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The Internet (or lack thereof) is driving me crazy!

Remember when we used to call the Internet the “World Wide Wait”? Sigh. The truth is that it isn’t really that Uganda as a whole doesn’t have access to the Internet but really that, depending on who your service provider is, and how much you are willing to pay, and where your geographic location is, you get wildly different quality of service.  If you are willing to pay several thousand dollars/month for a dedicated VSAT line you can get a pretty zippy connection.  If you can pay $2k/month, you can get a 128/256 (read: about the equivalent of a DSL connection about 5 years ago in the US).  Although in practice, even if you get a link advertised at 128/256, the ISP’s connection to the Internet might not be so great.  For example – at the moment, I have a 128kbps link to Kampala, but I’ve only got at 10kbps link to London or NYC (For better or for worse, I am using Speedtest to test the effective bandwidth). And about 1 in 5 packets to google are getting dropped so that 10kbps link is pretty useless…

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. ;)

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WECARE goes to Africa Part III

Laura’s back in Africa for her third trip to Kofan Gayan Memorial Hospital, a rural municipal hospital (district hospital) in northern Nigeria, where she’s provisioning solar power to support lighting (led headlamps and DC led floodlamps) and communications (icom walkie talkies) for a maternity ward.  While she’s there, she’s emailing periodic updates about her progress, which I’ll crosspost here.

From:  Laura Stachel

Cross-posted from wecaresolar.com
Hello friends and family,
I’ve been in Nigeria for 5 days and it’s been a whirlwind of activity and accomplishments. Please take a look at the WE CARE website: www.wecaresolar.com if you want some detailed updates. The solar project is phenomenal – the solar panels are being installed, wiring is being done, and lights will be up in the maternity ward, operating room, and labor and delivery by the end of Monday. We’ve also installed outlets to enable suctioning in the operating room, and ongoing battery charging for the walkie-talkies and LED headlamps. Nurses in ALL of the wards are using the LED headlamps, and I’m learning that they are no longer having to postpone critical nursing care due to lighting problems. So intravenous lines are being placed on time, babies are getting the antibiotics they need, and stress levels are going down. The new antenna for the walkie talkies has been installed, and the repeater will be put in place on Monday. Then I will test the system to
verify that the walkie talkies will extend for 12 miles. That means that all the hospital employees on call will be able to use them, not just the ones who live on the hospital grounds. I also met with a group of visiting American doctors and convinced them to donate surgical supplies to the labor and delivery ward.  Finally, I have been observing and working with hospital staff, who have asked me to initiate a meeting next week to review difficult cases with poor outcomes, and to promote improved standards of care. They see me as  an allie and have responded to my gentle criticisms of their care in the most productive way possible.

And for the most special surprise – I procured a solar powered blood bank refrigerator and solar panels for the laboratory today

I’m going to be visiting the ministry of health on Monday, because the hospital wants to have a celebration in honor of WE CARE on Wednesday.

I haven’t been sending out my field notes about hospital care as I have in the past. I have been witness to many sensitive things, and worry about publicizing this for the world to see. If you would like any of my notes for your personal perusal, just let me know. They are at least as detailed and moving as the ones I blogged a year ago.

Finally, some of you have asked me how to make donations.  If you have not had a chance to make a donation to the WE CARE project and would like to, the website will accommodate donations through PAYPAL for a tiny fee, or you can send a check to: WE CARE, 3009 Hillegass Ave, Berkeley, CA. 94705.

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They Fixed the Kindle!

Omigoodness. I managed to get my hands on a Kindle 2 this past weekend and aside from the fact that the Whispernet (Amazon’s renaming of Sprint’s EVDO Internet service) is totally inaccessible for me, and it would be an absolute pain for me to actually put any books on the device, I really really really want the new Kindle. :)


Kindle 2 ($360) Kindle (discont’d) Sony Reader PRS-505  ($299)

My major complaints about the original Kindle were that it was flimsy, thick, clunky, and the buttons were not well designed. The plastic it was designed from made its weight distribution funny – so it actually even aggravated my tendonitis. I liked the WhisperNet feature, and the keyboard – but the slowness of the screen made annotating books a pain at best, and referencing the annotations wasn’t really useful enough to merit the design flaws. Amazon’s closed ebook format isn’t great either – most of stuff I want to read just happens not to be available in Kindle format (i.e. academic papers, textbooks, papers that I’m reviewing/editing), so I ended up with the Sony Reader which supports viewing of native PDFs as images, with additional support for portrait or landscape viewing (I wish there was a button), and a zoom button for magnifying the text if you have OCR’d text accompanying the image. Since I didn’t want to take a suitcase full of books with me to Uganda, I sliced the bindings off of them, scanned them to pdf and OCR’d them, and I’m reading them on my reader instead. Much better carrying a slim e-book reader on the plane than the 2-inch thick copy of James Scott’s Seeing Like a State.

The Kindle 2 is even slimmer than the Sony Reader, also comes with a leather case, and has the advantage of incorporating wireless and a keyboards for just $60 more. Kindle has access to a larger selection of copyrighted e-books, “Kindle Editions” at much better prices, with a much cleaner interface. Sony’s software, frankly, is flaky, slow, and crashes a lot. But at least I can put my PDFs on it directly. I think for the Kindle I still would have to email my PDFs to amazon and pay them 10-15 cents to upload them to the Kindle in some weird, potentially mangled, format. I might be able to put up with that from Berkeley, but depending on email access for giant PDFs out here is totally impossible. And I like my WYSIWYG PDFs. In that sort of vein – Sony’s ebook philosophies are actually more “free thinking” than Amazon’s (for all those copyleft people out there) and the Sony Reader supports the open eBook format (ePub), and as Wired notes, actually provides access to more public domain books than Amazon offers on the Kindle through a recent deal with Google Books.

What I really want is for Amazon to build a Kindle that supports GSM, so I can stick a Ugandan SIM card in it and download Kindle books over the local network? Please? Or I guess I can wait until i get back next year…

I have this vague theory that the Kindle devices might make decent computing platforms for rural areas.  Imagine – data connectivity, low-powered devices that don’t need to be charged more than once every two weeks or so, built-in keyboards, screens that are visible in sunlight, a large screen, and a price point comparable to smartphones, or less?  What the heck am I doing working with smartphones with tiny screens, batteries that die in a day, and keyboards that are too small for healthworkers to read?  Oh yeah… waiting for the ebooks to take off, the platform to stabilize and open up, and um.. trying to finish up my dissertation before starting another project. But if amazon is willing to throw some summer interns at me this year, and a few Kindles, I think I could manage to host them here in Uganda.  Umm.  We just need to find an EVDO network or get Sprint to subsidize the roaming charges? =)  Anyone know someone at Amazon?

There’s also a Sony Reader PRS-700, which I haven’t seen, retailing for $399. It includes an LED light (which I think is great, since I can’t get my booklights to attach, and I think it is lame to have to wear my headlamp to bed, or to have to lift the mosquito net to turn off the lamp on my nightstand), and a touchscreen. I can’t imagine how the touchscreen actually works – I think it’s something I’ll have to see to really understand/evaluate.  But ultimately I think Sony will have to move towards integrating wireless into their readers…

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Orange Telecom Launches in Uganda

One of the more quiet headlines of the week in Kampala is the launch of a new mobile service provider – the France Telecom owned Orange Telecom. Reactions are mixed but hopeful. Orange is the 5th major operator here, following South African owned MTN, Zain (pakistani-owned? Formerly known as Celtel), Uganda Telecom/Mango, and Warid (also foreign owned). Village Phone is a virtual network operator, using high gain antennas to extend MTN’s network to fixed locations in remote villages.

By far and away, MTN is the dominant operator. Zain/Celtel was the first to market, but as my Ugandan friends say “then they started cheating us, overcharging – we will not forget.” So when MTN arrived with giant masts, reliable infrastructure, and fair rates, the Ugandans switched en masse.

UTL is the government owned operator (they may be partially privatized, I would have to check), so they also carry the stigma of distrust of high prices, as well as perception of inadequate infrastructure. In my experience – their GPRS is great, EDGE is not so good, but their overall coverage is not as widespread as MTN or Zain.

Warid is a new arrival – as of about 2 years ago, and already they have a reputation for being an all-over network – that is what their billboards say (if you have time, browse my flickr photos from fall 2008). They don’t have huge market share yet but people say they will make gains. In the meantime, they are also entering the broadband market, offering low cost Internet services via a city-wide WiMax network at less than $100/month with minimal installation costs. Revolutionary in an area where VSAT is the norm.

Orange. Another provide means more competition. Will it force an existing provider out of business by driving prices lower? Will more money go into infrastructure rollout in rural areas?

Another extremely important aspect of telecommunications rollout in Uganda is the Uganda Communication Commission’s rural communications development fund, the RCDF. Using part of the income from the taxes on the voice communications, take bids from the mobile phone operators to fund projects to develop unreached rural areas that don’t have mobile coverage yet – and might not be a viable market normally. I think it is structured well here, with a good balance of investment in innovation and practical deployment. Orange has the potential to be another player here, if they are willing to participate in Uganda’s development, and not just trying to tap the mobile phone market. The two can be mutually beneficial. We shall see.

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First HealthyBaby Birth

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

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

As I have been pre-occupied with writing lectures for my class, and setting up my research, my collaborating partners at Marie Stopes International Uganda have been busy launching a new phase of the output-based aid voucher program, financing in-hospital delivery of babies, in addition to the in-clinic treatment of sexually-transmitted infections (STIs). The new program, called HealthyBaby is eligible to mothers who qualify under a specific poverty baseline and covers four antenatal visits, the delivery, and a postnatal visit. Last week they just started distributing vouchers, and this past weekend was the delivery of the first baby whose birth was covered by the program.

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 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.

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The Drawbacks of Having the Perfect Noise Isolating Headset in Uganda

I love my headset. I got them at Costco a few years back after months of research, and hours of pestering Joe Hall and various other friends on what kind I should get, whether noise-canceling technology was actually worth the money, etc etc etc.

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...

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.

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Ergonomics, Ugandan Style (sort of)

My Stopgap Ergonomics Setup

My Stopgap Ergonomics Setup

Well, you can’t really call it Ugandan style if it involves a stack of 4 eeePC boxes, admittedly, and I’m not actually going to use this as my permanent setup. But I thought it would be entertaining to share this with you.  Most days I’m too lazy to set up the entire stack – I only do it when I’m doing a LOT of typing, and/or my tendonitis has already flared up.

It’s basically my stack of eeePC boxes, with an open binderbox being used as a keyboard tray, and the laptop on top. The top three eeePC boxes are raising the laptop to eye level and counterbalancing the keyboard so that it is stable while I am typing.  There’s a fourth underneath (not visible) that lifts the keyboard a little off the chair so that the keyboard is a little below elbow level and such that I can sort of fit my knees under it. I’m using my goldtouch keyboard and a small portable usb mouse, connected to a 4 port usb 2.0 hub.

I’ve wandered all around looking for actual keyboard trays, and everyone looks at me a little blankly. Hah. But I finally found a store that actually sells computer desks for $70-$100 with built-in keyboard slider trays and adjustable “secretary chairs” for about $100. Expensive, especially by Ugandan standards, so I’ll have to think about it pretty seriously, but ergonomics and RSI is serious, yeah?

My other theory is to hire a carpenter to build a wooden keyboard tray into the desk pictured on the right of the picture.  Or to see if I can find a small waist-high table to fit under the desk.  I think I’ve been too spoiled by keyboard trays that can be tilted in every-which direction and fully adjustable.  Strange to have to find a way to cope out here…

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A Socially-Responsible Amazon/Textbooks for MUST

My friend Ben pointed out Better World Books,  an online bookstore that ships books worldwide for only $3.97! I did a bit of poking around, and realized that not only do they have crazy low shipping prices, but somehow their proceeds go to support literacy – specifically through World Fund, Books for Africa, Room to Read, NCFL, and Invisible Children. They get donations of books through various organizations – mostly donation drives at universities and libraries, and rescue perfectly readable books from landfills, either donating them or selling them online. Cool, huh?

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.

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Ubuntu-ifying the eeePCs (Netbook Mania Part II)

(Warning: This one is for the techies)

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.

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Netbook Mania

So one of the outcomes of my study last August is that admittedly.. people don’t want mobile phones for their health records, they want laptops. And these new netbooks – well they cost the same as these smartphones. But last August, the eeepcs had a battery life of 1.5 hours and only about 4MB of storage. So when they died in the middle of the comparative studies, all of the people I talked to changed their minds and said that battery life was a non-starter; they had to have something that would last. I did a little shopping though – and for just about $50 more, you can get a standard hard drive (instead of solid state), and a 6 cell battery, and end up with a 10in eeePC that lasts for 7 hours and has 160GB of hard drive space.

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.

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