Recently I have been working on a project involving Community Health Workers in the slum of Korogocho. The idea is to have the CHW using FrontlineSMS to map trends of sicknesses and outbreaks in the slum, by mapping CHW using on Health Map and having for each CHW his correspondent string of SMS, of course avoiding to publish any personal data of the patients.
My work has been to do the preliminary assessment of the feasibility of this project by going to visit the slum, meet the CHW and see what kind of work-flow would better fit their organizational structure.
Korogocho is one of the slum of Nairobi, in addition to Kibera and Mathare. Korogocho is one of the worst slum I have ever visited in my life: not because it is big, in fact it is in term of population fairly small, 350000 people, but in terms of conditions of life of the population. In some areas of Korogocho the rate of HIV reach 75% of the population.
In my second meeting in Korogocho I was supposed to meet with a couple of CHW and speak with them about the project. The woman that was helping me, a resident and CHW of the slum, Florence, told me she asked to some of her colleagues to come and speak with me to let me understand what they do. Florence is a CHW since years and she does it completely for free, cause there is no money to pay Health Workers in Korogocho.
When I arrived at her house for my second meeting there were 28 CHW, all women. Some of them had two or three children with them. All of them had HIV and all of them were abandoned by their husband or were widows.
I started the meeting by explaining to them the project, what we wanted to do and why. After almost 10 minutes I finished my presentation. I wasn’t really sure I was getting my message through: I wasn’t definitely expecting them to be excited in front of a white musungu telling them how mobile technology and health mapping could help them in their life. I wasn’t and am not sure it will help them at all.
What happened after my presentation is what changed entirely my perspective and made me really understand why I do what I do. Those women took a piece a paper and start drawing on it. They draw the map of the slum, and then they draw themselves on the map, and then started drawing the clinics and the latrines. After this they started discussing the advantages of having a map, from the possibility to see trends, to their ability to know where everything is, to their need to connect in between them but also with the world outside.
I went to Korogocho to explain to them what my project was, and here I was, listening to them telling me what my project should be, how they wanted, why and how to achieve the goals and what the goals should be, how they wanted information to be visualized, who they wanted to access the information and how. It was one of the most inspiring conversation of my life. They didn’t need me at all, they got it and pushed it forward and created an awesome project. I just needed to listen and take notes, that was it.
I end up spending 7 hours in a room that was 4X4 square meters, with 28 CHW and almost 15 kids, listening and learning where I thought I would have been the one teaching. But not only that: those women knew and understood mapping much more than me: their map what not a piece of paper with dots in it, it was an organizational structure, it was a living representation of their job and of the health life in the slum.
In that day I learned some good lessons I wanna share:
1) let the crowd map, they know what there must be in map, they know what they want the map to tell them
2) space is just another part of identity, and as such, who lives in that space owns it in terms of deep knowledge of its specificity
3) health is social, political and anthropological
4) mapping is not about space, mapping is about people
5) technology is not new, ever, technology may sometimes be a new way to do what we were meant to do anyway
6) if you need to know what to do and how, let the crowd tell you