Categories: David Banks, HIV/AIDS Awareness and Prevention in Ghana
Tags: David Banks
Edward and I installed our first vending machine today. The machine was placed at a gas station a few miles away from the hospital. Within minutes of installing the machine the employees had completely emptied it! We refilled it and just before leaving, it was already half-empty. This presents a new challenge: how to modify the machines to accept more condoms. This is a great problem to have- since it arms us with crucial market data that will help us convince local metal workers and recently-graduated engineers that they can make a living building machines that dispense condoms.
The gas station is on a remote highway that, is crucial for transport of goods and distant travelers, but is in a much more rural location than the hospital or the other locations we plan on visiting. If other places are busier than the gas station, an owner could conceivably refill the machine three to five times a day. We could raise the price, which may become necessary anyway (if we can’t find a supplier of high-quality and low cost condoms, the project becomes unviable), but we would rather provide more condoms than charge more money.
Perhaps I’m getting ahead of myself. There are much more immediate hurdles to clear than raising capacity or increasing the price per condom. For example, we ran into a few problems drilling into the wall, so we may need to buy concrete drill bits and an assortment of screws and sinkers. These materials will help make installation of the existing machines quicker and easier. The Central Market will most likely provide us with both of these things. A much more difficult challenge involves sourcing rectangular condom packages and their necessary boxes. As long as we use the machines we brought over, we will need to find a supplier of tiny boxes and rectangular condoms (see below).
The ultimate goal –establishing local suppliers of the machines as well as the condoms– also presents my own biggest fear. Vending machines for condoms can quickly turn into vending machines for bottled water, cell phone minutes, and other daily necessities. This familiar struggle –replacing people with machines in the name of profit– is not one I care to instigate. How does one prevent the inclination to apply technologies across markets? It is difficult to overcome the seemingly natural inclination to apply new practices, that increase efficiency and reduce inputs, to as many aspects of life as possible .Jaques Ellul would call this technique. This force is at the very heart of the modern nation state and the capitalist enterprise. STS scholars typically think of the “tech fix” as a superficial solution to a deep problem. But the way I see it, the technical fix is anything but a bandaid on a broken arm: it is a stress trigger to a virus called technique that lays dormant in the body politic. When you apply the forces of routinization, standardization, and mechanization you leave open the distinct possibility that technique will flare up like a fever blister. What sorts of stress management practices can we implement that will temper the forces of technique and prevent the total loss of human economies and mutual aid networks? Ellul says that forces like religion and nationalism were able to constrain technique. Can we build new institutions that are equally powerful? What would they look like and how would they behave? These are questions that deserve concrete answers, but the continued spread of HIV demands that we proceed without perfect knowledge of the consequences. This reminds me of what Andrew Pickering calls the Mangle of Practice. You act based on educated guesses about how the world works, watch the reaction, and proceed from there. When you meet resistance, you accommodate the new-found reality and push forward.