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Like many observers of the recent Gujarat elections, I was stumped. Was, because reading M.R. Venkatesh's incisive analysis of Modi's victory threw considerable light on voters and voting.

Venkatesh explains India's history:

"Secularists, with their firm belief that the concept of this nation could be built from a clean slate without any reference to her past, are oblivious of this set of voters and their psyche. Remember, we are a nation with a historical baggage of defeats in the past thousand years or so."

and neatly ties that to voters' fears:

"And our collective understanding is that all this happened because we Indians were never politically conscious of defending ourselves...Crucially, we did not have strong leaders to defend the nation from such predators."

And as feared, the greatest casualties of this polarization are "increased communal tensions and social friction. As Indian society gets divided on these lines, it could well lead to the revival of militant Hinduism -- leading to shriller retaliation from the secularists leading to a vicious spiral of polarisation of the polity, voters and society."

Part I: The need to innovate

We live in an era of unprecedented global economic growth and widespread poverty. While poverty rates in many parts of the world, including India and China, have dropped significantly over the past decade, the benefits of economic growth to the most deprived sections of society still remains the "trickle" quoted in old economics textbooks. Fortunately, change is brewing.

Today, efforts in many disparate parts of the world to integrate the poorest of poor, better known as the "bottom of the pyramid" or BoP, are focusing on bringing goods and services to the deprived. And surprisingly, these goods and services have achieved a wide range of levels of sophistication, from savings programs that take advantage of group-based lending models (the most-widely quoted example is the Grameen Bank) to emerging re-insurance programs for micro-health insurers. Many, if not most of these financial programs rely on community savings, in a reversal of the primarily charity-based aid programs of yore. The new mantra today is not just "Give and ye shall receive" but also "Ye shall receive and give", encapsulating that oft-told story of the boot-strapped entrepreneur. In the process, many of the lessons of financial theory of portfolio diversification and risk management are being applied to sustain such services as health insurance and project finance for people who've been limited by the individual income profiles.

Yet many basic services including education, power and medical services have remained outside the scope of the microfinance services for various reasons. Some of these services are based on capital-intensive business models, which are a challenge for limited pools. Schools require buildings and the accompanying infrastructure. Power typically requires transformers, wires for transmission, and not to mention, expensive generators. The challenge is to innovate and adapt these services to the pay-as-you-go business models. The story of CavinKare, which pioneered the "sachet" model of marketing[1] by selling shampoo in the form of small packets, is now legendary among BoP thinkers. While these micro-packaging methods are not replicable everywhere and have been disputed as to their efficacy in boosting consumption, they point to the potential of tailoring business models to cater to the poor. And just as importantly, to tailor them to local circumstances.

There are parts of Africa where a HIV patient can be found in every family of a village. The consequences of contracting HIV are too long to list here. But the particularly nasty aspect of this affliction is the constraint it places on the families and dependents of its victims. Treatment of HIV patients is expensive both in terms of the financial burden it places on their families but also in the time taken to care for them. The latter is time lost on an occupation - an unfortunate double-whammy for these families. To add to their troubles, conventional health insurance programs place severe limitations on HIV treatment costs, thereby rendering them useless for the needs of most of these families.

My friend, Omar, and I are focusing on one such village, Lwala, in Africa. Lwala, in Omar's words, is a:

"village of approximately 1500 people near Lake Victoria in western Kenya. Within an hour’s walk, approximately 3000 additional people live in nearby villages accessible by dirt roads. The majority of the area residents are subsistence farmers….

The official 15% prevalence of HIV in the region is the highest in Kenya (2003 Kenya Demographic and Health Survey). Of the 529 villagers who were tested in 2006, 32% were infected (24% men and 40% women)."

Ordinary microinsurance providers can do little here; most are unwilling to finance the high costs associated with treating HIV patients. Our challenge is to build an insurance program that satisfies the medical needs of both sets of patients, spreads the risk across a large pool of members and is also self-sustainable. That's a difficult gap to close; ordinary medical expenses in Lwala cost less than $0.10 a day at first glance, but HIV treatment is upward of $2 a day.

Among some of my ideas to tackle this idea is to look at the externalities of HIV treatment. An HIV patient who is treated and cared for at a clinic frees up resources for his/her family. Relatives can pursue other occupations to generate revenue for their families. That is not to say that HIV afflicted families can afford HIV treatment any more than non-HIV families. But, their priorities and benefits from insured healthcare are substantially different. Can these families pay meaningfully higher premiums?

Successful treatment of HIV patients can also lead to meaningfully healthy lives. In such cases, the challenge of the model is to create a relationship with patients post-treatment to recover the costs, not unlike the deferred compensation model in labor theory. That challenge is also compounded by the fact that HIV is not curable. There are treatments out there to make the disease more manageable, but many of them cannot be afforded without very deep pockets.

It's a long list of challenges, but the promise of a solution is too great to be ignored. Being able to finance HIV treatment in Lwala would go a long way to getting this community back on its own feet. It could finally break the debilitating nature of the disease.

To learn more about Lwala's clinic initiative, which was started by Milton and Fred Ochieng, fellow Dartmouth graduates, I refer you to Omar's profile of this initiative at Real Medicine's website and the Lwala community clinic initiative website at Vanderbilt University, where Milton currently attends school.

[1] Inappropriately attributed to Hindustan Lever by CK Prahalad.

We often hear about campus politics in Kerala and its victims, including education. But few know about the cultural differences between colleges in Kerala.

In his post on Loyola's "“let-us-not-get-involved” political apathy", writer and editor Ashok R. Chandran gives his perspective on how Loyola has achieved a distinct reputation for being the school that bucks the trend. While other campuses have caved into hartals and intimidating student unions, Loyola has refused to bow to the violence that follows the two. However, Ashok questions, is the institutionalized attitude closer to apathy than a confrontation of such social evils?

All valid questions for anyone who wishes to see more mature political involvement at all levels in Kerala.

Schoolchildren in India

Silverine's story on Teresa reminded me of Melissa, the lady I tutor at my local community center. As a tutor, I help adults prepare for their high school equivalency examination. Most of the people who approach our community center have never completed high school, for a variety of reasons. And many of them are seeking to pass the GED exam to get a better job. But not Melissa.

When Melissa approached us with her desire to pass the GED math test, we were impressed. Here is a retired lady past her prime years but thinks highly enough of getting a high school education. And that too, in a discipline that many folks struggle with - math. Fortunately, math has always been my favourite subject.

During my first tutoring session with Melissa, I found that raising her math skills would be no easy task. One of her weaknesses is rounding numbers. In her preliminary test, when asked to round 6,360 to the nearest hundred, she answered 300. At first glance, one would think Melissa is starting from square one. But I deconstructed her thought process to identify that her problem was two-fold: attention (she left out the 6 in the thousands place) and perception (she had trouble grasping large numbers). I pointed out these issues with her constructively by encouraging her to use money as an example, a method she quickly grasped. Two sessions later, Melissa breezed through a quiz I prepared for her. As I watched her check her answers, I could scarcely imagine this was the same lady who believed her greatest weakness to be her failing memory.

Today, Melissa is rapidly mastering fractions and plugging holes in her math skills. In the two months as student and teacher and vice versa, she and I have learnt a lot about teaching and learning, much of it relevant to senior citizens. We have discovered that she has an optimal learning time and its much before the only time of the day we meet. We have also learnt that a two hour stretch is too long for her. So we keep our sessions to one and a half hours now. And we focus the first half of the stretch on new materials and the second stretch on homework. Also, practise makes perfect. So I give her plenty of exercises to take home. And all through this, I am pleasantly reminded of the human spirit to overcome.

Because of all the things I appreciate about Melissa, her ability to admit mistakes, to be patient, it's her perseverance that strikes me the most. And there is research to point that this skill is an important, if not the most significant, trait of a student - Scientific American recently ran an article , The Secret to Raising Smart Kids, which highlighted the results of several studies on how people learn. As the article notes,

"Teaching people to have a “growth mind-set,” which encourages a focus on effort rather than on intelligence or talent, produces high achievers in school and in life."

The writer elaborates on this difference in attitudes:

"Several years later I developed a broader theory of what separates the two general classes of learners—helpless versus mastery-oriented. I realized that these different types of students not only explain their failures differently, but they also hold different “theories” of intelligence. The helpless ones believe that intelligence is a fixed trait: you have only a certain amount, and that’s that. I call this a “fixed mind-set.” Mistakes crack their self-confidence because they attribute errors to a lack of ability, which they feel powerless to change. They avoid challenges because challenges make mistakes more likely and looking smart less so...The mastery-oriented children, on the other hand, think intelligence is malleable and can be developed through education and hard work. They want to learn above all else."

My theory of prosperity is tied to information and how it flows. One of my strongest beliefs about the way the world works, is that our life improves commensurately with our knowledge about ourselves and other forces in this world. More pithily put, "Knowledge is power". But less well understood is how we interpret the information comes our way, how we strive to open new avenues of information and how we act on that information. And as my experiences with Melissa show, the way we perceive information has possibly more power to shape our happiness than information itself.

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