Tanzania

As the Managing Director of IICD, I participated in the end of January in the World Bank’s “ICT Sector Week: Enabling Development” in Washington. This event was organised by the World Bank’s Global Information and Communication Technology (ICT) Department for the Bank’s staff and the staff of the International Finance Corporation, a member of the World Bank Group.

The purpose of the week was to engage IFC and WB staff, senior industry executives, and sector experts in discussion how to leverage ICT to scale up the development impact of the ICF and WB operations. 

Strategy sessions were held on increasing the reach and impact of services in public sector management, education, health, agriculture and rural development.

IICD was involved as speaker in the ICT for Health session and contributed to the panel discussion of the agriculture and rural development session. I also presented IICD in the ICT for Education session.

Find below my personal findings on the Health and Education sessions.

Working towards innovative health services delivery

The workshop on health was very interesting and included participants with lots of experience and key positions. After a well-received presentation the participants discussed: What is e-health? What long term commitment do we need from the bank? What is the role of, amongst others, health insurance and privacy of data?

A much respected female senior advisor of the World Bank suggested that the World Bank thinks about new ways to deliver health services in developing countries. She pointed out that the WB should not be willing to finance projects that are just replicating what was done in the past in the ‘North’. From this point of view she considered that there was a bright future for telemedicine and distance learning education.

“ICT is giving the opportunity to review what is done and to explore what should be possible and what should be adapted to the context of the developing countries.”

My view and experience on this is that ICT create opportunities for institutions in developing countries to do health service delivery in an innovative way: not matching Northern traditions but to be answering institutions’ own specific challenges. IICD is working much in line with this. What IICD is doing in the health sector attracted positive attention in particular because of our integrated approach (guiding principles or what I call ‘true capacity building’). Examples of our work within health services delivery are the Teleradiology project in Mali and the Telemedicine project in Tanzania.

Moving towards smart use of ICT in Education

As is already the case in the area of health services delivery, ICT is creating opportunities for developing countries to do education delivery in an innovative way: not according to Northern approaches but responding to its own specific challenges. The World Bank staff has an advisory role to governments in developing countries and should be prepared for these opportunities.

For IICD, it is worth to think about: do we want to mainstream ICT in education (using ICT to help teachers in their traditional education approach to make their work more attractive for the students) or do we want to stand in a new education paradigm (providing opportunities for innovative approaches) and look at how ICTs can play a role for this purpose? At the moment we are involved in both ways of developing education.

The current education system is a product of the industrial revolution, from 200 years ago. How will today’s digital revolution shape the future’s education? Education should be designed to help students to think creatively, reason systematically, and work collaboratively.

Sengerema Telecentre, monday morning. The floor in front of the training room is covered with shoes of people taking an exam in basic computer skills. A corner of the reception is being transformed into a little shop: a young entrepreneur is going to repair, refurbish and sell computers.

I am visiting the telecentre to meet Mr Felician Ncheye, manager of the telecentre and board member of TTN, the Tanzania Telecentre Network. Since last October, the telecentre is not the only place anymore where people can browse the internet in Sengarema. IICD assisted the Tanzania Telecentre Network in piloting a shared wireless (mesh) community network in Sengerema, making internet available and affordable to a large number of people living in the rural areas around the telecentre.

October is months away and I am curious to find out how the wireless mesh network is functioning. Are the clients still connected? Are they satisfied? In what way is the internet useful to them? And, very important in terms of sustainability: are they paying their monthly fee?

According to Mr Ncheye, the mesh network is working fine and most clients are paying their monthly bills in time. There are some problems with hardware, and ignorance on internet use.

Lismas, the technician, spends a lot of time teaching customers how to browse the internet.

“A customer told me there is a problem with the internet. When I checked it, I found out he typed only two w’s instead of three to enter the World Wide Web”.

Lismas also teaches customers how to find information. All have anti-virus software installed. Viruses still cause problems though.

Later that morning I continue my way to  the Teachers Resource Centre (TRC), one of the customers of the mesh network. TRC coordinator Mr Mugusi and Mr Mungo, headmaster of Sengerema Secondary School tell me that the internet is working well and used extensively by teachers of the school. Both are using the internet to study at the Open University Tanzania (www.out.ac.tz), which has a distance education programme. Mugusi is doing a Bachelor in Education and a minor in Kiswahili. He just started, and it takes four years. Mungo already studied before the teachers centre got its own connection; he is doing a Master in Education.

The teachers also use the internet to find teaching materials. Sometimes they print it to disseminate in class. They use Yahoo and Google to find materials. They also like www.answers.com. They feel that they need to catch up with the internet, as the students are picking it up much faster and are often challenging the teachers! Students sometimes come to the TRC too to use the internet but also go to the telecentre. Other teachers are still discovering the internet.

Mugusi: “To them the internet is still ‘uchawi’, witchcraft; they were amazed to see videos of Obama’s speeches online.”

Is the internet also having a negative impact? According to headmaster Mungo: “The secondary school has 20 teachers for 800 students. They used to have 36 teachers; most of them left for greener pastures. The possibility of distance-learning through internet may actually increase this brain drain”..

With Lismas I visit the Centre for Disabled People. An unstable plug prevents them from browsing, and Lismas quickly fixes it. They like to use the internet for skype and email. Their favourite Tanzanian website is www.mwananchi.co.tz, a newspaper in Kiswahili. They also have been looking online for funding for their centre.

Slowly but surely, the internet becomes a reality for the Sengerema community. In April the mesh network is going to be evaluated, providing more information on how the customers appreciate it and what kind of changes come with access to online information.

What I’ve seen in just half a day is promising. To be continued!

During my business trip to Tanzania, I planned to visit Magu for a Focus Group meeting with farmers. However, getting to Magu was a slight challenge... 

Part of the reason was the visit of “the esteemed president of the United States” to Tanzania. Days before the visit, from all road corners in Dar es Salaam, his grin would look at you from billboards with backdrops of the Kilimanjaro or the Tanzanian flag.

When he finally arrived, his visit turned into a practical problem: three out of probably five major roads in the city closed down, which made it hard to get around, and more specifically, to get to the airport. A day before my flight to Mwanza (in the Northwest of Tanzania, about 1,5 hour drive from Magu) we received word that the flight was moved two hours back because of this. Add to this: five more delayed and two cancelled flights at the airport, no luggage allowed on the plane because of fuel problems, boarding and then having to go back because of engine troubles, 300 waiting Tanzanians, 35 degrees centigrade, sticky airport food, incomprehensible messages over the airport intercom, wailing children, and 20 people hanging out of the airport bus taking pictures of Air force One. We waited for 5 hours, but - to my surprise - in the end the plane did leave. My biggest challenge was not to show my slight frustration, as the Tanzanians surrounding me remained their happy self, thanking God for finding the engine trouble before we left. 

The value of the Cromabu information centre

The following morning we left early from Mwanza for Magu. Together with Dr. Ngaiza, one of the Tanzanian partners for Monitoring and Evaluation, to be part of the end user Focus Group meeting. Our intention was to reflect with a group of end users from Cromabu, a price information project for farmers, on the data that the project collected over 2007. From the data we already knew that there were very little complaints from their side: the information that Cromabu disseminates was highly valued, both for its quality and for the service given in the information centre and the different farmer groups felt very much connected to all aspects of the centre. Apart from farmers, there were other people using the (paid) services of the centre. A local representative of the Salvation Army explained how he used the Internet service of the centre to stay in contact with his organisation’s headquarters in Dar es Salaam. 

Several groups of farmers had prepared a role play, explaining the daily process of getting the price information together, and disseminating it to the various communities in the Magu area. Impersonations of Cromabu’s manager and the mime of how bicycles are used to visit the communities were received with laughter and loud applause by the other participants. As was a sung poem on IICD’s assistance to the centre. Afterwards, we asked them to discuss some additional aspects found in the data analysis. Why did some people for instance not – or no longer - visit the centre and what could be done to remedy this? Or: would women also like to be involved in the use of the electronic media de project offers and if so: what impedes them to do this right now? Nobody seemed to feel shy getting into the discussion; everybody contributed and gave suggestions and ideas. 

The meeting started, ended and was paused with a great number of speeches: we were welcomed, thanked for being there and for our assistance and many farmers took the opportunity to tell in detail about the impact the project had had on their life. 

One of the things I learned working for IICD (apart from, for instance, eating a complete guinea fowl with just my right hand) is to come up with opening and closing speeches on the spot, a skill that came in handy during this visit. 

The impact of Cromabu on farmers' daily lives

As usual, I did feel somewhat uncomfortable with the speeches of gratitude. I feel I have a wonderful job working together with dedicated and professional local partners. Not something that I should particularly receive praise for, the way I see it. That said, it was amazing to hear from first hand all those stories that we confirm by means of formal questionnaires on a yearly basis: the impact Cromabu has on the daily lives of the farmers. In the open answers in the questionnaires collected by Cromabu and during the meeting users described that with the extra income they’ve earned from the information received, they send their children to school, buy cows, repair their roof or buy a bed. Statements that make it very clear that information for development is far from a luxury! 

Looking back on the day, one of the participants indicated that he was happy and proud that no issues were left out of the discussion. According to him, this showed that “it was both possible and necessary to have farmers be part of a process like this”. In my opinion a great compliment for our evaluation process and for the involvement of Cromabu with their user group. It’s very much worth coming to Magu for, despite all roadblocks and delays. Before we left, the users sang one more song. It was based on a well-know song for the emancipation of women, but with a spontaneous and small adaptation of the lyrics, they all sang: “Don’t go to sleep yet, Cromabu, there is still so much to do!”   

Anne-Marijke Podt

Officer Monitoring and Evaluation Tanzania, Ghana and Ecuador

Mr. Paul is running a telecentre in Katesh, in the north-east of Tanzania. His telecentre provides computer training, the only one in the region. His customers need information from the internet, like market price information. But the internet has not yet reached Katesh. Mr. Paul is planning to have an internet connection and an email address soon, but he needs information on how to go about it. 

I met Mr. Paul last week in Mwanza. He was one of the participants of the first Tanzanian Telecentre Network workshop. Together with many others, I have been planning this workshop for months. Meeting Mr. Paul made again clear to me why a telecentre network is needed. All participants came with questions and all came with answers on: How to improve their services to the community?. Where to get ICT support? Telecentre puzzles were solved in the workshop and its grapevines. Still many need to be solved. By sharing and by joining forces. 

In a speed geek session, every telecentre presented its approach to provide services to the community in a sustainable way. Some provide market price information to farmers; others provide computer courses to students, women, elderly, disabled, helping them to get a job. Some provide a community radio to inform the villages on burning issues like HIV-AIDS prevention, others provide library services. Some are entirely financed by the community; others share their internet connection with nearby schools. Some use VSAT connections; others have switched to recently available broadband. The telecentre leaders advised Mr Paul on all the available options. 

Through a mapping exercise, the telecentres present were indicated on a Google Earth map. Mr. Paul found out that other telecentres actually were not that far away from him! He now knows who he can contact for support. 

Then, after two days of workshopping, it is 4pm. It has been an exhausting day; participants discussed a vision, mission, objectives and organisational structure of their network, and made extensive use of the left part of their brains.

Would there still be anything wise to do, apart from calling it a day? Yes. Let’s use the right part of the brain and create a logo for the network! I was amazed by the sudden energy and creativity burst and tried to grasp it in a picture: the designers, including Mr. Paul standing in the middle, present the winning logo. 

Mr. Paul went back to Katesh, connected to a whole new network of colleagues through his mobile. With confidence he told me that the internet connection will soon follow.

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.

On Wednesday September 19^th 2007 I attended the first Dutch Plone users day in Amsterdam. One of the presentations was about the new features of Plone 3.0, which is, amongst other things, OpenID compatible!

The first time I heard about OpenID was about 2,5 years ago. A colleague of mine, who helps keeping me up to date on all sorts of things including web developments, showed this movie during a break in the web2.0 writeshop held at IICD.

OpenID is a sort of online passport. If you’re registered there, any other website which is compatible with OpenID, allows you to sign in with the OpenID profile. You don’t have to create another username and password combination for that specific website! For all the people like me, making use of web services like blogger, flickr, facebook, linkedIn, gmail, surveymonkey, etc. on top of your official accounts like email, network, ftp, cms’es, etc. it is such a hassle to have to remember all of those unique combinations of different usernames and passwords. Thank goodness someone out there is trying to find a solution to this problem, and thank goodness it seems to be catching on!

It was truly a feeling of “the future is here”, sitting there listening to the presentation, and seeing that Plone has now become OpenID compatible, something I had heard about once within the context of “this is what the future will bring”.

Another fun thing of that day was learning that Plone is becoming more Web 2.0. For example, without being a programmer, you can ensure that the content in your website is automatically pushed towards web 2.0 tools like delicious and reddit. Also, users can design their own member profile pages with widget-like portlets filled with content or RSS feeds of their choice. Besides the increased web 2.0 characteristics, Plone 3.0 also has great improvements in user interface functionalities and easing the task of content management through inline editing, OpenID, and link integrity. And of course, all the strengths of 2.5 remain, such as the use of resolveUID, RSS feeds and smart folders remains.

I also learned about Bungeni: “ It is a Parliamentary and Legislative Information System that aims at making Parliaments more open and accessible to citizens ... virtually allowing them "inside Parliament" or "Bungeni"  the Kiswahili word for "inside Parliament". (Source: http://www.bungeni.org/)

It is based on open source standards and applications including Plone and is being developed in collaboration with eight national parliaments in Africa, including three countries IICD works in, namely Ghana, Tanzania and Uganda. I hadn’t heard of Plone being applied in such a high profile project in Africa before.

It just goes to show, days like this Plone users day can lead to many unexpected new sources of inspiration and possibilities for finding synergies! Thank you to the “Stichting Zope & Plone” for organizing this day!

The project “District computerization Kinondoni” is to bring about good governance in the Kinondoni District (Dar es Salaam, Tanzania) by harnessing information for decision-making through the use of ICT. The project has been in implementation for some time now and has been using IICD's Monitoring and Evaluation system since 2003. This time around, a new approach was taken during the Focus Group Meeting.

On the 20th of April, 30 ICT users from various levels and departments of the Kinondoni municipality and four ICT staff members assembled in a Focus Group meeting to discuss the results of the questionnaires that were collected last year among the end users of the project. An important conclusion from the data coming out of these questionnaires was that generally, users viewed quite an impact of the project in their organisation, in terms of empowerment of the users working with ICT and the impact ICT was having on the organisation when it came to productivity and efficient reporting. The results also showed that improvements could be made to improve satisfaction, mainly where training of the users and technical assistance by the ICT staff was concerned.

In order to address the challenges, role play was used to facilitate the dialogue. One group of end users and one group consisting of ICT staff members were both asked to prepare a small play on the issues concerning technical assistance. Each group had to address positive and negative aspects of the technical assistance and in both plays end users and ICT staff members had to be acted out. This motivated the participants to step in each other shoes and to take both points of view into consideration. Two other groups, both consisting of end users, made plays concerning organisational efficiency: Does ICT really make the workplace more efficient?

The plays (in Kiswahili) resulted in a lot of laughter and sounds of approval; many participants recognised the situations in the scenes that for instance showed a member of the ICT staff using very technical language with puzzled-looking users or a secretary without appropriate training, trying to help out her boss who was too busy to deal with the computer.

After all plays, the participants made a list of concrete points of action. Interesting was that this action was expected not only from the ICT staff members, but also from the management and all users. Ideas that came up had to do with lessening the pressure on the ICT staff by on the one hand training and aiding users to better cope with problems themselves. The ICT staff could for instance make notes with very basic trouble shooting issues, so the users do not need to call upon the ICT staff for relatively simple problems. On the other hand, the ICT staff can be trained to better and simpler communicate with their end users. They can also be helped to develop a way that allows the staff to better deal with the limited time that they have: which problems have priority above others and what can users expect from them in terms of promptness of the assistance?

The meeting was enthusiastically reflected upon. As one of the ICT staff members put it: ”It would be really good if we could do this again next time. I feel that people now understand more about the ICT staff, that we are busy too, and that we understand them better. And everybody enjoyed it!”