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Talking Books in Afghanistan

Near Near Future points us to the US Department of Health and Human Services partnering with (aptly enough) LeapFrog, Inc., to make cheap electronic talking books for the women of Afghanistan (80% of whom are illiterate) in order to provide health information:

Developed jointly by HHS and LeapFrog Enterprises, Inc., the 42-page interactive books deliver important basic health information through state-of-the-art audio and point and touch technology. Books are available in both of Afghanistan's two major languages Dari and Pashto. [...] The book allows users to point to pictures, then the book speaks to the user incorporating a literacy tool with health information.


The book presents more than 350 items of recorded information concerning 19 personal health subjects. Basic health information covered includes diet, childhood immunization, pregnancy, breastfeeding, sanitation and water boiling, treating injuries and burns, and preventing disease. The books convey everyday household situations, as well as information specific to child and reproductive health. LeapFrog's patented LeapPad technology brings the health information to life through stories that convey the basic health lessons for the readers.

2,000 will be distributed to Afghan households and medical facilities to determine usability and behavioral shifts. This initial dissemination will shape the subsequent distribution of the full 20,000 book project. LeapFrog, Inc. has a more detailed press release about the project here (PDF), where they emphasize that "Women will be encouraged to use the books when they visit the clinics, especially as they wait to see health professionals."

I must admit to decidedly mixed feelings about this program. The LeapPad devices are undoubtedly rugged, and while they're used for children in the US, that doesn't mean that the localized information-for-the-illiterate versions would be seen as childish or a toy. But each device requires 4 AA batteries (at least the consumer version does, and based on the press releases, I don't think the Afghan version will differ); without power, the LeapPads are heavy plastic shells for slim paper books. Given the existing infrastructure problems in Afghanistan, the assumption that batteries will be readily available -- even to clinics -- is not necessarily warranted. A better solution might have been to add wind-up power to the devices, a technology which already exists for radios (which have a similar power draw).

Comments (13)

Jonathan Blocksom:

Another thing to not like about the LeapPad is that it's closed technology; as far as I know, there's no way anyone but LeapFrog can produce or sell the books and cartridges that go with it.

It seems like a stupid way to spend money to me. Even at the cost of the smaller distribution (2,000 books @ $60 = $120,000), you could fund a couple of teachers on the ground for a year or two, and you wouldn't've non-recyclable materials, nonrechargable batteries, and patronizing recorded voices which (based on the clips played on our local pubic radio) sound like they're teaching 5 year olds, not adolescents and adults.

Zaid Hassan:

Sounds like another consultant wet dream being given a field test.

What about using the money to promote indigenous medical knowledge? Or did Afghani women survive this long without Western medical interventions by sheer chance?

I find it hard to believe that they don't know about boiling water and looking after their children. I feel it would make much more sense to figure out what they already know and build on that.

Stefan Jones:

You could do much the same thing with comic books, for a lot less.

There are aspects to this project that the criticisms here, while largely valid, miss.

Metasilk, with even MSF pulling its doctors out of Afghanistan due to the danger, any attempts to fund more teachers will find the conditions challenging at best. Teaching systems (such as this LeapPad, an open alternative, or even books) arguably can be spread and used without putting people at added risk. Ideally, teachers would be a far better option, but those ideal circumstances aren't available.

Z, if we were talking about bringing in Western healthcare teaching devices to a relatively stable society, I'd be right there with you. But Afghanistan -- particularly Afghan women -- suffered from the combined tragedies of 25 years of near-constant war, more than a third of the surviving population becoming refugees, and the depredations of an ideologically extreme government which took great pains to keep women isolated and ignorant. The Taliban went after the very indigenous knowledge you mention -- there has long been a tension between Muslim teachings and local traditions (Pushtunwali) in Afghanistan, and the Taliban took that to an extreme.

Whether the information the devices present is useful for people living in Afghanistan is a separate question, and you're right to be skeptical. That the HHS is doing a small pilot program explicitly to watch how the systems are used gives me some hope, however.

Stefan, one of the key values of these systems that a purely-print alternative can't provide is the ability to present complex information to an illiterate person without having to have another person there to teach or read (or, quite possibly, censor) the material. A lone woman could use one of these systems to get information (or to learn to read) without having to have someone else looking over her shoulder.

These devices are by no means perfect, and the test distribution may end up being a flop. But they do solve a set of problems in a way that few other systems could. A version with a hand-crank dynamo for power and an open-access format so that any non-profit could easily provide more modules would be pretty damn useful.

Zaid Hassan:

Jamais, you write that "... one of the key values of these systems that a purely-print alternative can't provide is the ability to present complex information to an illiterate person without having to have another person there to teach or read etc etc."

I'm highly dubious of this claim. It's a very tall claim to make.

With regard to the indigenous knowledge - I can believe the Taliban tried to erradicate indigenous Pushtun knowledge but I don't see how substituting Western knowledge systems is the solution. I'm also not aware of the tensions between Islamic knowledge systems and local Pushtoon traditions. Other than general Pushtoon treatment of women - which I think is largely terrible and not at all in accordance with Islam.

While undoubtedly picture-only books can convey useful information, the detail and nuance that comes from language is very hard to replicate purely pictographically. If all you're doing is giving step-by-step instructions, pictures are probably sufficient (e.g., airplane emergency cards); if you're trying to explain why something is important to do/not to do, pictures are less clear. Of course, I don't know just how detailed and explanatory the verbal elements of the LeapPad books will be -- it's entirely possible that a picture book would have a close approximation of the results.

As for the substitution of Western knowledge systems... it's hard to say just how much of a substitution is going on without actually seeing the text, and how much would be information for which there wouldn't be much traditional knowledge. The original article I linked to (at NNF) lists three example issues: sexually-transmitted diseases; immunization; and "some homespun remedies, such as rubbing dirt into cuts to heal them." The first is an open question how much real information would be available to Afghan women; the second is defintely a Western approach, but one with some substantial benefits for refugee populations; and the third... well, I had never heard of that remedy before, so I have no idea whether there's any local knowledge involved, or is simply a folk meme without any substantive basis.

Finally, regarding cultural tension: as it happened, I wrote my (1988) Anthropology BA thesis on conflicts between Pushtunwali and Islam in Afghanistan (I had written my History BA thesis on 20th century Afghan revolutionary movements, so I got to get extra value out of my research). Prior to the Soviet invasion, there was an ongoing back-and-forth cycle of influence between madressa-trained ulema and local tribal leaders, particularly where Islamic teachings conflicted with pre-Islamic Pushtun traditions. The 1979 invasion threw this rough balance out-of-whack with the decimation of tribal leadership by the Soviet military; the subsequent arrival of the "Arab" mujahidin supported by Pakistan's security service and US/Saudi funding made matters worse. The Wahhabi version of Islam the "Arabs" brought with them -- and the Taliban embraced -- meshed well with traditional Pushtun in one very notable way: the treatment of women, which, as you note, is pretty awful.

Stefan Jones:

Has anyone (else) out there SEEN a LeapPad?

My nieces have one, and a dozen or so of the add-on books. (Each lesson / volume consists of a printed book and a ROM-cart.)

I got the impression that it was a "feel good" technology. The kids sure got into it . . . while Uncle and Aunt and Grandma and Grandpa were watching. Alysson and Jessica punched away at the pressure spots, calling up words and tones, but it more to show off the tricks they'd learned for the assembled grown-ups. (e.g., playing the ribs of the skeleton in the anatomy book like a xylophone.) I didn't get the impression that they were terribly *engaged*.

Maybe I've become cynical from studying Dead Media too long, but the LeapPad strikes me as yet another learning gimmick. They're sold to make worried moms and dads think that they're doing something positive.

I'll have to ask my sister if they deeply engage with the ThinkPad when they're not distracted . . . assuming they still use the toy at all.

* * *

I heard an NPR piece on the Afghan / ThinkPad project. The audio clip they played raised doubts as to the appropriateness of the software. A sugary encouraging voice, responding to correct answers with "Oh, you are so intelligent!" with the same tone you'd use to praise a toddler who "made" in the potty.

At the very least, I think they should choose another voice. A strong no-nonsense "granny" type, perhaps.

* * *

Comic books. Comic books and Freeplay radios so you can listen to the coordinated lessons broadcast by a regional transmitter in a familiar dialect. And some cash to pay a few of the 20% of women who ARE literate to do some teaching on the sly.

KC Jones:

I work for Leapfrog, and I've seen internal reviews of this project -- so I'm both in a position to comment and also constrained by my insider knowledge. I've also been an avid student of Afghan news since 9/11 and the Afghan war.

The model of LeapPad used is not the US consumer version. It is considerably more rugged, simpler, and cheaper to manufacture model. One goal for this version of the platform is to extend the LeapPad technology into adult education.

Battery usage is an issue. Alternatives were considered and rejected -- mostly for reasons of cost-of-goods and serviceability. Battery life is very long in these devices, and the Afghan people's ability to conserve and reuse valued goods may surprise us all. Unlike Yanks, they're much more likely to hang onto the pad after the battery dies, and either acquire new batteries or barter the pad to someone who can get some. Note too that the book inserts were designed to be valuable without the accompanying software/hardware -- so even if the pad dies the book will still be useful for the minority of literate or semi-literate Afghanis.

I didn't hear the NPR piece, so I don't know what audio they played, but if you understood it (i.e. it was in English) then it certainly was not the Afghan title. We partnered with experts in the local Afghani expat community here (the largest in the country) to gain both language and culture expertise. All the content is presented in a culturally appropriate way in either Pashto or Dari.

Yes the technology is closed, but Leapfrog does support 3rd party partners -- and there is zero profit motive in this project. Government money subsidized the development of this title, but believe me there is no possibility of profit on these titles. In addition to teaching critically needed public health knowledge, the books have the potential to help smart, inquisitive women learn to read. The LeapPad system really does work, and not just for precocious little kids.

You should know that life expectancy for the rural populations in Afghanistan is among the worst in the world, possibly the very worst. Maternal health is the worst in the world. Malnutrition is endemic. The idea that indigenous knowledge is all that is needed is self-evidently false. As others have noted, the Taliban and the hardships of war have created a brutal public health crisis. If these books help even one little bit, great. If they demonstrate a new way to communicate complicated material to illiterate populations then this approach could be replicated easily in other places.

KC, thank you for bringing some first-hand information into the discussion.

I'm curious -- among the battery options, was a hand-crank dynamo system looked at?

The preference expressed here for open-sourcing the file format has nothing to do with profit motive, and everything to do with making the ability to create material for these books as widespread as possible. If they are a good tool for the purpose -- and I do think that you make a case for them -- then their value would be even greater if any interested parties could make additional modules for the system.

KC Jones:

I'm not totally dialed into the options that were considered. I believe a crank option, like the crank operated "quake" radios was considered and rejected on a cost basis. We exploited an existing, low-cost platform for this project. The funding for this project went to content development and not hardware. We used an existing variation of the platform here.

My colleagues have talked about the idea of open content for various LF platforms. I don't really expect it will go anywhere. LF retains control of all content playable on LF hardware for many reasons, including the core-mission pedegogical control. In that sense its not unlike the 3rd party controls over game decks. The arguments pro and con are pretty similar. If LF opened the tools then some idiot would mint a smut-for-toddlers title and what would LF do? (I know, I know,... much good would folllow from openness too. But they really are less interested in selling hardware than they are in selling a fully QA'ed, fully vetted curricula for their audience(s). And retaining control has definite advantages.)

Zaid Hassan:

Just to be clear, I'm not saying that indigenous knowledge is all that's needed. As Jamais pointed out that knowledge too has been under attack. I was suggesting that we try and build on it - and I appreciate that may not be possible. I guess if this thing can help in even a small way that's a good thing.

I'm wary of such tech fixes because it seems to me that it would be far better to embed such knowledge in people rather than in gizmos - no matter how robust or clever.


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