October

This week is my first visit to the IICD country programme in Uganda. Within IICD, I am changing position and will be taking over the responsibility for project management in Uganda. In this trip a colleague is introducing me to the programme. So far the projects are really exciting. It is impressive to see how committed people are towards the projects. This weekend we visited the Health Child project, a new project which we are implementing together with Cordaid. Last week the project coordinator identified two rural communities to start Information Centers where women can be trained on Health prevention. The coordinator was a young woman, like myself. She quit her job in Kampala to live in the rural area to set up the centres. During the visit she and the rest of the implementing staff took us to one of the communities. The people were really keen on meeting us. They raised interesting questions, like how we would make sure that the elderly women of the community wouldn’t be excluded from this ‘innovative’ project. This shows that, fortunately, our end-users dare to be critical towards IICD.

More than 10 years of experience in applying information and communication technologies (ICT) to education, healthcare, governance and livelihoods in developing countries taught us that modern ICT make a difference and helps to improve the quality of life of people in developing countries. Still, one of the problems to overcome for successful implementation of ICT is connectivity. That is why looking for innovative solutions to ensure connectivity is an important aspect of our work.

It was at the eChallenges Conference in The Hague that my colleagues and I hoped to meet potential partners to help us solve this connectivity problem. This annual Conference, which took place from the 26 – 28 of October brings together research institutions, private and public sector partners to stimulate innovative information and communication solutions. To encourage innovative partnerships, the European Commission has set up a fund, CORDIS, for research activities that focus on specific problems, like for example healthcare improvement or citizen partnership.

Being responsible for representing IICD at the exhibition I was full of hope that I would encounter a lot of interesting people with challenging ideas about ICT-innovations that would make a real difference. And I did! Truly innovative solutions were presented for example on health checks at a distance which could be of use for elderly or disabled people who have difficulties getting out of the house. Or solutions to increase citizen involvement. But I could not stop thinking whether all these innovative solutions would really make a difference. Some technical solutions seem to be developed just for the sake of coming up with something different, something new instead of meeting a real need.

Like the digitisation of the pen; isn’t that just re-inventing something that already exists, but than packaging it into an electronic device that competes with, in this specific case, track changes within Word? I don’t know, but it made me feel sad. There are some real problems going on, like people who have no access to education or markets to sell their products or are unable to voice their needs. We need to get these people connected. We need to give them access to information and enable them to communicate. They don’t need gadgets. They need real innovative solutions to help them overcome the digital gap.

So let’s not talk about innovation just for innovations’ sake, but let’s talk about innovation to solve real problems.

I am already back in The Netherlands but I still owe you a reflection of the third and therefore last day of the Cross Country Learning Event (CCLE) in Tanzania. The first and second days are also covered in blogs.

During the third day we had a ‘ peer-to-peer assist'. For those who do not know the term, a peer-to-peer assist is a session whereby a project owner presents a problem/challenge to other project owners, with the request to come forward with suggestions for improvements or solving certain problems. People came forward with realistic problems and this session evoked sparkling discussions. For instance a certain project owner in Uganda was struggling with setting up a maintenance system in the periphery. How do you maintain contacts with the help desk organisations if your computer breaks down? And therefore if there is no communication, how do you financially maintain such a support/maintenance system? One of the options discussed was the suggestion for setting up a kind of fee for members/users so that we can finance such a maintenance system. A Tanzanian organisation had some experience with it, which helped actually its Ugandan counterpart to move forward.

Generally I learned that the peer-to-peer sessions indeed did assist the project owners with their problems and that the interaction between project owners did bring forward suggestions based on practical experiences. Is this remark an open door? I hope so.

We ended the three-day seminar with an evaluation session. It brought forward some nice remarks which I want to share with you.

• “Out of the three expectations I did only meet one. I expected Power Point presentations: no Power Points. I expected hand outs every evening: no hand outs. I expected knowledge: there was an overwhelming amount of knowledge.”
• “5 th October ( the closing date of the CCLE ) should continue.”
• “CCLE is a big library.”
• “Mali has inspired. It gives courage. Hope to meet again.”
• “Thanks for the commitment of IICD and Cordaid.”
• “Expectations were met. Do not stop here.”
• “We shared much more than in other types of seminars. It was not possible to sleep at this seminar.”
• “The level commitment was very good. Health does not know any boundaries and this is also shown in the East-West exchange.”
• “You made us take part of the whole process and the added value will not run away from me. “
• “Simple is beautiful. Very interesting and wonderful. Asante Sana.”

Thursday, 4th October 2007, the second day of the Cross Country Learning Event (CCLE) in Tanzania. A blog on the first day has also been posted.

It is remarkable to see how many people exchange information during a CCLE and it is a pity to see that you can never capture all the information which crosses the table. For me it also proves that there is a huge demand for information exchange and that the methodology used (open space) does bring forward the most important issues at stake, such as human resources and leveraging. In itself this is in line with the outcome of IICD’s M&E analysis. It is also encouraging to see that creating the right scene open ups the mind for an exchange. For the specialists in facilitation this might be an open door, but for people who are more focussed on determining directions it is good to be part of these exercises.

Leveraging
It also appears that leveraging is not just an IICD issue. It is a natural phenomenon which already takes place since ages. The only difference is that we tagged it as an IICD phenomenon. It is obvious that leveraging takes place if there are results, political willingness to expand and if there are the right circumstances. For instance in Uganda the project ‘Promoting Continuing Medical Education among Rural Health Workers by use of ICT’ of Uganda Martyrs University (UMU) is successful. UMU was approached by the Ministry of Health to expand the project to three other hospitals. At the moment of the request UMU was not ready to expand and therefore they turned the request down. The same accounts for the Kinondoni project, which I visited last Monday. People of Kinondoni are approached by other local governments to implement the project in their municipality. For these organisations it is difficult to do that because you need also the methodology to introduce such kind of projects, which means that they also use the methodology which made the projects so successful. This visit also taught me that maintenance of projects in some kind of form is important. I saw outdated software and a server room which was not suitable to be a server room. Leaking airconditioners does not create the right environment for a server room.

Dealing with governments
Another remark which strikes me is the fact that dealing with governments is not as difficult as often expressed by civil society. It is a matter of managing expectations and informing and even involving them at the start of the project. For some countries this might not be such kind of a problem because the mechanism is available to inform the government. What I understood is that Uganda has such kind of a mechanism in place. For some of the projects of civil society you need to seek the approval of the Ugandan government. Despite the fact that it might be a cumbersome process it also has positive effects.

At the CCLE, representatives of Malawi (CHAM and the School of Medicine) are present. I had a chat with them about our possible involvement in Malawi with Cordaid. They are very enthusiastic. Not so much for the funds, but more for the methodology we are applying and of which the CCLE is an example. I have been trying to temper their expectations and despite the fact that they were nodding I am not sure if I was that successful in the management of expectations. The fact that they are heavily involved in World Space receiver might be a hurdle to take, but may be we can integrate that in the approach.

Publicity
Another thing: there was an article published about the workshop in an English newspaper and it appears that the same article will be published in Kiswahili today. Coming weekend another article about ICT4 health will be published. Therefore COSTECH and IICD made a major step forward in putting ICT on the political agenda. What I also learned from this exercise is that journalists are stubborn people. You have explained very clearly the message you want to get across and they pick out one sentence. They have picked out my remark about the fact that the health services have improved as compared with seven years ago. Conclusion and lesson learned: journalists are independent but as interviewee you are confronted with the consequences.

Love for Africa
Enough reflection for the day. I am just looking out of the window and the first rainshowers are starting to poor in Dar es Salaam. It reminds me of one of the factors why it is always pleasant to be back on this continent despite all its challenges and difficulties. It is the sky. The combination of grey clouds coming in from the ocean, light softened by the rains and trees illuminated beautifully by the raising sun (it is just after 6:00 in the morning) makes the continent so beautiful.

See you in The Hague.

Deem

Wednesday, 3rd October 2008. First blog session from Dar es Salaam. It will be a kind of diary, through which I want to share with you some impressions on the cross country learning events (CCLE). This annual events brings together people working with ICT4D in the health sector. It’s a perfect opportunity for exchanging experiences, learning and therewith adding value to the development of ICT applications in the health sector.

First impressions are good. There is a lot of exchange and indeed what I also detect, is that there is a huge need for interaction. Discussions are lively and people are eager to share their experiences. There is also a lot of laughter and that shows that the atmosphere is excellent. Quotes reflect general ideas. The following were made during the first day.

‘A CCLE is a kind of library’ or ‘a thinking might create problems and other thinking might create challenges’. The best one of the day is the following: ‘I was only thinking in terms of the broadening bandwidth. Face-to-face meeting like the one over here creates the broadest bandwidth’.

Official openings in Africa are a special kind of sport. The Permanent Secretary of the Ministry of Health and Social Welfare (MoH) was present and the highest authority of COSTECH. Nice speeches which were far too long. Leveraging was highlighted and I think that through the presence of the highest civil servant of MoH we have an entrance at the Ministry for leveraging. We should take advantage of this significant step forward. There were also a bunch of journalists representing different newspapers and television stations. This resulted in an item on the 19:00 hours news of approximately 5 minutes. I have not seen the newspapers yet and how many times IICD is mentioned. Pity that the papers are not read in Europe as it may assist us in the acquisition of funds.

During the first day we exchanged information about all the projects which have been or are being initiated. This brought forward a lively exchange and in between the different sessions people also started to extract knowledge from each other. It is a pity that all the knowledge exchanged can never be captured completely. In general the projects in Eastern and Southern Africa can be clustered in a few categories. There are projects focussing on health management information systems, e-learning/distance learning, tele-consultation. There are also projects which cannot be captured in these categories, such as the one about data for blood transfusion in Zambia and the one about community health.

The projects of Mali are very interesting for the participants coming from the other side of the continent. I am afraid that there is an eagerness to adopt this project also for the Eastern and Southern region. The reason that the people like this project is that it is very focussed and practical. Think big and act small is an adagio which should also be a guideline for the other projects.

Some of the projects are still in the formation phase. That is not a problem for the participants, but I am of the opinion that it also dilutes the CCLE a bit. The exchange remains vague because it can not be based on true experiences during the implementation phase.

The analysis of the M&E data done by my IICD colleague Hannah is shared extensively. We sticked the lessons learned to the wall and requested for comments. That is happening now. It is nice way how we can use the M&E in a project. The challenge remains how we can specify the lessons learned better. Maybe we should add some qualitative data and a qualitative analysis. I am wondering if we can extract more lessons learned on the basis of the data we are gathering as lessons learned are usually also context dependent so-to-say.

The Health Management Information Systems are at different stages of development. Most of them are still busy with the organisation at central level, whereas the step of organizing the data at the more peripheral level and especially the jump that the peripheral health units should make use of these data for the improvement of their management is not made. I have the impression that many of the managers also did not make the jump mentally so there is a lot awareness to be done.

What also strikes me is that there is hardly any discussion about software, like was the case in discussions on the CCLE online Dgroup.

So far the first impressions. Shall try to share some more of the experiences tomorrow.

Today I received a mail from Sylvestre Ouedraogo, the coordinator of the Burkina-ntic network in Burkina Faso. He’s been uploading video’s they have recently made on YouTube. Bad as the connection is here in Bamako, I can view images of farmers using ICTs in Leo, the latest TV-Koodo film on the projects IICD supports in Burkina Faso, and even other stuff on traditional dances and on the reggae scene in Ouagadougou. It’s been only two months that we started to train our partners in Burkina on the use of this kind of multimedia tools, ant it already is starting to pay off! For me, this is one more proof that with relatively little effort and investment, ICT can gain access to worldwide audiences for people who have been relatively isolated up till recently. The empowerment that goes along with this access is hard to measure, but I can’t deny that I feel a lot of respect for the ones who are doing this under still difficult circumstances. Check it out on: http://www.youtube.com/watch?v=3BFGH8YNClY (and click on More Videos from this Channel to watch the other films). Or go directly to the site: http://www.wagues.org/

But my head is still buzzing. My lunch date today said “everyone who was here was relevant”… and “I learned to my limits”. I have to agree that even I have been fully saturated with participatory web (web2fordev) these past 5 days which is truly amazing. I didn’t think that could happen.

Is this the beginning of a movement, paradigm shift, breaking of silo’s and re-landscaping of the development web? My father worked his whole career in development. I wonder how he will respond when I explain to him how we have set up a facebook group with the IICD local partners and are going to try out the “web to text” functionality, keeping each other up to date on our moods.

Getting back to my lunch date, I was actually working alongside him for almost an hour before I realized who he was! I blame the coffee cup in his picture. Ismael Pena-Lopez from amongst other things the ICTlogy blog. His is a blog high up on my list of blogs I try to follow when I have time. And one whom I wondered if I would ever meet live. I am very grateful I did. Besides the fact that we realized he probably met my father years ago, he reminded me of the importance of reflection.

User generated content is needed, and is good, and is a revolution on the scale and availability that it is now… but I might easily forget how reflection, analysis, and abstraction can help us learn to a higher degree. Especially after days, weeks, months of running… not only for this conference but other activities, it is time to reflect.