Technology and Interventions

For the last class in leadership this term, we watched the short film “Water of Ayolé“. The film talks about a village in Togo where water was scarce. Women would walk many miles to the nearest source of water, a river. The water they managed to collect would be ferried back to the village by the women. The problem was that the water would be contaminated with guinea worm larvae. The infection, a.k.a. “Dracunculiasis”, can be very debilitating:


Although the disease is almost eradicated, other parasitic infections remain a problem where there is no clean water. In Togo, the government decided to install wells in the villages where there wasn’t any running water. The wells were operated by pumps. In the movie below, you get to see what happens in a few villages in Togo after the wells are put in. In some villages, the pumps would fail and the people would go back to ferrying water from far away. In one village, Ayolé, the intervention was a bit different.

Instead of just going in, installing the wells, and then leaving the villagers to tend to the pumps on their own, the clean water outreach workers took a different approach. They talked to the villagers and figured out what their needs were as well as training one of the villagers — the one with the most mechanical experience —  to fix the well when the pump would break. Imagine that, a public health intervention where you get the people being benefited involved and invested in their health. How many times do we hear of interventions that start off with lofty aims and end with the people being left to fend for themselves?

Water of Ayolé from SANDRA NICHOLS on Vimeo.

Technology is a wonderful thing, if it used wisely. The people of the village were taught about the technology that they were provided instead of just having that technology dumped on them. The film really is a lot about the whole “teach a man to catch a fish” thing. It’s also a lesson for those of us who want to go into communities and help them out. We can’t just go marching in and shove a solution down their throats (e.g. a water well with a complicated pump) and not involve them in the process. The approach must be less like we’re “saviors” and more like we’re servants.

I'm a doctoral candidate in the Doctor of Public Health program at the Johns Hopkins University Bloomberg School of Public Health. All opinions posted here are my own, of course, and they do not necessarily reflect the opinions of my school, employers, friends, family, etc. Feel free to follow me on Twitter: @EpiRen

One thought on “Technology and Interventions

  1. The lesson is several fold.
    First, any effort at installing pumps or similar technological help should include locally acquirable components, even if they are components that can be fabricated from available local materials.
    Second, one person and an alternate should be trained in the maintenance of the device.
    Finally, one person and an alternate should be trained in repair and local fabrication, if necessary, of components for the device, to the lowest level component.
    Think of the old “country” pump, pump the handle a handful of times, water comes out. That old pump was a simple lever and piston, the piston sealed with a leather cup. Leather could be trivially made, was in common use and hence, the pump was and remains trivially repairable.
    Finally, follow-up on the effort must be ongoing, just as vaccination programs should return to the same areas repeatedly, year after year.
    So, I say this:
    The approach must be less like we’re “saviors” and more like savants, teachers and helpers of others.


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