The first IT-related opportunity to help here was pretty exciting: help the pharmacy department keep track of its inventory.  That first day was spent touring the pharmacy, investigating the three bulk storage rooms and the dispensary, talking to the stakeholders to identify the key requirements and there is a great deal of management support for the project.  It appeared that everything was in place for a successful technology project!  Little did I know that this all would be derailed by overwhelming and time consuming computer “help desk” tasks.


Hark, is that the every-popular LinkSys DD-WRT2 Wifi-Router?

That first day brought to light that Macha Mission Hospital is a rural and growing medical center.  As such, it has growing computer and network infrastructure and support needs.  While the computing infrastructure here is very similar to many other businesses, how this infrastructure came to be is anything but.  Computers are new here, having been either donated or provided for in grants from the many NGOs here and abroad.  The computers were put in place without much provision for maintenance or a plan to update them over time.  While this has brought about significant gains in capability and productivity, the support burden is to the point where it is a threat to these very same capabilities and productivity.


You've Got Mail! I mean viruses. Lots of them.

Where to start?  There are challenges with the network infrastructure, internet access, desktop hardware and software support, computing policies, training for users and my new personal favorite – anti-virus and malware.  The inventory of equipment is on the order of 40 desktop computers, a mix of wired and wireless switches and many USB thumb drives.  Software is almost all Windows XP and Office 2003, with one install of QuickBooks Pro and a few workstations with SmartCare, the Zambian Government’s Anti-Retroviral (ARV) patient records system.


You have to respect this throwback to the old school days

I was introduced to Dunny who has been working under a contract with the ARV clinic and I proceeded to work with him to remove viruses, update computers with the latest service packs and patches, and provide general maintenance to as many computers as possible.  Luckily, he is quite familiar with computers and learns fast.

We soon found that the computers with internet access were the worst offenders.  Some had over 700 viruses on them (!) and required a complete format and re-install.  In fact, every computer we worked with required a format, although we were able to extract much of the user data after scanning it with no less than four different anti-virus and anti-malware tools.  It turns out that any computer with an internet connection is such a hot commodity that people will find a way to convince someone to get access to it.  With this comes USB thumb drives, malicious websites, downloads and a torrent of viruses and other nasty stuff.


Such a familiar sight, so far from home.

A few days into this process, I met with Edgar who manages much of the general infrastructure for the hospital.  He is also the x-ray and ultrasound operator.  In his spare time, he is also studying to become a chaplain.  We had a great discussion about the issues and put together a general plan based on our observations:

1. Develop computer, data protection and internet policies
2. Install quality anti-virus, spyware and malware tools on each new and newly-formatted computer
3. Devise a data backup strategy
4. Write a job description for the computer support person (every day they do x, every week they do y, every month they do z, etc.)
   

This, we decided, would be a “good start.”  The SmartCare system is a basic electronic medical record system, though the medical director does not see a universal EMR system being implemented anytime soon.  A comprehensive EMR system, of course, requires a talented support staff and reliable electricity to be considered as a replacement for the paper-based systems they currently use.  But I kept wondering aloud what I might do if I were here for 6-12 months, and it could entail:

1. Compile a suite of software and hardware spare parts, tools and utilities
2. Overhaul every computer and build a standard "image" of each type of computer with Terabyte Image For Windows, Ghost, TrueImage or similar
   
3. Assemble a robust network with managed gateway for internet access
4. Provide basic computer courses and application-specific courses
5. Identify and train new computer technicians among those who take a keen interest in computers
6. Build out a basic data center with redundancy and backup systems
7. Explore open-source OS and application alternatives
8. Opportunistic projects to support specific needs
9. Apply for grants to support the above
10. Recruit and train the next generation to take over all of this
    

By some back of the envelop calculations and creative use of off-lease and eBay purchases, I estimate that the cost could be less than $10,000 for all of the above.  The hard part, of course, is finding the person to drive this bus forward.  Feel free to apply directly to MMH if interested


Lastly, here's a shot for the FAA & NASA crowd: ABFA Airport