This is really inspirational stuff!!! :)

For those (many) of you who are new to the dsh-hubs list, let me do a
mini-intro of Julia.

Julia had a pretty cushy "research" job before.  When she asked to
join DSH, I told her that one small thing she wrote me in a long blurb
was more than enough to convince me: she told me that she had done
some survey work in Ghana in her previous job, and promised the locals
that she would return one day to follow up to do some real good work.
I thought the MacArthurian "I shall return" commitment was amazing :)

So she quit her cushy job, took a massive pay cut, came to Lucknow to
check things out, and in the past couple months, has been running a
show in Ghana, running a community health variation of DSH.  (Kind of
similar to what Anna is doing in Lucknow.)  The message below is
Julia's status report.

On a side note, I was just telling Ronak that I was truly blown away
by the caliber of independent work done by you kids barely out of
college, basically all running your own "shows" at far corners of the
world, innovating on your own, working with local communities (who I
understand are the ones who have to do the real work), solving daily
problems.  That's Paul, Anna, Julia, Ronak, and now we have Sumeet.
(Rikin should be in that category too---he's a little older but he
looks like an equally young punk :)  Old people like me can afford to
be delinquent :)

Hey Julia, I'll write more later responding to your points.  But
briefly, this is awesome and I personally definitely vote for
continuing the work (but we'll let the other dsh'ers have a chance to
voice their opinion on budget issues or what not).  And the phone
stuff is truly brilliant!  We should try to have this replicated at
all the other hubs.  (We should talk to the Ashesi CSE guys about
this.)


---------- Forwarded message ----------
From: Julia Lowe <jldlowe@gmail.com>
Date: Sun, Jul 20, 2008 at 1:12 PM
Subject: Re: Hi
To: rywang@cs.princeton.edu


Hilarious that I find this e-mail when I sign in, because I literally
just spent time penning an email in word to send to you when I came to
the internet cafe! Below if the update I had written! :)

Yo Randy—

Remember me?  (Yes, that was my joke to draw light to how long it's
been since I've updated you or the DSH list).  Sorry I haven't been a
better poster to the suite of DSH lists—but, if it is any
consolation—it's been because I have been busy working myself silly to
make up the for the fact that you appear to have settled into a state
of semi-permanent holiday-making. J

Okay—so things are working AMAZINGLY well here.   Kind of
overwhelmingly so, actually.  After the first mediation session, when
I was driving away from the site with a representative from my local
partner she looked back at me and said "Is that a tear in your eye?"
I had to pull the old "something in my eye" move, but the truth was, I
was just totally overwhelmed to see the system at play here, working
so well.  It is pretty damn cool. This scenario also made me realize I
was in desperate need for some vacation time because the very thin
line separating my work life and personal life had clearly been
corrupted at some point along the way… J And, also…just stating that
good mediation pretty much moved me to tears is somewhat pathetic…but
I'll put the admission out there anyway. :)

A quick re-cap:

GSCP (Ghana Sustainable Change Project)—is my main local partner.
They are a NGO that is run through AED (American Educational
Development), funded by USAID and their mandate is to support Ghana
Health Service in increasing positive behavior change around health
issues.  They work through the existing network of community health
centers/workers put in place by GHS throughout the country.  We
decided to pilot D* in one district—the Awutu District.

The content:

Although GSCP is my main local partner, I have worked with many local
partners to collect content, but it is distributed through GSCP's
network and using their main content framework (which focuses on
malaria, family planning and child nutrition).  The content that the
mediators are using is clustered in the three focus areas, but it is
from different partners in the country, which is one thing I'm pretty
pumped about.  I have collected content in these three focus areas
from several local partners over the past couple of months, and now
the GSCP network is being used to mediate messages of other government
messages and other good health NGOs, which is building some
much-needed collaboration within some big NGOs here in Accra… but that
is another story.

Now all those weeks of 5:30am start times for filming and bruises on
my legs from hauling around equipment are worth it, because we have a
decent amount of content.  It can pretty much all be organized into
three focus areas right now:  malaria prevention, family planning and
child nutrition.   Within each of those focus areas, there is the
"main content" which is a GSCP-facilitated session with key messages.
For each focus area, there are complimentary activities and sessions
filmed.  For example, for family planning, there are condom-education
sessions for both men and women, community discussion groups, ect.
For child nutrition, there are mother-to-mother support groups about
breast-feeding, child-growth counseling sessions, an example of how
Ghana Health Services conducts weight monitoring, ect.

Logistics of Equipment and Mediation

Right now I have for mediators from four different "zones" (That is
Ghanaian for village) in the Awutu District.  Their names are Joseph,
Stella, Mary and Comfort.  They were chosen by Ghana Health Services
and GSCP staff based on a list of parameters that I provided… and they
pretty much all rock!

The equipment is organized into "Mediation Toolkits"—which consists of
a TV, DVD player, and a bag with all the content DVDs, cords,
communication materials (the posters, flash cards and everything that
has the local partner's message on it), remotes, and a cell phone
(more on this in a minute!).  Everything is stored at the Awutu
District Health Center, which is a government clinic.

There is a focal person at the Health Center (Helen)—who is in charge
of checking the equipment in and out, organizing the mediators for
meetings and follow-up and paying the mediators.  She is a
government-employed community health nurse and is a total bad-ass.
Doesn't take crap from anyone….the perfect lady for the job.

The mediators are VERY self-sufficient, which is awesome.  They check
out a toolkit from Helen and set up at the location of the mediation
session and then check in all the equipment when they are done—and she
goes over each item in the kit to make sure it is there.  They make $5
per session, which is payment to include transportation to and from
the mediation site (it costs around $1 each way to transport the
equipment usually), payment to the site for the use of electricity
(usually around another $1), and some profit for the mediator.  I set
up a bank account with Helen, and she pays the mediators by check for
each session, and I get a copy of each check (so that I know exactly
who has been paid and when).

The cell-phone business.

This part is just plain cool.  Seriously.  So—as part of the Mediation
Toolkit, there is a cell phone that used as the monitoring and
evaluation device.  There is a program on the cell phone (That I
worked with these Ashesi CSE guys on) that allows me to monitor the
mediation activities from a website!  Basically, when the equipment is
checked out, Helene logs into the phone and fills out a form that says
who is checking out the equipment and sends it.  The mediators use
their individual login on the phone to "sign in".  They take a picture
of the audience (in addition to signatures, this is assurance against
fraud) that is dated and timed.  At the end of the session, the
mediators fill out a form on the cell phone saying what video they
mediated, how many participants there were, the duration of the
session and any questions or notes.  They submit that, along with a
picture, and then check the phone back in with the kit.  Helen uses
the phone (And her personal login), to ensure the equipment has been
checked in safely and promptly and notes that she has paid them.

All this information is sent to a website that I check from ANYWHERE!
That is right… when I am away from Accra, I won't even need to settle
into a state of holiday-making. (Wait…is the joke on me?!?!?) J  This
is REALLY "PHREAKING" (in Randy speak) COOL.  If you want, I can send
you my login info so you can look at the website, or I could make a
login for you in case you also want to check up on mediation
activities.

> From Here: 

The "pilot" phase in Awutu will last 12 weeks, which takes us to early
October.  During this time, each mediator is running one digital
session a week in addition to the traditional methods of disseminating
GSCP messages.  I will be monitoring the mediators along with GSCP
staff, who is also following up with individual participants from the
sessions to gauge their reactions to the medium. GSCP's in-house
monitoring and evaluation staff will be using their own data
collection and participant interviewing to determine the success of
the pilot relative to more traditional methods.  I know it is
impossible to postulate about this, but we all basically think there
is no way it is not going to be a huge success.  The first mediation
sessions were SO INCREDIBLY successful, that we can't really think of
what would make it turn sour.

Anyway—GSCP staff (both the leadership and the monitoring and
evaluation staff) and I will be working in concert over the next
couple of months to determine the success based on our collective
monitoring efforts—culminating in a decision by the first week of
October whether or not to scale the model up to other districts and
regions in Ghana.  If this is the case (again, we all anticipate that
it will)—I will work with one GSCP staff member and one Ghana Health
Service staff member to enable their organization to scale up
independently of me.  Basically, I would be doing some intense
training of a couple of individuals so that the institution functions
on it's own to collect new content, scale up to new villages and
monitor activities.

For me, this means that I will be working on monitoring and evaluation
for the next (roughly) two months and building an action-plan, along
with GSCP staff, for scaling up within their network.  I will also be
working on putting together some pretty intense training materials for
GSCP so that D* can become an engrained part of their program without
the need of someone like me there full-time doing the dirty work.  The
plan is for me to return to Ghana end of September and work
exclusively with GSCP and GHS for about 2—3 months.

IS DSH WILLING TO PAY FOR THIS?  Basically, what this involves is
paying for me (It would mean extending my employment through the end
of this year for UW), the cost of the next round of scaling up (I
would guess these scaling costs to be around 2-3k) and the continuing
costs of mediation in the sites (around 2k).

My goal is that GSCP and the government are running D* in this project
(and hopefully, others as well… they are already talking about using
the medium for new messages and in other sectors) without me by the
end of the year.  We have explicitly talked about this in planning
meetings.  From this point, it is the government's choice when and
where to employ the system.  (They, by the way, are OVER THE TOP
excited about the project…)

What do you think?

Enjoy the Bay while you can!!

       -Julia

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