So, I am currently in a town called Kasangati; about 30-40 mins away from Kampala, Uganda. The story of my chicken friend popped into my head when a colleague pinpointed a town close by, called “Kumbuzi” (loosely translated to “Goat meat town”), where they sell a lot of goat meat. The scent of the goat meat wafts over masses of bustling people and into the confines of our taxis (aka buses). I am even sure that the “goat smell” can permeate the helmets that sit on the heads of people who pass by on a speeding Boda Boda (motorcycle). But the goat smell got me thinking of my goat friend, and then my chicken friend…
Speaking of soup, it is ALL I eat here in Kasangati! When I order rice or sweet potato, or matoke (a kind of mashed, boiled plantains) or posho (sticky, cooked corn flour), chicken always comes with light soup.
But where is the stew?
I have been craving stew and can’t seem to find any here, not even in Kampala. Thus, based on my moderate exploration of restaurants in Kasangati and my interactions with people from eastern and western Africa, I made some conclusions about:
East African soup vs. West African stew
If west Africans like stew,
Then east Africans like soup.
But both soup and stew needs: pepper and salt.
West Africans fan, their peppery lips;
East Africans lick, their salty lips.
When she is drinking the soup,
She can’t help but ask: “where is the pepper?”
When she is ordering a rolex*
She can’t help but say: “just a little salt!”
Matoke and her were enemies;
Posho was derailed,
From the race for her heart.
Until that one good night at the Endere cultural center,
Where Matoke and G. nut soup
Sat side by side,
And were scooped together.
The sounds of the Agwara*,
The sway of adorned hips,
The beat of powerful drums,
Took a hold of her heart.
*rolex—a local Ugandan dish of chapati, eggs, and vegetables.
*Agwara—a traditional horn instrument.
But these statements I am making about eastern and western African cuisine cannot be representative of the general; they are just from my personal experiences. My opinion is a candle light next to the sun of cultural contexts and nuances that revolve around African food. For the poetic statements above to hold stronger meaning and greater credence, more thoughts and experiences need to be brought together, so that they showcase a more intricate and encompassing depiction.
Crowdsourcing is one way that can be used to collect opinions on African dishes across the continent—to create an African feast (of boiled, fried, dried, smoked, souped and stewed dishes…) from the northern pyramids, along the Nile river, through the Sahara desert, across the Niger river, by the Rift Valley and into the Kalahari desert.
My chicken could have also benefited from crowdsourcing. Just because animals can not speak our “human languages”—which are man-made and not earthly constants like the omnipresent air or the ginormous oceans—does not mean that animals like my chicken friend do not have something to say about how we: overproduce, mistreat, kill and eat them. A chorus of “crows” will cut across the world if chickens “crowdcrowed” and voiced their opinions about their lives and interactions with humans.
Crowdsourcing in Healthcare and Health Research
Crowdsouring is a great tool that can be used to solicit ideas and solutions about healthcare and health research; I learned about it in China and I am currently learning here in Uganda. Crowdsourcing is a research tool/method used to collect information from a broad range of people; people who might be hindered due to numerous factors, like social status, and educational and economic background. It provides a platform for a plethora of voices, from across the globe, to be heard. I believe that is has the potential to upturn our world for the better.
Imagine the doors that can be opened, if all voices were brought to the table? From making day-to-day decisions to writing equitable policies.
Below offers an overview of the benefits and the stages of crowdsourcing as well as some examples of innovative initiatives from the China and Uganda hubs.
Overview on crowdsourcing
According to the Crowdsourcing in Health and Health Research: A Practical Guide (which available for people to explore and utilize to potentially initiate their own crowdsourcing initiatives), crowdsourcing in public health has numerous advantages including:
- Increased Engagement: community involvement is greater;
- Pro-Social: creates an obligation for contest holders to give back;
- Easier Work Load: it shifts the burden of work to a broaden group and environment;
- Network: it taps into existing networks;
- Lower Cost: it saves money compared to other approaches .
Crowdsourcing contest is a six-stage process
1. Selecting crowdsourcing as a method
a. Where there is diversity in opinions; independence of ideas; a decentralization of information specialists from a variety of fields, and an aggregation mechanism for the judges, who review the submitted solutions, to come to a collective decision.
2. Organizing steering committee
a. The steering committee must come from diverse backgrounds including the local community; they decide the contest rules, evaluation criteria, prizes, and timeline for the calls that solicit solutions from the public.
3. Engaging community to contribute
a. The community must have access to clear description of purpose, expectations, and rules, through promotions (in-person and/or online).
4. Receiving and evaluating contributions
a. Judging style varies depending on the number of submissions. The solutions are reviewed via eligibility screening, crowd judging by key stakeholders based on the topic of the contest, panel judging of experts and non-experts.
5. Recognizing finalists
a. The steering committee makes final selections based on the judges’ feedback and make announcements.
6. Sharing and implementing solutions
a. The solutions are shared with numerous parties including government agencies and at the local level. They are often offered support to implement their solutions; the solutions are also archived.
Although crowdsourcing has great potential, (oh so much so that I get giddy when I think about it, especially as I learn about it through the work of these hubs), it has some risks associated with it:
- Failure to organize a steering committee can hinder the success of the contest.
- Failure to engage the community often limits the reach of promotion and the variation of submissions, especially in terms of a broader target audience as well as the types of solutions submitted.
- Poor judging might impact the type of solution(s) selected and their strengths.
- Poor implementation might prevent the fruition of the solutions.
· The Women Leaders in Global Health Challenge Contest
Challenge: How to increase the low number of women who apply for a mid-career fellowship from WHO/TDR, in low- and middle-income countries (LMICs).
Submissions: There were 311 submission from 63 countries, with majority from LMICs including Nigeria, Uganda and Egypt.
Solution: Three of the selected ideas included:
- The enhancement of mentorship through alumni champions,
- The improvement of communication about the fellowship,
- The development of a nomination system to encourage individuals to apply for the fellowship .
There was another project they worked on, which was very innovative; that is:
· The Pay-it-Forward Study, among men who have sex with men (MSM) in China
Challenge: Low number of MSM testing for gonorrhea and chlamydia; STDs that are asymptomatic at extragenital sites and also increases an individual’s likelihood of acquiring HIV—which is rapidly spreading among this community.
Strategy: Utilized the pay-it-forward model (from behavioral economics where one person receives a gift and is asked whether they want to pay-it-forward) to implement a pilot program for chlamydia and gonorrhea testing.
Results: Higher diagnostic testing rate of 57% compared to the 18% of the control; higher donation rate of ~95% .
There were also other contests that focused on different health issues including the Healthy City contest, the Antimicrobial Resistance (AMR) Education Challenge and the TDR Mentorship contest—which is currently in progress (focused on getting practical ideas for enhancing research mentorship in low-and middle-income countries). Here is a link to submit, if interested; the deadline is December 1, 2019.
As seen via these contests, China’s work has a focus on vulnerable populations, particularly the LGBTQ+ community (despite the decriminalization of Homoesexuality in 1997, about 5% of the community choose to disclose their sexual orientation, gender identity or gender expression to family—who have highest rejection— at school, in the workplace, or in the religious communities), and on the ways human capacity in health and health research can be built and strengthened .
Uganda, on the other hand, has a different focus at the moment: maternal and child health. In Uganda, under-5 mortality death has been estimated to be 90 in every 1,000; the causes range from lack of proper nutrition, to the health risks of mothers in labour, to the delay/absence of treatment . SIHI Uganda’s previous 2017 crowdsourcing call was focused on identifying high impact community-based social innovations that are improving maternal and child health in Uganda.
For this crowdsourcing call, they received 25 nominations. Some of the suggestions for improving maternal and child health included:
· Action for Women and Awakening in Rural Environment (AWARE)
o An organization that offers a holistic approach to empower and advocate for women (often suffering from gender-based violence, limited access to care…), through equipping them with agricultural and business skills.
· Bwindi Mothers’ waiting hostel
o It provides a place of stay for mothers who are living in hard-to-reach areas and also have about one month before delivery, to decrease risks of complications.
These are very cool and empowering community-based initiatives that have the potential to have greater impact if scaled.
One way to do this is to show the effectiveness of the initiatives, via research, to not only provide evidence to institutions (including the government), but also warrant the confidence that will help draw financial and human capital. For example, one innovative project I learnt about in Uganda is the “Drug Shop Integrated Management of Childhood Illness” project. I found it to be an extraordinary but simple innovation, to decrease the deaths of children (from malaria, diarrhea, and pneumonia…). This project works on equipping drug shop owners—who have over 60% of patients (mothers with children) visiting them anyway—with community case management training, appropriate diagnostics equipment, and subsidized medication supplies .
In Uganda, our team led a Stakeholders’ and Partners’ workshop where I got to learn about the work of the different SIHI hubs in the global south as well as the particular projects of innovators in Uganda. One of the innovative Ugandan organizations called “the Social Innovation Academy: From Marginalized Youth to Social Entrepreneurs” really spoke to me. They work with youth from vulnerable backgrounds (from refugees to sex workers) and offer them an opportunity to tap into their potential, explore, self-learn (with the guidance of mentors) to tackle issues within their own communities and come up with solutions including environmentally friendly jackets made of African prints and rice sacks as well as organizations like “Ask Without Shame”—a non-profit that provides emergency sex education via mobile phones .
There are more organizations doing such great work, and I am so excited and humbled to be meeting them and hearing about their work, including the whole Latin America SIHI network in Colombia.
And I am burning to find ways these organizations can be expanded (like the drug shop research project) and linked together, for a broader impact.
For more information about initiating your own crowdsourcing project, in addition to the practical guide (stated above), check out this crowdsourcing clinic .
1. Crowdsourcing in health and health research: a practical guide. Geneva: World Health Organization; 2018. TDR/STRA/18.4. Licence: CC BY-NC-SA 3.0 IGO
2. Liu, Ewen, et al. “Womens Global Health Leadership in LMICs.” The Lancet Global Health, vol. 7, no. 9, 2019, doi:10.1016/s2214-109x(19)30308-0.
3. Li, Katherine T, et al. “Pay-It-Forward Strategy to Enhance Uptake of Dual Gonorrhea and Chlamydia Testing among Men Who Have Sex with Men in China: a Pragmatic, Quasi-Experimental Study.” The Lancet Infectious Diseases, vol. 19, no. 1, 2019, pp. 76–82., doi:10.1016/s1473-3099(18)30556-5.
4. Willcox, Merlin L, et al. “Circumstances of Child Deaths in Mali and Uganda: a Community-Based Confidential Enquiry.” The Lancet Global Health, vol. 6, no. 6, 2018, doi:10.1016/s2214-109x(18)30215-8.
5. Awor, Phyllis. “Drug Shop Integrated Management Of Childhood Illness.” Social Innovation in Health Initiative, socialinnovationinhealth.org/case-studies/drug-shop-integrated-management-of-childhood-illness/.
6. Sina. “From Marginalized Youth to Social Entrepreneurs!” SINA, 5 Sept. 2018, http://sina-community.org/.
7. “Crowdsourcing Clinic .” Sesh Crowdsourcing Clinic, http://crowdsourcingclinic.org/Clinic/.
8. Being LGBTI in China – A National Survey on Social Attitudes towards Sexual Orientation, Gender Identity and Gender Expression. 2016. United Nations Development Programme