Q & A with PJ Wall, PhD Researcher

PJ Wall says: My current research focus is on mobile health (mHealth) in low and middle-income countries, with a specific focus on how program implementors can design, develop, implement, scale and sustain mHealth programmes more effectively.

PJ Wall is a PhD Researcher and a teacher with the Trinity College, Dublin, with a keen interest in rock climbing and mountaineering.

Arun: Tell us about yourself and your hobbies
PJ Wall: My name is PJ Wall, and I am a PhD researcher with the School of Computer Science and Statistics in Trinity College Dublin, Ireland. I also lecture in Trinity College Dublin, where I teach a number of development informatics and ICT4D modules at Masters degree level. I have been lecturing, working and researching in the field of development informatics for the past 15 years, and I have extensive experience working in a variety of countries in South East Asia, Africa, and South America. My current research focus is on mobile health (mHealth) in low and middle-income countries, with a specific focus on how program implementors can design, develop, implement, scale and sustain mHealth programmes more effectively.

I am also interested in the social, political and cultural aspects of implementation of information technology and information systems in developing environments. I travel extensively, and much of my time is taken up with writing and trying to complete my PhD, but I enjoy rock climbing and mountaineering, and also reading science fiction. I also tweet about ICT4D and M4D at @pj_wall.

Arun: You have an under-graduate degree in Accounting and now you are working for your Ph.D. focussing on mHealth technologies in emerging countries. How did this shift happen?
PJ Wall: In retrospect, I can now say that I was never really passionate about accountancy and business studies. I have no regrets, as I believe an undergraduate degree in business and accounting is a very valuable thing to have, and it has given me a somewhat unique perspective on my current research areas. After completing my undergraduate degree, I started teaching and lecturing. It was during this period that I found myself being drawn more and more to the technology behind accounting and business. I also become interested in open source software, and how entire communities could be leveraged to produce software that could potentially serve a social good. This inspired me to complete a Masters degree where my final thesis explored the consequences and lessons learned from the implementation of open source software in a large Irish trade union.

In parallel with all of this, I was also working on a number of assignments for Irish Aid (the development section of the Irish Government Department of Foreign Affairs) in Africa and South America. Although I had travelled extensively, these projects gave me first hand experience of working in a development context, and the problems that many low and middle-income countries face on a daily basis. It was during this period that I began to realise that if health information systems could be implemented effectively and efficiently in developing environments, the potential was there to have a massive positive effect on the lives of many of the most underserved people on the planet.

Arun: How different are the Public Health Systems in Asia, Africa, and South America and the key challenges faced by local healthcare professionals?
PJ Wall: These public health systems in Africa, Asia, and the West are vastly different. The main differences are resources and training. In lower income countries there are few (if any) resources, and this means that a lot less can be done. There are also differences in the amount and quality of training of health professionals. In Sierra Leone for example, there are 0.03 doctors per 1000 people, whereas this figure in many European countries is over 3 doctors per 1000 people (source: http://www.nationmaster.com/graph/hea_phy_per_1000_peo-physicians-per-1-000-people). This obviously means that less can be done.

Arun: You have traveled a lot internationally. Can you share an interesting personal healthcare experience from a cultural context?
PJ Wall: I have seen a few interesting things in my travels, with many of these happening in India. I remember being high in the mountains of Northern India where a travelling companion of mine had a gallstone “sucked” out through her stomach by a traditional healer (my companion is very happy and healthy to this day). I saw it with my own eyes … but I’m still not sure I believe it!!! Maybe it was the altitude playing tricks with me…

Arun: From your perspective, what might be the necessary factors for implementing a mHealth solution in a specific geographical location? 
PJ Wall: In my experience all mHealth implementations are challenging!!! There are many, many factors at play. These range from the technology, to the social, political, and environment conditions existing. Even the climate and the road/telecoms infrastructures can have an effect. All of these factors have to be taken into account, and it is vital to create an appropriate socio-technical environment in which the technology fits with the social structures and vice-versa. Other big issues are finding sustainable business models for mHealth (who pays??), and finding ways to scale pilot projects to national level.

The majority of mHealth implementations still fail to scale beyond pilot, so there is obviously a lot to learn. However, I am encouraged by the fact that there are a growing number of examples of mHealth projects that are successfully expanding beyond pilot. My hope is that implementors can leverage what we already know about successfully implementing mHealth programmes with advances in modern technology to provide public healthcare to the poorest and most disadvantaged peoples on Earth.