Three Models of Development: Community Ophthalmology NGOs and the Appropriate Technology Movement

Abstract

This paper describes a new shift in the appropriate technology movement in less economically developed countries as seen in a multi-sited ethnography of non-govemmental organizations (NGOs) in the scientific field of ophthalmology. This research reveals how Aravind Eye Care System in southern India and Tilganga Institute of Ophthalmology in Nepal are addressing "undone science" for avoidable blindness. They are creating the requisite local hospital and personnel infrastructure while conducting "civil society research." They are also providing high quality modern care to low-income patients of the global south while charging reduced or no fees. This paper argues that they represent a third model in the appropriate technology movement-contextually appropriate local production of high technology. This third model focuses on socially responsible innovation for purposes of social improvement; it is rooted in nonprofit, social enterprise organizations to include the following four aspects: (1) scientific innovation or the "appropriation" of new science; (z) organizational innovation, including changes in operations management for self-sufficiency through multiple revenue streams; (3) technological innovation or the creation of new products and artifacts; and (4) an underlying ideological orientation that is based on local philosophy (and challenges hegemonic understandings of postcolonial dependency or neoliberalism).

Production Challenges in Least Developed Countries

“…For a successful set up of new production locations in developing countries, it is crucial to offer appropriate products regarding costs, function and quality [80][81][82][83][84][85] Hereby, a reduction of complexity should be attained e.g., through reducing the number of components [86], standardization [8,16,29,64,72,87] and reduction of resources (such as financial invest, material, production time) [38,49,51]. As unappropriated products are seen as inefficient [79], local population should be involved in product development [38,79] including local product testing [79,80].…”

“…Technology Process Adequate and low in expedience 8 [13,29,54,[63][64][65][66]83] Flexible in speed, product mix and quantities 5 [6,52,55,67,110] Low in complexity 2 [5,38] Low in effort 1 [6] Robust 1 [68] Avoid tests 1 [69] Fast to ramp up 1 [70] Standardized in process and measurement 8 [8,30,34,41,60,64,71,72] Output depends on the worker's skill level 3 [46,54,111] Output depends on technological capabilities 4 [46,65,67,73] Appropriate to local requirements and assembly intensive 9 [5,27,29,47,54,57,64,65,90] Local information system 4 [30,36,38,64] Energy sav...…”

Mapping Superpositionality in Global Ethnography

“…Studying through afforded me the opportunity to concentrate on elucidating the discourses and ideologies produced by the network. I found community ophthalmologists were challenging the prominence of developmentalist discourse in the global scientific field of ophthalmology (Pieterse 1991;Williams 2017Williams , 2013. Challenging developmentalism is something I too am interested in doing within broader science, technology, and development networks.…”

“…My high geopolitical status and relative economic wealth were enough to transport me to my field site, but afterward it was not useful. Although I was initially welcomed to perform the pilot study at Tilganga Institute of Ophthalmology, I quickly encountered the day-to-day realities of conducting fieldwork: my occupational status as a student ethnographer from a wealthy industrialized nation was relatively unimportant in comparison to community ophthalmology professionals' high status as local high-tech elites (where community ophthalmology is eye health care focused predominately on the rural poor, see Williams 2017Williams , 2013. Also, my black skin caused me to have low status in a city where billboards frequently advertised skin bleaching cream for whitening the range of already light beige, tan and brown skin tones represented among Kathmandu's residents.…”

An introduction to generative justice

“…The challenge is not simply a technical issue. Gómez-Márquez, for example, is up against a multibillion dollar healthcare industry that often makes "uncertified" health instruments illegal (Williams, 2013). It is only by coupling these efforts with social justice movements, national policy changes or other broad social forces that those technologies and practices can effect deep change.…”