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Saturday, December 18, 2010
Global Development and the Idiom of Community: A Collision of Global and Local Discourse
Global development since colonization has been influenced by the idiom of community. The collision of the global and local discourses of development, is impacting the implementation and outcomes of the narrative. This paper will discuss colonization and the invention of modernization and community, and how the assumptions about community, market, tradition and ‘the other’ effect the process of development.
The idea of development through modernization is rooted in European colonialism and would create “direct confrontation of 'civilized' Europe with 'savage' and 'barbaric' peoples”(Asad, 1973:264), in the decades to come. Who they colonized and what those societies adopted can have future implications for international relations (Anderson, 2003: 176). The revolution of modern science and technology in Europe consolidated their hegemony, ensuring their dominance (Asad, 1973:264). As the period of colonial rule ended, the technological and economical gaps continue to widen, making the dichotomy of wealth among nations into a global concern. This encouraged the continuation of colonial structure through agents of development continues since the rise of community development in the 1950s, allowing:“authoritarian intervention which was selective and arbitrary; the neglect of the very poor; a bias against women; the submission of technical expertise to the interests of control; and the difficulty that bureaucrats have in accepting multi-task workers and female authority –have all endured.” (Lewis, 2000:374)
The theory of modernization was solidified by W.W. Rostow’s Five Stages of Growth, in which he technically defines the transition of a nation-state from traditional to modern. Rostow views traditional society as a synonymous starting point for all nations and as a hinderance to modernization; with pre-Newtonian, unenlightened ideals creating a ceiling for development, Rostow believes this explains the current gap between rich and poor nations (Rostow 1971: 9).
Mauss, on the other hand, helped cement the idiom of community, defining “community as the bearer of gift, home to barter, share values and embedded relations” (Hayden 2003: 360). As, “an idealized and necessary source or site of quasi-sovereignty, collective authorship and ethical capacity” (Hayden 2003: 368), the community structure is perceived as no only compatible, but critical for sustainable and successful development. This assumed natural structure continues to play its role in development since the age of European-lead colonization(Mosse 1999): “The task of development doctrine was to provide a foundation for state policy and, in so far as the doctrine was developed from Comte to Mill, the developmental ideal of policy came to be that of developing a community” (Cowen & Shenton 1996: 57).
In rural third world development, these communities are presumed in disjunction with the modern world, confined and bound to their land. Their isolation and separation from the state ensures their traditional, natural lifestyle: they have not been constructed by political and historical forces. To ensure sustainability, these communities were seen as needing a form of self-governance. Initially, government intervention would be available to “support economic and social advancement would underpin the very gradual political maturity of ‘African peoples’”(Lewis, 2000: 302). However, static definition essentializes and homogenizes communities, will hinder the success of development objectives like self-governance: if one cannot recognize diversity, one cannot accurately represent the community.
When community is idealized as natural structure, it ignores stratification, and even conflict, within the target society. In the example of Zimbabwe CAMPFIRE project for wildlife management, a respondent was states: “Politics has affected CAMPFIRE. It would have been better if development projects had nothing to do with the councillor or politics”(Mapedza & Bond 2006). This project could not sustain itself, as the elite minority had would not invest in the regulated commons without reciprocity. It is assumed, that “The political elite represent, to a greater or lesser degree, the interest of the mass of the people” (Asad, 1973: 265). However, as the CAMPFIRE example demonstrated, the presumed transparency and effectiveness of political representation of a community is rendered null through elite capture (Derman 1995, Mapedza & Bond 2006, Matzke). The tyranny of elite capture ensures the benefits received from the state or NGO are not distributed to all facets of the community, ensuring the power and economic dominance remain in few hands. As such, these assumed high levels of consensus within the community, do not recognize how various institutions and idioms have influence. The idea of community, is presented as a simple abstraction (Li 2002), and hence easily entangled with seemingly compatible idioms of the market, tradition and the ‘other’.
Marx defined the market “as the site of abstraction, commodity transaction, rational actors, and disembedded and disentangled relations” (Hayden 2003: 368). The market, as per Adam Smith, assumes individuals are rational actors who will act in their own best interest causing the market to naturally regulate itself. The ‘village community’ would be considered the best form for regulation with taxation or rent collection (Cowen & Shenton 1996: 51). The market, is assuming the community to be one cohesive unit, and thus benefit as one(Neumann 1997 ). However, like in politics, the market is captured by the elite class. As Malthus puts failures of the market in development on the over-extraction of rent or tax. While social hierarchies may contribute to that, it is clear that community, as a natural entity, cannot be a factor causing negative repercussions.
Heavily influenced by Thomas Malthus’s Tragedy of the commons that hypothesizes, “humans will increase their numbers beyond their means of subsistence until famine, war and disease wipe out the excess”, development seeks to close the commons to ensure sustainability. As, traditional societies are most often associated with being subsistence based, sustainability is often considered natural value and practice (Li 2002). However, communities deemed as ‘traditional’, can also be seen to lack the means and will to ensure the protection of their commons.
Traditional is considered a natural feature of rural developing communities that involves practice as well as values. However, this traditional knowledge has been heavily influenced by development agents who have instilled new practices and values, or conformed them to fit the development model. For example, “The notion of ‘traditional’ land tenure is largely a result of colonial governance, rather than an ancient feature of African property relations”(Neumann, 1991:573). Local communities have also ‘invented tradition’: “set of practices, normally governed by overtly or tacitly accepted rules and of a ritual or symbolic nature, which seek to inculcate certain values and norms of behaviour by repetition, which automatically implies continuity with the past”(Hobsbawm 1983:1-2).
The idea of nationalism, a product of colonialism, also rise to traditional ‘minorities’ and ‘ethnicities, as opposition to the forces that changed society and hence reclaim what was taken in the past (Anderson, 2003). However, as “All communities larger than primordial villages of face- to-face contact (and perhaps even these) are imagined. Communities are to be distinguished, not by their falsity/genuineness, but by the style in which they are imagined (Anderson, 2006:6).
In the idiom of traditional wrongly lies the idiom of indigenous. Indigenous peoples are ethnic groups that are the earliest known inhabitants of a geographical region. However, as discussed previously, homogenization of communities, does not recognize different ethnic groups and stratification (Derman, 1995). “We can see local indigenous societies as subject to some of same troubling politics of class, ethnicity, and gender that confront us” (Neumann 1991:577): From such a general definition, the ‘indigenous’ is often convoluted within ‘community’(Sylvain 2002). Like the imagined fictitious traditional communities have demonstrated, development agents hold the power to the benefits of trusteeship. The development narrative must recognize this imbalance and seek to minimize its power relationship.
‘Traditional’ and ‘indigenous’ have allowed for the construction of ‘the other’: those inherently different or opposite from the modern west. The idea of the ‘other’ has enabled the west to define their modernity and superiority in contrast with the developing world. In defense, communities have self-orientalized, with the creation of, the preciously discussed, imaginary community (Hobsbawm 1983). The other has been so strongly constructed that people even act in accordance to the illusionary role in order to take advantage of the development programs through legally recognized indigenous status or gaining the attention of development agents (Neuman 1997).
If properly facilitated, it is possible that these contradictions can open up space for debate and reshape the assumptions of the other. Unfortunately, the juxtaposition of the local and global discourses do not turn into realities on the ground(Sylvain 2002). Trustees and NGOs,“seek to introduce long-term conservation directions into societies governed by short-term need fulfillment and development imperatives. This contrast between long-term conservation perspectives and short-term political imperatives is not of course simply a first world/third world contrast; it is an internal political conflict within the societies of the first world themselves” (Derman, 1995:213). Social and historical factors become either secondary or of little relevance to the western idea of development. With little being done to subvert the dominant paradigm (Leach & Fairhead 2000), one can predict development will continue to make changes and create tensions it did not set out to accomplish.
References:
Anderson, B. 2003. Nationalism and Cultural Survival in Our Time: A Sketch. In Dean, B. & Levi, J.M. (eds.), At The Risk of Being Heard: Identity, Indigenous Rights, and Postcolonial States, University of Michigan Press, Ann Arbor. 165-190.
Asad, T. 1973. Two European Images of Non-European Rule, Economy and Society 2(3):263-277.
Cowen, M.P. & R.W. Shenton, 1996. ‘The Indian Iteration and Conclusions” in Doctrines of Development. London: Routledge.42-59
Derman, B. 1995. Environment NGOs, Dispossession, and the State: The Ideology and Praxis of African Nature and Development. Human Ecology 23(2): 199-213.
Hayden, C. 2003. From Market to Market: Bioprospecting's Idioms of Inclusion. American Ethnologist. 30(3) August 2003:359-371.
Hobsbawm, E. 1983. Introduction: Inventing Tradition. In Hobsbaum, E. & T. Ranger (eds.), The Invention of Tradition. New York: Cambridge University Press. pp. 1-14.
Leach, M. & J. Fairhead. 2000. Fashioned Forest Pasts, Occluded Histories? International Environmental Analysis in West African Locales. Development and Change, 31(1): 35-59.
Lewis, J. 2000. The Imperial Politics of Inclusion: Community Development and Social Engineering 1948-53 & Conclusions. Empire State-Building: War and Welfare In Kenya 1925-52. Oxford: James Curry: 298-374.
Li T. M. 2002, Engaging Simplifications: Community-Based Resource Management, Market Processes and State Agendas in Upland Southeast Asia. World Development. 30(2): 265–283.
Mapedza, E. & I. Bond, 2006. Political Deadlock and Devolved Wildlife Management in Zimbabwe: The Case of Nenyunga Ward. The Journal of Environment & Development. Vol. 15 Num. 4 December 2006 407-427.
Matzke, G. E. and N. Nabane 1996. Outcomes of a Community Controlled Wildlife Utilization Program in a Zambezi Valley Community. Human Ecology 24(1): 65-85.
Mosse, D. 1999. Colonial and Contemporary Ideologies of 'Community Management': The Case of Tank Irrigation Development in South India. Modern Asian Studies, Vol. 33, No. 2 (May, 1999), pp. 303-338
Neumann, R., 1997. Primitive Ideas: Protected Area Buffer Zones and the Politics of Land in Africa. Development and Change 28(1997): 559-582.
Sylvain, R. 2002. "Land, Water, and Truth": San Identity and Global Indigenism. American Anthropologist 104(4): 1074-1085
The idea of development through modernization is rooted in European colonialism and would create “direct confrontation of 'civilized' Europe with 'savage' and 'barbaric' peoples”(Asad, 1973:264), in the decades to come. Who they colonized and what those societies adopted can have future implications for international relations (Anderson, 2003: 176). The revolution of modern science and technology in Europe consolidated their hegemony, ensuring their dominance (Asad, 1973:264). As the period of colonial rule ended, the technological and economical gaps continue to widen, making the dichotomy of wealth among nations into a global concern. This encouraged the continuation of colonial structure through agents of development continues since the rise of community development in the 1950s, allowing:“authoritarian intervention which was selective and arbitrary; the neglect of the very poor; a bias against women; the submission of technical expertise to the interests of control; and the difficulty that bureaucrats have in accepting multi-task workers and female authority –have all endured.” (Lewis, 2000:374)
The theory of modernization was solidified by W.W. Rostow’s Five Stages of Growth, in which he technically defines the transition of a nation-state from traditional to modern. Rostow views traditional society as a synonymous starting point for all nations and as a hinderance to modernization; with pre-Newtonian, unenlightened ideals creating a ceiling for development, Rostow believes this explains the current gap between rich and poor nations (Rostow 1971: 9).
Mauss, on the other hand, helped cement the idiom of community, defining “community as the bearer of gift, home to barter, share values and embedded relations” (Hayden 2003: 360). As, “an idealized and necessary source or site of quasi-sovereignty, collective authorship and ethical capacity” (Hayden 2003: 368), the community structure is perceived as no only compatible, but critical for sustainable and successful development. This assumed natural structure continues to play its role in development since the age of European-lead colonization(Mosse 1999): “The task of development doctrine was to provide a foundation for state policy and, in so far as the doctrine was developed from Comte to Mill, the developmental ideal of policy came to be that of developing a community” (Cowen & Shenton 1996: 57).
In rural third world development, these communities are presumed in disjunction with the modern world, confined and bound to their land. Their isolation and separation from the state ensures their traditional, natural lifestyle: they have not been constructed by political and historical forces. To ensure sustainability, these communities were seen as needing a form of self-governance. Initially, government intervention would be available to “support economic and social advancement would underpin the very gradual political maturity of ‘African peoples’”(Lewis, 2000: 302). However, static definition essentializes and homogenizes communities, will hinder the success of development objectives like self-governance: if one cannot recognize diversity, one cannot accurately represent the community.
When community is idealized as natural structure, it ignores stratification, and even conflict, within the target society. In the example of Zimbabwe CAMPFIRE project for wildlife management, a respondent was states: “Politics has affected CAMPFIRE. It would have been better if development projects had nothing to do with the councillor or politics”(Mapedza & Bond 2006). This project could not sustain itself, as the elite minority had would not invest in the regulated commons without reciprocity. It is assumed, that “The political elite represent, to a greater or lesser degree, the interest of the mass of the people” (Asad, 1973: 265). However, as the CAMPFIRE example demonstrated, the presumed transparency and effectiveness of political representation of a community is rendered null through elite capture (Derman 1995, Mapedza & Bond 2006, Matzke). The tyranny of elite capture ensures the benefits received from the state or NGO are not distributed to all facets of the community, ensuring the power and economic dominance remain in few hands. As such, these assumed high levels of consensus within the community, do not recognize how various institutions and idioms have influence. The idea of community, is presented as a simple abstraction (Li 2002), and hence easily entangled with seemingly compatible idioms of the market, tradition and the ‘other’.
Marx defined the market “as the site of abstraction, commodity transaction, rational actors, and disembedded and disentangled relations” (Hayden 2003: 368). The market, as per Adam Smith, assumes individuals are rational actors who will act in their own best interest causing the market to naturally regulate itself. The ‘village community’ would be considered the best form for regulation with taxation or rent collection (Cowen & Shenton 1996: 51). The market, is assuming the community to be one cohesive unit, and thus benefit as one(Neumann 1997 ). However, like in politics, the market is captured by the elite class. As Malthus puts failures of the market in development on the over-extraction of rent or tax. While social hierarchies may contribute to that, it is clear that community, as a natural entity, cannot be a factor causing negative repercussions.
Heavily influenced by Thomas Malthus’s Tragedy of the commons that hypothesizes, “humans will increase their numbers beyond their means of subsistence until famine, war and disease wipe out the excess”, development seeks to close the commons to ensure sustainability. As, traditional societies are most often associated with being subsistence based, sustainability is often considered natural value and practice (Li 2002). However, communities deemed as ‘traditional’, can also be seen to lack the means and will to ensure the protection of their commons.
Traditional is considered a natural feature of rural developing communities that involves practice as well as values. However, this traditional knowledge has been heavily influenced by development agents who have instilled new practices and values, or conformed them to fit the development model. For example, “The notion of ‘traditional’ land tenure is largely a result of colonial governance, rather than an ancient feature of African property relations”(Neumann, 1991:573). Local communities have also ‘invented tradition’: “set of practices, normally governed by overtly or tacitly accepted rules and of a ritual or symbolic nature, which seek to inculcate certain values and norms of behaviour by repetition, which automatically implies continuity with the past”(Hobsbawm 1983:1-2).
The idea of nationalism, a product of colonialism, also rise to traditional ‘minorities’ and ‘ethnicities, as opposition to the forces that changed society and hence reclaim what was taken in the past (Anderson, 2003). However, as “All communities larger than primordial villages of face- to-face contact (and perhaps even these) are imagined. Communities are to be distinguished, not by their falsity/genuineness, but by the style in which they are imagined (Anderson, 2006:6).
In the idiom of traditional wrongly lies the idiom of indigenous. Indigenous peoples are ethnic groups that are the earliest known inhabitants of a geographical region. However, as discussed previously, homogenization of communities, does not recognize different ethnic groups and stratification (Derman, 1995). “We can see local indigenous societies as subject to some of same troubling politics of class, ethnicity, and gender that confront us” (Neumann 1991:577): From such a general definition, the ‘indigenous’ is often convoluted within ‘community’(Sylvain 2002). Like the imagined fictitious traditional communities have demonstrated, development agents hold the power to the benefits of trusteeship. The development narrative must recognize this imbalance and seek to minimize its power relationship.
‘Traditional’ and ‘indigenous’ have allowed for the construction of ‘the other’: those inherently different or opposite from the modern west. The idea of the ‘other’ has enabled the west to define their modernity and superiority in contrast with the developing world. In defense, communities have self-orientalized, with the creation of, the preciously discussed, imaginary community (Hobsbawm 1983). The other has been so strongly constructed that people even act in accordance to the illusionary role in order to take advantage of the development programs through legally recognized indigenous status or gaining the attention of development agents (Neuman 1997).
If properly facilitated, it is possible that these contradictions can open up space for debate and reshape the assumptions of the other. Unfortunately, the juxtaposition of the local and global discourses do not turn into realities on the ground(Sylvain 2002). Trustees and NGOs,“seek to introduce long-term conservation directions into societies governed by short-term need fulfillment and development imperatives. This contrast between long-term conservation perspectives and short-term political imperatives is not of course simply a first world/third world contrast; it is an internal political conflict within the societies of the first world themselves” (Derman, 1995:213). Social and historical factors become either secondary or of little relevance to the western idea of development. With little being done to subvert the dominant paradigm (Leach & Fairhead 2000), one can predict development will continue to make changes and create tensions it did not set out to accomplish.
References:
Anderson, B. 2003. Nationalism and Cultural Survival in Our Time: A Sketch. In Dean, B. & Levi, J.M. (eds.), At The Risk of Being Heard: Identity, Indigenous Rights, and Postcolonial States, University of Michigan Press, Ann Arbor. 165-190.
Asad, T. 1973. Two European Images of Non-European Rule, Economy and Society 2(3):263-277.
Cowen, M.P. & R.W. Shenton, 1996. ‘The Indian Iteration and Conclusions” in Doctrines of Development. London: Routledge.42-59
Derman, B. 1995. Environment NGOs, Dispossession, and the State: The Ideology and Praxis of African Nature and Development. Human Ecology 23(2): 199-213.
Hayden, C. 2003. From Market to Market: Bioprospecting's Idioms of Inclusion. American Ethnologist. 30(3) August 2003:359-371.
Hobsbawm, E. 1983. Introduction: Inventing Tradition. In Hobsbaum, E. & T. Ranger (eds.), The Invention of Tradition. New York: Cambridge University Press. pp. 1-14.
Leach, M. & J. Fairhead. 2000. Fashioned Forest Pasts, Occluded Histories? International Environmental Analysis in West African Locales. Development and Change, 31(1): 35-59.
Lewis, J. 2000. The Imperial Politics of Inclusion: Community Development and Social Engineering 1948-53 & Conclusions. Empire State-Building: War and Welfare In Kenya 1925-52. Oxford: James Curry: 298-374.
Li T. M. 2002, Engaging Simplifications: Community-Based Resource Management, Market Processes and State Agendas in Upland Southeast Asia. World Development. 30(2): 265–283.
Mapedza, E. & I. Bond, 2006. Political Deadlock and Devolved Wildlife Management in Zimbabwe: The Case of Nenyunga Ward. The Journal of Environment & Development. Vol. 15 Num. 4 December 2006 407-427.
Matzke, G. E. and N. Nabane 1996. Outcomes of a Community Controlled Wildlife Utilization Program in a Zambezi Valley Community. Human Ecology 24(1): 65-85.
Mosse, D. 1999. Colonial and Contemporary Ideologies of 'Community Management': The Case of Tank Irrigation Development in South India. Modern Asian Studies, Vol. 33, No. 2 (May, 1999), pp. 303-338
Neumann, R., 1997. Primitive Ideas: Protected Area Buffer Zones and the Politics of Land in Africa. Development and Change 28(1997): 559-582.
Sylvain, R. 2002. "Land, Water, and Truth": San Identity and Global Indigenism. American Anthropologist 104(4): 1074-1085
Monday, December 13, 2010
The carbon footprint of a coffee bean...
Wednesday, December 8, 2010
Sunday, December 5, 2010
A Summary and Analysis of Hernando De Soto’s Mysteries of Capital
“The Mystery of Capital: Why Capitalism Triumphs in the West and Fails Everywhere Else” by Hernando De Soto, is a book about the transformation of dead capital into live capital through the institution of formal property rights. De Soto believes by integrating the extralegal agreements into a unified formal property rights system, the world’s poor will be enabled through the creation of ‘fictitious commodities’. Being a Peruvian himself, the majority of De Soto’s examples are specific to his Peru and various other Latin American countries. Written in 2000, Hernando’s book is from the context of Latin America during the 1990s where the world was recovering from the oil shocks, and debt crisis of the 1980’s and resulting in prescriptions of neo-liberal politics encouraged by the IMF. Peru particularly, had over 50% of it’s population under the poverty line. As the president of the Peruvian Institution of Liberty and Democracy he is primarily focused on capital formation for developing nations, and has been a major influence in economic and legal reform of Peru. Currently, less than half of peru live below the poverty line, and so it seems positive economic change has been made.
In De Soto’s book he claims there are five ‘mysteries of capital’: The mystery of missing information, the mystery of capital, the mystery of political awareness, the missing lessons of US history, and the mystery of legal failure. His obvious focus is on the Mystery of Capital, however the others are the basis for his argument, his evidentiary support. This essay will discuss each of De Soto’s ‘mysteries’, and it’s strengths and weaknesses, then conclude with my opinion on De Soto’s theory of development and prescription for social change.
In ‘The Mystery of Missing Information’, De Soto demonstrates his different, more practical and observational, approach to economics. He quotes Ely Devons saying, “if economists wished to study the horse, they wouldn't go and look at the horses, They’d sit in their studies and say to themselves, ‘what would I do if I were a horse?’” (De Soto, 15). De Soto would not do his research this way, and instead did years of field research around the globe; “Over the past five years, I and a hundred colleagues from six different nations have closed our books and opened our eyes- gone out into the streets and countryside's of four continents to count how much the poorest sectors of society have saved. The quantity is enormous. But most of it is dead capital”. This is what De Soto claim’s to be the missing information, dead capital. If the world’s poor could realize this dead capital into live capital they would have opportunity similar to what many micro-loan institutions do today for hopeful, yet poor entrepreneurs, with no initial capital to realize their goals. This, however, raises questions about the quality of De Soto’s research. Even among 100 colleagues, research on six different nations in 5 years seems barely touched.
De Soto, recognizes the stereotype placed on third-world nations by Westerners. Eighty percent of the world is considered poor, however “80 percent majority is not, as westerners often imagine, desperately impoverished” (De Soto, 15). De Soto is saying that while dichotomies of wealth do exist, the ‘poor’ do have possessions but lack the ability to produce additional value from those possessions. The eighty percent is still surviving, however, De Soto wishes to enable that part of the population to realize their assets, in order to properly join the capital game.
How much will it enable the individual? While the capital, altogether might add up to quite a hefty sum, it does not mean split between all the owning individuals that it is enough to truly enable entrepreneurship from the slums. Furthermore, it has yet to be proven that encouraging the poor into capitalism will help alleviate poverty. In fact, the development theory of Post-Development would argue that this method is the wrong, neo-colonial approach to development. As such, this calls into question the appropriateness of his theory.
At current there are political roadblocks that stand in the way of your average person gaining legal property rights. De Soto tried an experiment, trying to register a business to sell T-Shirts. His researchers “spent 6 hours a day at it and finally registered the business-289 days later” (De Soto, 18). Not only does it take too much time to properly register a business, but the cost alone in this case was thirty-one times the minimum wage of that country, and to top it off, the owner also risks losing the property (as they are now surprisingly more susceptible to government laws). These hurdles to formal property registration are why there so many extralegal sectors exist in these slum dwellings. However it is these “extralegal social contracts have created a vibrant but undercapitalized sector, the center of the world poor… these new entrepreneurs are filling the gaps in the legal economy as well” (De Soto, 28). This is why De Soto has hope for the poor of the world. He believes that “in the midst of their own poorest neighborhoods and shantytowns, there are - if not acres of diamonds- trillions of dollars, all ready to be put to used if only the mystery of how assets are transformed into live capital can be unraveled” (De Soto, 37).
Although this hopeful attitude towards poverty is positive, and while altogether the sum of slum property is enormous, has De Soto, a capitalist forgotten what capitalism is all about? Capitalism is for the individual actor, acting in their own self-interest. He never answers how the individual living in the slum can accomplish this. I’m weary to accept their property value will amount to enough.
The Mystery of Capital is the most important part of De Soto’s book, where he explores how to revive this dead capital; his solution is formal property rights. De Soto, explains what he means by active capital drawing on Smith references saying “for accumulated assets to become active capital and put additional production in motion, they must be fixed and realized in some particular subject ‘which lasts for some time after that labour is past. It is, as it were, a certain quantity of labour stocked and stored up to be employed if necessary upon some other occasion’ ” (De Soto, 42).
There is so much potential for the poor, but they will only realize this potential when they are able to gain Property Rights; “what the poor lack is easy access to the property mechanisms that could legally fix the economic potential of their assets so they could be used to produce, secure or guarantee greater value in the extended market” (De Soto, 48). Specifically De Soto has six effects of formal property rights has brought to West and have allowed for generations of generation of capital; fixing the economic potential of assets, integrating dispersed information into one system, making people accountable, making assets fungible, networking people and protecting transactions.
Fixing the economic potential of assets allows for a standard interpretation of the human- attributed economic and social value of such asset; “it represents the invisible qualities that have the potential for producing value” (De Soto, 50). With such potential realized, the property can now be an investment, or be even be realized as collateral. De Soto thinks this to be important because without the ability to leverage assets, one is unable to produce surplus value. “Legal property thus gave the West the tools to produce surplus value over and above its physical assets”(De Soto, 51). This is important because as De Soto said, “money does not earn money. You need a property right before you can make money” (De Soto, 64).
Integrating dispersed information into one system is a difficult but integral part of property rights. It took about one hundred years for the West to have fully integrated property rights. “The reason capitalism has triumphed in the West and sputtered in the rest of the world is because most of the assets in Western nations have been integrated into one formal representational system”, and most of the world’s nations have yet to integrate extralegal property agreements into one formal legal system” (De Soto, 53)
Making people accountable will create individuals from the masses. (De Soto, 54). Formal property rights allow one to realize previous impossibilities De Soto admits that after instating formal property rights, rights and laws are more impersonal and one forfeits “the ability to lose themselves in the masses” (De Soto, 55); you are now legally linked to your property. Formal property rights have allows assets to be fungible, setting a global and national standard for trade, and allows for the easy flow of assets between individuals. In doing so it has enabled the networking of people, improving “the flow of communication about assets and their potential” (De Soto, 59).
Lastly, formal property rights have brought the protection of transactions to the West, which ensures all sales and purchase information is transferred and records of transaction are kept. Yet, De Soto also stated, “a great part of the potential value of legal property is derived from the possibility of forfeiture”, (De Soto, 55). It is also possible that while this could alleviate others, it could cause huge loses for the rest. It brings up the question, which is the lesser evil?: a greater dichotomy with less but more extreme poverty, or or greater amounts of poverty with a lessened dichotomy? I am unsure if this is truly a working solution.
Our third mystery is, consequently, why there a lack of political awareness surrounding this issue: Why have the governments not tapped into the potential of the poor? This is because the recent mass urbanization that has been occurring around the globe. De Soto states “for better or for worse, people outside the West are fleeing self-sufficient and isolated societies in an effort to raise their standards of living by becoming interdependent in much larger markets” (De Soto, 70). As such, this is a problem we must accept as inevitable and address. Particularly urbanization must be addressed as these countries lack the institutions to deal with the mass migration to their urban centers and they are resulting in “the fragmentation of their property arrangements and the unavailability of standard norms that allow assets and economic agents to interact and governments to rule by law” (De Soto, 76). Marx would say that this is the bourgeoisie keeping the proletariate from utilizing the tools of the bourgeoisie, politically alienating them.
Despite the lawless stereotype of the slums, it is clear to De Soto that the poor want to be integrated into the system. This is shown through their actions: “people are spontaneously organizing themselves into separate, extralegal groups until government can provide them with one legal property system” (De Soto, 73). However, there are so many other issues and poorly run institutions that property rights has been left behind and remains outdated and extralegal agreements flourish, (De Soto, 74). “In Brazil, for example, the construction industry reported mere 0.2 percent growth in 1995; yet cement sales during the first six months of 1996 soared by nearly 20 percent. The reason for the apparent anomaly, according to a Deutsche Morgan Grenfell analysis is that 60 to 70 percent of the regions construction never makes it into the records”
Lastly, De Soto focuses on the US as his western example of the transition from developing to developed, as it was just “more than 150 years ago, it (the U.S.) too was a third World country”. Just like developing nations now, the United States experienced massive migration, explosions of extralegal activity, political unrest and general discontent. De Soto does not want the third world to slavishly imitate the US transition to formal property rights but rather take the “primary lesson is that pretending extralegal arrangements do not exist of trying to stamp them out, without a strategy to channel them into the legal sector, is a fools errand”(De Soto, 150).
De Soto believes that we, of the West, are too focused on the disparity of other nations that ‘we’ forget how ‘we’ made the transition from a extralegal to formal legal system. In 13 years, De Soto claims he has visited every property-related institution in the advanced world; to his shock, non of them ad thought about formal property rights and their role in economic development; “my primary concern, however, was not property rights per se but “meta-rights” - access or rights to property rights. Although we had many subjects of mutual interest, such as how to reengineer a record-keeping organization so as to integrate information gathered in the field into one database, or how to develop procedures to digitize boundaries on base maps, the property experts could not tell me how to bring people who hold their assets by extralegal arrangements into the legal property system”, (De Soto, 106). However, he still does praise the history of the west saying, “In every country, it was the result of a few enlightened men deciding that official law made no sense if a sizable part of the population lived outside it.”
De Soto discussed the final mystery, the myth behind why the extralegal cannot be integrated into a formal legal system: and that is due to the corruption within the extralegal system. Trying to avoid being getting caught is taxing enough in itself (De Soto, 155). People want the security of a well-run and integrated political and legal system. In conclusion, there are so many particulars to the legal property system in the West that it is important that the developing nations come to realize their own property system by integrating their extralegal sector into a legal and over the years the intricacies of a more-developed property system will emerge and integrate into all sectors of society.
Overall, Hernando De Soto’s theory about formal property rights for the world’s poor lacked convictions. Riddled with metaphors and flowery language, for example “most of us are like the six blind men in the presence of an elephant: one grasps the animal’s searching trunk and thunk the elephant is a snake; another finds tail and thinks the elephant is a rope; a third is fascinated by the large, snail-like ears; another embraces its leg and concludes that the elephant is a tree. No one views the elephant in its totality and thus they cannot come up with a strategy for dealing with the very large problem at hand” (De Soto, 74). While language to appeal to the average reader is important it diminishes from his argument dragging out topics reliant on the reason and logic of old wives tales.
De Soto made it seem as though extralegal systems did not exist in the western nations when in fact they are plentiful. For example in Canada, the largest agricultural production is of an illegal plant marijuana. Said to trade more than seven-billion annually, it’s sales are three times as large as wheat (Macleans.ca).Furthermore, countries in the west have ‘third-world’-like living situations in their own countries, just not to the same magnitude. Maybe the problem is trying to model development after an imperfect and constantly changing model. This is why I found De Soto’s constant reference to US history to hinder his argument, as he does not fully explain why the US and other Western nations have been so successful in their development. The solution thus, seems over-simplified, and like other theories he criticizes, he is negating the importance in other institution reform for the specific western-like, industrial development he is aiming for.
While, I do agree with De Soto that the ‘west’ unfairly stereotypes and homogenizes the ‘the rest’ of the world, especially the poor, and that the poor could benefit from having more readily attainable formal property rights, I do not believe that this is the sole solution.Being educated and raised in the west, like De Soto, it was easy for me abroad to notice the differences or even similarities between ‘their’ and ‘my’ milieu. However, I believe that there is a difference between recognizing that things are different and glorifying one over the other. As I have mentioned previously, De Soto glorifies the direction that the United States and its citizens have taken. While he may encourage each country to make change in their own manner specific to their population, De Soto still has an overall sense of a meta-narrative leading to US-like development. And it begs me to ask the question if De Soto, being Peruvian but educated in Europe, if he understands his fortune and milieu makes it impossible for him to truly understand the needs of the majority of his country, because he cannot separate his bias adoration for western-style life. Especially, during our current recession it seems pertinent to ask if formal property rights, especially those that lead to live capital through credit, loans etc., lead to more entrepreneurs or more Willie Loman’s?
In De Soto’s book he claims there are five ‘mysteries of capital’: The mystery of missing information, the mystery of capital, the mystery of political awareness, the missing lessons of US history, and the mystery of legal failure. His obvious focus is on the Mystery of Capital, however the others are the basis for his argument, his evidentiary support. This essay will discuss each of De Soto’s ‘mysteries’, and it’s strengths and weaknesses, then conclude with my opinion on De Soto’s theory of development and prescription for social change.
In ‘The Mystery of Missing Information’, De Soto demonstrates his different, more practical and observational, approach to economics. He quotes Ely Devons saying, “if economists wished to study the horse, they wouldn't go and look at the horses, They’d sit in their studies and say to themselves, ‘what would I do if I were a horse?’” (De Soto, 15). De Soto would not do his research this way, and instead did years of field research around the globe; “Over the past five years, I and a hundred colleagues from six different nations have closed our books and opened our eyes- gone out into the streets and countryside's of four continents to count how much the poorest sectors of society have saved. The quantity is enormous. But most of it is dead capital”. This is what De Soto claim’s to be the missing information, dead capital. If the world’s poor could realize this dead capital into live capital they would have opportunity similar to what many micro-loan institutions do today for hopeful, yet poor entrepreneurs, with no initial capital to realize their goals. This, however, raises questions about the quality of De Soto’s research. Even among 100 colleagues, research on six different nations in 5 years seems barely touched.
De Soto, recognizes the stereotype placed on third-world nations by Westerners. Eighty percent of the world is considered poor, however “80 percent majority is not, as westerners often imagine, desperately impoverished” (De Soto, 15). De Soto is saying that while dichotomies of wealth do exist, the ‘poor’ do have possessions but lack the ability to produce additional value from those possessions. The eighty percent is still surviving, however, De Soto wishes to enable that part of the population to realize their assets, in order to properly join the capital game.
How much will it enable the individual? While the capital, altogether might add up to quite a hefty sum, it does not mean split between all the owning individuals that it is enough to truly enable entrepreneurship from the slums. Furthermore, it has yet to be proven that encouraging the poor into capitalism will help alleviate poverty. In fact, the development theory of Post-Development would argue that this method is the wrong, neo-colonial approach to development. As such, this calls into question the appropriateness of his theory.
At current there are political roadblocks that stand in the way of your average person gaining legal property rights. De Soto tried an experiment, trying to register a business to sell T-Shirts. His researchers “spent 6 hours a day at it and finally registered the business-289 days later” (De Soto, 18). Not only does it take too much time to properly register a business, but the cost alone in this case was thirty-one times the minimum wage of that country, and to top it off, the owner also risks losing the property (as they are now surprisingly more susceptible to government laws). These hurdles to formal property registration are why there so many extralegal sectors exist in these slum dwellings. However it is these “extralegal social contracts have created a vibrant but undercapitalized sector, the center of the world poor… these new entrepreneurs are filling the gaps in the legal economy as well” (De Soto, 28). This is why De Soto has hope for the poor of the world. He believes that “in the midst of their own poorest neighborhoods and shantytowns, there are - if not acres of diamonds- trillions of dollars, all ready to be put to used if only the mystery of how assets are transformed into live capital can be unraveled” (De Soto, 37).
Although this hopeful attitude towards poverty is positive, and while altogether the sum of slum property is enormous, has De Soto, a capitalist forgotten what capitalism is all about? Capitalism is for the individual actor, acting in their own self-interest. He never answers how the individual living in the slum can accomplish this. I’m weary to accept their property value will amount to enough.
The Mystery of Capital is the most important part of De Soto’s book, where he explores how to revive this dead capital; his solution is formal property rights. De Soto, explains what he means by active capital drawing on Smith references saying “for accumulated assets to become active capital and put additional production in motion, they must be fixed and realized in some particular subject ‘which lasts for some time after that labour is past. It is, as it were, a certain quantity of labour stocked and stored up to be employed if necessary upon some other occasion’ ” (De Soto, 42).
There is so much potential for the poor, but they will only realize this potential when they are able to gain Property Rights; “what the poor lack is easy access to the property mechanisms that could legally fix the economic potential of their assets so they could be used to produce, secure or guarantee greater value in the extended market” (De Soto, 48). Specifically De Soto has six effects of formal property rights has brought to West and have allowed for generations of generation of capital; fixing the economic potential of assets, integrating dispersed information into one system, making people accountable, making assets fungible, networking people and protecting transactions.
Fixing the economic potential of assets allows for a standard interpretation of the human- attributed economic and social value of such asset; “it represents the invisible qualities that have the potential for producing value” (De Soto, 50). With such potential realized, the property can now be an investment, or be even be realized as collateral. De Soto thinks this to be important because without the ability to leverage assets, one is unable to produce surplus value. “Legal property thus gave the West the tools to produce surplus value over and above its physical assets”(De Soto, 51). This is important because as De Soto said, “money does not earn money. You need a property right before you can make money” (De Soto, 64).
Integrating dispersed information into one system is a difficult but integral part of property rights. It took about one hundred years for the West to have fully integrated property rights. “The reason capitalism has triumphed in the West and sputtered in the rest of the world is because most of the assets in Western nations have been integrated into one formal representational system”, and most of the world’s nations have yet to integrate extralegal property agreements into one formal legal system” (De Soto, 53)
Making people accountable will create individuals from the masses. (De Soto, 54). Formal property rights allow one to realize previous impossibilities De Soto admits that after instating formal property rights, rights and laws are more impersonal and one forfeits “the ability to lose themselves in the masses” (De Soto, 55); you are now legally linked to your property. Formal property rights have allows assets to be fungible, setting a global and national standard for trade, and allows for the easy flow of assets between individuals. In doing so it has enabled the networking of people, improving “the flow of communication about assets and their potential” (De Soto, 59).
Lastly, formal property rights have brought the protection of transactions to the West, which ensures all sales and purchase information is transferred and records of transaction are kept. Yet, De Soto also stated, “a great part of the potential value of legal property is derived from the possibility of forfeiture”, (De Soto, 55). It is also possible that while this could alleviate others, it could cause huge loses for the rest. It brings up the question, which is the lesser evil?: a greater dichotomy with less but more extreme poverty, or or greater amounts of poverty with a lessened dichotomy? I am unsure if this is truly a working solution.
Our third mystery is, consequently, why there a lack of political awareness surrounding this issue: Why have the governments not tapped into the potential of the poor? This is because the recent mass urbanization that has been occurring around the globe. De Soto states “for better or for worse, people outside the West are fleeing self-sufficient and isolated societies in an effort to raise their standards of living by becoming interdependent in much larger markets” (De Soto, 70). As such, this is a problem we must accept as inevitable and address. Particularly urbanization must be addressed as these countries lack the institutions to deal with the mass migration to their urban centers and they are resulting in “the fragmentation of their property arrangements and the unavailability of standard norms that allow assets and economic agents to interact and governments to rule by law” (De Soto, 76). Marx would say that this is the bourgeoisie keeping the proletariate from utilizing the tools of the bourgeoisie, politically alienating them.
Despite the lawless stereotype of the slums, it is clear to De Soto that the poor want to be integrated into the system. This is shown through their actions: “people are spontaneously organizing themselves into separate, extralegal groups until government can provide them with one legal property system” (De Soto, 73). However, there are so many other issues and poorly run institutions that property rights has been left behind and remains outdated and extralegal agreements flourish, (De Soto, 74). “In Brazil, for example, the construction industry reported mere 0.2 percent growth in 1995; yet cement sales during the first six months of 1996 soared by nearly 20 percent. The reason for the apparent anomaly, according to a Deutsche Morgan Grenfell analysis is that 60 to 70 percent of the regions construction never makes it into the records”
Lastly, De Soto focuses on the US as his western example of the transition from developing to developed, as it was just “more than 150 years ago, it (the U.S.) too was a third World country”. Just like developing nations now, the United States experienced massive migration, explosions of extralegal activity, political unrest and general discontent. De Soto does not want the third world to slavishly imitate the US transition to formal property rights but rather take the “primary lesson is that pretending extralegal arrangements do not exist of trying to stamp them out, without a strategy to channel them into the legal sector, is a fools errand”(De Soto, 150).
De Soto believes that we, of the West, are too focused on the disparity of other nations that ‘we’ forget how ‘we’ made the transition from a extralegal to formal legal system. In 13 years, De Soto claims he has visited every property-related institution in the advanced world; to his shock, non of them ad thought about formal property rights and their role in economic development; “my primary concern, however, was not property rights per se but “meta-rights” - access or rights to property rights. Although we had many subjects of mutual interest, such as how to reengineer a record-keeping organization so as to integrate information gathered in the field into one database, or how to develop procedures to digitize boundaries on base maps, the property experts could not tell me how to bring people who hold their assets by extralegal arrangements into the legal property system”, (De Soto, 106). However, he still does praise the history of the west saying, “In every country, it was the result of a few enlightened men deciding that official law made no sense if a sizable part of the population lived outside it.”
De Soto discussed the final mystery, the myth behind why the extralegal cannot be integrated into a formal legal system: and that is due to the corruption within the extralegal system. Trying to avoid being getting caught is taxing enough in itself (De Soto, 155). People want the security of a well-run and integrated political and legal system. In conclusion, there are so many particulars to the legal property system in the West that it is important that the developing nations come to realize their own property system by integrating their extralegal sector into a legal and over the years the intricacies of a more-developed property system will emerge and integrate into all sectors of society.
Overall, Hernando De Soto’s theory about formal property rights for the world’s poor lacked convictions. Riddled with metaphors and flowery language, for example “most of us are like the six blind men in the presence of an elephant: one grasps the animal’s searching trunk and thunk the elephant is a snake; another finds tail and thinks the elephant is a rope; a third is fascinated by the large, snail-like ears; another embraces its leg and concludes that the elephant is a tree. No one views the elephant in its totality and thus they cannot come up with a strategy for dealing with the very large problem at hand” (De Soto, 74). While language to appeal to the average reader is important it diminishes from his argument dragging out topics reliant on the reason and logic of old wives tales.
De Soto made it seem as though extralegal systems did not exist in the western nations when in fact they are plentiful. For example in Canada, the largest agricultural production is of an illegal plant marijuana. Said to trade more than seven-billion annually, it’s sales are three times as large as wheat (Macleans.ca).Furthermore, countries in the west have ‘third-world’-like living situations in their own countries, just not to the same magnitude. Maybe the problem is trying to model development after an imperfect and constantly changing model. This is why I found De Soto’s constant reference to US history to hinder his argument, as he does not fully explain why the US and other Western nations have been so successful in their development. The solution thus, seems over-simplified, and like other theories he criticizes, he is negating the importance in other institution reform for the specific western-like, industrial development he is aiming for.
While, I do agree with De Soto that the ‘west’ unfairly stereotypes and homogenizes the ‘the rest’ of the world, especially the poor, and that the poor could benefit from having more readily attainable formal property rights, I do not believe that this is the sole solution.Being educated and raised in the west, like De Soto, it was easy for me abroad to notice the differences or even similarities between ‘their’ and ‘my’ milieu. However, I believe that there is a difference between recognizing that things are different and glorifying one over the other. As I have mentioned previously, De Soto glorifies the direction that the United States and its citizens have taken. While he may encourage each country to make change in their own manner specific to their population, De Soto still has an overall sense of a meta-narrative leading to US-like development. And it begs me to ask the question if De Soto, being Peruvian but educated in Europe, if he understands his fortune and milieu makes it impossible for him to truly understand the needs of the majority of his country, because he cannot separate his bias adoration for western-style life. Especially, during our current recession it seems pertinent to ask if formal property rights, especially those that lead to live capital through credit, loans etc., lead to more entrepreneurs or more Willie Loman’s?
Friday, December 3, 2010
Thursday, December 2, 2010
Is TRACnet a Sustainable Solution for HIV/AIDs in Rwanda Post the 1994 Genocide?
Introductory Footnote:
In the summer of 2009, I was fortunate enough to pack up my bags and move to Kigali, Rwanda. I was set to work with an organization called Women’s Equity in Access to Care and Treatment (WE-ACTx), primarily working with Information Communication Technologies (ICTs) in their HIV/AIDs clinic in Centre-ville. Working directly with the staff of the clinic, my job became less focused around infrastructure and simply teaching basics of computers, Microsoft suits, database: the transition from paper to digital was one that needed support. These digital upgrades were to increase the clinics efficiency in seeing patients and in research, as that is a primary mode of funding. Clinic staff (Doctors, Nurses, Psychologists, Pharmacists) must also meet TRACnet requirements biweekly, which means comfortably operate with their graphical user interface (GUI), as you cannot submit all report via telephone.
As a computing student, I study Human-Computer Interaction (HCI), the study of the interaction between computer-technology; specifically how one's capability with computer-technology is effected by the user interface. The study of HCI is of the mind that the learning curve of computer-technology can be sped up through thoughtful design. If the learning curve is not efficient enough, the HCI needs to be questioned with respect to its users. It is personally why I think projects like One Laptop per Child will continue to fail, and why TRACnet’s western -developed HCI needs questioning.
Rwanda is a small, landlocked East African Country with a dense population of 8.2 million people. Unfortunately, the country is best known internationally for the genocide of 1994. After the Arusha Peace Accords of 1994, Rwanda has struggled to regain peace, as well as it’s international image. As Rwandans struggle to live in the post-traumatic stress, they are confronted with a plethora of other obstacles: one central issue being HIV/AIDs. As the Genocide played its part in the perpetuation of HIV/AIDs, like through tactical rape, the issue holds a lot of controversy and shame. While Rwanda has been able to lower its percent of the population living with HIV/AIDs to 3%, it still faces considerable problems with fighting the virus and protecting it’s citizens. Specifically Rwanda has developed TRACnet in 2003 in order to amalgamate HIV/AIDs patient information to provide the most comprehensive support available, and overall, increase the efficiency of the health-care network itself. This paper will give a brief summary of Randan History post Belgian Colonization, discuss the interconnection with HIV/AIDS, rape and the genocide, then discuss the current impact of HIV/AIDS on Rwandans, concluding with an explanation of TRACnet, TRACnet Plus and their pitfalls.
Colonized by Belgium in 1916, Rwanda remained under Belgian rule until 1962. The ethnic division of Tutsi, Hutu, and the lesser known Twa pygmies, among Rwandan nationals was the result of colonization and perpetuated by the interjections of other euro-centric narratives and observational bias. The Tutsi’s would be deemed the ruling ethnic class by the Belgians, forcing their dominance over the Hutu majority. In the years prior to independence, the Party of Hutu Emancipation Movement came to power and thousands of Tutsis fled to neighboring countries. In 1973 the military took control of the country and abolished all political activity, in a coup d’etat led by Juvenal Habyarimana, a radical supporter of bringing the hutu majority to power. In the 1980s, Rwanda begins to experience the HIV/AIDS epidemic with the rest of the world. Then, in 1990, after several rounds of single party elections, Tutsi exiles formed the Rwandan Patriotic Front (RPF) and invaded from Uganda. While a ceasefire was negotiated in 1992, the tension of the ethnic divide culminated in the genocide of 1994 after Habyarimana’s plane was shot down. It is estimated that 800,000 Tutsis and moderate Hutus were killed, while millions fled to neighboring countries (Prunier). However, the genocide continues its effect on Rwandans, as these colonial social-constructed ethnicities remain ingrained within society, and the proliferation of HIV/AIDS.
Approximately 250,000 women were said to be raped during the few months in 1994, not even including numbers of any possible male-on-male rape (WE-ACTx: video). “Rape committed during war is often systematic and intended to terrorize the population, break up families, destroy communities, and, in some instances, change the ethnic make-up of the next generation. Sometimes it is also used to render women from the targeted community incapable of bearing more children.”(United Nations (2)) HIV-transmission was hence solidified as a war tactic, and has ensured the persistence of the virus among the Rwandan population. “Although not all cases of HIV/AIDS among rape survivors can be traced to the sexual violence they survived, the mass rape during 1994 contributed significantly to the spread of the virus in Rwanda, particularly as rates of HIV transmission during sexual violence are believed to be high.” (Amnesty International) In a case-study done by the Rwandan Association for Genocide Widows, AVEGA (Association des Veuves du Genocude), found of the 1125 members that had been raped during the genocide, 66.7% were seropositive(Amnesty International).
Presently, 3% of Rwandans are seropositive, with the highest concentrated around Kigali, the capital and major urban centre. Kigali has a 7.5% seropositive population, while Gitarama at 8.1% and Gisenyi District at 9.7 percent are just outside of the city (World Health Organization: http). In 2009, USAID said that in Rwanda, “The prevalence rate has remained relatively stable, with an overall decline since the late 1990s, partly due to improved HIV surveillance methodology. In general, HIV prevalence is higher in urban areas than in rural areas, and women are at a higher risk of HIV infection than men.” (PEPFAR: http). In 2001, according to the World Health Organization(WHO), 22 000 persons died of AIDS and in 2007, 7 800 persons died of AIDS in Rwanda. With a high birthrate in Rwanda, juxtaposed to this death rate from HIV/AIDS and the genocide, the numbers of orphaned children is quite hight; in 2001 there were 230 000 and in 2007, there were 220 000. These statistics have drawn NGOs and monetary support for the development of Rwanda.
“As of September 2009, with PEPFAR support, 89,000 individuals received HIV-related basic health care and support at 205 sites. Services include medical care, psychosocial support, income-generating activities, and prevention activities for HIV-positive individuals. The number of clients served represents 50 percent of all people living with HIV/AIDS” (PEPFAR: http). While the number of VTCs providing ART has increased with foreign aid, condom prevalence remains low; in 2005 condoms were estimated to be used by .9% of the time people engaged in sexual intercourse (World Health Organization: http)). As such, Rwandan Government does not feel as though it is reaching enough of it’s population and through projects like TRACnet they hope to remedy that.
Treatment and Research AIDS Center (TRAC) is a division of the Rwandan Ministry of Health. TRAC’s mission is “To promote and facilitate measures and actions taken in respect to the prevention, care, treatment, and research in the fields of HIV and AIDS, Malaria, Tuberculosis and other Epidemics Infectious diseases.” (TRAC Rwanda: http). Their six goals are to improve overall health of the population, to “strengthen the heath and public health systems”, to define the publics needs and priorities to develop meaningful policy, actively research, improve quality of health care, and to “Enable and facilitate participation of population through information and guidance” (TRAC Rwanda: http).
In 2005, TRAC launched TRACnet, funded and provided administrative support through the US Centers for Disease Control(CDC) and the President's Emergency Plan for AIDS Relief (PEPFAR). TRACnet is a national, bilingually-accessible (French and English, not Kinyarwanda) database, that provides additional functions for example patient graphs of CD4 count (Fraser: http). This program was designed to facilitate information transfer for patients in a country where roads and communication technology are inadequate, hence playing it’s part in the above six goals of TRAC. “When patients live far from the laboratories where diagnosis can be made precisely and from the main warehouses where drugs are stored, the treatment chain can be broken, immediately affecting those who suffer.” (United Nations: http). TRACnet interacts with more than just VTCs and partners with Central Purchasing of Essential Drugs, Medical Consumables and Equipment in Rwanda(CAMERWA: Centrale d’Achat Des Medicaments Essentiels, Consommables et Equipements Medicaux du Rwanda) to keep regular stock and ensure availability of Antiretroviral (ARV) medication.
Supported by Rwanda’s two largest telecommunication companies RwandaTel and MTN-Rwanda, through the use of a TRACnet satellite (and solar-powered) phone or by dialing a toll-free number, or texting to the number, VTCs in rural areas can give and receive patients updates (Nsabimana: 430-433). “The reasons the impact of TRACnet technology has been so immediate is because it utilizes the existing mobile phone infrastructure and is based upon SMS, a mobile phone feature that Rwandans use regularly in their daily lives” (Veen: http), deminishing some reliance on an unreliable internet infrastructure (as fire-optic and/or copper cables have not been laid in the vast majority of the country) (Fraser: http ). “The system now connects 75% of Rwanda’s 340 clinics and covers over 32,000 people.” (Veen: http)
Since the start of TRACnet’s gradual implementation in 2003, there have have been ideas of how to expand TRACnet beyond seropositive peoples, to include other health epidemics like malaria and tuberculosis, and beyond that a general health care number system and database.“TracPlus is the primary national agency responsible for Preventing Mother-to-Child Transmission (PMTCT) and Voluntary Counseling and HIV testing (VCT), Epidemiology Surveillance, and Health ICT/ Information Management” (Fraser: http).The implementation of TRACnet Plus (Centre for Treatment and Research on AIDS, Malaria, Tuberculosis and other Epidemics) has recently began it’s integration into Rwandan Health Care in 2009 and is expected to be fully implemented by 2012 (TRAC Rwanda: http).
Human Computer Interaction(HCI) is a computer science field, that studies how to create technology so it has an optimized learning curve. HCI scientists believe that the interface can directly affect the user’s experience and potential ability with the technology. Following scientific method to ensure a diverse and random group of participants, HCI has yet to realize the global exclusions of its practice, if technology is only tested in it’s western origin. In the case of TRACnet2, HCI is developed both for the graphical user interface (GUI) online, but also for how one would submit data by text (for example code words would be used to specify what information should be directed to what part of the database, or to specify they wish to receive information not submit).
TRACnet used a Western approach to HCI, as it was developed by an American company, Voxiva, and they continue to provide Information Communication Technology(ICT) support to the project (United Nations: http). “TRAC also has a team of IT personnel, who train health care providers at the health facilities in how to use TRACnet, and who also monitor reporting into TRACnet and publish monthly reports” (United Nations: http). The question should really be who does the maintenance of the database back-end, and if the answer is foreign Voxiva employees, can this program really be deemed sustainable?
Voxiva is the largest player in the e-Health space to date, and TRACnet is one of many Health Care databases created by Voxiva in the developing world (Cooper). While their approach does imply the database can be adjusted for addressing different information, their approach for distributing, creation and implementation of the technology has remained consistently top-down. It is important to recognize that the research gathered includes a large portion of the seropositive population, but it excludes a large portion as well:“While this type of surveillance is valuable for capturing a broad understanding of groups of patients on ART, it does not identify the segment of the population whose HIV status is unknown. These data collection efforts offer only a partial picture of the epidemic unless coupled with population-based survey efforts.” (Veen: http)
Still, “Interviews with stakeholders and users of TRACnet confirm that TRACnet is reducing the costs and time associated with submitting ART data. However, submissions through TRACnet remain inconsistent and often inaccurate.”(Nsabimana). The accuracy of reported data through TRACnet is questionable: “One evaluation suggested that there is wide variance in the completeness of data depending on the size of the facility.”3 This accuracy is variable in part because of the technology, and in part due to adherence to medical visits. Texting is seemingly easy, however you are limited to 160 characters, hence causing the detail of the report to suffer. Sixth-month check-up rates were 56% for small clinics, 60% for medium clinic and 14% for large clinics. (Fraser: http)
While submitting information via text-message is seemingly easy but in reality cumbersome and slow: it really only allows rural VTCs to access vital information. To rural communities TRACnet can only offer health alerts, test results, supply and recall of pharmaceuticals. Furthermore, cell-phone infrastructure is far from perfect, in remote, hilly areas (as Rwanda is the land of 1000 hills), “mobile phone reception is spotty or non-existent. In these circumstances, health workers must walk (or climb) to a location where there is a signal so they can send their information to Kigali.” While this effort seems feasible in light of an emergency, for a regular practice it becomes an added hurdle.
“Thanks to their familiarity with the technology, health workers are trained to use the system in an average of only 30 minutes.”(Veen: http)If it is the familiarity with this ICT, a mobile phone, that makes the project most appealing but most inefficient and inaccurate, sustainable and positive for the study and prevention of HIV/AIDS in Rwanda? Columbia University Study of TRACnet asked if, “it be a better use of resources to try to bring Internet access and PCs to remote regions in Rwanda? Perhaps in the long run”(Veen:http). If the current project is not impacting the prevention and treatment of HIV/AIDS, let alone the other diseases and infections TRACnet Plus has added to the plate, then this is a waste of resources and capital that could benefit elsewhere in HIV/AIDS bureaucracy.
As mentioned before, TRACnet is partnered with CAMERWA to ensure stocked quantities of pharmaceuticals. However, “The difficulty of verification may provide perverse incentives to clinics; since drug supply is based on the number of patients they report, over-reporting might be rewarded with excess medications and supplies” (Veen: http). Still, despite these drawbacks, TRACnet is continually seen (by officials and NGOs) as “a valuable model of a technology that could lead to increased efficiency, accountability, and better health outcomes in treating infectious diseases worldwide” (Veen: http).
The Genocide and the rise of HIV/AIDS have created a situation in Rwanda that needs support, and TRACnet was part of that solution: However, it is questionable whether TRACnet with all it’s pitfalls can be sustainable for HIV/AIDS let alone a health care system. The complex history of Colonialism and ethnic conflict surely contribute to Rwanda’s current perspective, and is hence intertwined with the HIV/AIDS epidemic. If this solution, creates Rwandan dependance of ICT, then it is questionable whether this will bring expected benefits to fighting HIV/AIDS. As Gunder-Frank would look at this, the imports are larger than the exports forcing Rwanda into a satellite relationship with the metropole, the United States.
Bibliography:
*Amnesty International, 2004. RWANDA:"MARKED FOR DEATH", RAPE SURVIVORS LIVING WITH HIV/AIDS IN RWANDA. Retrieved November 13, 2010. (http://www.amnesty.org/en/library/info/AFR47/007/2004).
Cooper, Phillip j. and Claudia Maria Vargas. 2007. “Sustainable Development in Crisis Conditions: Challenges of War, Terrorism, and Civil Disorder” US : Rowman & Littlefield Publishers
Frasier H., Maria A. May and Rohit Wanchoo, 2008. e-Health Rwanda Case Study. Retrieved November 13, 2010. (https://www.amia.org/files/shared/Rwanda___Appendices.pdf)
Nsabimana, Marns M., Irene Anne Jillson and Theodore Svoronos. 2008. “TRACnet's absorption into the Rwandan HIV/AIDS response”. International Journal of Healthcare Technology and Management. 9: 430-445.
Prunier, Gerard, 1995. “The Rwanda Crisis: History of a Genocide” USA : Columbia University Press.
TRAC Rwanda. 2009. Retrieved November 8, 2010. (http://www.tracrwanda.org.rw)
United Nations, 2008. TRACnet, Rwanda: Fighting pandemics through information technology Innovation for Sustainable Development: Local Case Studies from Africa, Department of Economic and Social Affairs, Division of Social Development, United Nations
United Nations (2), 2007. Lessons From Rwanda: The United Nations and the Prevention of Genocide. Retrieved November 12, 2010 (http://www.un.org/preventgenocide/rwanda/support.shtml)
US Presidenial Emergency for AIDS Relief. 2009. HIV/AIDS AT A GLANCE. Retrieved November 12, 2010.(http://www.usaid.gov/rw/our_work/programs/factsheets.html)
Veen, Allison, 2009. Rwanda: TRACnet Mobile Health Information System. Retrieved November 12, 2010 (http://www.columbia.edu/itc/sipa/nelson/newmediadev/Health.html)
*WE-ACTx, 2007. Interview Excerpt with Anne-Christine D’adesky. Retrieved November 12, 2010. (http://www.youtube.com/watch?v=QLZdoL5xPag)
World Health Organization, 2008 . Epidemiological Fact Sheet on HIV and AIDS, Rwanda.Retrieved October 29, 2010. (www.who.int/globalatlas)
In the summer of 2009, I was fortunate enough to pack up my bags and move to Kigali, Rwanda. I was set to work with an organization called Women’s Equity in Access to Care and Treatment (WE-ACTx), primarily working with Information Communication Technologies (ICTs) in their HIV/AIDs clinic in Centre-ville. Working directly with the staff of the clinic, my job became less focused around infrastructure and simply teaching basics of computers, Microsoft suits, database: the transition from paper to digital was one that needed support. These digital upgrades were to increase the clinics efficiency in seeing patients and in research, as that is a primary mode of funding. Clinic staff (Doctors, Nurses, Psychologists, Pharmacists) must also meet TRACnet requirements biweekly, which means comfortably operate with their graphical user interface (GUI), as you cannot submit all report via telephone.
As a computing student, I study Human-Computer Interaction (HCI), the study of the interaction between computer-technology; specifically how one's capability with computer-technology is effected by the user interface. The study of HCI is of the mind that the learning curve of computer-technology can be sped up through thoughtful design. If the learning curve is not efficient enough, the HCI needs to be questioned with respect to its users. It is personally why I think projects like One Laptop per Child will continue to fail, and why TRACnet’s western -developed HCI needs questioning.
Rwanda is a small, landlocked East African Country with a dense population of 8.2 million people. Unfortunately, the country is best known internationally for the genocide of 1994. After the Arusha Peace Accords of 1994, Rwanda has struggled to regain peace, as well as it’s international image. As Rwandans struggle to live in the post-traumatic stress, they are confronted with a plethora of other obstacles: one central issue being HIV/AIDs. As the Genocide played its part in the perpetuation of HIV/AIDs, like through tactical rape, the issue holds a lot of controversy and shame. While Rwanda has been able to lower its percent of the population living with HIV/AIDs to 3%, it still faces considerable problems with fighting the virus and protecting it’s citizens. Specifically Rwanda has developed TRACnet in 2003 in order to amalgamate HIV/AIDs patient information to provide the most comprehensive support available, and overall, increase the efficiency of the health-care network itself. This paper will give a brief summary of Randan History post Belgian Colonization, discuss the interconnection with HIV/AIDS, rape and the genocide, then discuss the current impact of HIV/AIDS on Rwandans, concluding with an explanation of TRACnet, TRACnet Plus and their pitfalls.
Colonized by Belgium in 1916, Rwanda remained under Belgian rule until 1962. The ethnic division of Tutsi, Hutu, and the lesser known Twa pygmies, among Rwandan nationals was the result of colonization and perpetuated by the interjections of other euro-centric narratives and observational bias. The Tutsi’s would be deemed the ruling ethnic class by the Belgians, forcing their dominance over the Hutu majority. In the years prior to independence, the Party of Hutu Emancipation Movement came to power and thousands of Tutsis fled to neighboring countries. In 1973 the military took control of the country and abolished all political activity, in a coup d’etat led by Juvenal Habyarimana, a radical supporter of bringing the hutu majority to power. In the 1980s, Rwanda begins to experience the HIV/AIDS epidemic with the rest of the world. Then, in 1990, after several rounds of single party elections, Tutsi exiles formed the Rwandan Patriotic Front (RPF) and invaded from Uganda. While a ceasefire was negotiated in 1992, the tension of the ethnic divide culminated in the genocide of 1994 after Habyarimana’s plane was shot down. It is estimated that 800,000 Tutsis and moderate Hutus were killed, while millions fled to neighboring countries (Prunier). However, the genocide continues its effect on Rwandans, as these colonial social-constructed ethnicities remain ingrained within society, and the proliferation of HIV/AIDS.
Approximately 250,000 women were said to be raped during the few months in 1994, not even including numbers of any possible male-on-male rape (WE-ACTx: video). “Rape committed during war is often systematic and intended to terrorize the population, break up families, destroy communities, and, in some instances, change the ethnic make-up of the next generation. Sometimes it is also used to render women from the targeted community incapable of bearing more children.”(United Nations (2)) HIV-transmission was hence solidified as a war tactic, and has ensured the persistence of the virus among the Rwandan population. “Although not all cases of HIV/AIDS among rape survivors can be traced to the sexual violence they survived, the mass rape during 1994 contributed significantly to the spread of the virus in Rwanda, particularly as rates of HIV transmission during sexual violence are believed to be high.” (Amnesty International) In a case-study done by the Rwandan Association for Genocide Widows, AVEGA (Association des Veuves du Genocude), found of the 1125 members that had been raped during the genocide, 66.7% were seropositive(Amnesty International).
Presently, 3% of Rwandans are seropositive, with the highest concentrated around Kigali, the capital and major urban centre. Kigali has a 7.5% seropositive population, while Gitarama at 8.1% and Gisenyi District at 9.7 percent are just outside of the city (World Health Organization: http). In 2009, USAID said that in Rwanda, “The prevalence rate has remained relatively stable, with an overall decline since the late 1990s, partly due to improved HIV surveillance methodology. In general, HIV prevalence is higher in urban areas than in rural areas, and women are at a higher risk of HIV infection than men.” (PEPFAR: http). In 2001, according to the World Health Organization(WHO), 22 000 persons died of AIDS and in 2007, 7 800 persons died of AIDS in Rwanda. With a high birthrate in Rwanda, juxtaposed to this death rate from HIV/AIDS and the genocide, the numbers of orphaned children is quite hight; in 2001 there were 230 000 and in 2007, there were 220 000. These statistics have drawn NGOs and monetary support for the development of Rwanda.
“As of September 2009, with PEPFAR support, 89,000 individuals received HIV-related basic health care and support at 205 sites. Services include medical care, psychosocial support, income-generating activities, and prevention activities for HIV-positive individuals. The number of clients served represents 50 percent of all people living with HIV/AIDS” (PEPFAR: http). While the number of VTCs providing ART has increased with foreign aid, condom prevalence remains low; in 2005 condoms were estimated to be used by .9% of the time people engaged in sexual intercourse (World Health Organization: http)). As such, Rwandan Government does not feel as though it is reaching enough of it’s population and through projects like TRACnet they hope to remedy that.
Treatment and Research AIDS Center (TRAC) is a division of the Rwandan Ministry of Health. TRAC’s mission is “To promote and facilitate measures and actions taken in respect to the prevention, care, treatment, and research in the fields of HIV and AIDS, Malaria, Tuberculosis and other Epidemics Infectious diseases.” (TRAC Rwanda: http). Their six goals are to improve overall health of the population, to “strengthen the heath and public health systems”, to define the publics needs and priorities to develop meaningful policy, actively research, improve quality of health care, and to “Enable and facilitate participation of population through information and guidance” (TRAC Rwanda: http).
In 2005, TRAC launched TRACnet, funded and provided administrative support through the US Centers for Disease Control(CDC) and the President's Emergency Plan for AIDS Relief (PEPFAR). TRACnet is a national, bilingually-accessible (French and English, not Kinyarwanda) database, that provides additional functions for example patient graphs of CD4 count (Fraser: http). This program was designed to facilitate information transfer for patients in a country where roads and communication technology are inadequate, hence playing it’s part in the above six goals of TRAC. “When patients live far from the laboratories where diagnosis can be made precisely and from the main warehouses where drugs are stored, the treatment chain can be broken, immediately affecting those who suffer.” (United Nations: http). TRACnet interacts with more than just VTCs and partners with Central Purchasing of Essential Drugs, Medical Consumables and Equipment in Rwanda(CAMERWA: Centrale d’Achat Des Medicaments Essentiels, Consommables et Equipements Medicaux du Rwanda) to keep regular stock and ensure availability of Antiretroviral (ARV) medication.
Supported by Rwanda’s two largest telecommunication companies RwandaTel and MTN-Rwanda, through the use of a TRACnet satellite (and solar-powered) phone or by dialing a toll-free number, or texting to the number, VTCs in rural areas can give and receive patients updates (Nsabimana: 430-433). “The reasons the impact of TRACnet technology has been so immediate is because it utilizes the existing mobile phone infrastructure and is based upon SMS, a mobile phone feature that Rwandans use regularly in their daily lives” (Veen: http), deminishing some reliance on an unreliable internet infrastructure (as fire-optic and/or copper cables have not been laid in the vast majority of the country) (Fraser: http ). “The system now connects 75% of Rwanda’s 340 clinics and covers over 32,000 people.” (Veen: http)
Since the start of TRACnet’s gradual implementation in 2003, there have have been ideas of how to expand TRACnet beyond seropositive peoples, to include other health epidemics like malaria and tuberculosis, and beyond that a general health care number system and database.“TracPlus is the primary national agency responsible for Preventing Mother-to-Child Transmission (PMTCT) and Voluntary Counseling and HIV testing (VCT), Epidemiology Surveillance, and Health ICT/ Information Management” (Fraser: http).The implementation of TRACnet Plus (Centre for Treatment and Research on AIDS, Malaria, Tuberculosis and other Epidemics) has recently began it’s integration into Rwandan Health Care in 2009 and is expected to be fully implemented by 2012 (TRAC Rwanda: http).
Human Computer Interaction(HCI) is a computer science field, that studies how to create technology so it has an optimized learning curve. HCI scientists believe that the interface can directly affect the user’s experience and potential ability with the technology. Following scientific method to ensure a diverse and random group of participants, HCI has yet to realize the global exclusions of its practice, if technology is only tested in it’s western origin. In the case of TRACnet2, HCI is developed both for the graphical user interface (GUI) online, but also for how one would submit data by text (for example code words would be used to specify what information should be directed to what part of the database, or to specify they wish to receive information not submit).
TRACnet used a Western approach to HCI, as it was developed by an American company, Voxiva, and they continue to provide Information Communication Technology(ICT) support to the project (United Nations: http). “TRAC also has a team of IT personnel, who train health care providers at the health facilities in how to use TRACnet, and who also monitor reporting into TRACnet and publish monthly reports” (United Nations: http). The question should really be who does the maintenance of the database back-end, and if the answer is foreign Voxiva employees, can this program really be deemed sustainable?
Voxiva is the largest player in the e-Health space to date, and TRACnet is one of many Health Care databases created by Voxiva in the developing world (Cooper). While their approach does imply the database can be adjusted for addressing different information, their approach for distributing, creation and implementation of the technology has remained consistently top-down. It is important to recognize that the research gathered includes a large portion of the seropositive population, but it excludes a large portion as well:“While this type of surveillance is valuable for capturing a broad understanding of groups of patients on ART, it does not identify the segment of the population whose HIV status is unknown. These data collection efforts offer only a partial picture of the epidemic unless coupled with population-based survey efforts.” (Veen: http)
Still, “Interviews with stakeholders and users of TRACnet confirm that TRACnet is reducing the costs and time associated with submitting ART data. However, submissions through TRACnet remain inconsistent and often inaccurate.”(Nsabimana). The accuracy of reported data through TRACnet is questionable: “One evaluation suggested that there is wide variance in the completeness of data depending on the size of the facility.”3 This accuracy is variable in part because of the technology, and in part due to adherence to medical visits. Texting is seemingly easy, however you are limited to 160 characters, hence causing the detail of the report to suffer. Sixth-month check-up rates were 56% for small clinics, 60% for medium clinic and 14% for large clinics. (Fraser: http)
While submitting information via text-message is seemingly easy but in reality cumbersome and slow: it really only allows rural VTCs to access vital information. To rural communities TRACnet can only offer health alerts, test results, supply and recall of pharmaceuticals. Furthermore, cell-phone infrastructure is far from perfect, in remote, hilly areas (as Rwanda is the land of 1000 hills), “mobile phone reception is spotty or non-existent. In these circumstances, health workers must walk (or climb) to a location where there is a signal so they can send their information to Kigali.” While this effort seems feasible in light of an emergency, for a regular practice it becomes an added hurdle.
“Thanks to their familiarity with the technology, health workers are trained to use the system in an average of only 30 minutes.”(Veen: http)If it is the familiarity with this ICT, a mobile phone, that makes the project most appealing but most inefficient and inaccurate, sustainable and positive for the study and prevention of HIV/AIDS in Rwanda? Columbia University Study of TRACnet asked if, “it be a better use of resources to try to bring Internet access and PCs to remote regions in Rwanda? Perhaps in the long run”(Veen:http). If the current project is not impacting the prevention and treatment of HIV/AIDS, let alone the other diseases and infections TRACnet Plus has added to the plate, then this is a waste of resources and capital that could benefit elsewhere in HIV/AIDS bureaucracy.
As mentioned before, TRACnet is partnered with CAMERWA to ensure stocked quantities of pharmaceuticals. However, “The difficulty of verification may provide perverse incentives to clinics; since drug supply is based on the number of patients they report, over-reporting might be rewarded with excess medications and supplies” (Veen: http). Still, despite these drawbacks, TRACnet is continually seen (by officials and NGOs) as “a valuable model of a technology that could lead to increased efficiency, accountability, and better health outcomes in treating infectious diseases worldwide” (Veen: http).
The Genocide and the rise of HIV/AIDS have created a situation in Rwanda that needs support, and TRACnet was part of that solution: However, it is questionable whether TRACnet with all it’s pitfalls can be sustainable for HIV/AIDS let alone a health care system. The complex history of Colonialism and ethnic conflict surely contribute to Rwanda’s current perspective, and is hence intertwined with the HIV/AIDS epidemic. If this solution, creates Rwandan dependance of ICT, then it is questionable whether this will bring expected benefits to fighting HIV/AIDS. As Gunder-Frank would look at this, the imports are larger than the exports forcing Rwanda into a satellite relationship with the metropole, the United States.
Bibliography:
*Amnesty International, 2004. RWANDA:"MARKED FOR DEATH", RAPE SURVIVORS LIVING WITH HIV/AIDS IN RWANDA. Retrieved November 13, 2010. (http://www.amnesty.org/en/library/info/AFR47/007/2004).
Cooper, Phillip j. and Claudia Maria Vargas. 2007. “Sustainable Development in Crisis Conditions: Challenges of War, Terrorism, and Civil Disorder” US : Rowman & Littlefield Publishers
Frasier H., Maria A. May and Rohit Wanchoo, 2008. e-Health Rwanda Case Study. Retrieved November 13, 2010. (https://www.amia.org/files/shared/Rwanda___Appendices.pdf)
Nsabimana, Marns M., Irene Anne Jillson and Theodore Svoronos. 2008. “TRACnet's absorption into the Rwandan HIV/AIDS response”. International Journal of Healthcare Technology and Management. 9: 430-445.
Prunier, Gerard, 1995. “The Rwanda Crisis: History of a Genocide” USA : Columbia University Press.
TRAC Rwanda. 2009. Retrieved November 8, 2010. (http://www.tracrwanda.org.rw)
United Nations, 2008. TRACnet, Rwanda: Fighting pandemics through information technology Innovation for Sustainable Development: Local Case Studies from Africa, Department of Economic and Social Affairs, Division of Social Development, United Nations
United Nations (2), 2007. Lessons From Rwanda: The United Nations and the Prevention of Genocide. Retrieved November 12, 2010 (http://www.un.org/preventgenocide/rwanda/support.shtml)
US Presidenial Emergency for AIDS Relief. 2009. HIV/AIDS AT A GLANCE. Retrieved November 12, 2010.(http://www.usaid.gov/rw/our_work/programs/factsheets.html)
Veen, Allison, 2009. Rwanda: TRACnet Mobile Health Information System. Retrieved November 12, 2010 (http://www.columbia.edu/itc/sipa/nelson/newmediadev/Health.html)
*WE-ACTx, 2007. Interview Excerpt with Anne-Christine D’adesky. Retrieved November 12, 2010. (http://www.youtube.com/watch?v=QLZdoL5xPag)
World Health Organization, 2008 . Epidemiological Fact Sheet on HIV and AIDS, Rwanda.Retrieved October 29, 2010. (www.who.int/globalatlas)
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