This week I’m at the Global Health Council’s conference in Washington D.C. IntraHealth (my employer) is working hard to promote our work in Capacity building and, especially, the work we’ve been doing in iHRIS and other projects with Open Source Software. Listening to great speakers like Hans Rosling of Gapminder.org is always fun and entertaining. Hans promotes a fact-based world in a way that challenges a lot of our assumptions about the world and isn’t afraid to kill sacred cows. “You should forbid the discussion of ‘HIV in Africa’” he said at one point after presenting data that showed the differences of infection rates across the continent. (I had a chance to meet Hans and talk to him about the iHRIS software when he came to IntraHealth’s event Wednesday night. He asked lots of great questions.) But it is often said that conferences are most useful for what happens in the hallways, not the main sessions. From the people I met during the conference, it made my time at the GHC36 much more valuble to me and, I hope, IntraHealth. Here are some of the more interesting people that I met at the conference:

  • Martin Namutso — Actually, I met Martin last year in Uganda when I helped him implement a new Knowledge Management portal for the Ministry of Health in Uganda. He works as an Open Source developer in Uganda, implementing Open Source solutions like iHRIS. It was good to catch up with him and talk about future prospects. I especially like the story Martin tells about his decision to focus on Linux and Open Source right out of school in order to compete for different jobs than most of his Microsoft-focused classmates.
  • Paul Biondich — Paul is one of the creators of OpenMRS. He’s a pediatrician and software developer bringing an Open Source EMR (Electronic Medical Records) system to low-income countries. When I mentioned that I had worked on a pilot project in which I created a PHP interface into the OpenMRS’s database schema, he asked for my help in maintaining the PHP interface to the OpenMRS API in any future work I do. I hadn’t found this when I was looking before, so I readily agreed. Working with OpenMRS’s API instead of the database directly would be a much more robust solution to building PHP applications that work with OpenMRS.
  • Jørn Klunsøyr — Jørn is a registered nurse and software developer at the University of Bergen where he works on mobile projects like EpiHandyMobile to make form submission with cell phones much easier. Using a web-based application, it is possible to build forms and push them to a low-power J2ME cell phones. Later, after the data has been gathered, the data is sent from the phone via SMS, GPRS, or BlueTooth to the EpiHandy server and, from there, to applications like Clinica and OpenMRS. When he demonstrated the software, I immediately saw applications for iHRIS: making it easy to fill in the iHRIS information in the field when a laptop and Internet access might not be available.
  • Eric Woods — Eric Woods is the Executive Director and Founder of Africa Aid. His org is helping distribute cell phones to doctors across Africa. While the phones are useful in and of themselves, he is looking for applications and partners that would make the phones that much more valuble for the doctors. One example he thought of was a cell phone directory. Making the contact information in iHRIS available to other doctors would make it possible for doctors to more easily consult with each other and develop relationships that they might not otherwise.

These are just a few of the people that stand out from those that I met. After talking to them, I can see ways that we could work together and I hope that before we meet at GHC next year, I will have worked with a few of them.

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Almost two years ago, when I started working at IntraHealth, dcm told me about IntraHealth Open. Being a neck-bearded freetard, the idea really appealed to me: Use open source in the education of students in developing countries across Africa to build a workforce that could support the IT infrastructure of the continent without using Western consultants. The use of Free and Open Source Software (FOSS) is essential to the goal. Using software that is freely licensed for perpetuity avoids the "First Hit is Free" model many software companies use to get developing countries hooked on their software. Building the use and understanding of FOSS into the curricula gives the students the skills they need to use software on the job. And deploying freely-licensed software like Ubuntu, OpenOffice, iHRIS Suite and OpenMRS into these developing countries will create a local demand for workers who can use, understand, and maintain the very software they’ve learned about in school. I’m very excited about the new IntraHealth OPEN initiative. You can even take part. Senagalese musician Youssou N’Dour is working with other musicians to help raise funds for the OPEN initiative by making his music and remixes of it available for free download under a Creative Commons license. So go download some music and consider making a donation to IntraHealth OPEN. UPDATE: Listen to dcm talk about Open in the Launchpad podcast.

One of the other developers for IntraHealth has been abusing PHP in every way possible. This time Carl may have gone too far. We’re putting together a “shelf-top” appliance for installations of iHRIS that don’t have a server room to rack-mount equipment. As much as possible, we want to make it easy to plug the box into your network and go with as little fiddling as possible. To that end, I found the Mini-Box M200 with an LCD panel that we could set up with a simple menuing and configuration system. In all the other projects we’ve been working on, we’ve used PHP because of, among other things, the low barrier to entry it offers compared to, say, Java. PHP has been irritating at times, but I think it may be worth it if it means that we can get more people involved in the client countries. When I first saw the LCD panel, my thought was “You know, it’d be nice to have an ncurses front-end for that thing.” Then you could test in terminal window and deploy it without changing your code. Carl had the same thought. So he began hacking out an ncurses-based menu system for the LCD display. And it’s written in PHP. I don’t think I’m going too far out on a limb here to say that this is the first PHP code designed to be used through an LCD panel. This only confirms my suspicion that Carl is a genius, of the evil, insane variety.

(Took some more pics on my ride yesterday. Played with macro a bit, too.) Last night, I gave a talk at the Central PA Linux Users Group (CPLUG) that I called “Bringing Open Source to Africa”. While I could have made it more general and talked about the various Open Source projects that have grown out of or are centered around Africa — and perhaps this is a topic for another time — I focused on the projects that IntraHealth is doing and how we’ve created or used Open Source. The talk was followed by some good discussion and I got to talk about KnowledgeTree some as one of my friends there had heard of it and thought it would be useful, but was a little scared of setting it up. The biggest drawback was that, due to my poor planning, I didn’t get a set of slides done till just before the talk. I was lucky here because other people at IntraHealth have done so many talks so I was able to use their material to create my own presentation. (copy of my slides.)

When I first came across _why‘s tweet on PerlBuzz, I thought it was so profound (by which I mean, anti-consumeristic), that I told dvfmama right away.

when you don’t create things, you become defined by your tastes rather than ability. your tastes only narrow & exclude people. so create.

This is why I would rather listen to my three-year-old belt out show tunes than watching American Idol. This is why I would much rather see my daughter practice standing on her head than watching America’s Got Talent. This is why I can only zone for so long while I idle away hour after hour in solitary web surfing or late night TV watching. This is why I was so happy to give the Ugandan Ministry of Health something that they would use. I hate being a consumer. I fall into the “entertain me” trap more often than I want to confess, but I hate seeing myself there. I hate the thought that my children will be passive participants in culture rather than creative, engaged people. This doesn’t mean that I want them to go out and get a degree in the Humanities. (dvfmama wouldn’t allow it anyway.) So I’m probably already diverging somewhat from what _why originally meant. But who cares? Do not wait for other people. Get out there, do things, be engaged, and tell others about it. (By the way, my co-worker-at-a-distance, Shannon picked up on the Why Create? theme.) But that last bit (“tell others about it”) is a key I’ve been missing for some time. And, for someone who spends 90% of his time working 400 miles away from his co-workers, this is a real shame and, worse, a real impediment to good work. I’m good communicator when I need to be, but till recently, I haven’t been in the habit of communicating regularly with other people that I’m working with. Sure, a lot of this was the physical distance, the lack of face-to-face time — the fact that I abhor teleconferences. But a lot of the problem (and the problem shows up even when I’m working down the hall from people) can be fixed by just sending out a regular email, making sure that everyone who might be concerned knows what I’m doing. Sure, a lot of times it’ll get filed in the bit-bucket, but (and I’ve begun to realize this and put it into practice more since my trip to Uganda) communication isn’t optional, it isn’t overhead; it’s a necessary habit. Of course, it was really helpful that I had this epiphany about communication and started putting it into practice in the past couple of weeks. Today, I met with some IT auditors here in Chapel Hill and told them what my role was in the organization. Before this, I probably would have been much more resentful of the very idea. But for now, at least, I’m feel like I’m on top of the world and I’m happy to tell them what it is I do.

This week I start working on a project to help gather medical information in villages throughout Rwanda, so the project I’ve been working on for the past couple of months is officially over.  I’ve written my postmortem and had a chance to recuperate from the travel (including the airline losing my baggage in London and a screaming three year old on an eight hour flight — horror stories best only hinted at). But this last project looks as if it was about as successful as I could hope for, so indulge me a few moments while I tell you what we did. While medical information is gathered throughout Uganda, reports are regularly written, and analysis is frequently done, sharing information between health care workers and officials is problematic. Until now, there was only one small central library at the Ministry of Health which held only a single stand-alone PC for accessing and reading electronic documents. To make matters worse, the proprietary software for storing and accessing the electronic documents only accepted PDFs, so anything a doctor wrote in, say, Microsoft Word had to be converted before it could be used in the system. With the help of the Knowledge Management (KM) team at IntraHealth, a few of us on the Informatics team put together a Joomla+KnowledgeTree combination that would allow health care workers and officials to upload any Office document, collaborate around them, and easily access them from any networked computer. My work centered on the integration and initial set up of the software — putting it all together in a way that made the KM people happy. And, frankly, much of that work isn’t any different than what I could be doing in almost any Tech Shop or corporate environment.  And for a while, it was like any software project, full of frustrations and delays.  While KnowledgeTree was an obviously mature piece of software, I found some of its idiosyncrasies irritating and some of its capabilities anemic. The real difference — the real satisfaction — came when I was finally able to sit down with the librarian at the Ministry of Health in Uganda and I heard him say “This is great, it is so much better and easier to than our current system!  And we don’t have convert all our files to PDF first!” It was a relief to hear those words.  Until then, doubt still lingered.  But after that meeting, while there was still a lot of work to be done and a lot of work that I wouldn’t be able to complete, now I knew that we had a successful, even worthwhile, product. Even better, the technical people I worked with and trained as well as the Ministry workers all understood the usefulness and had the same goal in mind: fostering adoption of the new “electronic library” throughout Uganda. Now, back to the work.  Hopefully I’ll have another success story in a few months.

Today, I spent most of my time waiting on a server. I couldn’t get Ubuntu to install on a Dell Poweredge server. Suse worked fine, though.  (It looks like I might have avoided some of the problem by changing a bios setting from “I2O” to “Mass Storage” but there doesn’t seem to be a good reason that Ubuntu wouldn’t work where Suse could.) This meant even more waiting for downloads over a very slow, African satellite connection.  The installation CDs I had for Suse didn’t have Java 1.5 and, joy of joys, I couldn’t find Java RPMs Suse 10.  So I’m downloading an installer from Sun.  17MB. Oh, and did I mention that KnowledgeTree needs OpenOffice running in the background?  Another 170Mb download.  (And why is the OpenOffice download finishing before the Java one?) While I waited, I sympathized with a fellow American suffering from a recurrence of Strep.  She had used up her pennicilin just before we left on the trip.  She was fine when we got here, but then seemed to have a flare-up. Of course, being used to the American medical system, we didn’t realize that you can purchase pennicillin (and most other drugs) over the counter here after talking to the pharmacist/chemist.  Even though my brother and brother-in-law are both pharmicists, I’ve often wondered what exactly they were supposed to be doing besides complaining about drug-ignorant doctors.  Seems like the Ugandans (and many other countries, for that matter) have the right idea. Instead of treating doctors like health-gods who are supposed to know everything (when the evidence clearly shows how ignorant many of them are about drugs), it would seem like they could work more closely with the dispensers of the drugs to make sure they get the right drug and dosage to a patient. In a related note, I had to get an anti-malaria drug, Malarone, for my trip to Uganda.  I knew I was up-to-date on all my other meds since I traveled just south of here a few months ago.  So, instead of going to the Travel Nurse again, I went to my family doctor.  (He had been bugging me to come in anyway when I saw him at church.)  He gave me a perscription for Malarone that the pharmacist was willing to fill, but forgot to put down a dosage. That’s the perfect situation for getting the drugs directly from the pharmacist without requiring the bother of a scrip-writer as the middleman. Still, it was gratifying to see my doctor.  I hadn’t been in for 3 and a half years and, in the meantime, had dropped 30 lbs.

We arrived in Uganda last night.  I’m here to finish installing the Knowledge Management Portal (Knowledge Tree + Joomla) that I put together over the past few weeks and help train the local staff. Following are my first impressions of Uganda.  Keep in mind that I arrived after sunset and am staying at a nice hotel so my first impressions are especially limited.   Still, using my time in Rwanda as a frame of reference, I do have a little insight. During the drive from the airport in Entebbe to Kampala, I kept thinking of how I could describe what I’ve seen so far here in Africa.  My first thought was that much of it is like many rural areas of the U.S. during the early 20th century.  But there are a lot more cars and more electricity. Then I thought about the government in Africa.  The “Wild West” seems to work a little better, then.  The West with electricity and cars.  And paved roads. Of course, I wasn’t yet in Kampala when I was thinking about all this.  What I saw of Kampala last night, and from what I can see today, Kampala is fairly modern.  Short, modern office buildings, plenty of paved roads.  We’ll see if my impression changes once I actually get a chance to drive around today. Speaking of roads: In Uganda, they drive on the left.  In Rwanda (the other land-locked country just south of Uganda), they drive on the right.  I wonder what happens at a border crossing.  Oh, and they use yet-another-power-connection.  I had to pay 15,000 UG Shillings for a new adaptor today.  Highway Robbery, I tell you! I suppose you can tell exactly which European country colonized which African nation by looking at their power plugs and on which side of the road they drive.  Uganda is clearly a former British colony — left side driving and British power plugs — wheras Rwanda, with its power plugs and right side driving is clearly a former Belgium colony. One more thing before I start work.  International flights are about the most fun you can have (if you don’t sense sarcasm there, let me point it out for you here). Take Amsterdam, for instance.  I hopped off my flight from Philadelphia, went through customs once to enter then country and then again to hop on a flight to Uganda.  Hurrah!  At least this was better than transiting the U.S. where they make you grab your luggage even if you’re just catching the next flight out of the country. Customs (long lines, lots of waiting) and switching flights (long layovers, long lines, lots of waiting) mean that I left Philly at 6:30pm Tuesday and, after hours in airports and whatnot, arrived in my hotel in Uganda at 9:00pm Wednesday.  Not much jet lag, though.  I seem to have a knack for sleeping on planes — even in the cramped economy class conditions.