Thursday, April 16, 2009

International Day of the Midwife 2009: Reaching midwives who do not have Internet access

I am currently working with Deborah Davis to organise a 24 hour virtual event to celebrate International Day of the Midwife on May 5th. We have started making plans on this wiki - so please check it out if you would like to know more.

Program for IDM 2009
I have been merrily emailing various contacts around the world asking if they would participate, thinking that online events would be one way of reaching midwives who would otherwise be unable to afford to go to face-to-face conferences etc. I have been surprised at the number of midwives who do have access to the Internet in developing countries. And I have been careful to include asynchronous events to the program for midwives who do not have the technology to attend real-time web conferences.

My arrogance?
However, one conversation with a colleague who works with midwives in a developing country has made me stop and reflect on the assumptions I have which underpin this initiative. When I asked him if any midwife he knows would be interested in joining the events he pointed out that the Internet was too expensive and what was available was of very poor quality. He went on to say:

I often think that it is a strange sophistication that we would expect people to access the internet for learning and life when most people have no electricity, poor water and are the victims of multiple morbidities. It makes teaching and learning for most western people very challenging as it relies on the use of what are now referred to as "outdate(ed) modalities".

So where does this leave me and the work I am trying to do using online technology?

Looking at myself
OK. So I can't change the lives of the millions of women and children who suffer horrendous living conditions. There's not a lot I can do about providing good quality Internet access to midiwves who would dearly love to be able to communicate with colleagues around the world. But what I can do is look at myself and my attitudes as a privileged westerner, and try to work out what I can do for the environment and world I live in.

When searching the term "outdated modlaities" I found a post "Back to the Future? Time, Technology, and the Ability of Academics to Create Real Change" by Tim Terway. In this blog post Tim says:

I can’t help but to return to a comment made by my girlfriend Tara on Saturday night, the self-professed “Homer Simpson” in the room. “The only way to change the masses is to directly affect their quality of life.” Rather than throw invisible life preservers around the necks of outdated processes in an emergent universe (everything from auto-industries to bloated, slow-science practices that only set targets meant to be missed), why can’t we realize the value of attempting to change ourselves instead of hopelessly attempting to change how others think?

Where to from here?
I am not really sure where this leaves me personally except that I have to continue to be mindful of the many midwives who are un-connected, and have little or no way of reaching out to the wider international midwifery community.

So how do we in developed countries support these midwives to support the families who do live in appalling conditions? How can we connect with midwives who do not have access to free and easy-to -use communication tools? How do we step back and re-evaluate our use of "outdated modalities" to teach and learn with colleagues in developing countries. What do you think?

Image: 'Mape choir kids' kahunapulej


James BonTempo said...

I can definitely empathize. Working for Jhpiego as the Learning Technology Advisor, it's my job to do this very thing: look for ways technology can be integrated into the learning process in limited-resource settings.

I have been putting a lot of thought into, and engaging in the many discussion around, the opportunities afforded by mobile phones in development. Personally, I think even the simple, 140-character SMS message holds a lot of potential -- I'm just trying to discover the "killer app." I'll let you know what it is when I find it!

Of course, if the context is pre-service education at a school, or even in-service training at a training site, many times computers are available. And even if Internet connectivity is not available, there may be a local area network (which can be used to simulate the on-line experience). So, sometimes more sophisticated computer-assisted learning is completely appropriate.

Then there's radio, television, CD/DVD, and many other devices and media that can be leveraged. It just depends on having a good understanding of what you're trying to do and the environment in which you're trying to do it.

I, myself, am still learning how to do this effectively :)

Anonymous said...

Thank you for this thoughtful post. Keep on doing what you are doing. It is vitally important!! As to your question about midwives with lack of communication access. The problem is being addressed at many levels - - one good idea is the use of cellphones; inexpensive, low maintenance messsaging potential for better health care in inaccessible areas. That said, the problem is not as simple as that. Besides comm devices and connectivity, there is often a problem of hierarchy. Those who are chosen to attend trainings funded by large organizations are usually the same ones, and in-country trainers is often a closed group. What I have seen working small-small is individual initiatives for training locally (always ex-pats). This is a strenuous route with countless hours of individual effort and private donors that greatly helps mostly the informally trained midwives. As you may begin to see, continuing education is a rather complex issue for resource poor countries. I hope to someday make a difference here. But, really Sarah, you are addressing the need for education as you can and making a HUGE impact; don't stress the rest. As midwives like to say, "We are changing women's lives one woman at a time." Each one of us has her place in space and time; each one her mission to fulfill. Thank you for doing your part! - - Maggie Traore in Burkina Faso

Sarah Stewart said...

@James What about Twitter? Is that likely to get to places other applications won't reach, especially knowing the number of cell phones in the world?

@Maggie Thank you so much for this email - it meant a lot to me - I really appreciated your encouragement!