First Vending Machine

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Writing this in the Suntreso Government Hospital right now, over an MTN HSPA connection. We’re waiting on a gas station owner to come by and take us to his business. We’ll be installing a machine without electronics today. Helena, the Data Manager of the hospital and our main interlocutor, has said that she really wants a machine with usage monitoring in the hospital. Edward and I will be working on assembling one of those this afternoon.

Our biggest challenges thus far have been adapting the machine to the Ghanaian context. Replacement parts are not readily available, and Helena is worried that the machines will empty very quickly. It is becoming immediately obvious that what we truly need is a locally-made machine. One that can be easily modified to accept the correct amount of money for market rates, and dispense condoms that do not require more packaging than absolutely necessary. We are also hoping that there is someone at KNUST that could work on the electronics component.

Last Night in Kumasi

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One of many cell phone towers in Kumasi stands by the road.

Tonight is our last night in Kumasi. We’ve accomplished and learned a great deal, but it is obvious that this is just the beginning. We brought a SMS condom-finding service, thinking that there was a problem of information, not acceptance. We now realize that most people know where the condoms are, (and those places are close-by) but the stigma and anxiety over purchasing a condom is a major deterrent. We will not be installing the SMS system before we leave, but will use it as a starting point for continued research.
We must now look for ways to 1) reduce the stigma surrounding condom purchasing and usage. By incorporating regular condom use within a culturally-informed ad campaign that uses well-known local symbols, we aim to change popular perceptions about what it means to use a condom. 2) We must provide a way to make condom purchasing less intimidating by providing anonymity and convenience. We hope to achieve this by setting up condom vending machines in private places. To be sure, we do not want to drive condom purchasing into the shadows- rather we want to make it easier to purchase condoms using a variety of methods that have differing levels of human interaction and publicity. This also opens up opportunities for social entrepreneurship (managing vending machines)

The Two-Pronged Approach

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Brainstorming for a new Adinkra symbol.

Like I said in my last post, we originally thought there was a lack of information and an adequate level of acceptance. As the interviews have shown, this does not seem to be the case. Rather, access to condoms is relatively easy- they aren’t prohibitively expensive, nor are they hard to find. The problem is the social stigma attached to requesting a condom in the pharmacy. Reactions range from shy, to outright fear of retaliation (mostly from men). The condom-finding SMS system reduces the anxiety of asking for directions to a place that sells condoms, but does little for addressing the stigma at the point-of-sale.

We hope to address this in a two-pronged approach. First, condom points-of-sale must be put in less-intimidating locations and customers must be given the option to engage in an automated transaction (vending machines). Condom vending machines can be placed in women’s restrooms and even hair salons. This, however, does little for acceptance once the condom is acquired and when sex is performed. The second prong involves a culturally-informed ad campaign that uses the native Ashanti adinkra symbols to change attitudes towards condom use. Our interviewees have consistently replied that condoms are seen as something you use with someone you are not faithful to, or love. We are working with a family of adinkra cloth makers to come up with a new adinkra symbol for using condoms. The above picture, is a rough draft of one of the contenders. The Sankofa symbol (represented by, among other things, a bird) represents a proverb indicating one’s ability to go back for something forgotten or left behind. The addition of the condom in the bird’s mouth is a straight-forward addition to an existing symbol. We are also considering a modification of the classic, internationally-recognized- aids ribbon. By linking the international symbol for AIDS awareness to our specific campaign, we hope to connect Ghana to existing AIDS prevention programs while also leveraging existing symbols and iconography.

I’ve uploaded a few condom seller locations, and I hope to test the service this evening or tomorrow morning. Street addresses are even harder to come by (and less used) that originally expected, and so the form we use to enter new locations may have to be modified. Hope to work on it more tomorrow.