[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.00,0:00:03.00,Default,,0000,0000,0000,,There's an old joke about a cop who's walking his beat
Dialogue: 0,0:00:03.00,0:00:04.00,Default,,0000,0000,0000,,in the middle of the night,
Dialogue: 0,0:00:04.00,0:00:06.00,Default,,0000,0000,0000,,and he comes across a guy under a street lamp
Dialogue: 0,0:00:06.00,0:00:09.00,Default,,0000,0000,0000,,who's looking at the ground and moving from side to side,
Dialogue: 0,0:00:09.00,0:00:11.00,Default,,0000,0000,0000,,and the cop asks him what he's doing.
Dialogue: 0,0:00:11.00,0:00:13.00,Default,,0000,0000,0000,,The guys says he's looking for his keys.
Dialogue: 0,0:00:13.00,0:00:15.00,Default,,0000,0000,0000,,So the cop takes his time and looks over
Dialogue: 0,0:00:15.00,0:00:17.00,Default,,0000,0000,0000,,and kind of makes a little matrix and looks
Dialogue: 0,0:00:17.00,0:00:20.00,Default,,0000,0000,0000,,for about two, three minutes. No keys.
Dialogue: 0,0:00:20.00,0:00:23.00,Default,,0000,0000,0000,,The cop says, "Are you sure? Hey buddy,
Dialogue: 0,0:00:23.00,0:00:25.00,Default,,0000,0000,0000,,are you sure you lost your keys here?"
Dialogue: 0,0:00:25.00,0:00:26.00,Default,,0000,0000,0000,,And the guy says, "No, no, actually I lost them
Dialogue: 0,0:00:26.00,0:00:28.00,Default,,0000,0000,0000,,down at the other end of the street,
Dialogue: 0,0:00:28.00,0:00:34.00,Default,,0000,0000,0000,,but the light is better here."
Dialogue: 0,0:00:34.00,0:00:35.00,Default,,0000,0000,0000,,There's a concept that people talk about nowadays
Dialogue: 0,0:00:35.00,0:00:38.00,Default,,0000,0000,0000,,called big data, and what they're talking about
Dialogue: 0,0:00:38.00,0:00:40.00,Default,,0000,0000,0000,,is all of the information that we're generating
Dialogue: 0,0:00:40.00,0:00:43.00,Default,,0000,0000,0000,,through our interaction with and over the Internet,
Dialogue: 0,0:00:43.00,0:00:44.00,Default,,0000,0000,0000,,everything from Facebook and Twitter
Dialogue: 0,0:00:44.00,0:00:49.00,Default,,0000,0000,0000,,to music downloads, movies, streaming, all this kind of stuff,
Dialogue: 0,0:00:49.00,0:00:50.00,Default,,0000,0000,0000,,the live streaming of TED.
Dialogue: 0,0:00:50.00,0:00:53.00,Default,,0000,0000,0000,,And the folks who work with big data, for them,
Dialogue: 0,0:00:53.00,0:00:55.00,Default,,0000,0000,0000,,they talk about that their biggest problem is
Dialogue: 0,0:00:55.00,0:00:57.00,Default,,0000,0000,0000,,we have so much information,
Dialogue: 0,0:00:57.00,0:01:00.00,Default,,0000,0000,0000,,the biggest problem is, how do we organize all that information?
Dialogue: 0,0:01:00.00,0:01:03.00,Default,,0000,0000,0000,,I can tell you that working in global health,
Dialogue: 0,0:01:03.00,0:01:06.00,Default,,0000,0000,0000,,that is not our biggest problem.
Dialogue: 0,0:01:06.00,0:01:07.00,Default,,0000,0000,0000,,Because for us, even though the light
Dialogue: 0,0:01:07.00,0:01:10.00,Default,,0000,0000,0000,,is better on the Internet,
Dialogue: 0,0:01:10.00,0:01:13.00,Default,,0000,0000,0000,,the data that would help us solve the problems
Dialogue: 0,0:01:13.00,0:01:16.00,Default,,0000,0000,0000,,we're trying to solve is not actually present on the Internet.
Dialogue: 0,0:01:16.00,0:01:18.00,Default,,0000,0000,0000,,So we don't know, for example, how many people
Dialogue: 0,0:01:18.00,0:01:20.00,Default,,0000,0000,0000,,right now are being affected by disasters
Dialogue: 0,0:01:20.00,0:01:23.00,Default,,0000,0000,0000,,or by conflict situations.
Dialogue: 0,0:01:23.00,0:01:27.00,Default,,0000,0000,0000,,We don't know for really basically any of the clinics
Dialogue: 0,0:01:27.00,0:01:29.00,Default,,0000,0000,0000,,in the developing world, which ones have medicines
Dialogue: 0,0:01:29.00,0:01:30.00,Default,,0000,0000,0000,,and which ones don't.
Dialogue: 0,0:01:30.00,0:01:33.00,Default,,0000,0000,0000,,We have no idea of what the supply chain is for those clinics.
Dialogue: 0,0:01:33.00,0:01:36.00,Default,,0000,0000,0000,,We don't know -- and this is really amazing to me --
Dialogue: 0,0:01:36.00,0:01:39.00,Default,,0000,0000,0000,,we don't know how many children were born,
Dialogue: 0,0:01:39.00,0:01:42.00,Default,,0000,0000,0000,,or how many children there are in Bolivia
Dialogue: 0,0:01:42.00,0:01:45.00,Default,,0000,0000,0000,,or Botswana or Bhutan.
Dialogue: 0,0:01:45.00,0:01:47.00,Default,,0000,0000,0000,,We don't know how many kids died last week
Dialogue: 0,0:01:47.00,0:01:49.00,Default,,0000,0000,0000,,in any of those countries.
Dialogue: 0,0:01:49.00,0:01:52.00,Default,,0000,0000,0000,,We don't know the needs of the elderly, the mentally ill.
Dialogue: 0,0:01:52.00,0:01:55.00,Default,,0000,0000,0000,,For all of these different critically important problems
Dialogue: 0,0:01:55.00,0:01:58.00,Default,,0000,0000,0000,,or critically important areas that we want to solve problems in,
Dialogue: 0,0:01:58.00,0:02:03.00,Default,,0000,0000,0000,,we basically know nothing at all.
Dialogue: 0,0:02:03.00,0:02:06.00,Default,,0000,0000,0000,,And part of the reason why we don't know anything at all
Dialogue: 0,0:02:06.00,0:02:08.00,Default,,0000,0000,0000,,is that the information technology systems
Dialogue: 0,0:02:08.00,0:02:12.00,Default,,0000,0000,0000,,that we use in global health to find the data
Dialogue: 0,0:02:12.00,0:02:15.00,Default,,0000,0000,0000,,to solve these problems is what you see here.
Dialogue: 0,0:02:15.00,0:02:17.00,Default,,0000,0000,0000,,And this is about a 5,000-year-old technology.
Dialogue: 0,0:02:17.00,0:02:18.00,Default,,0000,0000,0000,,Some of you may have used it before.
Dialogue: 0,0:02:18.00,0:02:20.00,Default,,0000,0000,0000,,It's kind of on its way out now, but we still use it
Dialogue: 0,0:02:20.00,0:02:22.00,Default,,0000,0000,0000,,for 99 percent of our stuff.
Dialogue: 0,0:02:22.00,0:02:26.00,Default,,0000,0000,0000,,This is a paper form, and what you're looking at
Dialogue: 0,0:02:26.00,0:02:30.00,Default,,0000,0000,0000,,is a paper form in the hand of a Ministry of Health nurse
Dialogue: 0,0:02:30.00,0:02:33.00,Default,,0000,0000,0000,,in Indonesia who is tramping out across the countryside
Dialogue: 0,0:02:33.00,0:02:37.00,Default,,0000,0000,0000,,in Indonesia on, I'm sure, a very hot and humid day,
Dialogue: 0,0:02:37.00,0:02:39.00,Default,,0000,0000,0000,,and she is going to be knocking on thousands of doors
Dialogue: 0,0:02:39.00,0:02:41.00,Default,,0000,0000,0000,,over a period of weeks or months,
Dialogue: 0,0:02:41.00,0:02:44.00,Default,,0000,0000,0000,,knocking on the doors and saying, "Excuse me,
Dialogue: 0,0:02:44.00,0:02:46.00,Default,,0000,0000,0000,,we'd like to ask you some questions.
Dialogue: 0,0:02:46.00,0:02:50.00,Default,,0000,0000,0000,,Do you have any children? Were your children vaccinated?"
Dialogue: 0,0:02:50.00,0:02:51.00,Default,,0000,0000,0000,,Because the only way we can actually find out
Dialogue: 0,0:02:51.00,0:02:54.00,Default,,0000,0000,0000,,how many children were vaccinated in the country of Indonesia,
Dialogue: 0,0:02:54.00,0:02:57.00,Default,,0000,0000,0000,,what percentage were vaccinated, is actually not
Dialogue: 0,0:02:57.00,0:03:00.00,Default,,0000,0000,0000,,on the Internet but by going out and knocking on doors,
Dialogue: 0,0:03:00.00,0:03:03.00,Default,,0000,0000,0000,,sometimes tens of thousands of doors.
Dialogue: 0,0:03:03.00,0:03:05.00,Default,,0000,0000,0000,,Sometimes it takes months to even years
Dialogue: 0,0:03:05.00,0:03:07.00,Default,,0000,0000,0000,,to do something like this.
Dialogue: 0,0:03:07.00,0:03:09.00,Default,,0000,0000,0000,,You know, a census of Indonesia
Dialogue: 0,0:03:09.00,0:03:11.00,Default,,0000,0000,0000,,would probably take two years to accomplish.
Dialogue: 0,0:03:11.00,0:03:13.00,Default,,0000,0000,0000,,And the problem, of course, with all of this is that
Dialogue: 0,0:03:13.00,0:03:15.00,Default,,0000,0000,0000,,with all those paper forms — and I'm telling you
Dialogue: 0,0:03:15.00,0:03:17.00,Default,,0000,0000,0000,,we have paper forms for every possible thing.
Dialogue: 0,0:03:17.00,0:03:20.00,Default,,0000,0000,0000,,We have paper forms for vaccination surveys.
Dialogue: 0,0:03:20.00,0:03:24.00,Default,,0000,0000,0000,,We have paper forms to track people who come into clinics.
Dialogue: 0,0:03:24.00,0:03:26.00,Default,,0000,0000,0000,,We have paper forms to track drug supplies,
Dialogue: 0,0:03:26.00,0:03:29.00,Default,,0000,0000,0000,,blood supplies, all these different paper forms
Dialogue: 0,0:03:29.00,0:03:31.00,Default,,0000,0000,0000,,for many different topics,
Dialogue: 0,0:03:31.00,0:03:33.00,Default,,0000,0000,0000,,they all have a single common endpoint,
Dialogue: 0,0:03:33.00,0:03:36.00,Default,,0000,0000,0000,,and the common endpoint looks something like this.
Dialogue: 0,0:03:36.00,0:03:40.00,Default,,0000,0000,0000,,And what we're looking at here is a truckful o' data.
Dialogue: 0,0:03:40.00,0:03:45.00,Default,,0000,0000,0000,,This is the data from a single vaccination coverage survey
Dialogue: 0,0:03:45.00,0:03:47.00,Default,,0000,0000,0000,,in a single district in the country of Zambia
Dialogue: 0,0:03:47.00,0:03:49.00,Default,,0000,0000,0000,,from a few years ago that I participated in.
Dialogue: 0,0:03:49.00,0:03:52.00,Default,,0000,0000,0000,,The only thing anyone was trying to find out
Dialogue: 0,0:03:52.00,0:03:55.00,Default,,0000,0000,0000,,is what percentage of Zambian children are vaccinated,
Dialogue: 0,0:03:55.00,0:03:58.00,Default,,0000,0000,0000,,and this is the data, collected on paper over weeks
Dialogue: 0,0:03:58.00,0:04:01.00,Default,,0000,0000,0000,,from a single district, which is something like a county
Dialogue: 0,0:04:01.00,0:04:02.00,Default,,0000,0000,0000,,in the United States.
Dialogue: 0,0:04:02.00,0:04:04.00,Default,,0000,0000,0000,,You can imagine that, for the entire country of Zambia,
Dialogue: 0,0:04:04.00,0:04:08.00,Default,,0000,0000,0000,,answering just that single question
Dialogue: 0,0:04:08.00,0:04:10.00,Default,,0000,0000,0000,,looks something like this.
Dialogue: 0,0:04:10.00,0:04:12.00,Default,,0000,0000,0000,,Truck after truck after truck
Dialogue: 0,0:04:12.00,0:04:16.00,Default,,0000,0000,0000,,filled with stack after stack after stack of data.
Dialogue: 0,0:04:16.00,0:04:17.00,Default,,0000,0000,0000,,And what makes it even worse is that
Dialogue: 0,0:04:17.00,0:04:19.00,Default,,0000,0000,0000,,that's just the beginning,
Dialogue: 0,0:04:19.00,0:04:21.00,Default,,0000,0000,0000,,because once you've collected all that data,
Dialogue: 0,0:04:21.00,0:04:23.00,Default,,0000,0000,0000,,of course someone's going to have to --
Dialogue: 0,0:04:23.00,0:04:26.00,Default,,0000,0000,0000,,some unfortunate person is going to have to type that into a computer.
Dialogue: 0,0:04:26.00,0:04:28.00,Default,,0000,0000,0000,,When I was a graduate student, I actually was
Dialogue: 0,0:04:28.00,0:04:30.00,Default,,0000,0000,0000,,that unfortunate person sometimes.
Dialogue: 0,0:04:30.00,0:04:33.00,Default,,0000,0000,0000,,I can tell you, I often wasn't really paying attention.
Dialogue: 0,0:04:33.00,0:04:35.00,Default,,0000,0000,0000,,I probably made a lot of mistakes when I did it
Dialogue: 0,0:04:35.00,0:04:38.00,Default,,0000,0000,0000,,that no one ever discovered, so data quality goes down.
Dialogue: 0,0:04:38.00,0:04:41.00,Default,,0000,0000,0000,,But eventually that data hopefully gets typed into a computer,
Dialogue: 0,0:04:41.00,0:04:43.00,Default,,0000,0000,0000,,and someone can begin to analyze it,
Dialogue: 0,0:04:43.00,0:04:45.00,Default,,0000,0000,0000,,and once they have an analysis and a report,
Dialogue: 0,0:04:45.00,0:04:49.00,Default,,0000,0000,0000,,hopefully then you can take the results of that data collection
Dialogue: 0,0:04:49.00,0:04:51.00,Default,,0000,0000,0000,,and use it to vaccinate children better.
Dialogue: 0,0:04:51.00,0:04:54.00,Default,,0000,0000,0000,,Because if there's anything worse
Dialogue: 0,0:04:54.00,0:04:56.00,Default,,0000,0000,0000,,in the field of global public health,
Dialogue: 0,0:04:56.00,0:04:59.00,Default,,0000,0000,0000,,I don't know what's worse than allowing children on this planet
Dialogue: 0,0:04:59.00,0:05:02.00,Default,,0000,0000,0000,,to die of vaccine-preventable diseases,
Dialogue: 0,0:05:02.00,0:05:05.00,Default,,0000,0000,0000,,diseases for which the vaccine costs a dollar.
Dialogue: 0,0:05:05.00,0:05:08.00,Default,,0000,0000,0000,,And millions of children die of these diseases every year.
Dialogue: 0,0:05:08.00,0:05:12.00,Default,,0000,0000,0000,,And the fact is, millions is a gross estimate because
Dialogue: 0,0:05:12.00,0:05:15.00,Default,,0000,0000,0000,,we don't really know how many kids die each year of this.
Dialogue: 0,0:05:15.00,0:05:17.00,Default,,0000,0000,0000,,What makes it even more frustrating is that
Dialogue: 0,0:05:17.00,0:05:20.00,Default,,0000,0000,0000,,the data entry part, the part that I used to do as a grad student,
Dialogue: 0,0:05:20.00,0:05:22.00,Default,,0000,0000,0000,,can take sometimes six months.
Dialogue: 0,0:05:22.00,0:05:25.00,Default,,0000,0000,0000,,Sometimes it can take two years to type that information
Dialogue: 0,0:05:25.00,0:05:28.00,Default,,0000,0000,0000,,into a computer, and sometimes, actually not infrequently,
Dialogue: 0,0:05:28.00,0:05:30.00,Default,,0000,0000,0000,,it actually never happens.
Dialogue: 0,0:05:30.00,0:05:32.00,Default,,0000,0000,0000,,Now try and wrap your head around that for a second.
Dialogue: 0,0:05:32.00,0:05:35.00,Default,,0000,0000,0000,,You just had teams of hundreds of people.
Dialogue: 0,0:05:35.00,0:05:37.00,Default,,0000,0000,0000,,They went out into the field to answer a particular question.
Dialogue: 0,0:05:37.00,0:05:39.00,Default,,0000,0000,0000,,You probably spent hundreds of thousands of dollars
Dialogue: 0,0:05:39.00,0:05:43.00,Default,,0000,0000,0000,,on fuel and photocopying and per diem,
Dialogue: 0,0:05:43.00,0:05:46.00,Default,,0000,0000,0000,,and then for some reason, momentum is lost
Dialogue: 0,0:05:46.00,0:05:47.00,Default,,0000,0000,0000,,or there's no money left,
Dialogue: 0,0:05:47.00,0:05:49.00,Default,,0000,0000,0000,,and all of that comes to nothing
Dialogue: 0,0:05:49.00,0:05:52.00,Default,,0000,0000,0000,,because no one actually types it into the computer at all.
Dialogue: 0,0:05:52.00,0:05:55.00,Default,,0000,0000,0000,,The process just stops. Happens all the time.
Dialogue: 0,0:05:55.00,0:05:58.00,Default,,0000,0000,0000,,This is what we base our decisions on in global health:
Dialogue: 0,0:05:58.00,0:06:03.00,Default,,0000,0000,0000,,little data, old data, no data.
Dialogue: 0,0:06:03.00,0:06:06.00,Default,,0000,0000,0000,,So back in 1995, I began to think about ways
Dialogue: 0,0:06:06.00,0:06:08.00,Default,,0000,0000,0000,,in which we could improve this process.
Dialogue: 0,0:06:08.00,0:06:11.00,Default,,0000,0000,0000,,Now 1995, obviously that was quite a long time ago.
Dialogue: 0,0:06:11.00,0:06:13.00,Default,,0000,0000,0000,,It kind of frightens me to think of how long ago that was.
Dialogue: 0,0:06:13.00,0:06:15.00,Default,,0000,0000,0000,,The top movie of the year was
Dialogue: 0,0:06:15.00,0:06:16.00,Default,,0000,0000,0000,,"Die Hard with a Vengeance."
Dialogue: 0,0:06:16.00,0:06:19.00,Default,,0000,0000,0000,,As you can see, Bruce Willis had a lot more hair back then.
Dialogue: 0,0:06:19.00,0:06:22.00,Default,,0000,0000,0000,,I was working in the Centers for Disease Control,
Dialogue: 0,0:06:22.00,0:06:25.00,Default,,0000,0000,0000,,and I had a lot more hair back then as well.
Dialogue: 0,0:06:25.00,0:06:28.00,Default,,0000,0000,0000,,But to me, the most significant thing that I saw in 1995
Dialogue: 0,0:06:28.00,0:06:29.00,Default,,0000,0000,0000,,was this.
Dialogue: 0,0:06:29.00,0:06:32.00,Default,,0000,0000,0000,,Hard for us to imagine, but in 1995,
Dialogue: 0,0:06:32.00,0:06:36.00,Default,,0000,0000,0000,,this was the ultimate elite mobile device.
Dialogue: 0,0:06:36.00,0:06:38.00,Default,,0000,0000,0000,,Right? It wasn't an iPhone. It wasn't a Galaxy phone.
Dialogue: 0,0:06:38.00,0:06:40.00,Default,,0000,0000,0000,,It was a Palm Pilot.
Dialogue: 0,0:06:40.00,0:06:43.00,Default,,0000,0000,0000,,And when I saw the Palm Pilot for the first time, I thought,
Dialogue: 0,0:06:43.00,0:06:46.00,Default,,0000,0000,0000,,why can't we put the forms on these Palm Pilots
Dialogue: 0,0:06:46.00,0:06:48.00,Default,,0000,0000,0000,,and go out into the field just carrying one Palm Pilot,
Dialogue: 0,0:06:48.00,0:06:52.00,Default,,0000,0000,0000,,which can hold the capacity of tens of thousands
Dialogue: 0,0:06:52.00,0:06:54.00,Default,,0000,0000,0000,,of paper forms? Why don't we try to do that?
Dialogue: 0,0:06:54.00,0:06:57.00,Default,,0000,0000,0000,,Because if we can do that, if we can actually just
Dialogue: 0,0:06:57.00,0:06:59.00,Default,,0000,0000,0000,,collect the data electronically, digitally,
Dialogue: 0,0:06:59.00,0:07:01.00,Default,,0000,0000,0000,,from the very beginning,
Dialogue: 0,0:07:01.00,0:07:04.00,Default,,0000,0000,0000,,we can just put a shortcut right through that whole process
Dialogue: 0,0:07:04.00,0:07:07.00,Default,,0000,0000,0000,,of typing,
Dialogue: 0,0:07:07.00,0:07:09.00,Default,,0000,0000,0000,,of having somebody type that stuff into the computer.
Dialogue: 0,0:07:09.00,0:07:11.00,Default,,0000,0000,0000,,We can skip straight to the analysis
Dialogue: 0,0:07:11.00,0:07:14.00,Default,,0000,0000,0000,,and then straight to the use of the data to actually save lives.
Dialogue: 0,0:07:14.00,0:07:17.00,Default,,0000,0000,0000,,So that's actually what I began to do.
Dialogue: 0,0:07:17.00,0:07:20.00,Default,,0000,0000,0000,,Working at CDC, I began to travel to different programs
Dialogue: 0,0:07:20.00,0:07:24.00,Default,,0000,0000,0000,,around the world and to train them in using Palm Pilots
Dialogue: 0,0:07:24.00,0:07:27.00,Default,,0000,0000,0000,,to do data collection instead of using paper.
Dialogue: 0,0:07:27.00,0:07:29.00,Default,,0000,0000,0000,,And it actually worked great.
Dialogue: 0,0:07:29.00,0:07:31.00,Default,,0000,0000,0000,,It worked exactly as well as anybody would have predicted.
Dialogue: 0,0:07:31.00,0:07:34.00,Default,,0000,0000,0000,,What do you know? Digital data collection
Dialogue: 0,0:07:34.00,0:07:36.00,Default,,0000,0000,0000,,is actually more efficient than collecting on paper.
Dialogue: 0,0:07:36.00,0:07:38.00,Default,,0000,0000,0000,,While I was doing it, my business partner, Rose,
Dialogue: 0,0:07:38.00,0:07:41.00,Default,,0000,0000,0000,,who's here with her husband, Matthew, here in the audience,
Dialogue: 0,0:07:41.00,0:07:44.00,Default,,0000,0000,0000,,Rose was out doing similar stuff for the American Red Cross.
Dialogue: 0,0:07:44.00,0:07:46.00,Default,,0000,0000,0000,,The problem was, after a few years of doing that,
Dialogue: 0,0:07:46.00,0:07:49.00,Default,,0000,0000,0000,,I realized I had done -- I had been to maybe
Dialogue: 0,0:07:49.00,0:07:52.00,Default,,0000,0000,0000,,six or seven programs, and I thought,
Dialogue: 0,0:07:52.00,0:07:54.00,Default,,0000,0000,0000,,you know, if I keep this up at this pace,
Dialogue: 0,0:07:54.00,0:07:56.00,Default,,0000,0000,0000,,over my whole career, maybe I'm going to go
Dialogue: 0,0:07:56.00,0:07:58.00,Default,,0000,0000,0000,,to maybe 20 or 30 programs.
Dialogue: 0,0:07:58.00,0:08:01.00,Default,,0000,0000,0000,,But the problem is, 20 or 30 programs,
Dialogue: 0,0:08:01.00,0:08:04.00,Default,,0000,0000,0000,,like, training 20 or 30 programs to use this technology,
Dialogue: 0,0:08:04.00,0:08:06.00,Default,,0000,0000,0000,,that is a tiny drop in the bucket.
Dialogue: 0,0:08:06.00,0:08:10.00,Default,,0000,0000,0000,,The demand for this, the need for data to run better programs,
Dialogue: 0,0:08:10.00,0:08:13.00,Default,,0000,0000,0000,,just within health, not to mention all of the other fields
Dialogue: 0,0:08:13.00,0:08:15.00,Default,,0000,0000,0000,,in developing countries, is enormous.
Dialogue: 0,0:08:15.00,0:08:19.00,Default,,0000,0000,0000,,There are millions and millions and millions of programs,
Dialogue: 0,0:08:19.00,0:08:22.00,Default,,0000,0000,0000,,millions of clinics that need to track drugs,
Dialogue: 0,0:08:22.00,0:08:23.00,Default,,0000,0000,0000,,millions of vaccine programs.
Dialogue: 0,0:08:23.00,0:08:25.00,Default,,0000,0000,0000,,There are schools that need to track attendance.
Dialogue: 0,0:08:25.00,0:08:27.00,Default,,0000,0000,0000,,There are all these different things
Dialogue: 0,0:08:27.00,0:08:29.00,Default,,0000,0000,0000,,for us to get the data that we need to do.
Dialogue: 0,0:08:29.00,0:08:34.00,Default,,0000,0000,0000,,And I realized, if I kept up the way that I was doing,
Dialogue: 0,0:08:34.00,0:08:37.00,Default,,0000,0000,0000,,I was basically hardly going to make any impact
Dialogue: 0,0:08:37.00,0:08:39.00,Default,,0000,0000,0000,,by the end of my career.
Dialogue: 0,0:08:39.00,0:08:41.00,Default,,0000,0000,0000,,And so I began to wrack my brain
Dialogue: 0,0:08:41.00,0:08:42.00,Default,,0000,0000,0000,,trying to think about, you know,
Dialogue: 0,0:08:42.00,0:08:44.00,Default,,0000,0000,0000,,what was the process that I was doing,
Dialogue: 0,0:08:44.00,0:08:47.00,Default,,0000,0000,0000,,how was I training folks, and what were the bottlenecks
Dialogue: 0,0:08:47.00,0:08:49.00,Default,,0000,0000,0000,,and what were the obstacles to doing it faster
Dialogue: 0,0:08:49.00,0:08:51.00,Default,,0000,0000,0000,,and to doing it more efficiently?
Dialogue: 0,0:08:51.00,0:08:54.00,Default,,0000,0000,0000,,And unfortunately, after thinking about this for some time,
Dialogue: 0,0:08:54.00,0:08:58.00,Default,,0000,0000,0000,,I realized -- I identified the main obstacle.
Dialogue: 0,0:08:58.00,0:09:00.00,Default,,0000,0000,0000,,And the main obstacle, it turned out,
Dialogue: 0,0:09:00.00,0:09:01.00,Default,,0000,0000,0000,,and this is a sad realization,
Dialogue: 0,0:09:01.00,0:09:04.00,Default,,0000,0000,0000,,the main obstacle was me.
Dialogue: 0,0:09:04.00,0:09:06.00,Default,,0000,0000,0000,,So what do I mean by that?
Dialogue: 0,0:09:06.00,0:09:08.00,Default,,0000,0000,0000,,I had developed a process whereby
Dialogue: 0,0:09:08.00,0:09:13.00,Default,,0000,0000,0000,,I was the center of the universe of this technology.
Dialogue: 0,0:09:13.00,0:09:16.00,Default,,0000,0000,0000,,If you wanted to use this technology, you had to get in touch with me.
Dialogue: 0,0:09:16.00,0:09:18.00,Default,,0000,0000,0000,,That means you had to know I existed.
Dialogue: 0,0:09:18.00,0:09:20.00,Default,,0000,0000,0000,,Then you had to find the money to pay for me
Dialogue: 0,0:09:20.00,0:09:21.00,Default,,0000,0000,0000,,to fly out to your country
Dialogue: 0,0:09:21.00,0:09:23.00,Default,,0000,0000,0000,,and the money to pay for my hotel
Dialogue: 0,0:09:23.00,0:09:26.00,Default,,0000,0000,0000,,and my per diem and my daily rate.
Dialogue: 0,0:09:26.00,0:09:29.00,Default,,0000,0000,0000,,So you could be talking about 10,000 or 20,000 or 30,000 dollars
Dialogue: 0,0:09:29.00,0:09:31.00,Default,,0000,0000,0000,,if I actually had the time or it fit my schedule
Dialogue: 0,0:09:31.00,0:09:33.00,Default,,0000,0000,0000,,and I wasn't on vacation.
Dialogue: 0,0:09:33.00,0:09:36.00,Default,,0000,0000,0000,,The point is that anything, any system that depends
Dialogue: 0,0:09:36.00,0:09:39.00,Default,,0000,0000,0000,,on a single human being or two or three or five human beings,
Dialogue: 0,0:09:39.00,0:09:41.00,Default,,0000,0000,0000,,it just doesn't scale.
Dialogue: 0,0:09:41.00,0:09:43.00,Default,,0000,0000,0000,,And this is a problem for which we need to scale
Dialogue: 0,0:09:43.00,0:09:46.00,Default,,0000,0000,0000,,this technology and we need to scale it now.
Dialogue: 0,0:09:46.00,0:09:48.00,Default,,0000,0000,0000,,And so I began to think of ways in which I could basically
Dialogue: 0,0:09:48.00,0:09:50.00,Default,,0000,0000,0000,,take myself out of the picture.
Dialogue: 0,0:09:50.00,0:09:55.00,Default,,0000,0000,0000,,And, you know, I was thinking,
Dialogue: 0,0:09:55.00,0:09:57.00,Default,,0000,0000,0000,,how could I take myself out of the picture
Dialogue: 0,0:09:57.00,0:09:59.00,Default,,0000,0000,0000,,for quite some time.
Dialogue: 0,0:09:59.00,0:10:01.00,Default,,0000,0000,0000,,You know, I'd been trained that the way that
Dialogue: 0,0:10:01.00,0:10:04.00,Default,,0000,0000,0000,,you distribute technology within international development
Dialogue: 0,0:10:04.00,0:10:06.00,Default,,0000,0000,0000,,is always consultant-based.
Dialogue: 0,0:10:06.00,0:10:09.00,Default,,0000,0000,0000,,It's always guys that look pretty much like me
Dialogue: 0,0:10:09.00,0:10:11.00,Default,,0000,0000,0000,,flying from countries that look pretty much like this
Dialogue: 0,0:10:11.00,0:10:14.00,Default,,0000,0000,0000,,to other countries with people with darker skin.
Dialogue: 0,0:10:14.00,0:10:17.00,Default,,0000,0000,0000,,And you go out there, and you spend money on airfare
Dialogue: 0,0:10:17.00,0:10:20.00,Default,,0000,0000,0000,,and you spend time and you spend per diem
Dialogue: 0,0:10:20.00,0:10:22.00,Default,,0000,0000,0000,,and you spend [on a] hotel and you spend all that stuff.
Dialogue: 0,0:10:22.00,0:10:24.00,Default,,0000,0000,0000,,As far as I knew, that was the only way
Dialogue: 0,0:10:24.00,0:10:27.00,Default,,0000,0000,0000,,you could distribute technology, and I couldn't figure out a way around it.
Dialogue: 0,0:10:27.00,0:10:30.00,Default,,0000,0000,0000,,But the miracle that happened,
Dialogue: 0,0:10:30.00,0:10:33.00,Default,,0000,0000,0000,,I'm going to call it Hotmail for short.
Dialogue: 0,0:10:33.00,0:10:35.00,Default,,0000,0000,0000,,Now you may not think of Hotmail as being miraculous,
Dialogue: 0,0:10:35.00,0:10:38.00,Default,,0000,0000,0000,,but for me it was miraculous, because I noticed,
Dialogue: 0,0:10:38.00,0:10:40.00,Default,,0000,0000,0000,,just as I was wrestling with this problem,
Dialogue: 0,0:10:40.00,0:10:44.00,Default,,0000,0000,0000,,I was working in sub-Saharan Africa mostly at the time.
Dialogue: 0,0:10:44.00,0:10:46.00,Default,,0000,0000,0000,,I noticed that every sub-Saharan African health worker
Dialogue: 0,0:10:46.00,0:10:50.00,Default,,0000,0000,0000,,that I was working with had a Hotmail account.
Dialogue: 0,0:10:50.00,0:10:53.00,Default,,0000,0000,0000,,And I thought, it struck me,
Dialogue: 0,0:10:53.00,0:10:55.00,Default,,0000,0000,0000,,wait a minute, I know that the Hotmail people
Dialogue: 0,0:10:55.00,0:10:58.00,Default,,0000,0000,0000,,surely didn't fly to the Ministry of Health of Kenya
Dialogue: 0,0:10:58.00,0:11:01.00,Default,,0000,0000,0000,,to train people in how to use Hotmail.
Dialogue: 0,0:11:01.00,0:11:03.00,Default,,0000,0000,0000,,So these guys are distributing technology.
Dialogue: 0,0:11:03.00,0:11:05.00,Default,,0000,0000,0000,,They're getting software capacity out there
Dialogue: 0,0:11:05.00,0:11:07.00,Default,,0000,0000,0000,,but they're not actually flying around the world.
Dialogue: 0,0:11:07.00,0:11:09.00,Default,,0000,0000,0000,,I need to think about this some more.
Dialogue: 0,0:11:09.00,0:11:11.00,Default,,0000,0000,0000,,While I was thinking about it, people started using
Dialogue: 0,0:11:11.00,0:11:14.00,Default,,0000,0000,0000,,even more things just like this, just as we were.
Dialogue: 0,0:11:14.00,0:11:15.00,Default,,0000,0000,0000,,They started using LinkedIn and Flickr
Dialogue: 0,0:11:15.00,0:11:18.00,Default,,0000,0000,0000,,and Gmail and Google Maps, all these things.
Dialogue: 0,0:11:18.00,0:11:21.00,Default,,0000,0000,0000,,Of course, all of these things are cloud-based
Dialogue: 0,0:11:21.00,0:11:23.00,Default,,0000,0000,0000,,and don't require any training.
Dialogue: 0,0:11:23.00,0:11:25.00,Default,,0000,0000,0000,,They don't require any programmers.
Dialogue: 0,0:11:25.00,0:11:26.00,Default,,0000,0000,0000,,They don't require any consultants, because
Dialogue: 0,0:11:26.00,0:11:29.00,Default,,0000,0000,0000,,the business model for all these businesses
Dialogue: 0,0:11:29.00,0:11:32.00,Default,,0000,0000,0000,,requires that something be so simple we can use it ourselves
Dialogue: 0,0:11:32.00,0:11:33.00,Default,,0000,0000,0000,,with little or no training.
Dialogue: 0,0:11:33.00,0:11:35.00,Default,,0000,0000,0000,,You just have to hear about it and go to the website.
Dialogue: 0,0:11:35.00,0:11:40.00,Default,,0000,0000,0000,,And so I thought, what would happen if we built software
Dialogue: 0,0:11:40.00,0:11:42.00,Default,,0000,0000,0000,,to do what I'd been consulting in?
Dialogue: 0,0:11:42.00,0:11:43.00,Default,,0000,0000,0000,,Instead of training people how
Dialogue: 0,0:11:43.00,0:11:46.00,Default,,0000,0000,0000,,to put forms onto mobile devices,
Dialogue: 0,0:11:46.00,0:11:48.00,Default,,0000,0000,0000,,let's create software that lets them do it themselves
Dialogue: 0,0:11:48.00,0:11:50.00,Default,,0000,0000,0000,,with no training and without me being involved?
Dialogue: 0,0:11:50.00,0:11:52.00,Default,,0000,0000,0000,,And that's exactly what we did.
Dialogue: 0,0:11:52.00,0:11:56.00,Default,,0000,0000,0000,,So we created software called Magpi,
Dialogue: 0,0:11:56.00,0:11:58.00,Default,,0000,0000,0000,,which has an online form creator.
Dialogue: 0,0:11:58.00,0:11:59.00,Default,,0000,0000,0000,,No one has to speak to me.
Dialogue: 0,0:11:59.00,0:12:02.00,Default,,0000,0000,0000,,You just have to hear about it and go to the website.
Dialogue: 0,0:12:02.00,0:12:04.00,Default,,0000,0000,0000,,You can create forms, and once you've created the forms,
Dialogue: 0,0:12:04.00,0:12:07.00,Default,,0000,0000,0000,,you push them to a variety of common mobile phones.
Dialogue: 0,0:12:07.00,0:12:09.00,Default,,0000,0000,0000,,Obviously nowadays, we've moved past Palm Pilots
Dialogue: 0,0:12:09.00,0:12:10.00,Default,,0000,0000,0000,,to mobile phones.
Dialogue: 0,0:12:10.00,0:12:12.00,Default,,0000,0000,0000,,And it doesn't have to be a smartphone.
Dialogue: 0,0:12:12.00,0:12:14.00,Default,,0000,0000,0000,,It can be a basic phone like the phone on the right there,
Dialogue: 0,0:12:14.00,0:12:16.00,Default,,0000,0000,0000,,you know, the basic kind of Symbian phone
Dialogue: 0,0:12:16.00,0:12:18.00,Default,,0000,0000,0000,,that's very common in developing countries.
Dialogue: 0,0:12:18.00,0:12:22.00,Default,,0000,0000,0000,,And the great part about this is, it's just like Hotmail.
Dialogue: 0,0:12:22.00,0:12:24.00,Default,,0000,0000,0000,,It's cloud-based, and it doesn't require any training,
Dialogue: 0,0:12:24.00,0:12:26.00,Default,,0000,0000,0000,,programming, consultants.
Dialogue: 0,0:12:26.00,0:12:28.00,Default,,0000,0000,0000,,But there are some additional benefits as well.
Dialogue: 0,0:12:28.00,0:12:30.00,Default,,0000,0000,0000,,Now we knew, when we built this system,
Dialogue: 0,0:12:30.00,0:12:33.00,Default,,0000,0000,0000,,the whole point of it, just like with the Palm Pilots,
Dialogue: 0,0:12:33.00,0:12:35.00,Default,,0000,0000,0000,,was that you'd have to, you'd be able to
Dialogue: 0,0:12:35.00,0:12:38.00,Default,,0000,0000,0000,,collect the data and immediately upload the data and get your data set.
Dialogue: 0,0:12:38.00,0:12:41.00,Default,,0000,0000,0000,,But what we found, of course, since it's already on a computer,
Dialogue: 0,0:12:41.00,0:12:44.00,Default,,0000,0000,0000,,we can deliver instant maps and analysis and graphing.
Dialogue: 0,0:12:44.00,0:12:46.00,Default,,0000,0000,0000,,We can take a process that took two years
Dialogue: 0,0:12:46.00,0:12:49.00,Default,,0000,0000,0000,,and compress that down to the space of five minutes.
Dialogue: 0,0:12:49.00,0:12:52.00,Default,,0000,0000,0000,,Unbelievable improvements in efficiency.
Dialogue: 0,0:12:52.00,0:12:57.00,Default,,0000,0000,0000,,Cloud-based, no training, no consultants, no me.
Dialogue: 0,0:12:57.00,0:12:59.00,Default,,0000,0000,0000,,And I told you that in the first few years
Dialogue: 0,0:12:59.00,0:13:01.00,Default,,0000,0000,0000,,of trying to do this the old-fashioned way,
Dialogue: 0,0:13:01.00,0:13:02.00,Default,,0000,0000,0000,,going out to each country,
Dialogue: 0,0:13:02.00,0:13:05.00,Default,,0000,0000,0000,,we reached about, I don't know,
Dialogue: 0,0:13:05.00,0:13:07.00,Default,,0000,0000,0000,,probably trained about 1,000 people.
Dialogue: 0,0:13:07.00,0:13:09.00,Default,,0000,0000,0000,,What happened after we did this?
Dialogue: 0,0:13:09.00,0:13:12.00,Default,,0000,0000,0000,,In the second three years, we had 14,000 people
Dialogue: 0,0:13:12.00,0:13:15.00,Default,,0000,0000,0000,,find the website, sign up, and start using it to collect data,
Dialogue: 0,0:13:15.00,0:13:16.00,Default,,0000,0000,0000,,data for disaster response,
Dialogue: 0,0:13:16.00,0:13:21.00,Default,,0000,0000,0000,,Canadian pig farmers tracking pig disease and pig herds,
Dialogue: 0,0:13:21.00,0:13:24.00,Default,,0000,0000,0000,,people tracking drug supplies.
Dialogue: 0,0:13:24.00,0:13:25.00,Default,,0000,0000,0000,,One of my favorite examples, the IRC,
Dialogue: 0,0:13:25.00,0:13:27.00,Default,,0000,0000,0000,,International Rescue Committee,
Dialogue: 0,0:13:27.00,0:13:30.00,Default,,0000,0000,0000,,they have a program where semi-literate midwives
Dialogue: 0,0:13:30.00,0:13:33.00,Default,,0000,0000,0000,,using $10 mobile phones
Dialogue: 0,0:13:33.00,0:13:35.00,Default,,0000,0000,0000,,send a text message using our software
Dialogue: 0,0:13:35.00,0:13:37.00,Default,,0000,0000,0000,,once a week with the number of births
Dialogue: 0,0:13:37.00,0:13:40.00,Default,,0000,0000,0000,,and the number of deaths, which gives IRC
Dialogue: 0,0:13:40.00,0:13:42.00,Default,,0000,0000,0000,,something that no one in global health has ever had:
Dialogue: 0,0:13:42.00,0:13:46.00,Default,,0000,0000,0000,,a near real-time system of counting babies,
Dialogue: 0,0:13:46.00,0:13:47.00,Default,,0000,0000,0000,,of knowing how many kids are born,
Dialogue: 0,0:13:47.00,0:13:49.00,Default,,0000,0000,0000,,of knowing how many children there are
Dialogue: 0,0:13:49.00,0:13:52.00,Default,,0000,0000,0000,,in Sierra Leone, which is the country where this is happening,
Dialogue: 0,0:13:52.00,0:13:55.00,Default,,0000,0000,0000,,and knowing how many children die.
Dialogue: 0,0:13:55.00,0:13:56.00,Default,,0000,0000,0000,,Physicians for Human Rights --
Dialogue: 0,0:13:56.00,0:13:59.00,Default,,0000,0000,0000,,this is moving a little bit outside the health field —
Dialogue: 0,0:13:59.00,0:14:02.00,Default,,0000,0000,0000,,they are gathering, they're basically training people
Dialogue: 0,0:14:02.00,0:14:05.00,Default,,0000,0000,0000,,to do rape exams in Congo, where this is an epidemic,
Dialogue: 0,0:14:05.00,0:14:07.00,Default,,0000,0000,0000,,a horrible epidemic,
Dialogue: 0,0:14:07.00,0:14:09.00,Default,,0000,0000,0000,,and they're using our software to document
Dialogue: 0,0:14:09.00,0:14:12.00,Default,,0000,0000,0000,,the evidence they find, including photographically,
Dialogue: 0,0:14:12.00,0:14:16.00,Default,,0000,0000,0000,,so that they can bring the perpetrators to justice.
Dialogue: 0,0:14:16.00,0:14:20.00,Default,,0000,0000,0000,,Camfed, another charity based out of the U.K.,
Dialogue: 0,0:14:20.00,0:14:24.00,Default,,0000,0000,0000,,Camfed pays girls' families to keep them in school.
Dialogue: 0,0:14:24.00,0:14:26.00,Default,,0000,0000,0000,,They understand this is the most significant intervention
Dialogue: 0,0:14:26.00,0:14:29.00,Default,,0000,0000,0000,,they can make. They used to track the dispersements,
Dialogue: 0,0:14:29.00,0:14:31.00,Default,,0000,0000,0000,,the attendance, the grades, on paper.
Dialogue: 0,0:14:31.00,0:14:32.00,Default,,0000,0000,0000,,The turnaround time between a teacher
Dialogue: 0,0:14:32.00,0:14:34.00,Default,,0000,0000,0000,,writing down grades or attendance
Dialogue: 0,0:14:34.00,0:14:37.00,Default,,0000,0000,0000,,and getting that into a report was about two to three years.
Dialogue: 0,0:14:37.00,0:14:39.00,Default,,0000,0000,0000,,Now it's real time, and because this is such
Dialogue: 0,0:14:39.00,0:14:42.00,Default,,0000,0000,0000,,a low-cost system and based in the cloud, it costs,
Dialogue: 0,0:14:42.00,0:14:45.00,Default,,0000,0000,0000,,for the entire five countries that Camfed runs this in
Dialogue: 0,0:14:45.00,0:14:47.00,Default,,0000,0000,0000,,with tens of thousands of girls,
Dialogue: 0,0:14:47.00,0:14:51.00,Default,,0000,0000,0000,,the whole cost combined is 10,000 dollars a year.
Dialogue: 0,0:14:51.00,0:14:52.00,Default,,0000,0000,0000,,That's less than I used to get
Dialogue: 0,0:14:52.00,0:14:58.00,Default,,0000,0000,0000,,just traveling out for two weeks to do a consultation.
Dialogue: 0,0:14:58.00,0:15:00.00,Default,,0000,0000,0000,,So I told you before that
Dialogue: 0,0:15:00.00,0:15:02.00,Default,,0000,0000,0000,,when we were doing it the old-fashioned way, I realized
Dialogue: 0,0:15:02.00,0:15:05.00,Default,,0000,0000,0000,,all of our work was really adding up to just a drop in the bucket --
Dialogue: 0,0:15:05.00,0:15:07.00,Default,,0000,0000,0000,,10, 20, 30 different programs.
Dialogue: 0,0:15:07.00,0:15:09.00,Default,,0000,0000,0000,,We've made a lot of progress, but I recognize
Dialogue: 0,0:15:09.00,0:15:11.00,Default,,0000,0000,0000,,that right now, even the work that we've done
Dialogue: 0,0:15:11.00,0:15:14.00,Default,,0000,0000,0000,,with 14,000 people using this,
Dialogue: 0,0:15:14.00,0:15:17.00,Default,,0000,0000,0000,,is still a drop in the bucket. But something's changed.
Dialogue: 0,0:15:17.00,0:15:18.00,Default,,0000,0000,0000,,And I think it should be obvious.
Dialogue: 0,0:15:18.00,0:15:20.00,Default,,0000,0000,0000,,What's changed now is,
Dialogue: 0,0:15:20.00,0:15:24.00,Default,,0000,0000,0000,,instead of having a program in which we're scaling at such a slow rate
Dialogue: 0,0:15:24.00,0:15:27.00,Default,,0000,0000,0000,,that we can never reach all the people who need us,
Dialogue: 0,0:15:27.00,0:15:31.00,Default,,0000,0000,0000,,we've made it unnecessary for people to get reached by us.
Dialogue: 0,0:15:31.00,0:15:34.00,Default,,0000,0000,0000,,We've created a tool that lets programs
Dialogue: 0,0:15:34.00,0:15:37.00,Default,,0000,0000,0000,,keep kids in school, track the number of babies
Dialogue: 0,0:15:37.00,0:15:40.00,Default,,0000,0000,0000,,that are born and the number of babies that die,
Dialogue: 0,0:15:40.00,0:15:43.00,Default,,0000,0000,0000,,to catch criminals and successfully prosecute them,
Dialogue: 0,0:15:43.00,0:15:46.00,Default,,0000,0000,0000,,to do all these different things to learn more
Dialogue: 0,0:15:46.00,0:15:51.00,Default,,0000,0000,0000,,about what's going on, to understand more, to see more,
Dialogue: 0,0:15:51.00,0:15:55.00,Default,,0000,0000,0000,,and to save lives and improve lives.
Dialogue: 0,0:15:55.00,0:15:57.00,Default,,0000,0000,0000,,Thank you.
Dialogue: 0,0:15:57.00,0:16:01.00,Default,,0000,0000,0000,,(Applause)