In Jinja, a town some 80 km from the Ugandan capital of Kampala, a favourite name for baby girls now is Mira. Some 5,500 km away, in Delhi, this is bringing smiles to the faces of social entrepreneurs Hilmi and Subhi Quraishi, founders of ZMQ Development.
For grateful Ugandans are naming their bonny baby girls after ZMQ’s mobile phone channel MIRA, which delivers life-saving health information in a fun way to pregnant women and adolescent girls.
MIRA, or Mobile Integrated Resources for Aurat, is one of the digital innovations on health and education ZMQ — a technology for development firm — has developed for thousands of people in rural India, Uganda and Afghanistan.
For the Quraishi twins, who are just short of 50, this kind of appreciation from the beneficiaries of their programme is far more significant than the many awards that have come their way in their 19-year social entrepreneurial journey.
Working out of an unpretentious office in a Delhi suburb, the Quraishi brothers have been quietly transforming the lives of many using the coding skills they learnt in Russia. Their mobile apps break down important health issues into simple stories and engaging games that are literally talking toolkits for people with low literacy levels.
More importantly, their out-of-the-box solutions are changing the traditional top-down approach to public healthcare in India.
To give an example: In treating Tuberculosis (TB), a major health problem that claims 500,000 lives every year just in India, non-compliance is a big challenge. Patients need to take their medication regularly to purge themselves of this infectious disease, but forget or do not complete the course leading to drug resistance. The WHO recommended approach followed by most nations is DOTS, or Directly Observed Treatment, Short Course, which focusses on surveillance. Typically, the patient has to report to a health centre and compliance is marked on a register. This, says Subhi Quraishi, is a top-down approach.
In contrast, ZMQ’s Freedom TB programme sends a voice notification to every TB patient at the medication time followed by an optimistic message that gives hope of cure soon.
When they started this campaign in Mewat in Haryana, the ZMQ team was shocked to find that the actual compliance rate was far lower than that recorded by government health workers. Often target-based recording of data results in over-reporting. Evidence-based reporting gives clues on why a patient has missed out on medication, and the issue can be addressed.
Similar mobile phone solutions have been developed for maternal health, immunisation, polio, HIV/AIDS, and other health challenges.
In most places ZMQ’s interventions ride on existing government platforms and systems. But often they add a layer of their own.
Take the case of maternal health. The Government’s Accredited Social Health Activists (ASHAs) educate and spread awareness on universal immunisation, reproductive care and child health among other things, at the village level. But they are over-worked.
What ZMQ has done is to send a set of MIRA workers to the field to teach rural women to use apps, ask questions, enter data and so on. Voice-based applications and visual icons help those unable to read.
Scaling it up and creating impact
Typically public healthcare projects face the challenge of scale. ZMQ has overcome this with its MIRA model, which after its successful rollout in Haryana is being replicated in Odisha and even internationally.
The good work in Mewat district, where there has been a 55 per cent increase in antenatal care consultations, 49 per cent jump in institutional deliveries and 41 per cent rise in child immunisation rate, caught the eye of the Millennium Alliance, a platform which helps scale up innovations that benefit the bottom of the pyramid.
Founded by the Technology Development Board, Department of Science and Technology, US Agency for International AID (USAID) and FICCI, the Millennium Alliance has taken MIRA to Uganda and Afghanistan giving ZMQ grants and helping with capacity building.
Says Nirankar Saxena, Deputy Secretary General, FICCI: “ZMQ has been one of the most promising social enterprises the Millennium Alliance has supported.” He describes how they have demonstrated measurable impact.
According to their stats, MIRA has touched the lives of 850,000 women, adolescent girls and children delivering health information at their doorstep.
Some 66,000 women, children and girls in Uganda and 43,000 in Afghanistan are using the solution. The results of this simple, low-cost intervention have been phenomenal with 3,000 Ugandan and 1,700 Afghani women successfully completing their pregnancies using the MIRA Channel. Not one maternal death has been reported during the project period.
And, MIRA is expanding by the day. Says Hilmi Quraishi, “In Uganda, we scaled from one to three districts. Beyond that the government is going to manage it.” He also shares his vision of “Ubering” MIRAs. “Every girl in a village can be a MIRA, and create a universe of Miras,” he says.
Fire in the belly and dad’s vision
Looking at their upbringing, the Quraishis’ foray into social entrepreneurship was pre-destined. Their parents instilled in them staunch Gandhian values and a thirst for knowledge. Their political scientist
dad, Dr Zahid Masood Quraishi (that’s where ZMQ derives its name from) and their mother Meraj, a lecturer, always exhorted them to spread learning. Hilmi describes how his dad, who named their elder sister Ilmana (knowledge), would say that if every individual educated just two more, illiteracy would vanish from India. The Quraishi twins did their schooling at Montfort school in Delhi’s Ashok Vihar, but when the boys were 16, their father, who had been educated partly in Egypt, sent them to the Soviet Union for higher studies as he wanted them to also absorb socialist values. They had finished their MS in Computer Science in Moscow and started on their PhD, when their dad died and the twins returned to India. “On the journey back, we decided to start an organisation in our father’s name that would deliver education,” says Hilmi.
In the initial years (1999-2002), all they had was the fire in their bellies, with only their mom’s salary and their dad’s pension to support them. They made mistakes. For instance, they created an entry-level literacy programme for children on CDs but when they went to villages they discovered these were useless with no computers. “We were doing things with passion but without any analysis,” says Hilmi.
But they learnt from every mistake. The break came when they created a game-based learning kit on HIV/AIDS. It was picked up by the Delhi State AIDS Control Society. By 2003, the brothers had launched their first mobile application — a game with social messaging. Reliance began running this on its R-World platform.
“We moved from HIV/AIDS to tuberculosis, and did campaigns on climate change, polio, leprosy, mental health — all through games on R-World,” says Hilmi.
Gradually, work began coming in from development organisations. Subhi Quraishi proudly points out that ZMQ may actually have been a pioneer in social games.
The Quraishi brothers’ minds are always ticking, solving problems. There is no resting on the success of MIRA. The next innovation — an adorable, talking doll that advices children and pregnant women — is ready. The Pashto-speaking doll has been given to women inAfghanistan.
“Women in villages often don’t get their own mobile phones. So, the dolls can take their place and reach them with useful messages,” points out bright-eyed Ayushi Singh, programme manager at ZMQ. The dolls also capture information — women can talk/reply to them. This is captured on a disk, which is collected by a MIRA worker and uploaded on a server.
Now, the Quraishis want to introduce the dolls in India. These will cost barely Rs 400-Rs 600, they say.
They are also working on an early education programme, Kreeda Aangan, that delivers basic literacy through games. “There is no better way than games to take education to the last mile,” says Subhi Quraishi.
A new project they are excited about is ‘Your Storyteller’. These are real stories gleaned from village people that have been animated and delivered back to them with a subtle message. Particularly poignant is a story on child marriage.
So far most of ZMQ Development’s work has been funded through grants or sustained through projects that the sister firm, ZMQ Technologies, does.
The Quraishis are clear they don’t want to mix commercial work with the non-profit service they do. As Subhi says, “I don’t want to die with a billion dollars in my bank account but would rather touch a billion lives.”