Crowdsourcing,Social Media,and Intercultural Communication About Zika: Use Contextualized Research to Bridge the Digital Divide in Global Health Intervention

Abstract

This article presents a case study of the Smarter Crowdsourcing project the International Development Bank and Governance Lab cohosted to cope with the emerging Zika outbreaks in Latin America countries. Using the lenses of intercultural communication methodologies, user-centered design, and global cultural flow, I examine the exclusion of at-risk populations as marginalized end users of the project. I also examine the impacts of this oversight on the effectiveness of the technocratic solutions. I then conclude by discussing the implications this case has for international health intervention, global technical communication, and community-based research.

Keywords

crowdsourcing global cultural flows intercultural research methodologies digital exclusion Zika

Introduction

Global epidemics require global responses. During the Zika outbreak in 2016, a novel approach, Smarter Crowdsourcing, was taken to rally international collaboration in order to explore effective ways to cope with Zika. To address this situation in Latin America and the Caribbean (LAC), the Inter-American Development Bank (IDB) collaborated with the LAC governments, New York University, and Governance Lab (GovLab) to launch an “innovative, actionable, [and] intersectoral strategy that takes advantage of current technological resources” in ongoing battles against Zika (IDB & GovLab, 2016). It is important to examine strategies used by and lessons learned from such innovative international endeavors because they can teach both health communicators and technical communicators important lessons about international communication research, distributed knowledge work, user research, and access and social justice.

This article examines the Smarter Crowdsourcing project as a historical case of international health intervention. It does so by first exploring its operation processes and then evaluating the effectiveness of its recommendations to help contain Zika outbreaks. To achieve this goal, I start with a brief review of crowdsourcing, international research methodologies, and Appadurai’s theory of global cultural flows before introducing connections between digital divide and social justice. I then analyze the process used by LDB and GovLab to bring globally distributed partners together for collaborative problem solving. Next, I examine the strengths and weaknesses of recommendations made by the Smarter Crowdsourcing project before concluding with lessons learned and recommendations for future endeavors of international health intervention and global technical communication.

A Perspective on Global Health Contexts

On August 31, 2016, I was invited to participate in an online conference “Assessing Public Awareness” of Smarter Crowdsourcing—Zika hosted by New York University’s GovLab along with experts from ten countries and public officials from four LAC countries, Brazil, Colombia, Panama, and Argentina. The team of experts consist of researchers from Google, Facebook, United Nations Children’s Fund (UNICEF), World Health Organization (WHO), RPI, and multiple universities in the United States and Spain. The conference started with brief summaries from the LAC countries about their Zika situations and challenges in evaluating public awareness of the epidemic. Then the panel of experts proposed “social media-based digital listening techniques” to provide rapid and affordable research results (Noveck, Ayoub, Hermosilla, Marks, & Suwondo, 2017, p. 21). The tension between experts and local needs started to emerge when, responding to the proposed technocratic solutions at the end of the conference, local health officials emphasized their needs for low-cost, quick-response solutions that could be done by local personnel and their lack of big data experts or infrastructure to carry out the proposed work.

As a participant-observer and one of the only two experts emphasizing locally appropriate, low-tech approaches in this intercultural event, I was struck by the mismatch between the proposed technocratic solutions and the divergent local exigencies and constraints. Viewing the smarter crowdsourcing event as a historical case to study methodological challenges in intercultural communication research, I decided to examine strategies used by GovLab brought globally distributed experts to the same discussion table and the effectiveness of solutions obtained from such globally distributed knowledge work. In doing such work, one quickly realizes the toll the spread of infectious diseases can take on populations around the world and the need to address outbreaks with carefully localized strategies.

Zika, Economic Tolls, and Transnational Project of Smarter Crowdsourcing

With the earliest human cases reported in 1952, Zika is transmitted by the Aedes aegypti mosquito and spread from Africa to Asia, the Pacific, and South America. In May 2015, Brazil issued the first report of locally acquired Zika disease in the Americas, after which Pan-America Health Organization/World Health Organization released an epidemiological alert. Brazil reported an unusual increase of microcephaly in newborn babies in October 2015 before declaring a national public health emergency on November 11. Between February 1 and 18 November 2016, Zika remained a “Public Health Emergency of International Concern” for WHO because of its connections with numerous neurological disorders and microcephaly.

Epidemics come with heavy economic tolls. The United Nations Development Programme (2017) predicted that Zika would cost between “US$7 to 18 billion” in LAC for the period 2015 to 2017 (p. 19). Identifying Zika as a “long-term global threat” (p. 3), the WHO (2016) spent about US$24 million on research, public health intervention, and public education related to Zika in 2016. In 2016, 69 countries or territories reported mosquito-borne Zika virus transmission and 13 of them reported person-to-person transmission of Zika. Zika infection can create staggering economic burden to individuals, communities, and nation states. Pregnant women infected by Zika have a 28% chance of giving birth to a child with microcephaly, a lifelong disease that requires lifetime medical care, which can cost up to US$10 million per child (Ulansky, 2016). The dynamics of crowdsourcing can provide a mechanism for alleviating such heavy economic burdens by containing the outbreak with more effective measures.

Crowdsourcing: Players and Processes

Combatting global epidemics requires careful attention to complicated challenges posed by transnational research and multinational intervention. IDB and GovLab’s experiments with crowdsourcing provided innovative insights into possible ways to make full use of globally distributed expertise in tackling global public health challenges. Coined by Jeff Howe and Mark Robinson in the June 2006 issue of Wired magazine (Howe, 2006), “crowdsourcing”

represents the act of a company or institution taking a function once performed by employees and outsourcing it to an undefined [large] network of people in the form of an open call. This can take the form of peer-production [or] individual [work].

Brabham (2013) later defined crowdsourcing as “an online, distributed problem-solving and production model that leverages the collective intelligence of online communities to meet specific organizational goals” in both private and public sectors (p. xix).

Originally designed to help solve organizational problems, crowdsourcing contests often require monodirectional, bidirectional, or multidirectional communication among the three different players listed here:

Seekers, namely, organizations with problems to be tackled,

Innovation intermediaries such as solution seekers, or organizations that broadcast technology needs of seekers to their networks of external experts via online platforms,

Individual or team solvers from crowds of external actors (Schäfer, Antons, Lüttgens, Piller, & Salge, 2017, see Figure 1).

Figure 1.

Players and processes of crowdsourcing.

Crowdsourcing events, therefore, combine participatory, meritocratic, and bottom-up innovative processes with top-down management needs and incentive mechanisms to encourage local, regional, or global networked prosumption (Brabham, 2013; Guth & Brabham, 2017).

Intercultural Research Methodologies and User-Centered Research

In intercultural professional communication and rhetoric, the deficiency model, namely, viewing non-Western cultures as inadequate compared with their Western counterparts, has been criticized for its west-centric approach. Much has been written about the need to go beyond monocultural preoccupation to explore cultural contexts and local needs, to collaborate with community partners to solve messy local problems, and to employ methodological reflectivity to cope with challenges posed by such intercultural work (Agboka, 2013; Ding & Savage, 2013; St. Amant, 2017; Thatcher, 2012). Such attention to cultural differences often directly impacts the validity of intercultural research (Thatcher, 2001; Walton, Zraly, & Mugengana, 2015). For studies examining the use of technologies to solve culturally situated problems, it is particularly important to pay close attention to socioeconomic, political, and cultural contexts surrounding such technological use (Kolko, Wei, & Spyridakis, 2003; Sun, 2012).

Criticism of Eurocentric methodologies has also been made in critical research paradigms such as community-based participatory research and participatory action research (Horowitz, Robinson, & Seifer, 2009; Smith, 1999; Wallerstein & Duran, 2010). These studies argue that research processes and content are equally important and that local participation plays a critical role in the entire life cycle of research, from design to execution, particularly with marginalized populations (see also Kovach, 2010; National Health and Medical Research Council, 2010; Richardson et al., 2017).

Participatory, user-centered design can play important roles in user empowerment and ethical engagement with users in civic, educational, and industrial settings (Johnson, 1998; Scott, 2008). User-centered design has been identified as a rhetorical methodology (Salvo, 2001), critical rhetoric that enable more ethical decision-making (Grabill & Simmons, 1998), and possible strategies to go beyond conventional, functional usability to enable productive usability that makes websites useful to civic endeavors (Simmons & Zoetewey, 2012). Taken together, these research approaches highlight the need for scholars to use participatory design in research that involves international stakeholders. Only by doing so can researchers create space for ethical engagement with all affected parties, included marginalized populations who are often silenced by and excluded from such international research endeavors.

Transcultural Flows and Graduated Sovereignty

Appadurai’s (1996) theory of global cultural flows provides useful lens to explore the full complexity of intercultural communication processes and global digital divide. He coined the terms of mediascape, ideoscape, ethnoscape, technoscape, and financescape to describe the flows of media discourses, ideologies, people, technologies, and investments and capital across national borders. Due to space constraints, this article employs only ethnoscape and technoscope as the two most relevant tools in its analysis.

Ethnoscapes often refer to what Ong (1999) called flexible citizens, or multiple-passport holders and highly skilled labor, who travel across national borders in pursuit of opportunities and profits. Ong (2000) provided another useful theoretical construct, graduated sovereignty, namely,

The differential state treatment of populations according to ethno-racial differences [in relation to market calculations], and the dictate of development programs […] in relation to their varying participation in globalized market activities (p. 57).

In essence, Ong’s (2000) construct highlighted important strategies employed by nation states to respond to global market forces through differential treatments of populations. Because such strategies allow nation statements to “maximize the returns on doing what is profitable and to marginalize the unprofitable,” (p. 58), analysis of how different populations would be influenced differently by such strategies will shed important light on issues of social justice, access, and power dynamics. The full range of ethnoscapes, therefore, include migrant workers, technical immigrants, illegal immigrants who cross national borders to escape political persecution or to seek employment opportunities, as well as unskilled labor with little privilege and thus little to no mobility.

Technoscape refers to the “global configuration of technologies and the fact that technologies, both high and low, both mechanical and informational, now moves at high speeds across various kinds of previously impervious boundaries” (Appadurai, 1996, p. 34). Offering a productive way to examine material conditions, technoscape includes both basic technologies such as water system and wastewater infrastructure and more advanced information technologies such as Internet cables, wireless infrastructure, and satellite services. It also provides a useful lens to investigate global digital divide by highlighting unevenly distributed access to information technologies and its impacts on underserved communities.

Highlighting transnational connectivity, Appadurai’s (1996) framework helps to move beyond the so-called methodological nationalism, namely, the treatment of nation states as the natural and necessary representation of modern society and the unit of analysis in intercultural communication. It also enables researchers to think about intercultural communication beyond the framework of traits geography, namely, the long-existing tendency to oversimplify cultures of individual countries as “some sort of traits list” of values (Appadurai, 2000, p. 7).

In emerging epidemics, transnational ethnoscapes and technoscapes play significant roles in communicating health risk to the public. Scrutinizing the historical, cultural, political, and economic contexts surrounding ethnoscapes and technoscapes allows us to better study the production, circulation, and consumption of widely dispersed, continuously evolving, and constantly contesting knowledge of emerging epidemics. Such approaches are important to international health-care contexts because they help us identify the different factors contributing to the complexities of such situations.

Digital Divide and Issues Related to Social Justice

The digital divide, or digital exclusion, is “really a socioeconomic, cultural, and power divide that exists at both local and global levels” (Bishop, Bazzell, Mehra, & Smith, 2001). Numerous publications call attention to a number of factors that contribute to blocked or inadequate access to information and communication technologies (ICT) as well as Internet. These include socioeconomic status, connectivity, affordability, power, motivation, usage, social resources and relationships, community and institutional infrastructure, and literacy and skills (Barraket, Ewing, MacDonald, Mundell, & Tucker, 2017; Bishop et al., 2001; Park et al., 2015; van Dijk, 2006; Warschauer, 2003). Defining digital inclusion as the universal ability to “make full use of digital technologies,” Barraket et al. (2017) highlighted the essential role played by digital inclusion by saying, “At its heart, digital inclusion is about social and economic participation” (pp. 5, 7). In his widely cited book on global mobile communication, Castells (2010) listed numerous factors that influenced how mobile phones were used across the world. These include levels of economic development, fixed-line and mobile phone infrastructure, pricing systems. They also encompass certain sociocultural factors such as PC penetration, transportation systems, communication preferences, and gender, ethnicity, income, educational attainment, and class.

The digital divide brings profound impacts on social justice and technical communication. This is because the lack of access to digital technologies poses challenges to all three types of social justice: distributive justice, procedural justice, and interactional justice (Jost & Kay, 2010). A growing body of literature has explored the connections between social justice and technical communication from the perspectives of human-centered design (Rose, 2016), diversity and inclusion, decolonial theory (Agboka, 2013), the Global South (Savage & Agboka, 2015), and contexts (Walton & Jones, 2013).

In their study of social justice in epidemic control, Ding, Li, and Haigler (2016) highlighted three types of connections: those among infrastructure access, distributive justice, and procedural justice in terms of both process control and decision control, those among literacy access, procedural justice, and interactional justice, and those among social acceptance access and interpersonal justice (see Figure 2). In their model, Ding et al. (2016) put professional and technical communication as the field that can bridge access (infrastructural, literacy, and social acceptance), procedural justice, and interactional justice by connecting end users and affected communities with decision makers.

Figure 2.

Connections among access, social justice, and technical communication.

In her analysis of materialist rhetoric employed by Beijing’s severe acute respiratory syndrome (SARS) sequelae patients in fighting a decade-long battle for official acknowledgement and support, Ding (2020) built further on this model by adding layers of immaterial labor (Hardt & Negri, 2001). Specifically, Ding examined communicative labor (rhetorical agency) and affective labor (Greene, 2004), to illustrate the rhetoric-social justice interconnections (see Figure 3). As illustrated by her study, professional communicators can often play major roles in providing communicative labor and helping orchestra affective labor for marginalized populations.

Figure 3.

Materialist-social justice approach: examining social justice and immaterial labor.

As illustrated by the case study discussed in the next section, in international endeavors to tackle challenges in countries with deep digital divide, whether or not to include end users in decision-making process often determines the validity and efficacy of proposed solutions.

Case Study: Smarter Crowdsourcing in Intercultural Health Research

To understand the full complexity of epidemic communication challenges faced by LAC countries, I did extensive research on local conditions concerning Zika outbreaks, patients and high-risk populations, infrastructure, and socioeconomic conditions that shaped local outbreaks. Data were gathered from a wide range of sources, that is, newspapers, scientific journals, trade magazines, and governmental publications and websites in addition to GovLab’s publications (see Table 1).

Table 1.

Data Used in Analysis of GovLab’s Smart Crowdsourcing Project.

Documents related to GovLab’s Smarter Crowdsourcing Project
Internal documents	Assessing Public Awareness: First Online Conference on August 31st and Logistics
Internal documents	Transcript: First Conference
Publicly accessible materials: Preconference	About
	Topics
	People
	Share Your Expertise
	Smarter Crowdsourcing for Zika Playbook (Public)
Postconference materials	Explore the Map
	Project Description
	Methodology
	Recommendations Summary
	YouTube Video: Smarter Crowdsourcing Zika \| The GovLab \| The Atlantic LIVE
	Smarter Crowdsourcing for Zika and Other Mosquito-Borne Diseases A Handbook of Innovative Legal, Technical, and Policy Proposals and a Guide to their Implementation
Documents about Zika-Related Cultural and Socio-economic Contexts in LAC Countries
Zika	Mapping Living Conditions and the Microcephaly Epidemic in Northeast Brazil
	Microcephaly epidemic related to the Zika virus and living conditions in Recife, Northeast Brazil
	A socio-economic impact assessment of the Zika virus in Latin America and the Caribbean: With a focus on Brazil, Colombia and Suriname.
	The economics of Zika
Class structure	Brazilian Criteria 2015 and social class distribution update for 2016
Infrastructure and access	Smartphone user penetration as percentage of total population in Latin America from 2011 to 2018
	Deficient water systems, poor sanitation driving Zika in Brazil.
	Brazil: Zika epidemic exposes rights problems
Issues related to gender and ethnicity	Violence against women: a statistical overview, challenges and gaps in data collection and methodology and approaches for overcoming them
	Tackling Brazil’s rape epidemic: activists see little hope in a country where a woman is raped “every 11 minutes.”
	The human rights of black women in Brazil: Violence and abuse

LAC = Latin America and the Caribbean. Italicized text can be used as research materials and intercultural background materials.

To examine this situation, I sought to address the following research questions:

Who were the high-risk populations of Zika? What were their living conditions like and how did such individuals access and use communication technologies, if applicable?

What local exigences and constraints did LAC countries face in coping with Zika outbreaks?

How feasible was it for LAC countries to implement technocratic strategies to evaluate public awareness of the epidemic? What barriers did they face and why?

What factors contributed to such mismatch between local needs and top-down solutions?

What insights can intercultural technical communication researchers bring to the conversation and what lessons can we learn about challenges in conducting such intercultural research?

Addressing such questions is important for both technical communicators and medical rhetoricians interested in working with marginalized populations or international communities. This is because top-down and international interventions will not work if such efforts fail to understand local exigencies or address local needs.

To examine this case, data were collected on a continuous basis as I moved beyond the original GovLab corpus to better understand the issues of access and resources faced by at-risk populations in Zika epicenters and to examine the socioeconomic and cultural contexts that helped to shape how LAC countries and affected communities responded to Zika. My analysis focused on

The assumptions brought by various stakeholders to the project.

Local infrastructural and socioeconomic conditions that might have constrained how LAC countries responded to Zika.

Existing research about Zika patients’ access to and use of communication technologies.

While analyzing these materials, I paid particular attention to strategies used by GovLab to set up its smarter crowdsourcing projects, the limitations of its proposed solutions, and the different cultural, infrastructural, and socioeconomic conditions faced by LAC communities. I also examined challenges related to access and social justice, namely, distributive justice, procedural justice, and interpersonal justice faced by at-risk populations.

The historical case of Smarter Crowdsourcing offers technical communicators and medical rhetoricians a valuable opportunity to examine the dynamics of distributed knowledge work and health communication in international contexts. Crowdsourcing can function as an innovative approach to address global public health emergencies in developing countries by pooling resources from globally distributed talents and research institutions. It is capable of providing low-cost, quick responses and real-time solutions with multidisciplinary approaches. The quality of international crowdsourcing may be compromised, however, because individual solvers tend to be parachuted to the project without sufficient local knowledge. Such disconnection with local problems can in turn result in ungrounded and thus ineffective solutions.

Results

The historical case of LDB-GovLab’s Smarter Crowdsourcing provides much insight into intercultural communication research and practice. To start with, the analysis of how GovLab coordinated the transnational crowdsourcing project reveals interesting insights into possible approaches of digitally inviting and managing globally distributed expertise to provide quick responses to local problems faced by developing countries or marginalized communities. It also calls attention to possible sociopolitical, socioeconomic, and infrastructural issues such intercultural research has to seriously engage with so as to produce locally appropriate solutions.

Smarter Crowdsourcing: Definitions, Players, and Procedures

As an innovation intermediary, GovLab defines smarter crowdsourcing as an approach that “marries the agility and diversity of crowdsourcing (also called open innovation) with curation to target those with relevant know-how and bring them together in a format designed to produce effective and implementable outcomes” (Can “smarter crowdsourcing” help). Consisting of IDB, GovLab, and project leads of each government partner, the steering committee held weekly meetings to determine “the general direction of the project” and to “ensure the timely completion of outputs and outcomes” (IDB & GovLab, 2016, p. 13). At the beginning of the project, the IDB, GovLab, and LAC governmental partners worked together to identify problems related to Zika control. Also contributing to problem definitions were project collaborators, namely, organizations with “subject matter expertise related to the region and prioritized problem areas,” (i.e., “IBD in-country officials, academic research organizations, and think tanks”; IDB & GovLab, 2016, p. 13). To promote citizen engagement and expert contribution, the GovLab identified and invited individual project supporters, or experts and innovators in technology, research, and policy-making to participate in online conferences. Missing from this global network of collaborators, however, were frontline medical workers and patients who had first-hand experiences of Zika.

While one can define IDB as the organizational seeker and GovLab as the intermediary, IDB-GovLab’s smarter crowdsourcing is far more collaborative than the traditional model. IDB, LAC governmental partners, IDB in-country project collaborators, and GovLab resorted to open communication and collaborating in defining the problems surrounding Zika in LAC countries (see Figure 4). Similarly, GovLab put in place networked mechanisms of interaction to enable open loops of feedback between problem solvers, namely, project supporters with multidisciplinary expertise, and IDB in-country project collaborators that provided both background information on problem areas and feedback on problem definitions.

Figure 4.

Players and processes of Smart Crowdsourcing used by IDB and GovLab. IDB = International Development Bank; GovLab = Governance Lab; LAC = Latin America and the Caribbean.

GovLab broke down the larger issues into a series of smaller problem briefs and posted such briefings for public comments before working with partners to prioritize problem briefs into different topics (Stage 1, see Figure 5 for the life cycle of the smarter crowdsourcing processes). While not publicly available for in-depth analysis for this study, these problem briefs are important documents used by the seekers to come up with preliminary definitions of the problems LAC countries were facing at that time. The problem briefs were central to organizing various themed conferences to enable smarter crowdsourcing to take place. Project supporters were identified and invited to participate in six online, 2-hour-long Smarter Crowdsourcing conferences between July and September 2016 (Stage 2). While discussions were conducted primarily in English for all conferences, the host provided a telephonic audio channel for simultaneous Spanish translation to ensure the LAC representative could follow along with experts’ discussions and raised questions in the Q & A sessions.

Figure 5.

Life cycle of the smarter crowdsourcing processes.

Videos, transcripts, and session summary briefings of each meeting were posted online in English, Spanish, and Portuguese for wide dissemination and comment before the GovLab presented recommendations to IDB and LAC partners (Stage 3). These materials were examined both to better understand how smart crowdsourcing worked for this particular project and to identify possible issues posed by the technocratic procedures. As the intermediary, GovLab compiled, analyzed, and synthesized recommendations from all teleconferences into a downloadable 138-page handbook focusing on innovative legal, technical, and policy proposals and implementation guide (Noveck et al., 2017).

IDB and GovLab made full use of the participatory and meritocratic nature of crowdsourcing by targeting interdisciplinary and globally distributed teams of experts who brought complementary knowledge and skills to the smarter crowdsourcing events. For instance, for the Public Awareness conference I participated in, governmental collaborators from four LAC countries, Argentina, Colombia, Panama, and Brazil were invited. IDB sent three representatives from its Social Protection and Health Division and its Competitiveness and Innovation Division. The supporters included five professors from engineering, public health, mathematics, communications, and government, with one from Spain and the other four from the United States. Two global institutions, namely, WHO and UNICEF joined the conference, represented by medical officers, data scientists and communication specialists. In addition, numerous federal, nonprofit, and for-profit research institutes also participated, including National Science Foundation, Pew Research Center, RTI International, and Facebook.

Globally Distributed Ad Hoc Academia–Government–Industry Partnership

The collaborative efforts made by IDB and GovLab helped to connect LAC countries with Western experts in public health, ICT, and risk communication. Such endeavors helped to create much needed opportunities of open deliberation and global collaboration, which in turn helped form ad hoc academia–industry–government partnerships. Such ad hoc partnership, however, can be problematic because of the disconnections between the foreign seekers and individual solvers. Without inside knowledge about target cultures under examination, expert participants tend to use ethnocentric and monocultural approaches in formulating problems and proposing solutions. This is exactly what happened in the awareness assessment conference.

Demographical and Socioeconomic Factors: The Invisible High-Risk Populations

Careful research quickly reveals a huge gap between recommendations made by the Smarter Crowdsourcing conferences and the realities faced by LAC countries. To begin with, de Oliveira et al.’s (2017) case–control study examined the association between microcephaly, Zika virus infection, and other risk factors in Brazil. The article was jointly published by 20 researchers and physicians from the Microcephaly Epidemic Research Group, Brazilian Ministry of Health, and Pan American Health Organization. It examined 91 cases (82 livebirths and 9 stillbirths) of microcephaly and 173 controls after screening 13,624 neonates in eight public maternity hospitals in Recife, Brazil from January 15 to November 30, 2013. It collected demographic and socioeconomic information and the use of insect repellent on skin. Moreover, the study examined the purchasing power of individuals and families, using Brazilian economic classification criteria 2015, which defines eight socioeconomic classes from A (highest) to E (lowest) (ABEP, 2015).

The demographic information revealed that 59% of the women in the case groups, namely, those who gave birth to babies with microcephaly, had no more than nine years of education, with 19% receiving less than four years of education, and only 5% got any form of higher education. About half of the women in the case group and the control group were very young (between 13 and 24 years of age) and self-identified as not White (92% vs. 82%). Most mothers of cases and controls lived in poverty; around half were classified in the two lowest levels of the socioeconomic scale (DE, respectively, 57% and 48% for both groups) and another third were in the third lowest level (C2, respectively, 31% and 35%).

According to Associacao Brasileira de Empresas de Pesquisa (ABEP, 2016), the groups of DE and C2 accounted for, respectively, 27% and 35.6% of Brazil’s total population in 2016, with an annual household income of 768 and 1,625 Brazilian reals, or the equivalence of 205 and 433 U.S. dollars. ABEP’s (2015) data showed that their expenditures on education and professional services accounted for only 4% and 5% of the national total, meaning these two groups spent most of their income on daily necessities such as food and shelter while having little resources for health care, sanitation, and education. Both groups of women had exposure to larvicides at the water storage site (54% vs. 53%), while less than 10% of them used insect repellent on the body (10% vs. 8%).

It should be noted that ABEP employed a rather elaborate methodology to develop these socioeconomic scales. It used a point system to look at the items of variables owned by the household (i.e., bathroom, domestic servants, automobiles, personal computers, refrigerators, microwave oven, motorcycles, and clothes dryers). The system also looked at householder education and access to public utility services such as piped water and paved ground.

Specific numbers were assigned to each of the items listed above and varied with the total numbers of items owned by the household. Interestingly, personal computer was listed as the third most highly ranked item in the list, only below bathroom and domestic servant and slightly above automobile. The fact that mobile phone had yet to be included in this list of valuable items in 2016 suggested the small numbers of users who own mobile phones or smart phones then.

The ABEP’s methodology highlights the vastly different socioeconomic contexts in which at-risk populations from LAC countries live and the mundane daily struggles they may have to go through, including the lack of access to bathrooms, running water, insect repellent, and healthcare. These findings have been corroborated by numerous other studies, including one that mapped out the correlation between microcephaly and the living conditions in densely populated Recife, Northeast Brazil, which was a hotspot of the outbreak (Souza et al., 2018). This study concluded that residents from deprived areas with precarious living conditions were at far great risks (with a prevalence ratio of 5.6) of giving birth to babies with microcephaly compared to those residing in areas with better living conditions (Souza et al., 2018).

Infrastructural Issues, Technoscape, and Access

Numerous sources have pointed out the close connections between Zika outbreaks, failing sanitation and water infrastructure, human rights issues, and gender inequality (Brazil: Zika, 2017; Sullivan, 2016). As the country most affected by Zika, Brazil suffered from poor sanitization and inadequate access to clean water systems and wastewater infrastructure. In Recife, Brazil’s epicenter of the microcephaly crisis, it would require a staggering investment of US$3 billion to install “universal sewer and water systems throughout the city,” which was unlikely to be funded by the Brazil government considering the disastrous economic crisis it went through in 2015 (Sullivan, 2016).

Over one third of Brazilians had no access to tap water and had to use containers to store water, which often became mosquito breeding grounds without proper treatment (Brazil: Zika, 2017). In addition, in 2015, more than three quarters of the population in northeastern Brazil had no access to sewer infrastructure and less than one third of wastewater was treated in that region (Brazil: Zika, 2017). Statista (2018) projected the penetration rate of smart phone in Latin America for 2016 as 34.3%, a little over one third of its population, based on survey results from 2014. That of mobile phone in the same year was, respectively, 71.4%, 70%, 68.3%, and 64.9% for Argentina, Colombia, Mexico, and Brazil and 61.3% for other parts of Latin America.

Considering the fact that women with lower socioeconomic statuses were most likely to be affected by Zika, cell phones would have been a luxury beyond the means of these women. Smart phones would be even more problematic because, in addition to the added device costs, users would have to pay wireless services to obtain mobile phone-based Internet access so as to use social media apps such as Facebook or Twitter. Therefore, the proposed digital listening strategy would not help to reach the high-risk populations.

Sociopolitical Issues: Ethnoscape, Graduated Sovereignty, and Ethnicity

After Pan American Health Organization announced Zika-related risks in November 2015, Women on Web, a nonprofit organization providing abortion medication in countries where women have little access to safe abortion services, witnessed a 108% increase in abortion requests from Brazil (Aiken et al., 2016). Ribeiro and Hartley (2018) identified two main enemies in Brazil’s war against Zika as highlighted in two major Brazilian newspapers, O Globo and Folha de São Paulo, with one enemy being mosquitos and the other being microcephaly. The former required a collective war against mosquitos, as exemplified by Brazil’s use of army forces to educate its citizens of approaches of identifying and eradicating possible mosquito breeding grounds around houses. The latter, however, stipulated a gender-based war against possible pregnancy that might give birth to babies with microcephaly. It put “the burden of responsibility” solely on women, who were expected to “adopt preventive measures and avoid pregnancy” (Ribeiro & Hartley, 2018). Such responsibilities were difficult to shoulder, though, considering Brazil’s anti-abortion policies and women’s limited access to contraception (Andreoni & De Janeiro, 2016; United Nation, 2005; Usborne, 2016).

In addition to economic disparity, northeastern Brazil also witnessed high levels of young pregnancy, high unemployment rates, high rates of sexual violence, and much lower levels of education in women. These problems were compounded by lack of access to sanitation infrastructure, health services, and contraception (Ribeiro & Hartley, 2018). These fundamental sociopolitical and gender related issues contributed to the concentration of microcephaly in impoverished states, or what Ong would describe as “internal colonies of poverty and neglect” which are “often abandoned and deprived of sustenance to survive” (p. 65). For instance, Souza et al. (2018) reported that their study of the spatial distribution of microcephaly in Recife, Northeast Brazila revealed “strong association between a higher prevalence of microcephaly and poor living conditions,” with few cases reported from “populations living in the richest socio-economic strata” (p. 5). Women giving birth to babies with microcephaly were more likely to be young, single, black, and poor, who lived in smaller cities or the outskirts of larger ones (“Mapping Living Conditions,” 2018).

What further complicated the socioeconomic landscape of Zika and microcephaly was ethnicity and racism. According to Geledés Instituto da Mulher Negra (2016), the majority of black women in Brazil lived in slums without access to sanitation, clean water, or proper garbage collection and thus were extremely vulnerable to mosquito-borne diseases such as Zika or dengue. It reported that unofficial and unconfirmed records showed that 70% of babies with microcephaly were “children of black women,” which revealed the disproportionately high impacts of Zika on black women in Brazil (p. 40).

Technocratic Solutions and Missed Opportunity of Engagement

Despite all the good intentions of IDB and GovLab, the smart crowdsourcing project suffered from the exclusion of frontline medical care workers or at-risk populations in the deliberation processes. This resulted in Eurocentric, technocratic solutions. The teleconference expert supporters often constructed the Zika outbreak in LAC as a technology problem. According to this perspective, such a problem could be efficiently fixed by high tech gurus such as Google or Facebook through data-driven analysis of popular search terms, digital listening, or semantic clustering of social media posts.

Numerous other technocratic solutions were also recommended, which can be found in the Zika Playbook (IDB & GovLab, 2016; see also Noveck et al., 2017). Serious games were recommended as a tool to enhance the public awareness of Zika; online forums and two-way SMS-based support systems were identified as tools to provide support for long-term medical care. Finally, drones and adaptive vehicles were recommended as tools to help identify sites with accumulated trash and remove trash from hard-to-reach areas. The technocratic guidelines provided by IDB and GovLab came with limitations, including Western-centric assumptions, expert design, and tool-driven, top-down solutions. These guidelines operated with the misperception that high-risk populations and epicenters of Zika would enjoy the same access to infrastructure and technologies.

By making unrealistic assumptions of its target users, GovLab’s playbook paid no attention to and thus completely silenced the marginalized, under resourced at-risk populations, who had been suffering from poverty, socioeconomic marginalization, and limited education. In other words, paying no attention to the distributive injustice suffered by its end users, GovLab unfortunately further disempowered the very populations it set out to help with procedural injustice, namely, depriving at-risk populations of process control and decision control by denying such communities access to essential infrastructure, educational resources, and social acceptance. Moreover, it inadvertently inflicted informational injustice, namely, rights to know, on such disadvantaged communities by disseminating and gathering important epidemic control information with digital technologies beyond the means of its end users. Originally designed to serve the public health needs of at-risk populations, the Smart Crowdsourcing project failed to meet the information needs of such communities by excluding them from having any process control or decision control in designing measures to contain Zika in their communities. Instead of serving as an advocate of the very communities it set out to help in the first place, the Smart Crowdsourcing project inadvertently designed much of its intervention plan without considering local conditions and problems. In so doing, it missed the vital opportunity of truly helping the LAC countries to address their political and socio-economic problems that were the very root of their own Zika outbreaks.

Discussion

Implications of Smarter Sourcing for Technical Communication

IDB and GovLab’s experiments with Smarter Crowdsourcing bring much insight into possible ways to leverage crowdsourcing to facilitate distributed knowledge work and to aggregate globally distributed expertise to tackle challenges posed by international technical communication projects and emerging epidemics. To start with, smarter crowdsourcing can function as an innovative way to enable globally distributed knowledge work that address global or regional issues. International agencies and national authorities can function as the seeker with complicated problems waiting to be solved. Research institutes or think tanks can serve as the intermediary to help broadcast such complex problems to multidisciplinary experts and to seek their input to formulate innovative solutions. Finally, teams of multisectoral individual solvers should be put together carefully to ensure full representation of all disciplines capable of contributing to the problem-solving processes.

In crowdsourcing events, providing solvers guidelines early in the process helps participants better understand local contexts and complexity of the problems. These factors allow participants to contribute more effectively to the online collaboration sessions. It is critical to ensure open, multidirectional communication can take place among the seekers, the intermediary, and solvers throughout the event. Such open communication can take place in formal channels such as briefing sessions and online or offline meetings or informal channels such as e-mail lists or discussion forums.

In addition to facilitating open communication among all players, it is also equally important, though often neglected, to bring to the discussion table end users of the crowdsourcing project, namely, individuals and communities affected by the proposed solutions. To ensure the success of the crowdsourcing projects, it is critical to fully involve the end users in the brainstorming, design, and deliberation processes so that they can contribute important insights into local conditions and needs. Despite the use of globally distributed teams, smarter crowdsourcing projects are always initiated to solve messy local problems. To stay relevant and useful, such projects have to rely on equal and open collaboration with local end users and stakeholders. Ideally, Smart Crowdsourcing teams should help local communities to fully tackle complex problems by collaboratively designing communicative plans while amplifying the affective needs of such communities. By opening space for public access and input, smarter crowdsourcing with user participation will help produce more just and inclusive policies. Such an approach can produce more desirable outcomes when coping with unfolding crises.

Technological Activism, Health Activism, and Challenges of International Intervention

Despite the widespread acclaim about the benefits brought by ICT and the Internet, such technologies are limited in their reach because of constraints such as costs, affordability, connectivity, and infrastructural access. Another complicating factor is literacy—namely, technological literacy and educational literacy—which, directly connected with social justice, influences people’s access to informational justice and procedural justice (Ding et al., 2016). Health crises are often political crises, as demonstrated by Ribeiro and Hartley’s (2018) description of Zika as a political problem for Brazil. Global health crises is further complicated by issues of economic globalization, its accompanying effects of poverty in economically disadvantaged regions, health disparity, varying material and sociopolitical conditions in various parts of the world, cultural values and beliefs, and the subsequent challenge of coming up with effective local solutions.

Technological activism, as advocated by IDB and GovLab, can play a much more prominent role when implemented along with health activism incorporating active local participation. To give full play to health activism, future crowdsourcing projects can benefit from both online and offline intervention plans to better reach at-risk populations, who most likely live in poor, marginalized, ethnically diverse, underemployed communities. Therefore, it is essential to conduct careful evaluation of high-risk populations in terms of their demographics, access to ICT such as mobile phones and wireless services, and health literacy before implementing deep collaboration with community partners.

Identifying Community Partners for Deep, Contextualized, and Ethical Collaboration

Global public health emergencies require full collaboration between international and national policy makers, health-care providers, and affected communities to bring epidemics under control. Public intervention campaigns can benefit greatly by inviting community leaders from affected communities to serve as cultural insiders, who can educate multidisciplinary experts about real local challenges and needs. Such deep, contextualized collaboration will help produce well-informed and thus useful solutions that address urgent local needs. As in the case of Zika outbreaks in the LAC countries, such deep collaboration would have revealed Zika as a socio-political challenge related to poverty, gender and ethnic disparity, and infrastructural failure. The experts’ attention, therefore, would have been directed toward pragmatic solutions that would have actually affected the at-risk populations instead of technocratic plans that centered on electronic devices which those affected by Zika could not afford in the first place.

In emerging epidemics, it may be difficult for national authorities or global agencies to predict where the epicenters are and who are subject to high risk of infection. Here, it helps to resort to what Appadurai (2000) called grassroots globalization to seek active involvement of local communities and nonprofit organizations with direct experiences of working with high-risk populations and early cases. It helps to build multilevel collaboration networks by inviting community partners from local healthcare providers, libraries, and community centers to provide offline, face-to-face educational events such as health fairs and training workshops.

Crowdsourcing projects can also be directed toward the development of accessible content, both print and electronic, to serve the information needs of affected communities. These community partners will provide important insights into the living experiences, perspectives, and values of communities most affected by health campaigns, which in turn helps develop locally appropriate intervention measures. By identifying these local civic groups as important grassroots collaborators early in the process, smarter crowdsourcing projects can fully incorporate localized knowledge in the design and implementation such projects. Meanwhile, efforts should be made to engage volunteers from at-risk populations to improve their technology and health capacity and to enable peer-to-peer learning in the long run. Putting local community leaders in charge of communicative labor and affective labor will not only give voice to local needs and concerns but convert local users into codesigners who can improve deliberation procedures and design decision, which in term leads to more appropriately localized solutions.

Concluding Thoughts: Community-Based Participatory Design

The study reported here highlights the importance of participatory, user-centered design in conducting intercultural research in both technical communication and health communication. To achieve deep, contextualized research when designing technological solutions for global problems, it helps to start with local user-centered research, first by investigating the demographics, socioeconomic statuses, and needs and concerns of communities affected by such problems. It is also key to explore infrastructural and material conditions faced by high-risk populations, for instance, technology penetration rates, costs of ICT and service plans, connectivity quality and reliability, and access to mobile devices or smart phones. Such participatory problem solving approach is vital to the ultimate success of digital intervention plans because, without solid user input, product or policy design can be problematic, and in some cases, faulty because they fail to address the real needs of end users (Ding, 2013; Grabill & Simmons, 1998).

Technologies such as Google and social media tools have great potential to tackle issues related to gender, ethnicity, poverty, and access. For instance, during the SARS outbreak in Hong Kong, volunteering engineers, owners of sosick.org, compiled user reports about locations of new SARS cases from the public before calling to confirm such cases with public health officials, building management offices, or hospitals (Ding, 2014). They updated such confirmed case numbers on their website on a daily basis, which eventually pushed the Hong Kong’s Ministry of Health to release daily updates of SARS cases in Hong Kong after repeated refusal to provide such data.

Local health authorities can use crowdsourcing to engage communities in affected regions to keep track of clean water infrastructure, mosquito eradication programs, mosquito breeding sites, and access to much needed supplies such as mosquito repellents and mosquito nets. It is also beneficial to use social media platforms to gather early reports from community partners about suspected cases and hot spots of infection with some preliminary quality control mechanisms. Such strategies of community involvement will help produce more valid community-based participatory research, which in turn help enhance the validity and effectiveness of future intervention plans.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author Biography

Huiling Ding teaches technical communication at North Carolina State University. Her research focuses on risk communication about emerging epidemics and artificial intelligence, intercultural technical communication, digital rhetoric, medical rhetoric, and social justice.

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