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even in stable regions. Post-confl ict regions are extreme situations with many addi-
tional complicating features for large-scale technology projects. This chapter sets
out fi ndings of a grounded theory case study of a successful, complex telemedicine
ICT system project in Kosovo. A grounded theory case study was used to explore
the success of the technology project, through the lens of Ciborra (Labyrinths of
information: challenging the wisdom of systems. Oxford University Press, Oxford,
2002) who puts forward the theory that the technology was a guest and the organisa-
tion was a host.
1
Introduction
Post-confl ict regions are territories where there has been a severe, recent violent
confl ict which has fundamentally destabilised a society; however, there is no
accepted defi nition. Whilst the post-confl ict situation may be stable (compared to
all-out war), this stability may be fragile and tentative. Lund described an 'unstable
peace' or 'negative peace' where tension and suspicion run high (Lund
1996
: 11).
Collier and Hoeffl er (
2002
) defi ne post-confl ict regions as having experienced civil
war in the last two decades and recorded some incidents of rebellion (incidents of
rebellion defi ned as when people engage in violence where perceived or actual
grievances are acute enough (Collier and Hoeffl er
2004
). Junne and Verokren (
2005
)
identify post-confl ict as a 'confl ict situation in which open warfare has come to an
end. Such situations remain tense for years or decades and can easily relapse into
large-scale violence'. Brahimi (
2007
: 3) describes post-confl ict as 'an absence of
war, but not necessarily real peace' adding that 'the end of fi ghting does offer an
opportunity to work towards lasting peace, but that requires the establishment of
viable institutions, capable of ensuring lasting security for the entire Population'
(Brahimi
2007
: 3). Walter (
2010
) found that the likelihood of recurrence of confl ict
in a region has increased dramatically since the 1960s where 43% of confl ict
occurred in a region with previous confl ict, to the 2000s where this fi gure rose to
90%. Post-confl ict regions include Rwanda, Sierra Leone, Sudan and Angola.
Post-confl ict regions comprise a particular set of features which differentiate
them from other, more stable, regions. The Organisation for Economic Co-operation
and Development (OECD) for confl ict, peace and security spending was US $1868
million in 2006, rising to US$ 3545 million in 2012 (OECD
2014
). A large portion
of donor funding is dedicated to providing important medical and related services to
those injured in the confl ict, whilst simultaneously re-establishing a working health
system for the ongoing medical needs of the population. In the aftermath of a major
confl ict, health service infrastructures are severely damaged. The opportunities pro-
vided by the need to rebuild the collapsed economy and infrastructure should make
aid particularly effective in the post-confl ict years (Mallaye and Urbain
2013
).
E-health is the 'use of information and communications technologies (ICT) in
support of health and health-related fi elds, including health-care services, health
surveillance, health literature, and health education, knowledge and research'
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