In November last year, Nigeria declared that its water supply, sanitation and hygiene sector was in crisis. This was partly prompted by the fact that the country has struggled to make progress towards ending open defecation.
Almost one in four Nigerians – around 50 million people – defecates in open areas. They do so because access to proper sanitation, like private indoor toilets or outdoor communal toilets, has not improved in recent years.
In fact, it’s got worse: in 2000, 36.5% of Nigerians had access to sanitation facilities that hygienically separate human excreta from human contact. By 2015 the figure had dropped to 32.6%, likely driven by rapid population growth and a lack of sufficient private and public investment.
Open defecation comes with many risks. It can lead to waterborne diseases, cause preventable deaths, and hamper education and economic growth. It also infringes on people’s privacy and dignity.
The government has tried several strategies to address this problem. In 2008 it adopted an intervention called “Community Led Total Sanitation”. This is a community-level intervention aimed at reducing open defecation and improving toilet coverage.
It draws in community leaders and ordinary residents so they can understand the risks associated with open defecation. By 2014 the intervention was deployed in all 36 Nigerian states, covering around 16% of the country’s 123,000 communities.
We wanted to know how effective the programme has been, if at all. So we conducted a study and found that community-led total sanitation programmes alone will not eradicate the practice of open defecation. But they could be part of the solution.
We found that the programme currently works quite well in poor communities but is less effective in richer places – that is, places with higher average ownership rates of assets such as fridges, motorcycles, TVs, smartphones and power generators.
Poorer communities distinguish themselves from richer ones in other ways, too. They tend to have higher levels of trust among their citizens, lower initial levels of toilet coverage and lower wealth inequality. But none of these characteristics is, on its own, as strong a predictor of where the intervention works better than community wealth.
Low community wealth is a simple measure that encompasses all these different features, and is associated with greater programme effectiveness.
Community-led total sanitation typically starts with mobilisation. This initially involves community leaders and then, through them, communities more broadly. Then, a community meeting is held at which residents typically start by marking their household’s location and toilet ownership status on a stylised map on the ground. They also identify and mark regular open defecation sites.
Facilitators use the map to trace the community’s contamination paths of human faeces into water supplies and food. A number of other activities may follow, such as walks through the community that are often referred to as “walks of shame” during which visible faeces are pointed out, to evoke further disgust and shame.
Another common activity involves calculating medical expenses related to illnesses that are caused by open defecation practices.
In 2015 we worked with the charity organisation WaterAid Nigeria and local government agencies in the states of Ekiti and Enugu to design a field experiment in areas with no recent experience of community led total sanitation, or similar interventions.
The community-led total sanitation programme was implemented in a random sample of 125 out of 247 clusters of rural communities.
To study the intervention’s effectiveness, we interviewed 20 randomly selected households before community-led total sanitation took place. We followed up with these households eight, 24 and 32 months after the intervention.
We found that the programme’s roll-out didn’t lead to any changes in sanitation practices in richer communities. But it worked in the poorest communities. The prevalence of open defecation declined by an average of nine percentage points in poorer communities when compared to other poor areas where the programme wasn’t implemented. This drop was accompanied by a similar increase in toilet ownership rates.
Impact depends on wealth
Our results are in line with observations by the designers of the programme. But we are the first to show quantitatively that community asset wealth is a good predictor of whether the intervention can be expected to be successful. Unfortunately, our data does not allow us to pin down why households in poorer communities are more susceptible to the programme. However, these results have important implications for more cost effective targeting of the programme.
Most countries, including Nigeria, have access to readily available datafrom household surveys that can be used to measure how asset-poor a community is. These data can be used to identify and target communities where community-led total sanitation is likely to have the biggest impact.
Eradicating open defecation is not just a Nigerian priority. Today, an estimated 4.5 billion people globally don’t have access to safe sanitation. So we also looked at data and research about this same intervention from other parts of the world.
Community-led total sanitation intervention was first developed in Bangladesh in 1999. It has now been implemented in more than 25 Latin American, Asian and African countries.
We used information from evaluations of this intervention in Mali, India, Tanzania, Bangladesh and Indonesia. The studies found widely differing impacts. These ranged from a 30 percentage point increase in toilet ownership in Mali to no detectable impact on toilet ownership in Bangladesh.
Using a measure of wealth for these countries, we found that sanitation interventions have larger impacts in poorer areas, such as Tanzania, and low or no impact in relatively richer areas, such as Indonesia. This supports the idea that targeting poorer areas maximises the impact of community led total sanitation.
Our research shows that while community-led total sanitation is effective in Nigeria’s poorer areas, there are two main challenges.
First, community-led total sanitation had no perceivable impact in the wealthier half of our sample. There, open defecation remains widespread. And second, even in poor areas, a large number of households still engaged in open defecation after the intervention.
This suggests that while community-led total sanitation can be better targeted, it needs to be complemented with other policies – subsidies, micro-finance or programmes that promote private sector activity in this under-served market.
Facebook Is Still Leaking Data More Than One Year After Cambridge Analytica
Facebook said late Tuesday that roughly 100 developers may have improperly accessed user data, which includes the names and profile pictures of individuals in certain Facebook Groups.
The company explained in a blog post that developers primarily of social media management and video-streaming apps retained the ability to access Facebook Group member information longer than the company intended.
The company did not detail the type of data that was improperly accessed beyond names and photos, and it did not disclose the number of users affected by the leak.
Facebook restricted its developer APIs—which provide a way for apps to interface with Facebook data—in April 2018, after the Cambridge Analytica scandal broke the month before. The goal was to reduce the way in which developers could gather large swaths of data from Facebook users.
But the company’s sweeping changes have been relatively ineffective. More than a year after the company restricted API access, the company continues to announce newly discovered data leaks.
“Although we’ve seen no evidence of abuse, we will ask them to delete any member data they may have retained and we will conduct audits to confirm that it has been deleted,” Facebook said in a statement.
The social media giant says in its announcement that it reached out to 100 developer partners who may have improperly accessed user data and says that at least 11 developer partners accessed the user data within the last 60 days.
Facebook has been reviewing the ways that companies are able to collect information and personal data about its users since the New York Times reported that political consulting firm Cambridge Analytica harvested data of millions of users. Facebook later said the firm connected to the Trump campaign may have improperly accessed data on 87 million users.
The Federal Trade Commission slapped Facebook with a $5 billion fine as a result of the breach. As part of the 20-year agreement both parties reached, Facebook now faces new guidelines for how it handles privacy leaks.
“The new framework under our agreement with the FTC means more accountability and transparency into how we build and maintain products,” Facebook’s director of platform partnerships, Konstantinos Papamiltiadis, wrote in a Facebook post.
“As we work through this process we expect to find examples like the Groups API of where we can improve; rest assured we are committed to this work and supporting the people on our platform.”
How A BlackBerry Wiretap Helped Crack A Multimillion-Dollar Cocaine Cartel
On August 18, 2017, four men travelling in a dual-engine speedboat carrying 1,590 pounds of cocaine were intercepted by the U.S. Coast Guard northwest of the Galapagos Islands.
The federal agents manning the channel chose to launch a helicopter to hover over the boat. With this aggressive move, the men began to jettison the bales of coke, each with their own GPS tracker so they could be picked up at a later date, according to the government’s narrative. They attempted to flee, and when they ignored the warning shots from the helicopter, the chopper fired rounds directly at the boat, disabling it.
After the bales were collected, the government realized they had just stopped a huge amount of cocaine from entering the U.S. In total, it carried a street value of $25 million. The four men, all Ecuadorians, were swiftly arrested and charged.
Though the cartel had set up a sophisticated, multilayered operation that sought to slip coke into the country and up to Ohio via land, air and sea, they had made a crucial error: They used BlackBerry phones. As the drug barons chatted about shifting cocaine and how to avoid the narcs over BlackBerry Messenger, a wiretap on a server in Texas was quietly collecting all their communications.
In a case that’s Narcos meets The Wire, federal agents have, since June 2017, been listening in on that server. And beyond that interception, Forbes can exclusively reveal it is yielding results. On Friday, an Ohio court is unsealing charges against one of the crew’s top brass: Francisco Golon-Valenzuela, 40.
Known as El Toro, Spanish for The Bull, the Guatemalan was extradited from Panama earlier this week and is appearing before a magistrate judge today. (Forbes hasn’t yet made contact with his counsel for a response but will update if comment is forthcoming.)
Described as one of various organizers and leaders of the unnamed cartel, El Toro is charged with conspiring to distribute at least 5 kilograms or more of cocaine on the high seas. As a result, he’s facing between 10 years and life in prison.
A key to BlackBerry
For any organized crime operation, BlackBerry has always been a poor choice. No longer extant since being decommissioned in spring this year, BlackBerry Messenger did encrypt messages, but the Canadian manufacturer of the once-ubiquitous smartphone had the key. And all messages went through a BlackBerry-owned server. If law enforcement could legally compel BlackBerry to hand over that key, they would get all the plain-text messages previously garbled into gibberish with that key.
Compare this to genuine, end-to-end encrypted messaging apps like WhatsApp or Signal; they create keys on the phone itself and the device owner controls them. To spy on those messages, governments either have to hack a target device or have physical access to the phone. Both are tricky to do, especially for investigations of multinational criminal outfits. Police can put a kind of tap on a WhatsApp server, known as a pen register.
This will tell them what numbers have called or messaged one another, and at what date and time, but won’t provide any message content. This makes those apps considerably more attractive to privacy-conscious folk than those where the developer holds the keys, though sometimes to the chagrin of law enforcement.
It’s unclear how or when the DEA got access to the BlackBerry server. A so-called Title III order was issued, granting them court approval to carry out the wiretap, though that remains under seal.
It proved vital to the investigation. “There would be no case without the without the Title III on BlackBerry Messenger,” said Dave DeVillers, who was recently nominated as U.S. Attorney for the Southern District of Ohio. “The defendants, the seizures, the conspiracy were all identified with the Title III.”
A spokesperson for BlackBerry said: “We do not speculate or comment upon individual matters of lawful access.” The company has, however, previously made its stance on encryption public: Unlike other major tech providers like Apple or Google, BlackBerry will hand over the keys if it’s served with a legitimate law enforcement request.
If the police did receive a key from BlackBerry, it wouldn’t be the first time. Back in 2016, it emerged that the Royal Canadian Mounted Police (RCMP) had decrypted more than one million BlackBerry messages as part of a homicide investigation dating back to 2010.
As per reports from that time, it’s possible to use one of BlackBerry’s keys to unlock not just one device’s messages, but those on other phones too. Forbes asked the DOJ whether investigators would’ve been able to access other, innocent people’s BlackBerry messages as part of this wiretap, but hadn’t received a response at the time of publication.
Fishermen and spies
However those BlackBerry messages were intercepted, they helped illuminate a dark criminal conspiracy constructed of myriad parts. As revealed in today’s indictment, made known to Forbes ahead of publication, the gang employed “load coordinators.” Think of them as project managers, helping locate drivers for trucks and boats while finding people to invest in the cocaine.
Fishermen and other maritime workers were also allegedly recruited. They would help both in refueling the drug baron’s ships, but also helping transport the powder, prosecutors said.
Other individuals became ad hoc spies, sharing information on the activities and locations of police and military personnel trying to intercept shipments, according to the government’s allegations. Other coconspirators sheltered individuals who were at risk of extradition—not that it saved El Toro.
Forbes first became aware of the investigation in 2017, when a search warrant detailed various BlackBerry intercepts. In one, a pair of cartel employees discussed having to put some cocaine transports on hold because of a multinational maritime exercise—the Unitas Pacifico 2017—taking place in their shipment lanes, according to the warrant. BlackBerry wasn’t the only major tech provider to help on the case; That search warrant was for a Google account linked to one of the suspects, which investigators believe was used for further logistics.
The investigation has revealed that the 2017 seizure wasn’t the only time the cops had disrupted what was evidently a criminal enterprise worth hundreds of millions. In May 2016, long before the BlackBerry wiretap went up and the investigation into the cartel had begun in earnest, U.S. authorities intercepted 1,940 pounds of coke near the Guatemalan-Mexico border, worth another $30 million.
Despite such successes, DeVillers told Forbes the American government will never interdict its way to ending the drug trade. “We can only disrupt it,” he added. “And if we turn the tools used by the cartels to run their organization against them, we do just that.”
-Thomas Brewster; Forbes
How Virtual Therapy Apps Are Trying To Disrupt The Mental Health Industry
Millions of Americans deal with mental illness each year, and more than half of them go untreated. As the mental health industry has grown in recent years, so has the number of tech startups offering virtual therapy, which range from online and app-based chatbots to video therapy sessions and messaging.
Still a nascent industry, with most startups in the early seed-stage funding round, these companies say they aim to increase access to qualified mental health care providers and reduce the social stigma that comes with seeking help.
While the efficacy of virtual therapy, compared with traditional in-person therapy, is still being hotly debated, its popularity is undeniable. Its most recognizable pioneers, BetterHelp and TalkSpace, have enrolled nearly 700,000 and more than 1 million users respectively. And investors are taking notice.
Funding for mental health tech startups has boomed in the past few years, jumping from roughly $100 million in 2014 to more than $500 million in 2018, according to Pitchbook. In May of this year, the subscription-based online therapy platform Talkspace raised an additional $50 million, bringing its total funding to just under $110 million since its 2012 inception.
The ubiquity of smartphones, coupled with the lessening of the stigma associated with mental health treatment have played a large role in the growing demand for virtual therapy. Of the various services offered on the Talkspace platform, “clients by far want asynchronous text messaging,” says Neil Leibowitz, the company’s chief medical officer.
Users seem to prefer back-and-forth messaging that isn’t restricted to a narrow window of time over face-to-face interactions. At BetterHelp, founder Alon Matas notes that older users are more likely to go for phone and video therapy sessions, whereas younger users favor text messaging.
“Each generation is getting progressively more mobile-native,” says John Prendergass, an associate director at Ben Franklin Technology Partners’ healthcare investment group, “so I think we’re going to see people become increasingly more accustomed, or predisposed, to a higher level of comfort in seeking care online.”
The ease and convenience of virtual therapy is another draw, particularly for busy people or those who live in rural areas with limited access to therapy and a range of care options.
Alison Darcy, founder and CEO of Woebot, a free automated chatbot that uses artificial intelligence to provide therapeutic services without the direct involvement of humans, says that with Woebot and other similar services, there is no need to schedule appointments weeks in advance and users can receive real-time coaching at the moment they need it, unlike traditional therapy. The sense of anonymity online can also lead to more openness and transparency and attracts people who normally wouldn’t seek therapy.
Along with stigma, the cost of therapy has historically acted as a barrier to accessing quality mental-health care. Health insurance is often unlikely to cover therapy sessions. In most cities, sessions run about $75 to $150 each, and can go as high as $200 or more in places like New York City. Web therapists don’t have to bear the expense of brick-and-mortar offices, filing paperwork or marketing their services, and these savings can be passed on to clients.
BetterHelp offers a $200-a-month membership that includes weekly live sessions with a therapist and unlimited messaging in between, while Talkspace’s cheapest monthly subscription at $260-a-month, offers unlimited text, video and audio messaging.
But virtual therapy, particularly text-based therapy, is not suitable for everyone. Nor is it likely to make traditional therapy obsolete. “Online therapy isn’t good for people who have severe mental and relational health issues, or any kind of psychosis, deep depression or violence,” says Christiana Awosan, a licensed marriage and family therapist.
At her New York and New Jersey offices, she works predominantly with black clients, a population that she says prefers face-to-face meetings. “This community is wary of mental health in general because of structural discrimination,” Awosan says. “They pay attention to nonverbal cues and so they need to first build trust in-person.”
Virtual therapy apps can still be beneficial for people with low-level anxiety, stress or insomnia, and they can also help users become aware of harmful behaviors and obtain a higher sense of well-being.
Sean Luo, a psychiatrist whose consultancy work focuses on machine learning techniques in mental health technology, says: “This why some of these companies are getting very high valuations. There are a lot of commercialization possibilities.” He adds that from a mental health treatment perspective, a virtual therapy app “isn’t going to solve your problems, because people who are truly ill will by definition require a lot more.”
Relying on digital therapy platforms might also provide a false sense of security for users who actually need more serious mental-health care, and many of these apps are ill-equipped to deal with emergencies like suicide, drug overdoses or the medical consequences of psychiatric illness. “The level of intervention simply isn’t strong enough,” says Luo, “and so these aspects still need to be evaluated by a trained professional.
– Ruth Umoh, Diversity and Inclusion Writer, Forbes Staff.
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