Is there too much “innovation” in development?

A friend of mine – let’s call him Bobby – recently asked me for help on a bid he was writing which needed to include “innovative approaches”. Bobby expressed a clear dislike for the Developmentspeak term “innovation”. For Bobby, the term is just a fad.

So do I agree with Bobby?

The term “innovation” has become a popular buzzword in the development sector. There are plenty of examples, from USAID’s Development Innovation Ventures, to UNICEF’s Innovation Unit. The Guardian featured “12 days of innovations” over Christmas in 2013, profiling “eye-catching innovations in development”.

I do see some advantages to an emphasis on innovation.  Calling for programmes to be more “innovative” encourages them to experiment more and try different solutions. This could generate unique ideas and new ways of approaching problems – just take a look at TechChange, Commcare, or FrontlineSMS.

However, many ‘innovations’ don’t actually contribute anything new, or do anything different. For example, I don’t see how telemedicine – using telecommunication and ICT to provide care at a distance – can today be seen as an innovation. Allowing patients to speak to health professionals over the phone came about in the UK in 1998 with NHS Direct!

Furthermore, there is a proliferation of pilots across the globe that are not being scaled up. A good example is mHealth, using mobile technology to help improve health. In 2008 and 2009 Uganda had 23 mHealth initiatives that did not scale up after they were piloted because the initial funding had dried up (see image below). It has reached the extent that some criticise the situation as a “pilotitis; a term used to describe a scenario where many NGOs are funded for relatively similar, but isolated, pilot projects, resulting in no resources left for scaling them up.

Map of Mhealth Pilots in Uganda. Source: Sean Blaschke, Technology for Development Specialist at UNICEF Uganda

The problem with “pilotitus” is that a lot of money is being wasted on these projects and the government has no idea what’s going on. In Uganda, it led to a moratorium on all mHealth projects being issued by the government.

What’s more, mHealth “innovations” have rarely been well monitored and rigorously evaluated. We need to ensure that monitoring and evaluation is taking place so that we know what’s going on and what works. This will (hopefully) mean that we can learn for future projects and reduce the risk of re-inventing the wheel.

So I ask myself again, do I agree with Bobby’s scepticism about innovation?

Encouraging innovations has led to great advancements and saved lives. I believe we should still encourage it, but always ensure that frameworks are in place to effectively monitor and evaluate these programmes’ progress. What do you think? Are innovations in the aid sector worth it?

What does it really mean to work on the ebola response

Recruitment for the ebola response continues unabated. There still aren’t enough volunteers to fill the positions needed. And with small INGOs joining in now, the numbers required are not going to reduce any time soon. Most NGOs have international staff on short contracts: 2 – 8 week rotations. This means that by the time you’ve hired someone, you need to start finding their replacement. Some positions are being transferred to national staff but they are justifiably fearful too.

So what is it really like working in West Africa right now?

The biggest difference is not being able to touch people. It’s weirdest when you meet new people, especially colleagues. You stand awkwardly a meter away and nod. But both of you are fully aware of it. Then comes the second meeting when you automatically want to reach out and touch them in that way we do to reaffirm the connection – a pat on the back or a brief touch of the arm. Again you can’t and the relationship seems rather formal.

In some places there are people who open doors for you. This is mostly in hotels so I think is probably more of a hang on from courtesy but it makes you more conscious when you do have to touch the door handle because there isn’t someone there opening it. The same handle that tens of other people have touched. Some people kick the door open with their feet. Others use a scarf or carry around a handkerchief. You would have to be really unlucky to catch it this way as the virus only lasts for 30-60 seconds outside the body when in a droplet of fluid.

Bars no longer sell peanuts or other nibbles with drinks. Some say this is because they can no longer import them, others tell you it’s because they don’t want to encourage the sharing of germs in one bowl. Passing a piece of paper to someone is also some how more awkward here. Paper can be a host for the virus, but again it would have to be very quick direct transmission e.g. one person’s blood from a cut on their finger goes directly in to the cut of the other person. And the first person would have to already be symptomatic.

Swimming is the new aid worker exercise of choice. Being surrounded by chlorinated water wins over the sweaty machines in the gym. Conversations in restaurants, no matter how juvenile, swiftly return to the topic of ebola: from gossip about the latest MSF workers sent home for getting it on to debates about how to have sex without breaking the no contact rule. 

Public health messages are everywhere. On the front doors of buildings, on the national ebola response cars, on the phone whenever you make a call, on shop windows. In some places this does seem to have encouraged behaviour change amongst West Africans – few people make contact now, chlorinated water is a norm and no-one blinks when asked to have their temperature tested before entering a building. In fact, one of the most popular games seems to be ‘guess my precise temperature’ before being told.

In some areas things are going back to normal. Traffic jams emerge again at about 5pm. Many of the white 4×4 vehicles from the time of conflict have been resurrected: you can tell because they still have the no guns stickers on them. Some religious groups are starting to meet again as the fear of congregating dissipates.

As ever, there are some winners as the aid circus rumbles in to town. Food prices have soured and so eating out is more costly. Hotels are full of UN, INGO and Donor Government staff willing to pay outrageous rates. And as many aid workers still fear going out and about, or are busy and so want the most convenient lunch, these hotels and their associated restaurants almost have a monopoly on the aid workers per diems.

For an introduction to the Ebola virus try Peter Piot’s No Time to Lose