I was in Los Angeles last week, and stayed with two friend, Arv and Anjali. Arv is an economist working on developmental economics - so we have lots to discuss - especially the fact that after recent experiences I no longer believe non-profit work is a viable solution to address public health and poverty issues. I have become a die hard capitalist - and believe the only solutions that address issues of poverty and health crises must be self-sustaining and not grant dependent. (More about this in another post perhaps). I am also against pilots (not ones that fly planes, or medical trial pilots). Also with the mass of data available I think that we need to revamp statistics - sample sets are less important - more important is noise reduction, or rather discerning salient information (trends) from the data, rather than extrapolating trends from a sample. (Again for another post)
Anyway, in speaking with Arv I remembered the importance of ethnographic research in the implementation of any solution. Many times projects fail, not because the data collection methodology is incorrect, or because the statistical analysis is not sound, but because people collect data incorrectly.
I was reminded of the passage in "American Caesar" a brilliant book by William Manchester about Douglas MacArthur.
When visiting Japan (before WWI), the Japanese generals said that there was a problem with malaria among their men. The men had prophylaxis (pills), but were still developing malaria - obviously something was wrong with the pills. MacArthur laughed and said something like "If I gave my men pills with instructions to take them every 4 hours - they would be dumped into a ditch and forgotten." The Japanese generals were horrified - our soldiers would never do such a thing. The next week a new batch of pills arrived with a new label - the emperor wishes that you to take a pill every 4 hours. After that there was never a problem with malaria.
No need for any fancy solution involving cell phones or alerts or sharks with laser beams - just ethnography (Arv liked this story too)