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TECH TALK: A Train Journey: Triage

June 17th, 2004 · No Comments

Making computing a utility in the lives of Indians is the next big challenge. While we can wait for top-down action, that is unlikely to happen. What we need is to seed enough of the ecosystem to enable a bottom-up revolution that makes computing access available everywhere across India. Of course, one can argue that this is a silly discussion in a country where hundreds of millions of people live below the poverty line, do not have access to clean drinking water or two daily meals, have lives dominated either by landlords or the monsoon. My counterpoint (influenced by Atanu Dey) is that we need to first focus on people on the margin lets help those who need the least help in moving to self-sufficiency from a state of dependency, rather than trying to distribute limited resources to everyone.

This is the principle of triage. Matthew Streger explains:

If you have limited resources, you will need to determine how to most efficiently use them. This is the foundation for triage. Triage, from the French verb trier, means to sort. Triage is used on every call. With one patient, we make decisions like whether to establish an IV or if the patient needs to be transported using lights and sirens. When we have more patients than available resources, we need to decide where those resources will be best utilized.

Our goal is to maximize the number of patients who will survive the incident. We want to do the most good for the most people. Some patients will live no matter what medical care they receive, and some will die regardless of the circumstances. Others die unless they receive medical care immediately. We don’t want to utilize valuable resources on people who are certain to die, nor do we want to use these resources on people who will survive without medical care. Our goal is to identify who will survive the event with immediate care.

For the people on the margin much of middle-class India and small- and medium-sized enterprises, access to computing can be the force that helps them take control of their own futures. They are the ones who can then transform the lives of others through innovation and entrepreneurship.

There are four barriers that need to be tackled in making computing available to this mass market in India: accessibility, affordability, manageability and desirability. Accessibility means making it available close to where people are. This could be their homes, schools, colleges, offices or factories or neighbourhood computing centres which provide shared access to a common set of resources. Affordability is about making the price such that they can easily pay for it either on a subscription basis, or a usage basis. Put another way, we need to bring the price points of a phone to a computer. Manageability means making computing as hassle-free to use as a telephone. Desirability means creating relevant content and applications that can make a difference to people and their businesses.

These are the challenges that we need to tackle with computing in India. It is not about solving one of the problems it is about removing all the four barriers simultaneously. It is about creating a complete computing ecosystem to catalyse the development of the country. India has too many gaps in its various systems and this is where the right computing infrastructure can make a difference.

The train journey helped consolidate and organise a lot of my thinking of the recent past. It brought me face to face with people whom I normally do not encounter during my work or personal life. It is these lives that we have to touch and transform. The train journey was, for me, a signal to start a new, personal odyssey.

Tomorrow: Gandhis Journeys


TECH TALK A Train Journey+T

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