Joel Selanikio, Co-Founder, DataDyne

“I think EpiSurveyor is the most widely deployed mHealth application in the world,” says Georgetown University pediatrician Dr. Joel Selanikio, creator of the open access software that aids in disease surveillance and collection of public health data in underserved regions.  He’s not so much boasting as marveling at the power of mobility and the Internet to break down barriers in the disjointed, occasionally frustrating realm of international development.

“The only thing that’s been amazing about EpiSurveyor is that it’s in international development,” Selanikio tells MobiHealthNews. “In Silicon Valley, there would be nothing amazing about it.”

Countless billions of dollars have been spent trying to improve living standards and health in developing countries, but much of the money falls into the hands of corrupt regimes, wasteful organizations and jet-setting diplomats who, according to Selanikio, “fly around the world first class and stay in 5-star hotels,” undercutting their mission.

Until perhaps a decade ago, Selanikio says, there was a thought that Africa was too hard a problem to tackle with technology since there had been just one example of technology taking hold globally in all of human history: Radio. But then cellular phones started showing up in some of the poorest corners of the globe.

“We’ve got this enormous, runaway success with the mobile phone being able to scale down to the village,” Selanikio says. “It’s the most successful tech product in the developing world since the radio.”

Essentially, the mobile phone took care of hardware distribution. The Web is starting to do the same with software. “Who seems to be the most successful at getting software out?” Selanikio asks. Companies that offer "open access" software like Google, Twitter and Facebook. These companies are succeeding where international development organizations have not.

“Hotmail, Gmail and Yahoo have given reliable email access to every health worker in the world,” Selanikio says. “The Web lowers the cost of entry for everyone.”

UPDATE: Selanikio makes a clear distinction between open source and open access. "Open source means 'allow any programmer to modify the software code' and it's very programmer-centric," he wrote MobiHealthNews in an email. "The problem is that the huge majority of people on earth, especially in developing countries, aren't programmers and wouldn't know what to do with software code if it fell on their heads. And buying programming expertise is inherently expensive. Open access means making things really simple to use for regular people, and very accessible (usually in the browser), with no need to have programmers involved. The latter -- open access -- is what EpiSurveyor is."

DataDyne, the distributor of EpiSurveyor that Selanikio co-founded, reported a 42 percent increase in downloads of the software in March compared to February, with substantial growth coming from West Africa. DataDyne also counted more than 18,000 page views from 102 countries in March, according to Selanikio.

“I don’t know what the people in West Africa are using it for,” Selanikio says, though. “The very nature [of an open access app] is that they can use it without contracting with us.” He reports seeing on Twitter last week that one entrepreneur from Silicon Valley downloaded EpiSurveyor for a Catholic relief agency to use in Zambia.

What Selanikio does know is that EpiSurveyor has more than 3,500 registered users worldwide and that it’s been somewhat of a disruptive technology. Among other accolades, he won the $100,000 Lemelson-MIT Sustainability Award in 2009 for his contributions to public health and international development.

Regardless, Selanikio continues to fight for respect and sustainability. He says there haven’t been any successful examples of open source technology scaling to the far reaches of the earth. “The only way to do it is to make a business out of it,” Selanikio says.

About a year ago, DataDyne added a paid version called EpiSurveyor Pro, featuring unlimited form building and unlimited data storage, but Selanikio reports that less than 1 percent of users are paid subscribers.  Still, he believes the model can be sustainable at 1 percent if he can increase the size of the user base.

Open access goes outside the traditional channels of international development by bypassing middlemen like aid agencies and foreign governments. “We think the way to scale things is by getting rid of some of the intermediate steps,” Selanikio says.

But that approach isn’t always well accepted in the world of international development, particularly in an area he calls “ICT4D,” or information and communications technology (a term often preferred to IT outside North America) for development.

Selanikio believes it might be time to re-think what ICT4D really is.

“ICT4D tends to be dominated by programmers,” Selanikio says. “To use EpiSurveyor, you don’t have to hire our programmers.” It’s similar to Gmail, except that in the case of Google’s free email service, the development costs are spread out across millions of users.

Mobile phones can be a form of ICT4D, too. “These are pocket computers,” Selanikio says, and he’s not just talking about smartphones.

Yet, some people don’t see platforms like these as true ICT4D, even if they work. “In some ways, it’s only considered ICT4D if it’s unsuccessful,” Selanikio laments.

And thus he continues to fight an uphill battle to deliver mobile technologies to health workers in villages around the world.