Wednesday, January 17, 2018

Dialing for Development

By Marjorie Howard

Cell phones are fast becoming game changers in poor countries for everything from banking to health care to literacy

In Kenya, city workers use cell phones to send money to their rural relatives. In West Africa, villagers learn to read and write through text messaging. In India, a lone physician in a remote area gets immediate access to an entire medical curriculum on her phone.

A convenience—and sometimes even an annoyance—in the United States, cell phones are revolutionizing life in developing countries. That’s because they aren’t just phones: they’re miniature computers. They are providing a nearly instant communications infrastructure in places where there has been little or none, says Jenny Aker, F97, an assistant professor of development economics at the Fletcher School. “Across rural-urban and rich-poor divides, mobile phones connect people to people, to information, to markets and to financial services, going where no technology has gone before,” she says.

And such phones are becoming more widespread every day. A United Nations report says there are now 60 cell phone subscriptions for every 100 people in the world, and that in developing countries the figure stands at 48, more than eight times what it was in 2000.

Now Aker and other Tufts faculty, students and staff are capitalizing on the phenomenon, initiating microfinance, literacy and health-care projects that use cell phones as tools of change.

The Joy of Text

Aker points to Africa as an especially compelling success story. When she first went to Ghana in 1997, the rural villages where she worked had few landlines, and there were no cell phones. But today cell phone towers are spread throughout the continent. According to the United Nations report, cell phone subscriptions in Africa rose from 54 million to nearly 350 million between 2003 and 2008. “While not everyone in a village might have a phone, at least a few do, and people share them,” Aker says. “It’s allowing them to get better access to information and to make better decisions.”

She cites the example of a woman in Niger who grows peanuts and sesame. In the past, the woman would only sell her crop locally, accepting whatever price she could get at her village market. Now she can receive text messages telling her the prices in other area markets, and sometimes she travels to earn more money. Similarly, Aker says, villagers could, for instance, potentially use text messaging to learn whether a distant health center has the medication they need.

In addition, texting has had unforeseen benefits. In 2006, Aker and a colleague at Catholic Relief Services, Erin Baldridge, noticed that traders and friends who had never attended school were teaching themselves how to read and write simple text messages.  They had the idea that using SMS—a format called Short Message Service used on many cell phones—might be a way to increase literacy.

With colleagues at Catholic Relief Services and the Ministry of Non-Formal Education in Niger, she helped to develop Project Alphabetisation de Base par Cellulaire (ABC, or Basic Literacy by Cell), in which participants use cell phones to learn to read and write in their local languages. The program includes a component that Aker’s student Joshua Haynes, F10, helped develop—a system that gives users a way to check market prices for agricultural products in four languages.

Aker describes the results of Project ABC as “amazing,” recalling stories like that of a woman who told her she can now read her child’s health card. “There were people I met last year who were unable to hold a pencil and put it to paper. Four months later, they were able to send me a text message. In one course, they could not only recognize numbers, do calculations and write words, but could send and receive messages and get price information,” she says.

A Bank for the “Unbanked”

More recently, Haynes won a Clinton Global Initiative Grant for a pilot project in Haiti that would have helped people use cell phones to keep track of their savings. The earthquake cut the project short, but he hopes to continue the work eventually.

He also helped organize a conference in Kenya on mobile banking, a concept quickly gaining in popularity in the Philippines, Afghanistan, Tanzania, Ghana and South Africa, among other countries. Haynes calls it a “bank for the unbanked.” As an example, one of the most popular mobile banking services in Kenya is called M-PESA (M for mobile; pesa for money in Swahili). Acommercial for it shows a young office worker in Nairobi visiting an M-PESA agent. Then the scene switches to an older couple who receive a text message as they till the soil in their village. In the next scene, they are happily walking into the office of a local business agent to pick up the cash their son has sent via text message.

Another emerging cell phone application could increase public safety. Yanina Seltzer, F09, is working on a system in Caracas, Venezuela, that would allow people to report crimes to the police through text messages. The messages would go to a central server, which would plot them on a map. The goal is to keep better track of locations where crimes are concentrated, so police can focus their attention on those areas.

Medical Info on Speed Dial

In India, meanwhile, cell phones are improving rural medicine. That’s because the Tufts University Science Knowledgebase, better known as TUSK, can now be used on mobile phones.

TUSK is essentially “an enterprise system to store an entire online medical curriculum,” says Associate Provost Mary Lee, J75, M83. “Think of all the online resources, images, libraries, course material syllabi—all of it is on our e-learning system with tools to support active learning and to manage programs.” Indeed, TUSK has proven invaluable to faculty and students at Tufts’ medical, dental and veterinary schools. Other medical schools in the United States and in Uganda and Tanzania are using it as well. And now students and health-care professionals anywhere can take advantage of these resources through a simple cell phone connection.

India’s Christian Medical College (CMC) has started using TUSK to support its network of roughly 200 hospitals that focus on underserved communities across the country. “Some of these medical posts are quite basic and isolated,” says Lee, and under such conditions, TUSK can literally be a lifesaver.

For instance, imagine that a doctor in one of these locations is faced with a patient with an unknown condition and no medical library or peers to consult. With TUSK and mobile access, Lee explains, “they could access the full wealth of Christian Medical College’s online resources, send an instant photo to peers for help with diagnosis, engage in an online discussion to obtain broad input from doctors across the network, and archive all that information into a searchable library so that other health workers could learn from that medical case in the future.”

While TUSK works well on the average cell phone, it’s even better on the so-called smart phones, she adds. India’s Christian Medical College has purchased six smart phones for use by doctors in remote areas across India as a pilot project.

Aker, who sees cell phones as a “transformative tool for development,” is enthusiastic about such efforts, but says they should be part of a wider framework that includes education and finance for the poor. “Years of development experience have taught us that there are no silver bullets,” she cautions. “Mobile phones are one piece of the puzzle and a crucial one, but they cannot stand alone.”

Marjorie Howard can be reached at

Posted May 04, 2010