-time video conferencing, making quality teachers virtually available to students in rural areas and distributing lectures and study material has become a reality.
Providing these amenities will help engage well-qualified teachers for the rural areas without uprooting them from their region of work. Successful initiatives have been seen and documented, like the learning guarantee program with Azim Premji Foundation in Karnataka, reading promotion in elementary education program with Pratham in MP, Bihar and UP and capacity building of teacher educators with the Naandi Foundation in AP.
Many such programs, however, depend on a brick-and-mortar model of scaling or use of CDs to disseminate data, which has led to their failure in making a disruptive and transformational change.
Solutions from Cisco and ThoughtWorks, instead, are based on a model that leverages the existing networking infrastructure (over which specialized applications are placed ) in collaboration with the government. For education, both the companies are making use of teleconferencing, wherein a lecture being imparted by a teacher in a classroom in, say, Delhi University can be simultaneously streamed to a rural village in Uttar Pradesh in real-time. The system also records lectures in a documented manner that can be later downloaded by students.
Using an NGO partner, Cisco provides supplementary education to over 2,000 children teaching them English, science, social sciences, and mathematics through technology. The company also uses its platform to train 250 teachers in three districts. As a result of these initiatives, school drop-out rates, student absenteeism, and the fear of speaking English have dramatically reduced. The company targets to extend this service to about 10 more schools in several other states with which it is in talks with. Plans to rope in private institutions in the project are also in the offing.
However, just providing access to quality data is not enough. “The success of the virtual model will be realized only when teachers are able to integrate technologies into the teaching process. This requires effective training programs for the teachers to familiarize them with the process,” says Sitaraman.
Other initiatives besides healthcare and education, there are other innovations that these corporates are taking up. Taking stock of the increasing number of missing children in rural areas, ThoughtWorks is working on Rapid Family Tracing and Reunification (RapidFTR), a mobile application and data storage system that helps aid workers collect, sort and share photographs and information about children in emergency situations. This volunteer project is under active development by the Child Protection in Emergencies Team at UNICEF. RapidFTR can be used as a tool to speed up and streamline family tracing and reunification efforts.
The RapidFTR system can work as a stand-alone data gathering system also. It can also be synchronized with the Inter-Agency Child Protection Information Management System (IA CP IMS), which is a case management tool for vulnerable children in emergencies supported by the child protection sub-cluster. Once tested and rolled out, this technology can serve to strengthen the child protection sector’s emergency response capabilities.
“Our focus is also on creating a tight feedback loop between users and the project team and to continuously deliver software upgrades to test changes and new ideas,” says Singham of ThoughtWorks.
Cisco runs a training program for retired soldiers, which has trained about 30 Indian army soldiers in Jabalpur on basic computing and networking skills offered through the Cisco Enabled Education Development (CEED) platform. Cisco in 2011 signed a memorandum of understanding (MoU) with the Indian army to help train retiring soldiers in networking solutions. The CEED platform facilitates a virtual classroom scenario where skilled trainers and subject matter experts impart dynamic, interactive, and real-time learning to students located anywhere in the world. This is part of the solution offerings from Cisco Inclusive Growth, which provides technology in an affordable and consumable form. These video-based solutions use elements of Cisco’s advanced collaboration suite to deliver the remote teacher to the classroom from a cloud in a secure manner.
A few years back, when technology had its limitations, responsibility of providing access to healthcare and education services in the rural areas was taken up by individuals and institutions driven by the need for social change. However, lack of basic amenities in villages made progress difficult. Even government’s efforts to make it mandatory for medical students to serve a stipulated time of practice in rural areas also met with a lot of opposition and resistance.
However, now, with the advent of new technologies and virtual environments that blur boundaries, providing urban-standard services in rural areas has become possible. Technology innovation coupled with increased marketability of rural areas has caught the private sector’s attention. The initial thrust has been on healthcare and education, both being the biggest bottlenecks of rural growth. But the point to note is that the companies involved in providing services in the rural areas are not doing it as mandatory CSR activities; the motivation this time round is market viability and revenue generation. Hopefully, several other companies will follow suit and take up the challenge of providing value through technology in rural areas—while keeping their business sense in place.