To design better tech, understand context | Tania Douglas

46,178 views ・ 2018-05-24

TED


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This is an equipment graveyard.
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It's a typical final resting place
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for medical equipment from hospitals in Africa.
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Now, why is this?
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Most of the medical devices used in Africa are imported,
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and quite often, they're not suitable for local conditions.
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They may require trained staff
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that aren't available to operate and maintain and repair them;
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they may not be able to withstand high temperatures and humidity;
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and they usually require a constant and reliable supply of electricity.
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An example of a medical device
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that may have ended up in an equipment graveyard at some point
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is an ultrasound monitor to track the heart rate of unborn babies.
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This is the standard of care in rich countries.
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In low-resource settings, the standard of care is often
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a midwife listening to the baby's heart rate
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through a horn.
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Now, this approach has been around for more than a century.
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It's very much dependent on the skill and the experience of the midwife.
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Two young inventors from Uganda
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visited an antenatal clinic at a local hospital a few years ago,
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when they were students in information technology.
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They noticed that quite often,
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the midwife was not able to hear any heart rate
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when trying to listen to it through this horn.
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So they invented their own fetal heart rate monitor.
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They adapted the horn and connected it to a smartphone.
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An app on the smartphone records the heart rate, analyzes it
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and provides the midwife with a range of information
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on the status of the baby.
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These inventors --
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(Applause)
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are called Aaron Tushabe and Joshua Okello.
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Another inventor, Tendekayi Katsiga,
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was working for an NGO in Botswana that manufactured hearing aids.
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Now, he noticed that these hearing aids needed batteries
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that needed replacement,
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very often at a cost that was not affordable
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for most of the users that he knew.
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In response, and being an engineer, Tendekayi invented
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a solar-powered battery charger with rechargeable batteries,
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that could be used in these hearing aids.
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He cofounded a company called Deaftronics,
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which now manufactures the Solar Ear,
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which is a hearing aid powered by his invention.
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My colleague, Sudesh Sivarasu, invented a smart glove
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for people who have suffered from leprosy.
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Even though their disease may have been cured,
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the resulting nerve damage will have left many of them
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without a sense of touch in their hands.
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This puts them at risk of injury.
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The glove has sensors to detect temperature and pressure
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and warn the user.
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It effectively serves as an artificial sense of touch
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and prevents injury.
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Sudesh invented this glove after observing former leprosy patients
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as they carried out their day-to-day activities,
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and he learned about the risks and the hazards in their environment.
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Now, the inventors that I've mentioned
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integrated engineering with healthcare.
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This is what biomedical engineers do.
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At the University of Cape Town,
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we run a course called Health Innovation and Design.
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It's taken by many of our graduate students in biomedical engineering.
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The aim of the course is to introduce these students
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to the philosophy of the design world.
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The students are encouraged to engage with communities
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as they search for solutions to health-related problems.
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One of the communities that we work with is a group of elderly people
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in Cape Town.
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A recent class project had the task of addressing hearing loss
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in these elderly people.
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The students, many of them being engineers,
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set out believing that they would design a better hearing aid.
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They spent time with the elderly,
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chatted to their healthcare providers and their caregivers.
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They soon realized that, actually, adequate hearing aids already existed,
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but many of the elderly who needed them and had access to them
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didn't have them.
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And many of those who had hearing aids
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wouldn't wear them.
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The students realized
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that many of these elderly people were in denial of their hearing loss.
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There's a stigma attached to wearing a hearing aid.
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They also discovered that the environment in which these elderly people lived
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did not accommodate their hearing loss.
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For example, their homes and their community center
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were filled with echoes that interfered with their hearing.
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So instead of developing and designing a new and better hearing aid,
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the students did an audit of the environment,
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with a view to improving the acoustics.
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They also devised a campaign to raise awareness of hearing loss
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and to counter the stigma attached to wearing a hearing aid.
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Now, this often happens when one pays attention to the user --
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in this case, the elderly --
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and their needs and their context.
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One often has to move away from the focus of technology
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and reformulate the problem.
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This approach to understanding a problem through listening and engaging
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is not new,
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but it often isn't followed by engineers,
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who are intent on developing technology.
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One of our students has a background in software engineering.
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He had often created products for clients
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that the client ultimately did not like.
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When a client would reject a product,
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it was common at his company
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to proclaim that the client just didn't know what they wanted.
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Having completed the course, the student fed back to us
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that he now realized that it was he who hadn't understood
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what the client wanted.
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Another student gave us feedback
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that she had learned to design with empathy,
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as opposed to designing for functionality,
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which is what her engineering education had taught her.
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So what all of this illustrates is that we're often blinded to real needs
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in our pursuit of technology.
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But we need technology.
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We need hearing aids. We need fetal heart rate monitors.
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So how do we create more medical device success stories from Africa?
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How do we create more inventors,
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rather than relying on a few exceptional individuals
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who are able to perceive real needs
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and respond in ways that work?
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Well, we focus on needs and people and context.
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"But this is obvious," you might say,
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"Of course context is important."
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But Africa is a diverse continent,
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with vast disparities in health and wealth and income and education.
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If we assume that our engineers and inventors already know enough
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about the different African contexts
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to be able to solve the problems of our different communities
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and our most marginalized communities,
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then we might get it wrong.
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But then, if we on the African continent
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don't necessarily know enough about it,
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then perhaps anybody with the right level of skill and commitment could fly in,
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spend some time listening and engaging
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and fly out knowing enough to invent for Africa.
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But understanding context is not about a superficial interaction.
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It's about deep engagement
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and an immersion in the realities and the complexities of our context.
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And we in Africa are already immersed.
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We already have a strong and rich base of knowledge
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from which to start finding solutions to our own problems.
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So let's not rely too much on others
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when we live on a continent that is filled with untapped talent.
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Thank you.
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(Applause)
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