Internet access: Blessing or curse?
For Idjwi, an island on the Rwanda-DRC border, isolation has been a gift.
Idjwi – For many of the world’s 7 billion people, it would be hard to imagine a world without the Internet. In just a couple of decades, our lives have become so intertwined with the World Wide Web that it’s difficult to remember a time when it wasn’t part of our lives. For the youngest among us, the world simply hasn’t existed without it.
But for the residents of Idjwi Island – a tiny place located on Africa’s Lake Kivu right between the Democratic Republic of Congo (DRC) and Rwanda – it is not the absence of the Internet that has been hard to imagine, it is the presence of it.
Until last August.
I watched the installation of the very first satellite dish in the garden of our hospital, like a flag symbolising a global infiltration of some kind, with a mix of excitement and trepidation.
This marked an enormous change in our community’s connection to the outside world. There is no newspaper or television in Idjwi. We have a community radio that transmits local news whenever their generator is working, but most of the time it takes a long time for people in Idjwi to learn about what is happening in the outside world.
Even mobile phones – that other essential of modern life – are extremely rare.
I’m a doctor originally from the area who now lives intermittently on the island. For the past eight years, I have been facilitating a community-led project to bring healthcare to the 250,000 residents there – a peaceful people who have been isolated from the notorious violence that has surrounded them in Rwanda and the DRC in the past decade.
But this has also kept them isolated from quality medical care. Health emergencies have to be handled on the spot. Communication with outside specialists, which in the developed world can mean the difference between life and death, has not been possible.
Bringing a “solar suitcase” was a relatively easy fix; it provided us with light to function during the night. Nutritional supplements were similarly uncomplicated; saving lives of small children who otherwise might have died.
But the Internet felt different. Do we really need the Internet in a place where 82 percent of people live on less than $1 per day? What will the Internet connection do to Idjwi? The latter was a particularly charged question in a place where isolation had actually been a cushion against the region’s outbreaks of genocidal violence.
The people of Idjwi have joined a battle that we’re all fighting: To make sure that technology serves people, rather than the other way around.
Internet access as hiring perk
Among the people of Idjwi itself, the verdict was a resounding “yes”. “Besides attracting the best doctors and nurses, the Internet will bring the world to Idjwi,” said my brother, who was eager to see the Internet come.
Our biggest challenge in building a local healthcare system, apart from financial constraints, was keeping talented doctors on the island. For years, I was the only physician and couldn’t stay longer than a few weeks at a time.
But recruiting was tough. The first doctor stayed two weeks and left, saying he loved the work but couldn’t stand being unable to communicate with his family back on the mainland.
Next, we were lucky to get an experienced Congolese physician who did most of his work in Rwanda.
One month later, he resigned, explaining that he was halfway to completing his public health degree on the mainland and felt he couldn’t keep in touch with his professors and classmates.
The Internet seemed like the answer, and we contracted with Ariave Satcom to install a satellite dish, router, modem and wireless base station for about $25,000. For a monthly service fee of $1,200, we have unlimited Internet access at about 150 kbs bandwidth. Currently, there are four laptops at the clinic which are connected to the Internet – including two which are dedicated for public use – and we are expecting to connect up to six desktop computers by February when our new hospital formally opens.
It’s too early to say what the lasting effects will be, but so far, this is what I’ve observed:
Shortly after we established the connection, a group of women gathered at the hospital and watched a YouTube video about enterprising women in Uganda and Bangladesh who use micro-lending to improve their economic and financial situations. As I watched the women watch the video, I realised something profound is happening. “We can do this!” Jacqueline, the leader of the group, exclaimed. “We aren’t alone any more.”
Another group of girls and teenagers watched the opening of the 2013 World Youth Day in Rio. The room was suddenly quiet. The girls’ faces focused on the laptop and they started whispering, surprised to see so many young people on a tiny screen.
Diagnosis by Skype
And it has proven useful for our medical work. While I was in New York recently, a woman in her 40s was brought to the Idjwi hospital unconscious. The staff was worried – they had no x-ray equipment, or oxygen, and feared she needed to be transported as an emergency case to Bukavu on the mainland – a trip of at least eight hours that could end up costing hundreds of dollars. They called me with Skype, and I was able to interview both the medical staff and the woman’s family and conclude that the mother of seven was simply suffering from hysteria and exhaustion. She was given fluids, allowed to rest, and soon recovered.
So far, the community’s direct interaction with the Internet has been limited. Computer keyboards are unknown in Idjwi, making personal access difficult, and very few people on the island have a sense of how much information is available. But some are already hoping to use the Internet to locate relatives further afield – Skype is popular – and we are going to be running training sessions to teach people to open Facebook accounts early next year.
Despite these encouraging sights, I still worry that the Internet may change the peaceful and resilient community. We are doing our best to educate people about the less positive aspects of the Internet, working with village elders to explain that – along with a wealth of new knowledge – it can sometimes bring unwelcome new diversions.
For most people on Idjwi, the arrival of the Internet has marked an astounding change. The machine has, indeed, come alive. Now we just have to make sure that it contributes to the quality of life on this tiny island. The people of Idjwi have joined a battle that we’re all fighting: To make sure that technology serves people, rather than the other way around.
Jacques Sebisaho is the founder of Amani Global Works and a medical doctor with additional degrees in healthcare policy and management, biomedical science, and philosophy. He is a 2013 Aspen Institute New Voices Fellow.
Follow him on Twitter: @sebisaho
Courtney E Martin is a writer, speaker and social media strategist based in Brooklyn. She is the author of Do It Anyway: The New Generation of Activists and the co-founder of the Solutions Journalism Network.