NDN Blog

Connecting Cuba

TeleCuba, a Miami-based communications firm, was just granted a permit by the Treasury Department to lay a fiber-optic cable between Key West and Havana. They'll be investing about $18 million (a pittance!) to tie the last unconnected country in the Western Hemisphere into the global grid.

TeleCubaJust a few weeks ago, President Obama's new policy easing restrictions on family travel, remittances, and telecommunications took effect. (A policy, I might add, that NDN had more than a little to do with shaping) It's good to see it's having an impact already.  And it's happening just in time-- Hugo Chavez recently pledged to lay his own fiber cable from Venezuela to Cuba-- albeit a cable eight times as long, delivered at four times the cost.

I've written before about the democratizing power of connectivity and information. We'll see how this plays out, but I have a hunch that broadband internet, cheap international phone calls, and cable TV will do more to democratize Cuba in six months than fifty years of embargo.

Governor Bill Richardson was at our offices last week talking about U.S.-Cuba relations.  Watch the video of his talk here.  Lastly, a quip I enjoyed from the AP:

The capacity of the cable will be 8 to 10 terabits per second, enough for more than 160 million simultaneous phone calls. The last operational copper cable from Florida to Cuba could carry 144 phone calls at the same time.

Global Mobile Quick Hits: Pedal Power Edition

Tabs I've collected today:

- Twitter is going multilingual.

- A good survey on the current status of mBanking in Africa.

- Another good big-picture review, this one of mHealth.

- And one more, generally addressing the future of mobiles for development.

- An iPhone game from African developers... download iWarrior now, and protect your village!

- And China has barred foreign investment in online games.  Too direct a path to the minds of the youth?

- LG has a new solar-powered e-reader.

- OLPC News on progress in Afghanistan: pedal power!

From the Archives: Tim Chambers

Digging int our mobile archives, I'd like to introduce you to our friend Tim Chambers.  Tim is co-founder of Dewey Digital, the Media 50 Group, and a long-time partner of our affiliate, the New Politics Institute.  In May 2008, Tim joined us to talk about the power of mobile media in politics and outreach. A lot of what he says sounds familiar now, since we saw much of it employed by the Obama campaign last year. Enjoy!

The Challenges and Opportunities of Telemedicine

I was at Brookings this morning for a discussion on "Consumer-Driven Medicine" (A curious euphemism for what I would call "patient-driven medicine"-- isn't it a disturbing reduction to think of patients as simply "consumers" of medical services? But I digress...). Specifically, telemedicine (or mHealth, or whatever you want to call it) in America was the subject of the day.

There was unanimous agreement that telemedicine has the potential to help improve healthcare outcomes without raising costs (and possibly lowering them). Further, as I was saying on Tuesday, the technology is basically already here, and AT&T, a presenter on the panel, has been developing technologies that would network all our mHealth devices. So why can't you track your blood sugar and check your medical records on your Blackberry?  A few key themes emerged:

  • TelemedicineThe biggest obstacle for telemedicine is that insurance doesn't cover it. Part of the problem here is that when the CBO costs out implementation of telemedicine infrastructure, they don't account for cost savings. True, a big upfront investment is required, but telemedicine is all about cost savings. It saves trips to the doctor.  It saves the valuable time of doctors.  Through preventive care and monitoring of chronic disease, people can avoid getting sick-- and that's a massive cost saver. So the CBO issue prevents Medicare and Medicaid from leading in telemedicine, and given a comfortable status quo, private insurers are unlikely to make the initial investment, either.
  • Rural areas stand to gain the most from telemedicine. One of the presenters was Dr. Karen Rheuban, a self-described "country doctor" (and also head of the American Telemedicine Association). Like in any developing country, rural America faces challenges of resource scarcity. Doctors are few, hospitals are far-between, and high-quality specialty care is virtually nonexistent. Dr. Rheuban talked about one initiative in Virginia that brought a mobile mammogram machine into rural communities.  The images were reviewed by doctors in Richmond, and results returned the same day.
  • Patients love telemedicine. Doctors are a little wary. The panelists concurred that after their first experience with remote monitoring or consultation, patients are enthusiastically ready to make it their norm. Doctors, while they know it has potential, and know it's where events are leading, tend to be more dubious. This was interestingly reflected by the audience at the event; in question after question, doctors seemed very wary of telemedicine, and of yielding much control to either data-crunching software or to patients themselves. Change is hard, but this is a case in which progress could lead to doctors having more of their rarest resource: time.

In sum, good event from Brookings on a crucial subject (and one, I'd say, that should have a bigger role in our current healthcare debate). 

Images of Violence in Guinea

If you've been keeping an eye on the junta running Guinea (that's just regular Guinea, not to be confused with Guinea Bissau or Equitorial Guinea), you'll know that the current iron-fisted military leader has fulfilled none of the promises he made upon taking power a year ago, and has seen public opposition to his rule grow. A week and a half ago, a rally against his government turned into a bloodbath, as soldiers killed as many as 157 people, and viciously targeted women for rape and sexual abuse.

As it turns out, a number of protesters snapped photographs of the violence on their cell phones, and the images of sexual violence-- seen as particularly heinous in this Muslim country-- have further grown and solidified opposition to the government.  From the NYT:

Violence in GuineaCellphone snapshots, ugly and hard to refute, are circulating here and feeding rage: they show that women were the particular targets of the Guinean soldiers who suppressed a political demonstration at a stadium here last week, with victims and witnesses describing rapes, beatings and acts of intentional humiliation... The cellphone pictures are circulating anonymously, but multiple witnesses corroborated the events depicted.

As in Iran earlier this year, mobile phones have empowered the citizenry to witness atrocities committed by a repressive state, and to share what they saw-- not just with the few thousand other people who were there, but potentially with millions of people across the country and around the world. 

Also as in Iran, with opposition growing, the government in Guinea faces a choice: Crack down harder to ensure control, or yield to popular demands.  It's hard to know how this will play out, but at a certain point, repressing a vocal, active, networked population of 10 million becomes very difficult.

The Future of Healthcare is Waiting for Us

Fast Company looks into the future of eHealth in a feature article about Susan, a 39 year-old cartoon with not just her own health to worry about, but her children's and parents' health as well.  She's a busy woman, so she finds it convenient to watch her own gluten intake, check her child for strep throat, and monitor her father's scrabble scores using her mobile device ("phone" hardly seems like the right word for such a machine...).

eHealthThe big argument here is twofold: First, that the continuous self-monitoring of your health through a variety of mobile and e-applications will make for more efficient and positive health outcomes than sporadic, occasional-trip-to-the-doctor monitoring.  Second, as the title encapsulates, "the future of healthcare is social"-- i.e., we'll be watching each other's health.

There's something a little eerie about uploading everything from your blood sugar levels to photographs of irregularities on your skin to the great cloud of networked devices. One of the biggest challenges eHealth proponents will face is reassuring prospective users of their privacy and security.  There will be other hurdles, too: getting medical records online and integrating them with the mobile network, creating user interfaces that are comfortable, comprehensive, and easy to use, etc. 

But the technology, by and large, is already here.  That's what is so exciting about this mobile space.  Technology has been advancing so quickly over the past few decades, that it has left every other part of our society in the dust.  We have the capability to do amazing things with what we already have, somebody just needs to imagine it and do it.

I'll be at an event hosted by Brookings this Thursday on "Consumer-Driven Medicine," which will look at how mobile and other technology can improve health outcomes. Let me know if you'll be there, too.  Otherwise, follow my live-tweeting during the event, and look out for a likely blog post afterwards.

Alec Ross Knows The Power of Mobile

A week ago, I introduced you to Global Mobile, and promised weekly videographic evidence of NDN's long history in this space.  What you're witnessing right now is me keeping my promises.  Don't get used to it.

Alec Ross is a Senior Advisor on Innovation to Secretary of State Hillary Clinton.  Before that, he was the co-founder and President of One Economy, a non-profit dedicated to bringing technology to low-income people around the world.  In 2007, he co-authored A Laptop in Every Backpack with Simon, a paper about the importance of connecting American children to the global communications and information network to better prepare them to compete in the 21st century economy.

This video comes from June of this year, from the party we hosted celebrating the launch of "mHealth for Development," a report from the UN Foundation and Vodaphone Foundation. In his talk, Alec discusses the promise of mobile technology to do everything from facilitate health care delivery, to offer banking services to the poor, to better connect people with their governments. He's a compelling speaker and a brilliant guy-- and it's good to know there are people like him running our government:

David Aylward of the mHealth Alliance

The mHealth Alliance is a new partnership between the Vodafone, UN, and Rockafeller Foundations committed to o "facilitate global innovation and ensure maximum impact in the field of mobile health." MobiHealthNews has a great interview with David Aylward, the new executive director of the Alliance: He talks about integrating the mHealth community, the potential for mHealth to tackle chronic disease, and synergies between the developing and developed world as both enter mHealth at the same time from different directions.  The whole thing is worth reading if mHealth is your game, but here are a few choice quotes anyway...

Here, he really captures the big-picture challenges with mHealth going forward:

All of these mHealth services that touch these various communities need to be connected in some fashion. Integrating those services is one mission. Integrating those kinds of services into underlying healthcare systems, e-health to use the short language, is a second. Getting sustainable economics under both of those is a third. Researching and showing the health and economic effect of doing that is a fourth. Underneath those there are more procedural activities, support activities like communications and connecting people together to technology initiatives. Fundamentally, though, it’s those four goals that we are after.

And here he talks about chronic disease, and how both developed and developing nations are de-emphasizing hospitals as a model for health care:

The dominant illnesses, of course, are chronic diseases. We find in the developed world that 80 percent of our healthcare costs are caused by chronic diseases. I don’t mean to say that 80 percent [of our healthcare spending] is spent on obesity or diabetes, but it is caused by those. What we see in the developed world is this huge trend of trying to take care of people in their homes and try to keep them out of hospitals, because we know that as soon as they walk into that facility’s door it’s a couple thousand dollars and plus they’ll catch infections and so on. In the developed world we see all these discussions about ways to keep people at home, get information from them while at home, export the knowledge at the center.

In the developing world we are seeing exactly the same thing, but for a completely different reason. We are seeing the same trend because they don’t have the resources to build the hospitals and related resources. Worldwide we have this very, very powerful trend that we and your publication are right at the forefront of, the edge of. In that sense we can benefit directly from the development of the protocols and knowledge base that result in long distance care for health problems. In that sense the developing world will benefit a lot, but not because they figured it out in the West and can now bring it to the South, but because we are all facing the same problem together.

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