Field Trip to Understand the Know-what and Know-why

We are all familiar with technology and most of the time we mean high technology – digital technology in corporated in computers and telecommunications devices – whenever we say technology. But the term technology is not limited to high technology alone. Indeed, technology is any knowledge about how to do things. It is know-how that is often embedded in artifacts such as computers and cameras and cars, but it is not limited to them. Technology is also know-how embedded in processes. For instance, the knowledge of how to make fertilizer from biomass is also technology. It is know-how that combines inputs in a certain way to produce output.

It is good to have know-how, or technology. But one can get enarmoured of what one understands and seek to apply that understanding indiscriminately. As the saying goes, to a person with a hammer, every problem appears to be a nail. Besides the know-how, for successful application of technology or knowhow, there are two other important bits. First is the know-what and the second the know-why. Without the other two bits, know-how is sometimes worse than useless.

To take a specific example, consider the information and communications technology (ICT) and its application to developing economies. For the most effective use of ICT for development, one has to understand what the nature of the developing economy is, what are the failures that plague the system, etc. We have to know what the system is all about. Then we have to understand why the system is the way it is. That is, we have to also have know-what and know-why. Only then can the ICT know-how be applied to the problem of economic development.

There are numerous ventures seeking to apply ICT to rural economies around India. A study of these projects is important for us understand their know-what, know-why, and know-how. We can learn from them and emulate their successes and avoid their mistakes. To do that, we are embarking on a field trip to visit projects around Andhra Pradesh around September 22nd. In the next few days, we will finalize our plans.


As one lamp lights another, nor grows less,
So nobleness enkindleth nobleness.

Those are lines from a poem (Yussouf by James Russell Lowell) that I had memorized in school many years ago. They immediately came to mind when I read about Dr. Govindappa Venkataswamy, or “Dr. V”, a few months ago. Reading about Dr V was empowering and I wrote Unsung Hero — Dr V in my weblog.[1] Today Karthik emailed me another article about Dr. V. Once again, there was that same feeling of being inspired, of being empowered to do what needs to be done.

Dr. V. created the Aravind Eye Hospital. I quote from the latter article:

Since opening day in 1976, Aravind has given sight to more than 1 million people in India. Dr. V. may not run a business, but it’s important to note that Aravind’s surgeons are so productive that the hospital has a gross margin of 40%, despite the fact that 70% of the patients pay nothing or close to nothing, and that the hospital does not depend on donations. Dr. V. has done it by constantly cutting costs, increasing efficiency, and building his market.

It costs Aravind about $10 to conduct a cataract operation. It costs hospitals in the United States about $1,650 to perform the same operation. Aravind keeps costs minimal by putting two or more patients in an operating room at the same time. Hospitals in the United States don’t allow more than one patient at a time in a surgery, but Aravind hasn’t experienced any problems with infections. Aravind’s doctors have created equipment that allows a surgeon to perform one 10- to 20-minute operation, then swivel around to work on the next patient — who is already in the room, prepped, ready, and waiting. Post-op patients are wheeled out, and new patients are wheeled in.

Aravind has managed to beat costs in every area of its service: The hospital’s own Aurolab, begun in 1992, pioneered the production of high-quality, low-cost intraocular lenses. Aurolab now produces 700,000 lenses per year, a quarter of which are used at Aravind. The rest are exported to countries all over the world — except to the United States. (In order for Aravind to get its lenses approved for sale in the United States, it would have to pay for an FDA study and a clinical study, which the hospital cannot afford.) Aravind even has its own guest house, and students and physicians from around the world come to teach, study, observe, practice — and boost their training.

So here I begin this journey with the proper invocations to Ganesha, the Remover of Obstacles, the One with the Broken Tusk, and with thanks to Dr. V. and his vision.


[1] That UC Berkeley blog is not available any more.

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