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Safe Healthcare is Good Business and Good Health

By David SouthDevelopment Challenges, South-South Solutions

SOUTH-SOUTH CASE STUDY

Many people have been shocked by recent stories about the proliferation of counterfeit drugs and the rate at which they are killing and harming people in Nigeria. The International Narcotics Control Board found that up to 50 percent of medicines in developing countries are counterfeit. This has driven home the point that without the presence of legitimate players in the African drug market, the illegal sharks will step in to make large profits – and a literal killing.

To counter this negative trend, what is most needed is support for reliable Africa-based companies: businesses that are long-term, sustainable and not living from one grant to the next. But as experience has shown around the world, nurturing businesses requires certain fundamentals: they must work to be profitable, they must find a market and exploit it, and they need cash infusions that are timed to the company’s growth, not to the cycle of international donors. This role, often served in developed countries by venture capitalists, who want a fast return of 35 percent – is too onerous a burden for most African businesses. What African companies need is a more conservative, long-term approach; one that expects returns of between five and 10 percent.

Kenyan company Advanced Bio-Extracts (ABE) is one good example. Only 18 months old and based in Nairobi, the company produces one of a new generation of low-cost anti-malarials known as artemisinin-based combination therapies (ACTs). The drug is produced from the green leafy plant Artemisia, or sweet wormwood. The company is the first in Africa to make this drug, and employs 7,000 local farmers in Kenya, Tanzania and Uganda, as well as scientists.

ABE has received two infusions of cash from non-profit social venture capitalists Acumen, as well as investment from Swiss drug giant Novartis. Acumen has so far invested US $9.6 million in 11 active investments focused on a diverse set of health challenges, including basic healthcare access in rural areas and treatment for malaria and HIV/AIDS.

“We are commercializing a product that had never been commercialized,” said ABE’s owner, Doug Henfrey, to the New York Times. “Those little windows of support make these things happen. We could not have done it otherwise.”

Acumen’s Kenya country director, Nthenya Mule, said “there are positive things happening in Africa, but they are not happening overnight, and some are happening quietly. ABE is exemplary. You will not see it as front-page news, but in 18 months they set up a factory with 160 people interfacing with 7,000 farmers and supplying one of the major pharma companies in the world.”

Stimulating private sector solutions to African healthcare problems is receiving an additional boost from a new fund established by the World Bank’s private sector arm, the International Finance Corporation. To be launched later in 2007, it will offer cash and loans totaling US $500 million to commercial healthcare projects in Africa. According to its own statistics, 60 percent of health expenditure in sub-Saharan Africa is privately funded, and the market, excluding South Africa, is worth US $19 billion.

Published: May 2007

Resources

  • Roll Back Malaria Partnership: Launched in 1998 by the World Health Organization. UNICEF, UNDP and the World Bank to coordinate the global campaign, to fight malaria.
  • Malaria Atlas Project (MAP): An online map showing up-to-date information on high-risk areas for malaria.
  • A paper on the global threat of counterfeit drugs: Click here

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP’s South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South’s innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator. 

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ORCID iD: https://orcid.org/0000-0001-5311-1052.

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Awards 1998-2003 | February 2020

UN/UNDP Mongolia Development Portal (www.un-mongolia.mn) 

I launched this portal in 1997, in the middle of a major economic crisis in Mongolia. This award-winning (winner in 1998 of the People’s Choice WebSite 500 award and the CyberTeddy Top 500 Website award) and pioneering United Nations Mongolia development web portal was singled out by UN headquarters as an example of what a country office website should be like.

At this time, Mongolia was still recovering from the chaotic and turbulent transition from Communism to free markets and democracy begun at the start of the 1990s, called by some “one of the biggest peacetime economic collapses ever” (Mongolia’s Economic Reforms: Background, Content and Prospects, Richard Pomfret, University of Adelaide, 1994). There was a thirst for information: access to the Internet was still limited and access to mobile phones was just the preserve of the rich. As a legacy of the past, information, especially that about the outside world and the country’s true economic and social conditions, was restricted. During the years of Communism, even simple travel from one place to the next was strictly regulated.

While today we can take it for granted that the Internet, and mobile and smart phones, deliver the world’s information in seconds, this just was not the case in the late 1990s in Mongolia.

“Cyber-Teddy’s Top 500 Web Site” was an online award from the late 1990s.
The UN/UNDP Mongolia development web portal addressed the urgent need to communicate what was happening in the country during a major crisis, and to transparently show what the UN was doing to address the crisis. It made critical data on the country’s development easy to find, and informed the wider world about the country and its people and culture. While the Internet had only just arrived in Mongolia, from the start the UNDP Mongolia Communications Office was experimenting with this powerful new technology to reach a global audience. This included Mongolia’s first web magazine, Ger (launched in 1998). After the http://www.un-mongolia.mn website launched in 1997, a media campaign began to inform readers of its presence. This ad appeared regularly in magazines, newsletters and newspapers.
“A UN System site. A very nice, complete, professional site. Lots of information, easily accessible and well laid out. The information is comprehensive and up-to-date. This is a model of what a UNDP CO web site should be.”

I was head of communications for the United Nations mission in Mongolia from 1997 to 1999. The mission had to primarily tackle three major crises: the country’s turbulent transition from Communism to free markets and democracy, the social and economic crash this caused, and the Asian Financial Crisis (Pomfret 2000) (Quah 2003)*.

Richard Pomfret said in 1994 “In 1991 Mongolia suffered one of the biggest peacetime economic collapses ever (Mongolia’s Economic Reforms: Background, Content and Prospects, Richard Pomfret, University of Adelaide, 1994).”

From Curbing Corruption in Asia: A Comparative Study of Six Countries by Jon S. T. Quah: “The combined effect of these three shocks was devastating as ‘Mongolia suffered the most serious peacetime economic collapse any nation has faced during this century’. Indeed, Mongolia’s economic collapse ‘was possibly the greatest of all the (peaceful) formerly’” Communist countries. 

“The years 1998 and 1999 have been volatile ones for Mongolia, with revolving door governments, the assassination of a minister, emerging corruption, a banking scandal, in-fighting within the ruling Democratic Coalition, frequent paralysis within the Parliament, and disputes over the Constitution. Economically, the period was unstable and rife with controversies.” Mongolia in 1998 and 1999: Past, Present, and Future at the New Millennium by Sheldon R. Severinghaus, Asian Survey, Vol. 40, No. 1, A Survey of Asia in 1999 (Jan. – Feb., 2000), pp. 130-139 (Publisher: University of California)

Writing in 2018, author John West  found, in a chapter titled Mongolia’s Corruption Curse (Transparency International and the World Bank had found corruption worsened in Mongolia after 2001), “In many ways, Mongolia has everything going for it. After being a satellite state of the former Soviet Union for much of the twentieth century, Mongolia regained its independence with the end of the Cold War. A relatively peaceful political revolution in the early 1990s ushered in a multi-party democracy and open society which have remained in place. … And it is blessed with vast reserves of copper, gold, coal, molybdenum, fluorspar, uranium, tin and tungsten deposits. True, Mongolia experienced great upheavals as the breakup of the Soviet Union saw its trade decline by 80%. But Mongolia was also perfectly placed to benefit from the commodity super cycle driven by China, which is now the destination for the vast majority of its exports.

“However, despite much hype about the Mongolian “wolf economy”, this country of so much promise is being dragged down by massive corruption. …

“Mongolia’s corruption is greatly weakening its attractiveness as an investment destination, is fracturing society and weakening its fragile political institutions. Its culture of corruption has also fed its love-hate relationship with foreign investors, which has destabilized the economy.” Asian Century … on a Knife-edge: A 360 Degree Analysis of Asia’s Recent Economic Development by John West, Springer, 24 January 2018.  

In this role, I pioneered innovative use of the Internet and digital resources to communicate the UN’s work and Mongolia’s unfolding crises. The UN called this work a “role model” for the wider UN and country offices. A survey of United Nations country office websites in 2000 ranked the UN Mongolia website I launched in 1997 and oversaw for two years (1997-1999), third best in the world, saying: “A UN System site. A very nice, complete, professional site. Lots of information, easily accessible and well laid out. The information is comprehensive and up-to-date. This is a model of what a UNDP CO web site should be.” (http://www.scribd.com/doc/274319690/UNDP-Mongolia-United-Nations-2000-Survey-of-Country-Office-Websites)

As part of a strategic plan to raise awareness of Mongolia’s development challenges and to spur action on meeting them, a Communications Office was established for the UN mission in 1997. Acting as a strategic hub, the Communications Office and its dynamic and talented team, were able to leverage the existing budget to spur action on many fronts.

In 2001, the UN won the Nobel Peace Prize for “their work for a better organized and more peaceful world” and its communications innovations, with work such as that in Mongolia being cited as a contributing factor to the awarding of the Prize

The Nobel Peace Prize 2001 joint winners.

GOSH Child Health Portal (www.gosh.nhs.uk)

In 2001 I undertook a two-year contract to modernise the online resources for the Great Ormond Street Hospital for Children NHS Trust (GOSH)/Institute of Child Health (ICH). My strategy was inspired and informed by initiatives encountered while working as a health and medical journalist in 1990s Canada – a time where government austerity spurred a need to experiment and try new ways of doing things.

Having seen the impact first-hand of pilot experiments in Toronto aimed at widening access to information and resources for patients and their families, I applied this knowledge to the GOSH Child Health Portal Project (2001 to 2003). Drawing on the wider NHS Modernisation Plan, and a multi-year consultation process undertaken by the hospital, the Project was launched in three phases. 

How far the UK had fallen out of step with global developments with the Internet became clear from the start. The distance that had to be traveled in the span of two years was vast. Essentially, to go from being a web laggard to a web leader. 

Award-winning (http://www.scribd.com/doc/35249271/Childnet-Awards-2003-Brochure), the GOSH Child Health Portal was called by The Guardian newspaper one of the “three most admired websites in the UK public and voluntary sectors,” and a UK government assessment called the overall GOSH child health web portal a role model for the NHS. At the time, Prime Minister Tony Blair (whose wife, Cherie Blair, was an early supporter and champion of the project) had this to say: “Making sure that your child has helpful, easy-to-read information will make a significant difference to their time in hospital. I am sure that this website will prove very useful for children and their families.”

The project was delivered in three phases. At every stage, progress was communicated to the wider public and colleagues in various ways, via in-house media and through constant engagement with British news outlets. Screen grabs and other resources from the project can be found online here: 

Phase 1: https://books.google.co.uk/books?id=g826gFjEXWsC&printsec=frontcover&dq=gosh+health+phase+1a&hl=en&sa=X&ved=0ahUKEwj5u__dqIHLAhVJOxoKHZ3IDZcQ6AEIJTAA#v=onepage&q=gosh%20health%20phase%201a&f=false 

Phase 2: https://books.google.co.uk/books?id=E2ZVlFbrCzsC&printsec=frontcover&dq=gosh+health+phase+2a&hl=en&sa=X&ved=0ahUKEwjEodr0qIHLAhWK2BoKHStJB7QQ6AEIJjAA#v=onepage&q=gosh%20health%20phase%202a&f=false

Phase 3: https://books.google.co.uk/books?id=KVE6QqDp1HsC&printsec=frontcover&dq=gosh+health+phase+3&hl=en&sa=X&ved=0ahUKEwiXwe-FqYHLAhVBvxoKHXhOCooQ6AEIJjAA#v=onepage&q=gosh%20health%20phase%203&f=false

Project documents: https://books.google.ca/books?id=4aeDBgAAQBAJ&dq=gosh+child+health+portal+key+documents&source=gbs_navlinks_s

The Cable and Wireless Childnet Award called Children First “an outstanding example of how a hospital can create quality, authoritative information on issues relating to health in a fun, child-centered and accessible way.”

More here from The Guardian and CBS: Hospital unveils international website for children and Web Projects For Kids Get Their Due 

The Childnet Awards in 2003 were awarded by Trond Waage, the Norwegian Ombudsman for Children, at the Science Museum in London.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021

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Mobile Phone Microscopes to Revolutionize Health Diagnostics

By David South, Development Challenges, South-South Solutions

New UNOSSC banner Dev Cha 2013

SOUTH-SOUTH CASE STUDY 

Mobile phone usage has increased hugely across the global South in the past five years. In Africa, the number of mobile phone subscribers reached 545 million in 2013, while there are 3.5 billion mobile phone users in Asia and the Pacific (ITU). Some 93 million people in Africa and 895 million in Asia and the Pacific have mobile phone Internet access (ITU).

“Every day we are moving closer to having almost as many mobile-cellular subscriptions as people on earth,” Brahima Sanou, Director of the ITU Telecommunication Development Bureau, wrote in its latest report on their growth.

The number of mobile phone subscriptions in the developing world has surpassed 5 billion and the number in the world as a whole reached 6.8 billion in 2013 (ITU), out of a world population of more than 7.1 billion. This compares to considerably lower numbers of people with access to the Internet: 2.7 billion in the world (ITU).

While many people in poorer countries have basic versions of mobile phones, the next generation of smartphones has been growing in number as prices come down (http://en.wikipedia.org/wiki/Smartphone). Examples of these smart phones include the BlackBerry, Apple’s iPhone, the Samsung Galaxy, and the Nokia Lumia. Smartphones tend to have enormous computing power and an ability to run complex ‘apps’ or applications – including public transport options, maps, restaurant and store locators, banking services and market information and resources. They can also access the Internet through Wi-Fi, and have camera and video capability.

What people can do with these feature-packed phones is limited by little other than human imagination. With the ability to store large amounts of data and images, using apps that perform a limitless range of services and tasks, smartphones can be deployed as powerful tools to tackle problems.

Science fiction sagas have long fantasized about people being able to walk around with small electronic devices that can do immensely powerful tasks, including being a medical diagnostic tool. But this science fiction dream is rapidly becoming reality in the global South.

Various initiatives and innovators are using mobile phones and smartphones to conduct medical diagnosis and gather data for medical studies in real time.

Some innovations are even turning smartphones into mobile microscopes.

Developed by the University of California, Berkeley in the lab of Professor Daniel Fletcher (http://cellscope.berkeley.edu/), the CellScope (cellscope.com) is capable of turning the camera on a cell (mobile) phone into a diagnostic microscope with a magnification of 5x to 60x. Fletcher’s lab has also pioneered work on needle-free injection technology.

The CellScope can be used for ocular imaging (technologies for visualizing and assessing a range of diseases of the eye) and for detecting tuberculosis, blood-borne diseases and parasitic worms.

Fletcher is a bioengineer and was impressed with how much mobile phone technology has proliferated across the global South.

“You don’t have to put in these copper wires (for phone lines) anymore; you have the (cell) towers. It’s big business,” Fletcher told The Scientist Magazine.

“It’s leaping over the need for infrastructure.”

Fletcher and his colleagues experimented by attaching extra lenses to smartphones. They then used the phone to image cells that had been stained with fluorescent dyes to make them easier to see. The quality of the image was so good, they were able to diagnose malaria from blood samples and tuberculosis from sputum (spit) samples.

With the addition of image analyzing software, the phone was able to automatically count the number of Mycobacterium tuberculosis bacilli. They were trying to prove you did not need conventional microscopes to do this sort of diagnostic work.

Fletcher and his colleagues are currently trialling the technology in Vietnam, India, Cameroon and Thailand.

“Technology alone doesn’t create effective health care,” Fletcher emphasizes. “It’s got to be part of a context in which the information is captured and validated and is analyzed in the right way, and treatments are then available in response to information.”

Another group from Toronto General Hospital in Canada (http://www.uhn.ca/corporate/AboutUHN/OurHospitals/Pages/TGH.aspx) has ‘hacked’ an iPhone smartphone by placing a 1 millimeter ball lens on the phone’s camera. Isaac Bogoch, an infectious disease specialist, had been investigating parasitic worm infections in children on Pemba Island off the coast of Tanzania. Along with Jason Andrews of Massachusetts General Hospital, they had been inspired by a report about how a team of researchers from the University of California, Davis had created a simple microscope out of an iPhone with a 1 millimeter lens. This makeshift microscope was used to take pictures of blood smears at a 350 times magnification and giving a 1.5 micron resolution.

“We thought that was a great idea,” Bogoch told The Scientist Magazine. Bogoch regularly works as part of an international team around the world, often in remote locations.

“We thought … we could take it to the field and see if it accurately works in a more real-world setting.”

Inspired, Bogoch got together with his colleagues and created a similar microscope with a 3 millimeter ball lens and then got to work using it to identify soil-transmitted helminth eggs in stool samples in Tanzania. When examining the stool samples of 199 children in a clinical trial using the makeshift microscope, they were able to accurately identify helminth infections in 70 per cent of the cases. They also found the iPhone microscope did very well at spotting eggs of particular parasites, such as 80 per cent of Ascaris lumbricoides infections (http://en.wikipedia.org/wiki/Ascaris_lumbricoides). The success rate dropped significantly, however, when trying to detect whipworm parasites (just over half) and hookworm infections (14 per cent).

But this is early days and an experiment: “Obviously the results aren’t perfect and there’s definitely room for improvement,” Bogoch admits.

What stands out is the potential to completely revolutionize health care by continuing to develop the capability of smartphones. With their portability and low cost, they also have the advantage of not needing a trained physician to operate them, according to David Walker, president of the American Society of Tropical Medicine and Hygiene, in The Scientist Magazine.

One of the many advantages of combining a microscope with a digital smartphone is the ability to take a picture and send it straight away to someone to make a diagnosis.

Even more exciting, Sebastian Wachsmann-Hogiu at the University of California, Davis (http://cbst.ucdavis.edu/people/sebastian/) is adapting mobile phones to undertake spectroscopy (http://en.wikipedia.org/wiki/Spectroscopy), using diagnostic test software to analyze samples on the spot. This, when successful, would be akin to the capabilities first mooted in the science fiction television and film series Star Trek (startrek.com). In Star Trek, the doctor is able to use a small handheld digital device to quickly diagnose what ails somebody.

The potential for this technology in the global South is significant. Aydogan Ozcan at the University of California, Los Angeles, who is also working on mobile phone microscopes, believes this is as significant as the dawn of the personal computer: “If you look at the early computers, they were bulky, they were extremely expensive,” he says.

But now computers “are portable … and almost anyone can afford them. The same thing is going on today (with microscopy). We are miniaturizing our micro- and nano-analysis tools. We’re making them more affordable; we’re making them more powerful.”

It looks like this science fiction dream will soon become today’s reality.

Resources

1) World Telecommunication/ICT Indicators Database. Website: http://www.itu.int/en/ITU-D/Statistics/Pages/stat/default.aspx

2) HealthMap: HealthMap was founded in 2006 by a team of researchers, epidemiologists and software developers at Boston Children’s Hospital. It is an established global leader in utilizing online informal sources for disease outbreak monitoring and real-time surveillance of emerging public health threats. Website: http://www.healthmap.org/en/

3) A home-made portable microscope: A design developed in the 1970s by Chinese students who fashioned a microscope from a plastic bottle. Website: http://www.microscopy-uk.org.uk/mag/indexmag.html?http://www.microscopy-uk.org.uk/mag/artjul00/awscope.html

4) Ways to make simple homemade microscope lenses. Website: http://www.microscopy-uk.org.uk/mag/indexmag.html?http://www.microscopy-uk.org.uk/mag/artoct07/jd-lens.html


This work is licensed under a Creative Commons Attribution 4.0 International License.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2022

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African Health Data Revolution

A pioneering tool for gathering health data now being used in Kenya could herald a revolution in the way diseases are tracked and defeated around the world. It uses mobile phones to better connect patients with medical and health personnel, and allows data to be gathered in real-time and used to track health and improve the delivery of services, especially to remote and under-serviced areas.

In the past couple of years, Kenya has become a hotbed of mobile phone and information technology innovation. The now-famous Ushahidi crisis-mapping platform (www.ushahidi.com) is just one example. Social enterprise Data Dyne (www.datadyne.org) – with offices in Washington DC and Nairobi, Kenya – is offering its EpiSurveyor application (www.episurveyor.org) free to all to aid health data collection. It bills itself as “the first cloud-computing application for international development and global health … Think of it as like Gmail, but for data collection!”

EpiSurveyor claims to have more than 2,600 users around the world and is currently being upgraded to a second version.

“With the touch of a button I can see what’s going on across the country in real time,” Kenyan civil servant Yusuf Ibrahim told Britain’s Daily Telegraph newspaper. “It is amazing.”

Ibrahim works in Nairobi as the Kenyan Ministry of Health liaison to Data Dyne.

He uses maps and charts on mobile phones to track deadly disease outbreaks and vulnerable pregnancies.

The EpiSurveyor application works simply: A user logs into the website and builds and creates the sort of form they want. They then download it to a phone and start collecting data straight away.

Ibrahim gathers this data from mobile phones used by health care workers across the country.

“It used to take days, weeks or even a couple of months to find out about an outbreak of polio on the other side of the country,” he said. “Now we know almost instantly. The speed with which we can now collect information has catapulted healthcare and prevention to another level. It has completely changed healthcare and saved countless lives.”

He proudly points out Kenya’s mobile phone data collection system is “probably better than what they’ve got in the West.”

“Although we are a third world country, I’m pretty sure we’ve done this before

Western countries. While they are still collecting information in hard copy on clipboards, we are getting it instantly.”

Packed with data processing power, mobile phones are capable of an immense range of tasks and applications. Some see phones as key to a revolution in how healthcare is provided: the mobile phone becomes one-part clinic, another part mobile hospital dispensing advice and transmitting vital information back to healthcare professionals and scientists in hospitals and labs.

Despite dramatic improvements to the quality of hospitals in Africa and the number of qualified doctors, the continent’s healthcare services are still a patchwork, with rural and slum dwellers poorly served and the stresses of treating patients with contagious diseases like HIV/AIDS and malaria pushing resources to the limit.

The United Nations has a number of initiatives partnering with mobile phone manufacturers, networks and software developers as part of a global campaign to reduce HIV/AIDS, malaria and deaths in childbirth.

EpiSurveyor is being used by more than 15 countries’ ministries of health and is the adopted standard for the World Health Organization (www.who.int) (WHO) for electronic health data collection.

It began as a partnership with the United Nations Foundation, The Vodafone Group Foundation, WHO and the ministries of health of Kenya and Zambia in 2006 to pilot test the software for EpiSurveyor.

At the United Nations Foundation (www.unfoundation.org), chief executive Kathy Calvin equates the impact of mobile phones on global healthcare to the discovery of the antibiotic penicillin.

“Instead of building clinics and roads to remote towns and villages so that people can access healthcare, we are bringing healthcare directly to the people via mobile phones. You get a lot more healthcare for your money,” Calvin told the Telegraph.

By David South, Development Challenges, South-South Solutions

Published: November 2010

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP’s South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South’s innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.  

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Slideshare: http://www.slideshare.net/DavidSouth1/development-challengessouthsouthsolutionsnovember2010issue

Southern Innovator Issue 1: https://books.google.co.uk/books?id=Q1O54YSE2BgC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 2: https://books.google.co.uk/books?id=Ty0N969dcssC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 3: https://books.google.co.uk/books?id=AQNt4YmhZagC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 4: https://books.google.co.uk/books?id=9T_n2tA7l4EC&dq=southern+innovator&source=gbs_navlinks_s

Southern Innovator Issue 5: https://books.google.co.uk/books?id=6ILdAgAAQBAJ&dq=southern+innovator&source=gbs_navlinks_s

Creative Commons License
This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2022