BY BRANDON PATTERSON AND MARC T. HENRY DE FRAHAN
Traveling from clinic to clinic throughout the greater Kumasi area of Ghana in West Africa, ME PhD student Ibrahim Mohedas noticed that measuring blood pressure was not as straightforward as it should be. In Ghana, like everywhere else, high blood pressure is a real problem that affects a substantial part of the population. But the tools used to measure blood pressure weren't meeting the people's needs. There was nothing wrong with the tools themselves, they were in many ways identical to those used by doctors and nurses throughout the world. Yet patients were still having problems getting useful information out of them. While this needed to be solved, the challenges identified by Ibrahim ranged far beyond blood pressure measurements. And at the heart of these failures was the engineering design process, the cornerstone of innovative technology. Solutions engineered elsewhere, didn’t fit the environment in Ghana. The design process had been applied to the wrong problem.
Many of the health problems that people face are the same all over the world. Yet the appropriate solution can change quite a bit from place to place, people to people, and culture to culture. All too often the developing world is handed solutions engineered elsewhere. These solutions often rely on infrastructure, training, and resources which just aren't readily available. Even solutions that are carefully targeted at a specific problem often fail to address the true needs of the population. Ibrahim saw that the needs of people in developing areas are often very different from those of people in more industrialized parts of world, even when the problems look the same at first glance. Solutions that will truly meet these needs must arise within the context of the problem.
This requires fundamentally changing the way we design solutions for the developing world. Typically, attempts are made to adapt solutions designed elsewhere. But these solutions do not consider the context and the needs where the solution will be deployed. Ultimately they fail because they attempt to address the wrong problem. By developing a new design framework, Ibrahim wants to change the way engineers approach and think about designing solutions for the developing world. To achieve this, Ibrahim is borrowing and adapting techniques from anthropology. The broad class of tools he uses are derived from ethnography, which is characterized by long exposures to an environment of interest in such a way the environment is no longer affected by the researcher’s presence. In a reversal of typical engineering design, Ibrahim went to Ghana with a blank slate, observing the people and situation, collecting notes, documentation and conducting interviews to identify the themes driving the population's needs. These tools provide Ibrahim with a far more in-depth understanding of the problem than traditional engineering methods. And, rather than imposing a general solution to a specific problem, Ibrahim advocates for unique, carefully tailored solutions based on each population’s specific needs.
By applying these ethnographic methods in Ghana, Ibrahim found that, in rural areas, training to use typical blood pressure measurement tools is scarce and healthcare workers with the necessary skills are few and far between. Armed with this deeper understanding of the problem Ibrahim and other researchers were able to develop a simple threshold system to determine if the blood pressure was too high.
But solving the problem of high blood pressure diagnostics in Ghana is just one of a huge number of problems throughout the developing world that could benefit from Ibrahim's techniques. According to Ibrahim, small changes in how we design solutions can have a dramatic impact on the developing world. His goal is to develop a streamlined design process that can be taken into problem areas of the developing world to create solutions in the context of the problem. With 5.9 billion people living in developing countries, if Ibrahim's process is a success, many people will start to see a lot of new solutions soon.