Designing With, Not For

Cowki

The video shows Ramakka, field coordinator and trainers at MAYA explaining the vision behind Channapatna Health Library and gives a glimpse of the work being done by the Health Navigators and team.

“We have so many resources from our localities about how to deal with Covid. It would be amazing if we had resources about other aspects of health too” – Ramakka.

Ramakka’s expression of our collective desire has led us to give shape to what we call as Community Owned Wireless Knowledge Infrastructure (COWKI) – Channapatna Health Library. 

COWKI enables communities to co-create their own local knowledge repositories and offer meaningful digital services that are relevant locally. 

Channapatna Health Library is an example of such a repository that we are building led by 12 Health Navigators and Ramakka, who are women community health workers, trained and supported by MAYA Health. Currently, it consists of three Infrastructural components: 

  • A Community Network as back-bone infrastructure for low-cost Internet access consisting of a series of wifi access points, deployed on a Mesh-Mash network. The Mesh-Mash is a combination of wifi mesh network that spreads internet access across multiple access points from a single broadband source, and sim-routers offering wireless 4G internet access. Currently, the COWKI project is setting up one wifi mesh network with 8 access points and 6 sim-routers in locations mapped by the HNs and in negotiation with the key community members in the locations. 
  • Feminist Server at Channapatna that runs Papad, an open-source tool co-designed with the HNs enabling them to collect and annotate audio and video recordings about local health experiences and knowledge. Papad is accessed across different devices on the community network: high-powered laptops for video and audio editing, server management, etc.; Raspberry Pi 400 computers; and the smartphones of the HNs and their community members. 
  • Local Knowledge Service Providers are the 12 HNs creating the knowledge artifacts with an aim to be local content service providers, and co-own and manage the infrastructure and the Channapatna Health Library, with co-designed tool-kits and training processes to support the content collection and co-curation work. 
The HNs using the LTE sim routers to upload the narratives they collected during the week on Papad, while discussing and annotating in smaller groups. (Starting clockwise from the light blue woman on the left hand side) Triveni, Jabeen Taj, Mangala, Chaya, Ramakka, Shilpa, Anitha, Mangalamma, Sarasamma, Rajeshwari, ZohraJabeen. (HNs not in the image): Saraswathi, Aasma.

Currently Channapatna Health Library has about 20-25 curated audio and 50-60 multimedia artifacts of community health knowledge, including health experiences, traditional practices and local resources. Led by the 12 HNs, we are working  with a total of 3000 households in and around Channapatna, enabling them to co-create a unique, locally relevant digital resource for community-driven health advocacy. The content in the library includes traditional practices of bone setting, herbal and home remedies, as well as more contemporary experiences of dealing with the broken health system and local know-how about how to navigate these systems for better experiences. 

Through constant and collaborative exploration on aspects that are directly relevant for the HNs and their communities and building on our mutually trusting relationship, COWKI is our ongoing demonstration of an alternative for digital health that is not a centralized, data-hungry, opaque machine exploiting people for their data, but a locally resourced, operated and owned resource that enhances the care work carried out by community health workers. 

Background

Designing for us inherently means building long-standing relationships of care, and with care, with the people who will be most impacted with the results of the technology that gets designed. Our long-time collaboration with MAYA has evolved into directly working with the HNs to collectively design and shape a local digital infrastructure that works for them and their communities, grounded in the principles of feminist ethics. 

MAYA has been trying to figure out a digital infrastructure to help them and the HNs manage their practices of data collection and analysis. In 2021 we got a small grant of GBP £3,420  as part of the HEFCW GCRF Fellowship Award, from our collaborator at Cardiff University to work with the HNs to design and conceptualize a data infrastructure that works for them. Due to our long term engagement with the HNs, we had gained a deeper and nuanced understanding of their data practices already, and hence we could utilize this small amount to focus on collaboratively charting what could be ideal possibilities, components, and features. However, the second wave of the Covid-19 pandemic came along. In multiple conversations with the HNs and team of MAYA we reoriented our efforts to figure out workable protocols of data collection (about local resources and actions) by the HNs (over phone calls) and sharing with their communities over WhatsApp and phone calls, as well as offering consistent support to the communities, acting as a Community Covid Companion

During this time, the HNs and us came to a collective understanding about the value and importance of local health knowledge and know-how. Subsequently we applied and got a grant by the 2021 LocNet Community Networks Grants by Association for Progressive Communications (APC) to collaboratively design and develop a Community-Owned Health Knowledge Infrastructure (COwHKi). Since October 2021, we are working with 12 HNs and Ramakka in Channapatna and  Janastu, with an overall ambition to set up a community wifi mesh network enabled feminist server and infrastructure to enable participatory archive of locally rooted and relevant health knowledge, as well as collaboratively build the archive. 

Collaborative Envisioning of the Library. 

Often the vision of what a technology must be, gets imported into local sites; participation of local actors gets restricted to inputs on usability and user experience, without much shift to the very idea of technology, its role, let alone its form and function. 

Following our approach of “designing with, not for”, we believe that people using the technology should also be the ones designing it–imagining and envisioning it, shaping it through tinkering and usage, and figuring out aspects of owning and maintaining it–in close collaboration with other experts. 

COWKI too has evolved through informal and formal speculative design sessions; some were actively facilitated to start the process of envisioning, while often just a casual conversation among the HNs has led to our collective imagination of what is and could be “Channapatna Health Library”. 

In these audios the HNs take turns to think about a future when the Health Library will be up and running and how it shaped their everyday life and activities of care work: 

  1. https://drive.google.com/file/d/1nipDgozSw0MHV5y8bc1bB25s0XniYhVw/view?usp=sharing
  2. https://drive.google.com/file/d/1FoppklrHuB1yxT51NzjhVFgyboEDUFVx/view?usp=sharing

In other times we have converted these and other conversations, into quick visual story-boards as a means to collectively see the future possibilities, and not remained only focused on the ‘here and now’, attempting to reclaim the realm of the imagination from the so-called technology innovators and entrepreneurs. 

A combination of drawing and oral future scenario imagination as a way for us to imagine specific pathways to design and sustain the Channapatna Health Library.

We have just begun talking about this work in public. The HNs too are now eager to share their stories, visions, actions of building the Channapatna Health Library. Stay tuned for a more detailed and collective public journaling of the initiative soon.