ictdchick

This is a verse I keep thinking of but could never remember where it was:

…work our your salvation with fear and trembling; for it is God who is at work in you, both to will and to work for His good pleasure. -Philippians 2:12-13

To me "work out your salvation" is a reminder that we should be thinking about our faith and what it means to be saved, to self-examine, and to question our own assumptions and habits in the light of God’s teachings, rather than just being sheep following the people around us. My confession of the day though is that it’s the following verse that is more appropriate for me today:

Do all things without grumbling or disputing; so that you will prove yourselves to be blameless and innocent.. -Philippians 2:14

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It is better to be of a lowly spirit among the poor than to divide the spoil with the proud.
-Proverbs 16:19

Feeling a little despondent about my relationship with God and my lack of engagement with the bible over the past few years, I’ve made a resolution to select and post a verse each day to this blog.

Today’s selection is from Sojourners Magazine’s daily verse and voice e-mails. The corresponding voice/quote is:

The church has only two alternatives in its confrontation with the world: either it adapts itself to the world and betrays the gospel, or it responds to the gospel and enters into conflict with the world. - Rene Padilla

In reality I doubt the work is so black and white as Padilla claims - much damage has been done by those who claim to be responding to the gospel, but in fact are responding to societal norms. In the end, they have betrayed the gospel, even if none are around to tell them so. It is more than possible to adapt oneself to the world without betraying the gospel… if only we really understand it in the first place.

“Teacher, which is the greatest commandment in the Law?” Jesus replied: ” ‘Love the Lord your God with all your heart and with all your soul and with all your mind.’ This is the first and greatest commandment. And the second is like it: ‘Love your neighbor as yourself.’ ” -Matthew 22:36-38

For I am confident of this very thing, that He who began a good work in you will perfect it until the day of Christ Jesus. -Phillipians 1:6

And this I pray, that your love may abound still more and more in real knowledge and all discernment, so that you may approve the things that are excellent, in order to be sincere and blameless until the day of Christ; having been filled with the fruit of righteousness which comes through Jesus Christ, to the glory and praise of God. -Philippians 1:9-11

It never ceases to amaze me how sometimes even when you have read a passage a thousand time before, it can look brand new when you read it again. This comes from the beginning of Paul’s letter to the Phillipians, written during his first imprisonment (dated at approx A.D. 61). What always strikes me is Paul’s voice of strength, hope and encouragement, even in prison. His hope in the Phillipians strikes me especially today - that he is so confident in us as the beginnings of God’s good work, and that, perhaps more importantly, we are constantly being perfected until the day of Christ Jesus. Perhaps this is in contrast to the preacher in the Poisonwood Bible (which I’m reading now), but really I think it’s just a reflection of good life philosophy: we should always be striving to better ourselves. I like the second selection also - to me it says that to better oneself is to allow love to abound, not blindly, but in knowledge and discernment. Makes one think, neh?

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One of my (many) projects here was to set up GPRS for my multitude of smartphones.  Out of the array I brought with me to Africa, I selected four to bring to Ghana, picking that number so I would have two and each of Paul and Rowena could use one. The finalists: my trusty personal treo650, which gets carted around because it has all my contacts on it and (I confess), Backgammon; the E-ten Glofiish, which runs windows mobile 5, has a slider keyboard, and a very large screen, not to mention a radio, GPS, and all the other bells and whistles a phone can have; the HPs710, another slider phone, considerably smaller, with an additional numeric keyboard, but no touch screen, my current favorite, if only because it was the only one I configured to check email successfully in Uganda; and the HTCP3600, the phone with no keyboard whatsover, but for some reason actually seems to be the most stable.

So one Friday I set out with a mission: to set up all my phones with Areeba Data Services and Tigo GPRS/EDGE. I found the addresses of the head offices, figured out a route, and resolutely headed into the traffic.  Altogether the process was a lot more hassle than strictly necessary.  If they had just put the name of the access point on the website, I could have pretty much done all the work myself.  Instead, I spent three hours at Areeba and another hour at Tigo, trying to convince them that I knew perfectly well how to configure my own phones, no matter how many other know-it-alls had come into their office before. :)  At Tigo, I finally pulled out all four phones, handed one to the agent, and asked for the access point.  I managed to configure the three in my possession and get them working while she continued to poke around the preferences on my poor treo. Okay okay, to be fair, she was extremely helpful and friendly, and I’m altogether pretty happy with Tigo customer service.  With Areeba, however… the whole thing was some weird bureacratic process… and I’ve been warned that I might have to go through it again when they switchover the name of their networks to MTN (they were recently acquired). But to get to the interesting part:

How to Configure your GSM Mobile for GPRS:

As it turns out, neither Areeba nor Tigo require any authentication, nor any particular special configuration.  So, if you can find the GPRS settings on your phone (under Preferencs on Palm, and under Settings -> Connections on WM) then you just need to set up a connection pointing to the right access point, and to make sure that the phone uses the right access point settings for whatever SIM card you have inserted.  For Areeba, you actually do have to go to the head office, because they have to "activate" your GPRS service on the network, tied to the SIM, because they charge an activation fee of 50,000 cedis (5 Ghana cedis,  aprox. $6).

Areeba Data Services
Access Point: internet.areeba.com.gh
SIM Card: 15,000 cedis, including 10,000 airtime
Airtime: 45,000 minimum balance recommended
Activation: 50,000 cedis
Charges: 19.89 cedis/kb

Tigo GPRS/EDGE
Access Point: web.tigo.com.gh
Authentication: not required, but if necessary you can use User:web/Pass:webhost
SIM Card: 15,000 cedis, including 10,000 airtime
Airtime: no recommendation (I purchased 40,000)
Activation: none
Charges: 9.2 cedis/kb

It’s been noted to me that Areeba is more expensive because they are bigger. Of course - if you are a Tigo customer and most people are on Areeba you are paying a lot more in airtime charges than Areeba customers that never talk to Tigo customers. So I guess it just depends on what your friends have. Or you can be like a lot of the people I see here and just have two SIM cards, one on each network.

Areeba was a bit of a struggle, so if you want to just be a casual Internet user, I suggest trying Tigo or possibly Kasapa (I haven’t tried Kasapa though!).  They are considerably larger and seem to have set up a bureacracy around customer service.  I was given a number and told to head upstairs, where I periodically shifted seats towards the front of the line and I severely objected to their as-yet-unexplained need to make a copy of my driver’s license.  I wasn’t afraid they were going to steal it - I just felt it was completely unnecessary for them to take it.  From there I talked to one agent, who asked me to wait while she served the other customers because it would take 40 minutes to configure my phone.  I waited, and at the end of 20 minutes was told to fill out a form and go pay the activation fee.  When I also mentioned that I needed another SIM card and air time… I was told that I couldn’t pay for the activation until I had a signature on the form with the sim card number and that I had to buy the airtime at yet another counter. But I couldn’t get the signature until I had paid for the SIM card.  Three visits to various cashiers, and one more visit to the customer service rep later, I finally sat down, with the appropriate signatures and lots of money paid to configure the phones.  After that it was relatively simple - she did some things on her computer to authorize my SIM chip, poked around and configured a phone, turned it off and on, and picked yahoo.com to show me that it worked.  I was a little miffed because Yahoo.com is not exactly a small page (m.yahoo.com is okay) and I was obviously paying for the download, so I stopped the page load and picked up m.gmail.com instead, sans images. The end result though!  I can now check my email even when the power goes out.  Ah the miracles of technology!

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http://uniteforsight.org/conference/2008/abstracts.php

Unite for Sight is a health conference held every April.  It’s an interesting gathering of people from a large number of backgrounds doing international health and development, and although it has a focus on eyecare, it incorporates numerous tracks and presentations on other aspects of International Health as well. Last year, Sonesh did a presentation on Aravind’s WiLD network.

The next conference is April 12-13, 2007, to be held at Yale University.  If you are interested in submitting an abstract, you need to sign up and send in your abstract by July 15th at the url above.

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It’s been a busy couple of weeks, with not nearly enough access to internet cafes!

This week I am back in Mbarara, currently using the computer science lab (which is empty because the students are all doing exams now), but also meeting with various professors here (again!) and working with Ben and Richard on the Smartphones for OBA project.

The major update is that we are now collaborating with the Faculty of Science at Mbarara (Physics Dept) to figure out solar power options for the health clinics participating in the OBA program. They are currently engaged in research evaluating the degradation of imported solar panels and are the perfect collaborators for this project. They also have experience with circuit-soldering, so they’ll try to use Manuel’s solar charge controllers both for their own experiments and our project.

We also visited the Marie Stopes International Uganda office and one of the Marie Stopes Uganda clinics. They are currently using the VMUS database developed by Microcare, and have two people entering the data from the (triplicate-carbon-copy) forms that are collected from the various clinics participating in the OBA program. Right now the system is down, so the forms are piling up, and they are entering the data into Excel, so they can process the reimbursements. I’ll head back there today or tomorrow to hammer on the SmartForm and figure out exactly what it should look like. At the clinic we spoke to Steven about his experience participating in the program. The major issues he identified are timeliness of reimbursement processing, limitations on the range of treatment options (if someone is diagnosed with a non-STI bacterial infection then they have to pay for treatment in addition to what they paid for the voucher, although I think the consult is covered), and patients coming in with vouchers that clearly don’t have an STI, and therefore are not eligible for subsidized treatment.  So there is a need for better and clearer marketing.  Richard suggested giving distributors placards that (literate) patients can read so they know what services the voucher will cover.  They also have problems with people going to multiple centers, and not having documentation for previous visits, or buying multiple vouchers and having tests done unnecessarily.   We hope that with the SmartForms project we’ll be able to address some of these issues, by making voucher records more accessible, and improving the communications process around the form submissions.  There’s lots of ideas flying around and a lot of work to do!

For the rest of the week (before I take off for Ghana) Richard and Ben and I will be visiting the various health clinics and talking to them about the project, getting a feel for their willingness/interest, as well as the environment in which the phones would be deployed.  We’ll start testing/piloting in August when I get back.

The culmination of our many many meetings was our presentations to the Ministry of Health and the Member of Parliament (MP) for Nakaseke district.  (Although admittedly the MP meeting was a bit of a surprise, so a bit extemporaneous.)  We had been spending our evenings in Luwero (the town near Nakaseke where we were staying) processing everything we learned, and our days visiting the health centers.  We interviewed the in-charges, nursing assistants, and records officers/assistants at 3-4 health centers a day, and asked about stock management, health information reporting, and the general challenges they each faced in their daily work.  Almost none of the lower health centers (HCIIs and HCIIIs) had power (”We use lamps”), but even in the HCs with power the staff had mobile phones.  In those cases, they charge the phone by sending it off overnight with a matatu (the public mini-bus system) driver for the price of 500 shillings.  Most people have nokia candybars that stay charged for about 4 days.

I’m impressed overall with the staff we’ve talked to, and with how well all of the health centers comply with the Ministry of Health’s health information reporting policies.  They each submit weekly reports on highly infectious diseases (sometimes by SMS) as well as more comprehensive (4 page) monthly reports on stock levels, outpatient population, and diagnoses. In Rakai (another district) they submit these reports via PDA and gprs - here, they submit on paper in person to the district hospital in Nakaseke.

You can check out our findings in the presentation we made to the MoH, along with some ideas for integrating smartphones into their existing system.  The presentations (ours and that of the ICT team) were well received, and we are all looking forward to further collaboration on a project proposal, and hopefully a pilot once we receive funding to move forward.  There’s a lot of questions left to be answered (how do we balance paper and digital records? What about power?) and a lot of work to be done, but I have high hopes that handheld computing and communication devices like smartphones can make a positive impact on healthcare in Africa!