As I mentioned in my last post, new technologies are being introduced primarily by the mobile service providers.  And for as much as I’m developing bits and pieces of software, my research is to introduce these technologies to the healthcare service providers (HSPs), to educate them on their use, and to study how they are assimilated.

Brief aside: For you students out there, what makes this a vaguely experimental context is that I’ve manipulated the context by forcing the introduction of computers, Internet, and Internet-enabled mobile phones, so I can ask very specific questions.  It’s only vaguely experimental because there’s all sorts of exogenous variables that I can’t control and, well I only have 8 subjects that are ultimately wildly different from one another.   All the statistical data I presented in my last post was from a survey of 59 health facilities, so that’s slightly different… but also to be discussed.

Okay, now this is long overdue, since MTN changed their GPRS settings at least 6 months ago.  But this week and next I’m setting up my 8 facilities with mobile Internet, so yesterday I went to Warid, MTN, Orange, and Zain and purchased Internet plans from each of them.  (UTL has CDMA and DSL broadband services, so they don’t offer GPRS services by monthly subscription, although they do have 3G equipment installed on their masts in Mbarara. We don’t know what their deal is.) Here’s a run down of all the prices:

The prices listed are in Uganda Shillings (conversion varies from day to day, I think it is actually about 1950 UGX to USD, but I generally use 2000 as my conversion rate for this blog, for round numbers, and so I don’t have to get out a calculator.)  For Orange and MTN, they offer discounted rates if you subscribe for multiple months. You can view Orange’s price list and coverage area online, and MTN’s price list as well.  Warid calls their plan Smartlink.  A primary thing to note is that not only is Orange half the price of the others, but Orange has 3G coverage in many of the major towns throughout Uganda, including Mbarara.  Practically speaking, this means I can watch live streaming video on the BBC News website using my Orange modem, and use skype again. Yikes.  My one modem is faster than the entire Mbarara University VSAT connection.  At the same time… I took the modem to Kaberebere yesterday, about half an hour away to a health facility, where only EDGE coverage was available, and I was only getting 4Kbps instead of 100Kbps, and when I took it to Kanoni, it didn’t work at all, so it really depends on where you are.

I spent yesterday morning purchasing mostly just the SIM cards from each of the providers – which I get away with because I’ve previously purchased modems from them and they all know me.  Usually you’ll have to argue with them if you try to purchase a monthly subscription without a modem, and prove that you have a phone that’s capable of handling it.  They just don’t want to deal with third party modems.  Don’t tell them that you have one if you do.

For each one, if you know what you are doing the APN is listed above, and the username and password is blank. IP address and DNS settings are automatic, and there are no proxy settings.

With Warid, there’s a trick – there’s a current promotion, in which for all the airtime you load, you get bonus airtime, which can be used for calling, but not for things like Pakalast or Internet.  So I loaded my personal phone with the airtime for the Internet and then transferred the airtime to the Internet SIM.

You don’t have to go to a Warid office to activate Internet on your Warid line.  Just send an SMS with the words data 85 to 158. Warid will deduct 85,000 from your account, and you will get 30 days of Internet.  Make sure you have 85,000 UGX already loaded on your phone.   By my experience I usually just go to the customer care office because no one but them actually sells that much Warid airtime… You can also send the words data 5 to 158, and you will get one day of Internet instead for 5,000 UGX.  I was told also that you can check your SIM card: if you have a 32k SIM card rather than a 64k SIM card, you may have some difficulties with Internet, and you should get your card replaced.  I have, however, never had a problem with using a 32k SIM card on a pay-per-kb basis.

For MTN, if you already have a line, and you don’t have Internet, you can call customer care on 123 and tell them you want Internet to be enabled on your phone.  If you already have 90,000UGX on your phone, then you can ask them to deduct that from your balance and then they can subscribe you.  Or you can just enable Internet and start using it at the pay-per-kb rate.

For Zain, once you first connect to the access point, you will need to activate a plan before using the Internet.  If you go to the store, then they will do this for you.  Now, first, I will mention that yesterday and today, Zain has been very very flaky – the coverage has been okay (totally down in Ruharo) but the AP has been down more often than up.   However, once you are able to connect you need to use a web browser to connect to http://www.zain.com.  You will then be redirected to a page that will invite you to choose between three Zain plans, Zain Access, Zain 1GB and Zain True Unlimited.  Zain Access is the pay-per-kb plan, Zain 1GB is the monthly plan for 90,000UGX per month, and True Unlimited is another monthly plan with no bandwidth cap, at a price I don’t remember.  Click on the link corresponding to the plan you want and it will display the name of the plan, its validity, and the price.  Then click on the subscribe link.  From there it should take you back to the Zain page and you should be ready to go and use any mobile web application on your phone.  Note – if you select Zain Access, you won’t be able to switch to Zain 1GB for at least one month on that same SIM card without a LOT of hassle, so make sure you know which plan you want to be on.  Or just get two SIM cards.

Orange offers 1GB, 3GB, and 10GB plans, both with and without their modems.  If you choose not to purchase their modem (150,000 UGX) then you have to subscribe for a minimum of 3 months. I tried to purchase one instance of this plan yesterday and was told that they were sold out of modem-less Internet SIMs and would have to return the following week, so clearly modem sales are a priority.  And iPhone sales. At 3G speeds, 1GB gets used up really really quickly.  3GB is probably reasonable 10GB is pretty expensive…

If you are using your mobile phone, most networks will try to configure your phone over the air (OTA).  I haven’t had a lot of success with the OTA configurations on my Nokia, and none with the Palm phones. But whatever.

If you purchase a modem from one of these providers, you’ll find that the modems from MTN, Warid, and probably Zain (they have a new modem now that I haven’t tried) all include OSX-compatable software.  I don’t use it.  The Orange modem doesn’t come with software, but is made by the same manufacturer, a Taiwanese company called Huawei.  Basically, I go into my Network Preferences, select the “HUAWEI Mobile” device, and add a new configuration.  From there I click the “Advanced” Button, and the Modem window displays.  For Vendor, select “Generic”, for Model, select “GPRS (GSM/3G)”, and enter the APN as above.  All other settings under advanced can be left as default.  If you have any proxy settings, you might want to uncheck them.  Click Ok to save your advanced settings, and then enter *99# as the telephone number. Click Apply.  Then Click Connect.

On a Mac you can also share your Internet connection with other WiFi-enabled people in the room.  Once you are connected, click “Show All”, then double-click on “Sharing”.  If you click on the words “Internet Sharing” you will see options for “Share your connection from:” and “To computers using.” Select the appropriate options (i.e.  Huawei Mobile and AirPort respectively) and click on the checkbox next to Internet sharing.  If you are successful it should  1) turn on your airport if it is not already on 2) ask you to start Internet sharing  3) turn your little wifi icon into an up arrow.

Of course, now having one of each network (except UTL) and being able to test them side by side in multiple locations I’m learning their differences.  I’ve extolled Warid and Zain before as having better performance, probably because their network isn’t glutted by lots and lots of users.  However – now the situation is different.  Warid has a lot more users, and it seems that I can barely get the modem to connect.  Zain is just having technical difficulties right now – I’m not sure if that is temporal or endemic.  After my previous post, I discovered that both Warid and Zain are much better in Kampala.  But from my perspective – it doesn’t matter – it’s much more important to ICTD to know how all of these networks are performing in the villages and towns outside of Kampala, for rural health centers where our potential users are, where the so-called bottom billion are receiving health care (or not receiving health care, as the case may be).

I’ve been putting up coverage maps for the past year, claiming that wherever there is mobile coverage there is GPRS coverage.  This is only partially true.  I just went to Kanoni on Monday and found that I couldn’t get any of my phones to connect to the Internet successfully – there was extremely weak phone signal, and no GPRS coverage.  I even got the Orange software to connect.  To no avail. (it connected on windows, but not on OSX, or on my phones) We suspect, it might work on Zain, but I didn’t happen to have a Zain card on me… and I’m worried, given the quality of the Zain network here right now.

So there’s theory and reality.  Orange makes a claim “All areas covered by the Orange network have EDGE available with speeds of up to 236kbps.” And yet in Kanoni we had 2-3 bars of reception, with no Internet at all.  I travelled to Ibanda with the doctor finally, and we uploaded his attachment at a whopping 1-2kbps.  Yes, we were connected using EDGE, but it was a slow and painful (dare I say dull?) EDGE.

And yet it is the best we have.  The best I’ve seen Warid connect with out here is GPRS. MTN connects in general using EDGE, but always more slowly than Orange, unless we’re out of an Orange coverage area (e.g. in Ruharo). MTN’s fallback in rural areas is GPRS, Orange’s fallback in rural areas is EDGE.  Much of Isingiro, a district bordering Tanzania, the location of the Uganda UNDP Millenium Village Project, has very little Orange/Warid/MTN coverage, and is only accessible by Zain. In those locations, Zain is the only recourse – and 3G is available (or so it is rumored).

In my office, Orange is faster (and cheaper) than our VSAT connection, and doesn’t go out when there are power cuts.   We used it to download all of the Windows updates for the six deployed laptops in my research study, with little effect on the connection performance. Useful. And I can skype again, not that I have the time these days… =)

I am deploying these modems according to which network works the best for the various providers in their facilities.  Each of them will get a subscription for one month, after which they are free to continue subscribing on their own, or to return the modem to me.  After the second month, they will have to arrange to purchase the modem from me or from the appropriate mobile phone company.  They also are equipped with Internet enabled mobile phones, and are keeping logs of their usage and spending.  Hopefully by the end of two months they can make an informed decision as to whether they would prefer to use Internet on their phones (cheaper but limited) on subscribe to Internet on laptops (expensive but more flexible).

I know it is a little weird to be working in development but to still be telling people in Africa to spend money. But I’m also perfectly fine with any decision, whether they choose to forego the phones and laptops altogether, or to spend lots and lots of money for everything.  I just want to learn their preferences, and why they make these choices, and how what they learn changes their choices and how they communicate.

Tweet This Post Facebook

Now, there’s clearly a difference between the startups of Silicon Valley that get venture capital and make millions, and the small business owners that run grocery stores or laundromats, and street hawkers that sell chewing gum from baskets on top of their heads. Profit margins are one.  But everyone has to start somewhere, and not everyone has the same connections; certainly environment and geography plays a large role in the probable capacity of an individual to aspire.

So what does it take to start a formal business in Uganda? To be a small business owner?  I’ve been encouraging some of my students along these lines, and thinking about the “Coded In Country” concept.  One thing that plays a large role in the ability to build local capacity is the country’s business environment; how hard is it to start and run a company in Uganda?

After a bit of word-of-mouth consulting, and talking to some small business owners here, I turned to google, and found the Doing Business Project, which provides indicators on 10 topics in 183 economies.  While the data itself is also very useful, from a very practical standpoint the fact that they’ve documented all of the (18) steps for starting a business in Uganda, and put them on the web is totally amazing to me.  This is not formal e-governance, since the government isn’t the one putting this information on the web, and in theory, the gov’t could change the policy, making this document out of date. However, this does make things easier for people… as long as they have Internet access and pick the right search terms (e.g. “starting a company in Uganda“).

Now, what does this information mean for my students?  Mostly it means that they need to hire a lawyer to incorporate as a partnership.  We’ve consulted with a friend of a friend of theirs, and it will cost about 365,000 UGX (180 USD) in licensing and lawyer’s fees to go through the entire process. Their hope is to start a company that uses information technology to support healthcare in Uganda, through the development of software and the support of IT systems. They are helping me by providing ongoing computer and mobile phone maintenance to the healthcare providers I’m working with, even after I go back to the States, and working on supporting the software we’re developing.

Now they just have to come up with a name for the company…

Tweet This Post Facebook

Dembbe Clinic WECARE Solar and Netbook Deployment

Kathe Medical Care Netbook Deployment

Barefoot Power PowaPak and Palm Treo Deployment

Here’s how my research works: There’s a lot of complicated stuff about claims and claim processing. However, what I actually do is a lot of qualitative research on how people do their work, perceive information technology, and manage information. Then I introduce new technologies, and then ask them what they think of them, and see what they do with them. Sometimes I’ve done weird things with these technologies (like umm.. written them or installed specific software), and I definitely have a specific approach – I interfere with my subjects a lot in terms of computer training, and in the case of my partnering agency, being an IT consultant in this office for 15 months.

My baseline studies and are showing that my target user base 1) has a high interest in using information technology for patient information management but 2) very little training (for the most part). So if I were to introduce a new system, let’s say a laptop/netbook, 1) they would be very interested in learning how to use it, even paying for it but 2) they would have little to no background knowledge on where to start.

This has deep implications for user interface design. For many people, they choose a “kiosk” approach, making computers that have only one application (also known as the “appliance”). However, this has implications on sustainability. For private health facility owners who need additional skills, or for programs that cannot be expected to finance the equipment externally – paying for purpose-built machinery when the computers are capable of general purpose applications is impractical.

In this case – Claim Mobile is probably not a sufficiently valuable application to motivate purchase of laptops or phones. However – the phones, bundled with a camera, medical calculators, bible readers, internet browsing capabilities, etc, and the netbooks, with Microsoft Office, and Hesperian ebooks, and other medical resources, Barack Obama’s speeches, and the ability to access the Internet are of great value to the health facilities, and to the program management of the Uganda OBA project, even without the claims processing component.  However – we hope to find out in this study how this value will actually play out against real purchasing decisions: laptops vs phones, Internet subscriptions vs pay per kb Internet use.  In addition, we will observe over time how the health facilities and the Uganda OBA project will make use of their ownership of these devices, and how the new uses play into relationships, communications, and the management of the OBA program in general.

Some caveats about the deployments so far.  Out of the first three deployments, two facilities did not have power.  In one location, we donated a solar suitcase to Dembbe Clinic through WE CARE, an organization I’m involved with that seeks to provide improved electricity and communications for maternal health care.  The two 20W panels provide sufficient power to charge the netbook, phone and lights for the facility.

In the second location, we are experimenting with the Barefoot Power Powapak, which provides solar led lighting sufficient for rooms (not quite surgery), and a cigarette adapter to charge phones. However I went back on Monday to check on the solar deployment, and discovered that the battery was completely discharged – probably because the solar panel was failing to charge the battery.  I’ll introduce some solar logs to have them track usage more closely in January. The phone is being charged every few days from the clinician’s other place of work, which has access to electricity.

• Daily WE CARE Solar Logsheet
• Daily Usage Log

The third location, Kathe Medical Care, has very reliable access to electricity, because they are on the power line connecting to Rwanda. However, what interests me about this particular clinic is their innovative uses of ICTs prior to the study.

Kathe Medical Care analyzes output indicators by local sub-districts

During my baseline surveys, I was introduced to Kathe Medical Care’s many colorful computer generated graphs and charts, all produced from the government-mandated monthly summary data.

There were charts showing trends of increasing numbers of antenatal visits over the past year, since the beginning of the OBA program, charts, comparing non-OBA deliveries to OBA deliveries, and charts showing from which  sub-counties patients were coming.

I learned that the clinician did all of these from an Internet cafe, taking his monthly reports to Mbarara each month, entering them into Excel, to produce the charts.

Based on these charts, I assessed this clinic, and had high hopes that I would be able to learn from him how other clinics could use their data to benefit from computers.

I also assumed that he had a usb flash drive.

But to my surprise – one of his statements upon entrance into this study was that he had been giving people these charts for a while and hoped that at some point  someone would think to give him a flash drive. You see it turned out that each time he produced one of these charts, he was entering in another year’s worth of data, all over again – he had nothing on which to save the Excel spreadsheet that he was using to create this chart. I think none of us ever imagined he could achieve so much without a flash drive in the first place!

This sort of begs a question: clearly he has enough income to purchase a flash drive, if he’s willing to purchase a netbook, and even a printer… What stopped him? (This is another blog entry entirely, maybe a paper or two).  There’s a lot to be said at this moment about 1) trust in electronics purchased in Uganda and 2) the perturbation that I am as a ethnographic researcher in this environment.  But I won’t say it now.

In the meantime… given what he was doing without a flash drive, and with the nearest Internet cafe an hour away at $1.50/hour,  let’s just imagine what he’ll do with his own netbook and Internet access.  Or perhaps not imagine… we can wait and see.

Tweet This Post Facebook

The Together as One Community Project (TACOP) claims a mission “To enable the community to raise investment Capital through net work saving” and encourages members to recruit more members to deposit money into specified bank account.  Each new member deposits 10,000 UGX (~5USD) into the TACOP bank account (Post Bank 1630003000139), and 5,000 UGX into each of seven (7) other member bank accounts, all listed on a numbered page (the paper I’m looking at is numbered 169).  Thus, joining entails a cost of 45,000 UGX (~25USD), but with the “promise” of earning 5,000UGX per person recruited to the project by their recruits.

There’s a very nice chart on the back, explaining that “your one form will turn into 3 forms, 9,27,81,243,729,and 2187, as you earn UGX 5,000/= from each form,” and showing that at level H they will have an income of 10,935,000/=. They of course forget to mention the detail that each level requires the recruitment of 3 times as many people , and that at level H, if you get there,  the so-called the community project has earned 32.8M UGX (16,400USD) from your “descendants” alone.  There’s no information on who runs this project, or how they plan to use this money.

They even suggest you can rejoin the program – presumably by paying another 45,000 UGX.

Apparently the “company” has just reached Mbarara, and are claiming that they just arrived in Kampala a month ago (so people don’t believe that the population is saturated, presumably), but my intern notes that it’s been in Kampala for over a year.

So let’s say that the #169 indicates that this is the 169th member of the company to be recruited. That puts this potential member at level 6 or level F in the overall company. To get to their level H (level 12 overall), over 797,161 people will have to have been recruited. At level 16, they will have exceeded the population of Uganda.

What really gets me though is that the fact that maybe 168 people have been recruited already means that some 120 people have probably put in money without actually receiving any deposits, and another 50 have only gotten a little back – whereas the 4 people that started the scheme already have 1,680,000 and 840,000 UGX in their banks.

At least they haven’t figured out yet how to use MTN Money and Zap for these schemes… which I’m guessing might make them largely untraceable given how easy it is to get new sim cards out here.

This isn’t the only pyramid scheme out here, a new one has also started up, with a higher buy in (I think around 95,000 UGX), possibly targeting higher income people.  We suspect also that it’s making its circuits right now because the students are returning to start classes, and may have cash on hand for their living expenses and tuition money, so both schemes might be targeting students.

Now here’s the thing that I’m thinking about.  What can we do about it?  What is the role of development in dealing with pyramid schemes in Uganda? Besides informing the banks and the Ministry of Finance so that they can do something about it?

1. I think we should think about ways in which mobile technologies and other ICTs might be misappropriated to propagate these schemes – not as a reason for not using these technologies, but so we can design better and more secure mechanisms. Do pyramid schemes have an implication for m-Pesa and other mobile finance programs? Or are they irrelevant?

2. I think we should think about how people access information, how they ask questions when they encounter new things like these “finance clubs”. For my coworkers, a lot of information is spread by word of mouth – they know things by rumor, by discussion and stories shared within the office during breaks and at lunch. Very different from our “new culture” of looking everything up on wikipedia, or the culture we might be trying to create by telling people they can query google for information.

3. Rights to information: how can we give people access to the information they need to decide for themselves whether a program is a good or a bad program.  Of course this slip of paper doesn’t have “Google Keyword: pyramid scheme” written on it anywhere. So how do they link information resources to the questions they might have?  Question Box tries to be a general purpose unspecified answer of whatever questions might come up – but hasn’t come into general usage yet. By American experience I’m not sure that this type of solution would become mainstream – Google Answers and Yahoo Answers seem to only serve particular audiences. Google search is more mainstream, but sometimes requires a some technical skill to get the required answers – and has severe limitations in the types of knowledge one can acquire.  Would Google search be adequate for the answers needed by our audiences in developing regions?  I can’t tell you how frustrated my colleagues at Mbarara University are by finding academic papers via Google search (they generally aren’t familiar yet with Google Scholar) only to be stymied by restricted access journals.

So, what is the role of ICTs in addressing the day to day issues of Ugandan poverty? Information about pyramid schemes in this case has already clearly benefited the scam artists involved – how can we use ICTs to also prevent pyramid schemes from propagating further?

Tweet This Post Facebook

At the moment, I’ve totally given up on using my 64/64 WiMax+VSAT link via Infocom (which costs $300/month) and I’m using my Warid Telecom GPRS/EDGE modem (cost $60 + $40/month), which incidentally also claims speeds up to 128kbps (16KB/s), but in reality usually sits at about 2-5 KB/s on a good day (I am getting about 1.0KB/s now).  The MTN EDGE/HSDPA service ($150 + $45 modem) is a bit of a joke and I have never seen it go above 1-2 KB/s (It’s supposed to be 384kbps, or 48KB/s).  My suspicion is that MTN, as the pre-dominant service provider in Uganda is over-subscribed, and they use older equipment here in Mbarara. Rumor has it that they get better performance in Kampala.  But it is totally beyond me why they claim 3G services and sell HSPDA modems but offer a service quality that is really completely unusable. In practice – I was able to get data services (with the same sim card) using my android g1 phone, but not with the modem they provided. Okay, I’m straying from my original topic – I’ll do another series later reviewing available mobile data services in Uganda, since that’s part of what I have to research here for Claim Mobile. (My findings are mysterious and intriguing, let me tell you… or just plain frustrating, take your pick.)

So why is a mobile phone researcher sitting here worrying about ISPs and various telecommunications providers, other than the fact that I can’t send emails and every time I manage to load my credit card website it times out and kicks me back to the log on page? Well, it’s actually part of my participant observation activities.  Yes… I get to be my NGO’s consultant on all things IT.  But it is also useful to know and understand these things – not just in theory but on the ground – what are NGOs actually facing in day-to-day experience trying to deal with ISPs, from selection of an internet service provider, to daily maintenance of an Internet connection, to their own understandings of why things are and are not working..

The technical people to whom we outsource things are in general okay.  There is a dependence on Windows products.  And I could wish that they would install proxy caches, especially since we are using VSAT services.  I like that Infocom uses WiMax.  But their connection to the Internet seems less than reliable, which is unreasonable given that they are multiplexing WiMax users. And really, when the Warid mobile internet for $40/month performs better than the $300/month Infocom link, you know that something is seriously wrong.

As I mentioned at the beginning – this isn’t an all-across Uganda problem.  I can go to my Mbarara University office, and my internet connection is fine – we use Uganda Telecom as an ISP there, and the connection is a lot faster.  Unfortunately for me, the sysadmin is a bit paranoid since he doesn’t quite know what he’s doing, and the firewall doesn’t let me POP3 my mail.

And I will also note that the story differs a lot when you change regions – East Africa Internet prices are very different from West Africa – in Ghana you can get fairly decent DSL broadband for $90/month, with out paying an arm and a leg for VSAT equipment, purely because West Africa has the SAT3 submarine fiber with a landing point in Ghana and a few other countries.

We’re waiting for that submarine fiber to Nairobi to be finished this summer?  Hopefully with a non-monopoly business plan? But even once East Africa has submarine fiber, that doesn’t solve pricing problems for the land-locked countries in central Africa.  While, there are many capital projects working on getting broadband Internet around the coast of Africa, no capital projects that I am aware of to date are investigating lowering the cost of Internet beyond the coast. More than a few invest in broadband via VSAT (e.g. o3b), but while VSAT may be expedient, it will remain expensive to maintain, and is not a new solution.

How many development projects have died after their three year term when the supporting NGO was no longer able to pay the $2000/month subscription fee for the VSAT service?  Even when coupled with on-the-ground last mile solutions like WiMax or WiFi for sharing the VSAT link amongst a number of users, we find that the per-user cost of VSAT is too high.  $2000/month here pays for maybe a 263/790kbps connection, which will support about 20-30 users.  That’s almost $100/user/month!  Let’s say we restricted applications to low-bandwidth apps and could support more users. With an optimistic 200 users, assuming no costs for maintaining a network that supports 200 users, $10/month is a lot of money to ask from a rural villager, discounting the cost of whatever device you are giving them. There’s still no real scenario in which this pricing model becomes affordable and sustainable. Shared VSAT plans are less expensive – but as I allude to in the beginning of my email – shared plans support fewer users.  This 64/64 Infocom plan is virtually non-functional at the moment.

There’s something on the horizon… Warid has started offering WiMax service in Kampala, for which they are charging about $150 for equipment and $100/month for “broadband” service.  In theory they will offer the same in Mbarara at the end of the month. (End of the month in Uganda usually means sometime in the next 3-6 months, as I’ve learned..)  I assume that this is similar to Infocom and MTN’s service – WiMax to VSAT, unless Warid has some sort of wireless relay going up through Kenya and Ethiopia to the Middle East that we don’t know about.

Also on the horizon is Eric Brewer’s plan to build long-distance wireless broadband (not necessarily WiFi or WiMax) links down the Rift Valley, effectively bringing broadband inland from a number of possible submarine fiber drop points to a selection of possible inland locations using existing(?) wireless towers.  Issues to surmount?  Spectrum licensing in each country, trans-boundary traffic issues, negotiating agreements between the various ISP associations in each country, pricing models, who will administer the network, etc.  Oh, and of course, setting up the network…. But TIER has experience with that…

In the meantime.  I’ll post this and be thankful that at least two of my three available Internet connectivity options are functional.

Tweet This Post Facebook

The mother receives the baby from the nurses at the clinic.

Like the HealthyLife program, the mother purchases a voucher for 3000 USh (approximately 1.50 USD, the HealthyLife program charges 3000USh for a pair of vouchers treating both sexual partners). The voucher then can be broken into several sticker stubs, one of which is submitted with a claim form on each visit.

The first mother puts her thumb print on the HealthyBaby claim form

The hospital then submits the claim form with the voucher to the funding agency (my collaborating organization), who then pays the hospital for the cost of the visit – labs, any prescriptions given, the consultation fee, etc. You can see in the picture to the right the nurse filling out the paper form and the mother putting her thumbprint on it. Filling out the forms can be tedious and error prone – this particular clinic had almost 18% of their STI claims rejected for errors last October. In the same month another clinics had 38.6% of their claims rejected. I am trying to work on digital systems that can help improve communications between the clinics and the funding agency, and also decrease the cost and burden of claims administration.

The Claim Mobile project actually focuses on the HealthyLife program – the STI treatment program, rather than the HealthyBaby program, but I hope to demonstrate the sustainability and replicability of the system that I’m developing by training the engineers here to retool my system for HealthyBaby – so by the time I leave, I am hoping it will be in place for both programs.

By coincidence, this first birth occurred in one of the two clinics where I’m running the pre-pilot of the Claim Mobile system.

Tweet This Post Facebook

The fact was that I spent a lot of time on airplanes and figured it might be worth the investment to spend some money on a headset such that I might be able to hear music and my recorded interview data over the sound of the airplane engines! And sometimes it is nice to be able to sit in a shared office and have some privacy.

The long and short of my research: Noise Canceling technology requires batteries and external power, and is ultimately bulkier and heavier. Noise isolation is great because you can actually turn down the volume being sent towards your ears, they work like earplugs, and it doesn’t require additional power. And they are cheaper. But it can be a little weird because – you are totally deaf to the outside world (i.e. you can’t tell if a flight attendant is trying to get your attention), and if you eat something you can hear yourself chewing, and sometimes they don’t work so well if you are running. Mine are fine as long as the cords are hanging relatively free, since V-Moda redesigned the cables with a cloth cover.

You can plan ahead, but sometimes you have to improvise a bit to make high-tech things work once you leave home...

The V-Moda ones are especially great (not that I’ve actually compared them) because they come with a carrying case. The ones I got came with a little compact leather case that open when you pinch it, and a v-shaped cord wrapper, which was initially a little mysterious to me but now I think is the best thing ever. I want one for all of my corded accessories! Unfortunately the new ones don’t come with the v-shaped thing – they come instead with a rectangular carrying case sized for the iPhone and the iPod Touch. I don’t blame them, but as an iPod Nano owner I’m glad I got my headset earlier.

Okay so that was a long intro. Onto my sob story. I was walking home the other day from work, and I decided to listen to one of my interviews on the way, so I pulled out my Nano, and my headset. As I connect the headset to my nano, I notice that one of the silicon ear fittings is missing. I should note that this happens to me almost every plane flight – these things fall off all the time and it drives me nuts. Why I don’t have spares is beyond me, but they give you three pairs in different sizes (small, medium, large), so I just picked my size and left the other two pairs at home when I came. On a plane, this is mostly fine – I mean, where can a little black rubber thing go on a plane anyways? I’ve always found it eventually. But this time, when i pulled the headset out, I managed to drop the earfitting onto an area of the ground littered with black pebbles, bits of trash, and random grass growth… and a ditch. Yikes. Ever hopeful, I searched anyways, to no avail.

So I walked home, listening to the interview, with one ear happily isolated from noise, and the other ear listening to the interview and the caws of the maribou vulture-storks, with a piece of metal uncomfortably perched in the canal. I had thought through this situation before, and I plotted, considering my options, and wondering if I could wait for someone to bring a batch of spare fittings to me in April…

My solution: well, since noise-isolating headsets are essentially earplugs with sound coming through them, why not use earplugs? So I got out an earplug, my handy-dandy leatherman, and hollowed out the center. The leatherman, as it turns out isn’t all that useful for hollowing out the centers of things, so once I made divots on either end of the earplug, and cut it to the appropriate length, I used the pen from my Palm Centro to poke a hole through the center, such that the middle could grip well onto the headset. I think it actually works better than the silicon fitting – at least it is less likely to fall off, even though it doesn’t look nearly as slick. And now it is much easier to tell the left from the right.

It goes to say that 1) I’m pretty privileged to have the gadgets that I do have, 2) to have the options that I have with which to fix them and 3) I should have brought extra silicon fittings with me (I’m not a boy, but the boy scout motto is Be Prepared after all). But I think this also says a lot about ICTD and technology transfer in general. What happens when we take information technologies and deposit them in developing regions without a thought towards their repair and maintenance?

Eventually things break, parts get lost, and things must be repaired. And spare parts don’t exist, or even if they do exist, or can be acquired, they are difficult or too expensive to acquire. So some people improvise. Others just allow the donated equipment to lie fallow until a new donation arrives, or another benefactor comes to repair the equipment. I have seen rooms full of dead computer equipment, “computer graveyards,” in Mexico, India, Ghana, and Uganda. I like mobile phone projects because there is a rapidly growing infrastructure and ecosystem outside of our own projects to support the repair and replacement of the mobile phones we are deploying – yet the truth is that often we are using very specialized phones. So even as mobile phone project developers we must be aware of the maintainability and serviceability of our devices. At least these objects are generally familiar to mobile phone service reps! (Maybe less so the android phone and the Palm phone. The blackberry seems to have gained popularity though. Obama has given it a popularity boost out here too!) Laptops are serviceable because they can be carried to a service center. But desktops are the hardest to carry because people are afraid to move them – afraid to break them, especially with the associated heavy CRT monitors.

And so while I was able to repair my headset, I have to admit that my solution isn’t perfect – they certainly aren’t the same as they were before. Getting the technology out here is one thing – making it work over a long period of time is yet another.

Tweet This Post Facebook

I was sort of hoping when I looked that they were a site that donated textbooks – so that I could get some textbooks for the Object-Oriented Programming class I’m teaching at Mbarara University of Science and Technology this year. I wanted to use Head First Java (which you can get from BWB for $32), or maybe Deitel and Deitel’s Java How to Program (available in various editions from BWB) at least as a reference, but unfortunately they don’t have either in their libraries (the library actually has a lot of copies of C++ How to Program and C How to Program), and I’m sure the students can’t afford to buy the books.  Alas even if they could I didn’t even know what class I was teaching until a few weeks ago, so it’s not like the books would be shipped on time. There are a bunch of other textbooks in the library – but unfortunately there’s about 20 books for my class of 208 students to share. I’m hoping they’ll cope with the online resources (e.g. the Java Tutorial) and my lecture notes, but that puts a lot of pressure on my lecture notes and very unreliable Internet connection.  I just gave my first lecture today, which was followed by lots of frantic copying of my slides to some very highly infected usb-keys.  Thank goodness I have an apple laptop. Whew. Sigh.

Anyone want to donate an electronic copy of a decent OOP-Java textbook?

Actually, lots of people here are asking me for advice on web development and some systems administration too.  I think we’d be happy to take donations of any textbooks, electronic or otherwise.

You can ship books to me here at the Institute of Computer Science:

Institute of Computer Science c/o Melissa Ho
Mbarara University of Science and Technology (MUST),
P.O. Box 1410
Tel: +25648520394 / +25648521373
Mbarara, Uganda

If you decide to ship anything else to me, umm, like computers (!!) let me know and I can give you an address in Kampala, which might be more secure/faster. =)

p.s. For my personal use, I’m perfectly happy to just buy and download pdfs of books from O’reilly or elsewhere and read them on my Sony Reader.  It’s a little slow sometimes, but I get instant gratification (relatively, compared to the post) and remarkably readable. And I can carry them home with me. But if you send me a physical book I’ll leave them here for the library.

Powered by Qumana

Tweet This Post Facebook

So I mentioned before that I purchased a bunch of eeePCs to test out in the health clinics and to use in the management agencies as asyncronous web servers and health information management devices.

I suppose to some extent that in retrospect these clinics will have wanted Windows on these laptops so I’ll eventually have to port all of the software to windows, but for now my systems are running on Ubuntu.  It’s just easier that way. 

Installing Ubuntu was remarkably easy. There’s instructions online here, as well as lots of hints and fixes.  This is sort of my simplified version for the particular eeePCs I was working with.

Ingredients:
    1 latest distribution of Ubuntu (currently 8.10)
    1 external usb cd or dvd-rom drive (e.g. the LG-GSA-E50L 8x USB DVD-RW)
    1 eeePC (i.e. the eeePC 1000HA, 10in, 160GB, 1GB RAM, 6-cell Battery)
    1 wired Internet connection (and presumably an ethernet cable)
    Note: In theory you can also install from a USB Stick

Instructions:
    1. When turning on the eeePC, press f2
    2. Verify that a) wifi is turned on (this is for later) and b) the usb device is listed first in the boot order
    3. If the dvd device is not connected, with cd burned with the latest copy of ubuntu on it inside already, do that now, and then continue booting
    4. Install and continue, following normal instructions
    5. After install completes, update all packages via a wired Internet connection
    6. From fixes page, you will note that wireless does not yet work. You’ll want to follow the instructions there, but do not do the modprobe ath5k. However, you do need to install the backport modules:

  sudo apt-get update
  sudo apt-get install linux-backports-modules-intrepid-generic

Wireless should work after this. I used Ubuntu Ibex 8.10

I neglected to put in all my arguments for netbooks vs the mac minis we used in the Ghana consultation network, vs locally purchased desktops, vs actual servers. Basically it boils down to the fact that the netbooks have built in batteries, so we don’t have to purchase UPSes to use as backup power for then the power goes out. And we don’t have to track down a separate monitor, keyboard, and mouse every time we want to do something, which was frankly a pain, when we were working with the minis in Ghana, and couldn’t access them via the network. Laptops are designed to be disconnected from power on a regular basis, and have built in peripherals. Convenient. And actually cheaper than the minis, if a little underpowered, comparatively.

Powered by Qumana

Tweet This Post Facebook

Even without the new configuration, people are raving about these netbooks. They won’t let me take them back to the states, and people keep buying them off me – so I have to replace them when I get back home, using the cash people give me. More stuff to carry when I come back – it’s a wonder I always make it through customs with my 6-8 laptops..

The reaction to my laptops this time is that everyone wants to buy these off of me “when your project ends” – to which I always say that when my project ends, the laptops will still be in use because the project will continue without me – unless they are already certain of my failure (I hope not!).

The proposal for now is twofold: two of the laptops will be used as asynchronous web servers, akin to the design used in the Ghana Consultation Network, allowing the Program Management Office in Mbarara and the Management Agency Head Office in Kampala to access claims information even when their Internet connection is down – basically, since the processor will certainly be slow, it will be a caching agent. (I might try Google Gears as well and see if that works better, but this is something that I can intelligently back up and that they can own locally.) The rest of the laptops will be allocated to two of the private health clinics for use in administering their claims forms. However – a primary distinction from the mobile phone solution is that they don’t include communications technology. I will explore a couple of options – including both a sneakernet style solution of sending the forms by SD card, or the more expensive solution of attaching a falcom modem to the laptop, which essentially doubles the cost of the laptop. A few other clinics will be assigned mobile phones, and the remaining clinics will be controls – I will visit them, continue to run surveys, and observe claims administration, and monitor their transcations, but I won’t deploy services there for at least the first 9 months, although I may encourage my partners to independent conduct their own deployment (i.e. with my supervision but not done by me) towards the end of my study.

This study involves simultaneously understanding both the technical feasibility of these solutions and the financial feasibility of these solutions – it will take time to make the service providers understand the ramifications of the various solutions – and the resultant costs and benefits to them. What are the tradeoffs they will make in the end? I think different providers will choose different means in the end.. and it is entirely possible that they might choose to purchase a laptop but not use it for online claims submission, purely for its other utilities. Or because the service provider is of higher means and higher claim volume, they might choose to do online claims submission and pay the service fees because timely payment is so extremely critical for them. I’m curious to see what happens, and I can’t wait to see how it all unfolds.

Tweet This Post Facebook