Beyond Expertise

Recently, I attended an interesting meeting looking at agricultural health issues, specifically influenza. For those wondering, human beings are only one of the species that can contract influenza and get sick. Farm animals are susceptible as well, particularly poultry and swine. The meeting was a gathering of immunologists, veterinarians, and agricultural specialists looking at how to address the chronic issues of influenza on the farm. We dove into the details involving the genomics of the influenza virus, how vaccines prompt an immune response, and how that response needs to spread through the whole body to provide systemic protection. Despite the advances we have made, the biochemistry of immunization is still a difficult science that features educated guesswork as part of the search for a solution.

As I sat and learned about the issues these experts faced, I began to see a pattern I've observed many times before. They were seeking a technical solution--a set of steps, compounds, or other methods from their toolboxes that could address the need for combating the disease. They dove far down into the details of T-cells, B-cells, and cytokines trying to identify the combination that would step toward a solution. It reminded me of my first success with computers, long before I had any "expertise" in the field. 

Very early in my career as an academic historian, I was working to turn my dissertation into a book for publication. Back then, personal computers existed, but cost was just out of my reach. Happily, the university where I was teaching had a mainframe with a word processing program. I spent months typing in my draft and revising it to prepare for submitting to a publisher. Once finished, I tried to get it printed on a high quality printer because submitting a manuscript on green-bar paper with a dot matrix printer was not going to be even considered. (How far we have come with electronic submissions these days.) 

I worked out a deal with the admissions office to let me use one of their letter-quality printers that they used to print out acceptance letters that looked like they were typed on an IBM Selectric. They were all connected to the mainframe because they used admissions  management software. So, I was able to stay into the evening to print out a manuscript that ran a few hundred pages. Problem solved!

Not quite yet. The printers jammed after a dozen pages and I'd have to abort the job and start over. The software was so primitive that I had to begin printing the whole file over again from the beginning. (Oh, the limitations!) After many evenings trying, I gave up on printing it out directly from the mainframe. Yet the problem remained. 

Fortuna smiled on me that summer when I agreed to teach for some extra pay. It was enough to buy a microcomputer and high-quality printer. I bought a Kaypro. The only question was how to get my text off the mainframe and onto floppy disks for my machine. Of course, the mainframe took a different size disk and had a difference format for its disks than my little 5.25 CPM diskettes could accept. So, after talking with everyone on campus who might be able to help me, I found one guy who was willing to try to help. (At this point, my wife usually asks, "Is this story going anywhere?")

I met him after work one day in the computer center. We tried hooking my little computer to a serial port on the mainframe and sending commands through a terminal emulator to the mainframe. (Sorry, in English, that means my computer would tell the mainframe what to do.) It didn't work. The technician helping me did not understand it and gave me very detailed reasons why this was impossible and that it should work. Those details went right over my head. I just kept thinking, "Man, I just want my manuscript. The reasons it does not work are of no interest to me." 

After several combinations of fixes with continued failure, he thought there might be an issue with the hardware connection and plugged in a diagnostic device that had a built-in keyboard. He could send the command to return with the file and see the characters streaming across a one-line display on the device. He then connected it to my computer to see if my machine could receive the commands and respond correctly, which it did with the characters streaming across his display in the other direction. So, there was no hardware issue on either end, but he could not see the path to a solution. He sat softly muttering as he thought through the possibilities of what could be wrong, going through the variations of the RS-232 communications protocols that had to be the root of the problem. 

My heart began to sink. I could only see me retyping the manuscript over many, many hours. (Remember, there is no auto-correct on a typewriter.) The thought filled me with the dread of wasted, redundant effort. I was desperate. Then, the solution come to me. I hesitated mentioning it to the expert because I didn't understand the nature of the problem we faced. My idea was naive, and who was I to propose it. But desperation drove me forward and I said, "Look, your device can send commands to the mainframe that it understands and return the text of the files. Plugging it into my microcomputer at the same time allows my machine to understand what the diagnostic device sends. Why not use the diagnostic device to send the command to the mainframe to download the file while it's also plugged into my machine which can receive the file?" 

He sat silent for a minute. His hands templed on the point of his chin. "Brilliant!" he whispered. "It could work." And it did. I walked away that day with the full manuscript on floppies and ready for a bit of clean-up before sending to a publisher. 

The lesson I took away from that encounter, is that sometimes the solution to a vexing technical problem has to focus on the goal and not the problem. Success is more likely if you can cross disciplinary boundaries to bring approaches and perspectives that escape the experts. I've tried to follow the experience of that encounter to continue to ask the naive question or make the simple suggestion when dealing with a complex technical problem. Sometimes it is not helpful and I can't avoid feeling the fool. But that is a small price to pay when it turns out to help a group see something with fresh eyes and then they figure it out. 

SwitchPoint 2013

I attended the SwitchPoint Conference as a guest of IntraHealth last week. It is the second such gathering to find solutions that will save lives and improve the health of the poorest regions on earth. 

One of the things I promised my host was to provide some reflections on what I saw and heard. My reflections are my own, based on what I could experience, and informed by my past, So, I may get situations wrong and misinterpret some encounters. My apologies in advance.

Front of the Saxapahaw General Store

First and Lasting Impressions

Funky surroundings. Music. Art. Ubiquitous technology. Ubiquitous. Set in the Saxapahaw Ballroom (it's a dye house that was part of an old mill with remnants of antique machinery here and there), the meeting had an air of 1900 meets the 21st Century. The group's diversity was striking with every continent represented--based on the names and accents in evidence. Everyone had a smartphone and everywhere someone was looking at a personal screen. Lots of tablets--usually iPads. A few laptops, but very few. 

Music permeates and punctuates everything. Usually a mix with a wide variety of sampled sounds. It's not an add-on, it's organically integrated into the experience. During presentations, visual art--usually digital--is included and occasionally incorporated into presentations or musical interludes. There is an activist aesthetic in play, often with stylish logos or icons as well as personal fashion. As one participant put it, "Art is the common language of technology now." 

Undercurrents are still working, however. Attendees have an underlying passion, a drive to find the solution to vexing challenges in global health and recognize the substrata of challenges in economic development. Economic determinists would find that gratifying, but these are people who are combating those realities. They are seeking solutions that rely on available resources in their host environments and find the patchwork solutions delightful and beautiful--no matter how many paper clips and how much duct tape (literally!) are involved. These anti-cool solutions of low-tech are the best responses as reckoned by these high-tech enthusiasts. While personal styles reflect the global village and the insouciance of tech, these are determined people. Listen for even a few minutes and the movement culture begins to emerge. 

Conference or Chautauqua?

They are all learners. Again and again are presentations where they experimented, failed, prototyped, deployed, failed, and cycled iterations as they closed in on the solutions. "Africa has more pilots than the United States"--referring to projects not aviators--was a refrain either said out loud or implicit in many conversations. Several times, the more experienced people talked about the growing maturity of the movement as these lessons percolated and spread from group to group. 

The conference reminded me of the American chautauqua of a century and more ago, where people of diverse backgrounds and ages came together to share what they have learned and learn what they share. Like the American Populists of the late 19th Century, these people live in a movement culture. (Many thanks to Larry Goodwyn's The Populist Moment to describe the phenomenon.) Activism, art, music, and a post-industrial infusion of technology--a lot of technology--combine in a heady brew. The audiences listen in rapt attention to the presentations (mercifully short and pointed) to find out what was done here and there. 

Between presentations and "ensembles" (essentially panel discussions) are musical interludes that do more than provide a stretch break for the audience. The music comes from the shared evolution of rhythm and beat of the urban West and rural areas in the developing countries. These connections work at an intellectual and visceral level simultaneously. The beat supports the body moving and the emotions flowing, paradoxically taking the edge off and allowing everyone to return with determined, aware mindfulness. 

Lessons Drawn 

We're on our own was a theme that lasted from front to back. The situation of people short on resources, knowledge, and know-how could be glimpsed by those who came to understand that a home-made hammer was the high-technology solution available for some. The iron age and wireless routers can rest side-by-side in a collapsing of epochs that is the modern world. The notion that if it can work in Africa, it can work everywhere was proudly offered as proof of the utility of these solutions. 

The open question was how could these solutions and approaches be brought to serve industrialized communities with their own systems of economic production and distribution. The issue of convergence was not brought up--meaning the narrowing of means and outcomes as the rest of the world catches up in material circumstances with the industrialized regions. I guess the distance is so great to the people working in sub-Saharan Africa or south Asia that it has yet to appear. Yet, some of the people living there are more advanced in the use of texting than even 12-year-old Americans. It might be an interesting area of exploration. 

One take-away notion was the rise of the app. It was not a dominant feature of the conference, but was an enticing idea by one presenter/musician who is finishing a book on it. The app seems to have all the characteristics needed for success in the regions these folks hope to serve. It can be platform-independent; with the latest tools for creation the barriers to entry are low; it can provide its own sustainability through low pricing and wide deployment; it can work over wifi, cellular, or no network; and it is battery-powered when the electricity inevitably goes off. Watch this space. 

How to scale solutions was a repeated theme, but the solutions still remained merely promising. The inventions and innovations were still in gestational stages of evolution and not fully ready for deployment. Sustainability was another open question, but some seemed to think that government policy was one of the paths. Several times the notion of a shift in policy or investment would change the issue on the ground at scale. Few, however, seemed to see entrepreneurship as an answer--even social entrepreneurship. Maybe I missed that discussion. 

Underlying Meanings

Everything is Local. 

The underlying theme of the conference was figuring out how to make do with local materials and local effort--assisted with tips and tools from agencies in the developed areas of the planet. Repeatedly, speakers and participants offered stories of ad hoc remedies and solutions that could scale if the right circumstances arose. (See Von Hippel, Eric.) 

Keep It Simple.

While the challenges are staggering, there is faith in the simple solution if taken to scale. In fact, the assertion is that if the solutions are not simple they will fail. Simplicity mirrors the material conditions of the challenge and must be heeded. If the tools and resources are not at hand, keep looking to find them. 

Build for Scaling

No matter how small and seeming insignificant the idea, it needs to be scaled to address the mountain of challenge facing the people in need of solutions. The question is how to do that. Often people voiced the need for a policy shift or initiative to get governments to back an initiative, whether workforce development or shifting economic incentives. But some did see a potential network effect, depending on situations and circumstances. Information creation and access was the quiet message. 

Fail Fast

Few used the word "failure" to describe pilots and other efforts that did not achieve the hoped-for results. But the word hovered in the air during many sessions, but with more of the sense that entrepreneurs use it as the pathway one travels. My guess is that the term has such emotional freight and connotes such despair that many avoided it. Yet, the most successful and scalable approaches told stories of revising and even starting over before progress was achieved. 

Final Words

I was privileged to encounter these hundreds of people who work to raise the health circumstances of billions. They admit they have not found the solutions, yet. But they are relentless in trying. Read more at The SwitchPoint Reader. I recommend it highly.