UnaMesa Association Report for 2008

What do rural Bangladeshi students have in common with Native American children, villagers in Sierra Leone, and political science students at Queens University in Canada? In 2008, each of these groups was served by partners of the UnaMesa Association who are working hard to create new educational opportunities and deliver critical health care information.

• In Bangladesh, students participated in a distance learning pilot course featuring innovative real-time interactivity via their mobile phones. Called the "Virtual Interactive Classroom," this course was offered by the Bangladesh Open University in conjunction with UnaMesa's Bangladeshi partner SoftEd. This pilot demonstrated a breakthrough in providing low-cost, high-quality distance instruction to students who have never had access to top-notch learning environments before.
• In Oakland, CA, the American Indian Child Resources Center (AICRC) serves hundreds of children through tutoring and other programs that help them to succeed in the wider world. Each day the center generates several piles of paper forms that track their progress. In the fall of 2008, the AICRC participated in a pilot "UnaMesa Academy" project designed to show them how to use greener "digital records" to both save resources and create a better experience for both staff and the families they serve.
• In Sierra Leone, villagers debated "on the designation of the two copies of Where There is No Doctor that I [Carolyn van Gurp] brought along, as each school, health center, and chief felt it would be best placed with them, all with very solid reasons." In 2008 the Hesperian Foundation, publishers of Where There is No Doctor, began a project to modernize their materials and deliver digital versions via mobile phones and other technologies so that the cost of buying and transporting a physical book would no longer be a barrier to disseminating good health care information. UnaMesa is the technical partner on this exciting, three year project funded by the Bill and Melinda Gates Foundation.
• At Queens University in Ottawa, Canada, Andrew Lister gave his political science students a new way of working with his lecture materials and with each other. Andrew and his classes used a "Student Notebook," developed by UnaMesa Associate Saq Imtiaz, to create slides, present them during class, make private notes, share public notes, and engage in discussions, corrections and amplifications of the course materials.

Despite the variety of geographical locations and content, each of these projects shares a common thread - determining how to get the right information to the right people at the right time. This theme underlies a core principle of the emerging "knowledge economy" and highlights a key difference with the "industrial economy" which focused on allocating scarce resources. In the above examples, we clearly see a shift from one-directional supply chains to two-way engagements that create knowledge and understanding through interactions.

Health care Worker Scenario

To give one concrete example of our vision for the future, consider a health worker in Bangladesh. Today that worker has very limited access to health care information and training. The people she treats do not have any formal medical records. Even basic information, such as vaccination history, relies on the fallible memory of the patient or their caretakers.

Through the UnaMesa projects, we are working to create a world where that health care worker can take a distance learning course from a regional expert using the Virtual Interactive Classroom (VIC / MORE project). Version 2.0 of Where There is No Doctor for mobile phones (Hesperian project) is a part of their course materials.

After that, every time the health care worker treats a patient, she makes a note on her mobile phone and gives a receipt to the patient, either by sending it to their phone or giving them a paper receipt (SharedRecords). When the patient sees another health worker, the previous receipts can be used by the medical staff to view the patient's medical history. Likewise, the patient can share receipts from other organizations with their primary health worker or anyone else who has an interest in their welfare.

When someone is ill, the health worker can give the patient or their caretaker a copy of treatment information from Where There is No Doctor. This treatment information can be customized for the specific needs of the patient and be delivered via mobile phone or a paper document, such as a one page flyer. For serious or unusual cases, the health-care worker can also consult with the regional expert to consider treatment options.

Current Status and Next Steps

We have a long way to go to fully realize the above scenario for improving health care or similar scenarios for improving education and social services. However, we are making progress and demonstrating the individual components in practical settings. We have purposefully chosen a wide variety of geographical locations and content in order to best understand common needs that span the full range of knowledge-based services.

We believe that the knowledge economy creates new opportunities for everyone. Our mission is to make those opportunities accessible to everyone through innovations in technology, practice, and exchange that enable educators, health care workers, and other social services to reach everyone with the best care possible. In effect, we want to create a "common denominator" for gathering, exchanging, and connecting information and knowledge similar to the way that institutions created the common standards which enabled the development of a global marketplace for trading industrial economy goods.

Our pilot projects in 2008 have taken us one step closer to establishing a "common denominator" for social services. In particular, we have found:

• mobile phone messaging is a very cost effective means to create a direct connection between a provider and client (e.g. Virtual Interactive Classroom project)
• data gathering remains a sticking point for effective services (e.g. UnaMesa Academy pilot with AICRC) and there is no single solution -- rather we need systems which support a flexible combination of paper, web based interfaces, and mobile phones
• effective use of knowledge requires both access to good information AND a community of peers connected to that information (e.g. Student Notebooks and Hesperian's community publications such as Where There is No Doctor)

These lessons from our pilot projects have informed and driven our work on a few key technologies. TiddlyWiki, a JavaScript based wiki, continues to evolve as an effective tool for gathering information and providing access to web based information without the need for a live internet connection. SharedRecords, a combination of software and web service, remains the only tool available for securely sharing medical records and other information anywhere in the world without the need to set up complex servers and administer usernames, logins, backups, etc. Continuing to improve these tools and support their community of developers and users remains a key day-to-day task for UnaMesa.

During 2009, we will be integrating these lessons into our work with partner organizations in order to improve their operations and help them effectively connect with a larger community. Planned partnerships include the Hesperian Foundation (publishers of health-care information), the Meridian Foundation (operates schools and publishes curriculum), and the TeamPlay Foundation (team based mentoring programs).

2008 project overview
For details on our 2008 projects, please see these links:

• Education: MORE project, Virtual Interactive Classroom, Student Notebook
  • See Prof Andrew Lister's blog posting about his experiences with the Student Notebook
• Health: Hesperian, CA Dept of Health workshop
  • Created online and offline versions of Hesperian's publication: Disabled Village Children
• Services: UnaMesa Academy, AICRC, SOZO, Forms, Formsbiz, ServiceLink
  • Prototyped a Forms sharing site (user: forms, password: rassak) as a first step to creating better ways of gathering critical information that serve needs of staff and clients
• Technology: TiddlyWiki, Wikispaces, SharedRecords
  • Continued to increase portability and usability of online data with converters such as HTML2Wiki and a MediaWiki plugin which allows offline access to Wikipedia and other wikis that use the same technology.

Our wiki contains much more information, including goals for 2009: http://tasks.projects.unamesa.org/Goals2009

Financial Status

Finally, I would like to share a brief note on our financial status. Currently, we are in good shape but we do need to find additional funding for 2009 in order to achieve our goals. During 2008 we added a corporate sponsor (thank you BT Osmosoft) and received a number of donations from individuals. However, everyone recognizes that the global downturn has put significant stress on every type of organization. We have felt some of this pain as one of our corporate backers significantly reduced their contributions for the second half of 2008 and the outlook for 2009 remains uncertain.

As of December 2008, UnaMesa has sufficient cash in the bank to maintain our existing level of operations through at least October 2009. We also have a commitment from one of our project partners to cover any additional costs resulting from that particular project. We expect to work out similar arrangements with other project partners early in 2009. In addition to those partnerships, we are seriously exploring additional revenue streams consistent with our mission. Offering fee based consulting services is one option under consideration. In this model, an organization would contract with the UnaMesa Association to develop certain software or services which are related to current projects. For example, a plugin for TiddlyWiki or a version of SharedRecords packaged specifically to work with OpenMRS or another electronic health record. As part of our mission, we would continue to make the output of any such work freely available to the broader social services community.

We welcome your comments, feedback, and questions. We would especially welcome input on what types of fund raising you would consider appropriate avenues for supporting this work.

As always, thank you for your ongoing support.

Greg Wolff
President, UnaMesa Association