What We Accomplished and Technology at the New Selian Hospital

OK, this is perhaps the “boring post” but also the most important, as it describes exactly what the heck I’ve been doing in Africa. Let me make it clear that Jessica, Mackie and Stephen spent significant time with me at the hospital doing everything from placing computrers, installing operating systems, configuring the software on computers including loading typing programs to creating beautiful flower arrangements for the hospital opening on December 11th.

The Arusha Lutheran Medical Center (ALMC) is where I spent all of my volunteer time working with my boss, Moye, who is a 26year old who received an RMIT degree from the University of Dar Es Salaam in Dar Es Salaam, which is in the largest city in Tanzania (with over 4 million people it is larger then the next 10 biggest cities combined). I loved working for someone else for a change, a nice break from the pressures back at home where we have a 10 person business with over 30 clients where I take on a lot of the decision making.

I was told many times that it is amazing that while I’ve been trying to make it out here for 5 years I couldn’t have come at a better time. They had an enormous amount of technological projects that needed to be accomplished and they very much appreciated the extra help.

I very much admire the way in which technology is being implemented at this hospital. Their primary software and operating systems are all “open source” (FYI – Open source is synonymous with “free” for those not in the know). While we do have computers donated with Windows 2000, for those without operating systems we install BSD, which is a flavor of Linux, an open source operating system. This can be installed on Pentium 3 computers with 256 MB of RAM (which is the typical system given to us and is about 10-12 years old) and runs fairly fast. The “servers, ” which were donated, are linux based as well, and run Apache web sites with back end databases written in mySQL, all open source software. The actual software that is being used to run the hospital is called care2x which maintains all of the patients, patient notes, meds, laboratory results, imaging and billing. There is also a program called WebERP, which is an accounting package. Again, both open source systems. Tom Barsch, a Denver based Kaiser radiologist working at Exempla Lutheran in Denver, brought over an expensive Mac server with 2 terabytes of storage for the Picture Archiving and Communication system (PACs) which will handle all of the digital imaging. The PACs software that is used is called Osirix and is open source as well (GE, Siemens, and Phillips all have software that is hundreds of thousands of dollars but again, because it is open source it is free). The PACs software is hooked up to a CT scanner, a xray machine and an ultrasound machine. We also installed SESType, an open source typing software program on all the Windows based computers so that people could improve their typing skills and also OpenOffice, a free program to create documents, spreadsheets and presentations that work with Microsoft programs as well (they can read and write to the Microsoft Word, Excel and Powerpoint formats).

So if you followed the primary points of the last paragraph you will realize that all of the donated systems run software that is free. This has been the goal of Mark Jacobson and the Evangelical Lutheran Church in Tanzania but the fact that it is all really starting to come together and works means that we have a very affordable (only in Africa would the term affordable be used to describe free software) solution that all 3rd world hospitals could take advantage of. I am building a wiki, a web based tool to share information, (http://africanmedicaltechnology.wikispaces.com ) and a discussion group (http://health.groups.yahoo.com/group/africanmedicaltechnology/). We will use these to share information and best practices HOPEFULLY with other African medical hospitals. Perhaps there are other discussion groups and wikis already, in which case we will shut these down and post information there.

The point is that the work is just beginning and the goal is to really work toward the continued building of these open source systems and finding PHP (a programming language) developers who want to contribute to medical technology that all 3rd world hospitals could benefit from using.

One of my primary duties has been deploying computers in the new facility. I’m happy to share that Allen Technology has donated about 3K to:
Purchase the necessary equipment to build a standby server that, in case the primary server fails, can be brought up in a matter of minutes
Purchase backup hard drives
Purchase a web site for plasterhouse.org
Purchase 5 flat screen monitors
Purchase power strips, power cords and other misc items that were needed to successfully deploy all of the computers
My other duties included documenting all of their technology environment, helping them audit the environment to determine where improvements were needed, inventorying all of their technology equipment, networking the new hospital to the existing Arusha Town Clinic (really oversaw this, can’t actually take any credit for the work done).

My most proud moments, however, were getting Stephen, Jessica and Mack involved in the deployment as stated in the first paragraph. It was great sharing knowledge and having them work alongside me.

Love,Ben and his little family