IT in the Field

Jeff Allen (jra), an aid worker and logistician for MSF, wrote a very “keep-it-real” article about IT in the field for aid workers, which Jon Thompson (former MSF) published on his blog. I will copy and respond to some of his points here:

Here’s a beneficiary for you: the data manager for a Congolese health district. During a meningitis epidemic, it’s his job to enter all the paper forms arriving by bicycle and moto from around the region into a spreadsheet setup by the WHO.

While this task appears to be artificially constructed by organisations and technology, it is an important one, and one where technology can also help. For example, if the data was entered on PDAs or mobile phones instead of paper forms, it would not be necessary to re-enter it. Using electronic data entry also has other advantages:

A user with a PDA and the 2000 survey forms it replaces.

Jeff continues:

My boss sent me over to him to try to find out why he could never give us the data we needed on time in order to make good decisions about our meningitis intervention. He explained that he can only work when the generator is on.

Easily solved with a laptop (as he later points out), or with a large UPS, or a low power computer (e.g. Inveneo, Aleutia) and solar and battery power.

Then he explained that sending files with Yahoo mail is slow, and doesn’t always work… Use POP, not webmail. Slow, unreliable, expensive connections are the enemy of web apps.

Webmail is indeed very slow, unreliable and inefficient over low bandwidth connections. But we have not yet succeeded in making desktop clients as easy to use. Melissa Ho writes in an email to TIER group:

Has anyone ever asked why everyone uses webmail even though that’s obviously the wrong thing to do in low bandwidth environments? Of course – set up is easier, and people do not necessarily have personal computers on which to download their mail… people don’t know how to configure their email or set up pop download. How many of you use pop? Even I had to go through three mail applications before I could get pop working properly in Uganda this past August.

ISPs and webmail providers could offer downloadable software preconfigured with the user’s login details for POP or IMAP use. Google could easily do this by using their own Gears library in their webmail software to make it work offline. Or any programmer could pick up the Thunderbird source code and work on making it easier to configure for Gmail users, for example.

we found evidence of several viruses making it impossible for him to open any document with “virus” in the filename.

Which is a bit of a problem for a health worker dealing with the AIDS virus or influenza, for example. Jon Thompson, another former MSF logistician, already responded to this point:

Anti-virus: AVG FREE Personal Edition. Enough said. Don’t even waste your time on anything else.  This will take care of 90% of your problems.

Unfortunately I have to take issue with this point. AVG has failed to detect several viruses that I have encountered in the field, and I have a laptop currently infected with one which it refuses to detect and AVG refuses to accept samples of the virus or display any interest at all in faults in their product as I’m not a paying customer. AVG helps a bit, but it does not solve the problem.

Better solutions could include switching to a less common operating system such as MacOS X or Ubuntu Linux, security lockdowns, and dedicated devices which can only be used for spreadsheets, word processing and web browsing, for example, and nothing else. A general-purpose computer is just as happy about running a virus as any other application. A dedicated one does not have to be.

Such computers can be supplied preconfigured and locked down by the “vertical programmes” which supplied the data manager’s “AIDS computer” and “Malaria computer.” In fact, for them to supply a computer to the field without a commitment to maintain it is bordering on irresponsible in my view, like leaving a huge pile of grain unguarded and causing a vermin infestation, or training staff to use a medical procedure that requires a particular type of supply and then withdrawing that supply, making their training useless.

Another issue with antivirus software (and hence with running Windows in the field, where antivirus is essential):

How do we remove viruses? It’s easy, right? Update your virus scanner and scan. But an update is 12 megs, or USD 60 on satellite, and completely impossible to download on a 30 kbit/sec link from Uganda. So no update. MSF solves this problem by sending virus update CDs to the field monthly. But the viruses you catch in Africa tend to be locally written (this one was from a technical university in Nairobi). If they ever end up in the virus databases at all, they arrive late.

Sixty dollars to download an antivirus update that probably won’t fix the problem? And you know most antivirus companies issue updates almost daily, right? That or get a virus. That’s the cost of using ordinary Windows (not locked down) in the deep field.

I also like the idea in a comment posted by Stefan on the blog:

Run a virtual Windows machine on a Windows base operating system that is not used for anything else. Keep a clean copy that you start up every day and ditch at night. Start up with the same clean copy the next morning. Keep your files on a thumbnail. If the virtual machine gets infected, just ditch it.

Unfortunately this will not stop your “thumbnail” (I hope he means thumb drive?) from getting infected and carrying the virus into your freshly cleaned virtual machine each day.

Jon sees the operating system/virus issue as “a problem with education and advertising,” and claims that billboard adverts for Ubuntu will help to fix it. I have to disagree here too. Using Ubuntu is not aspirational for people living on low incomes because it has virtually no presence here either, and certainly has an image problem compared to MacOS X and Windows. But that’s hardly the point.

The data manager is not going to take his PC supplied by an NGO, reformat it and install Ubuntu. No way. He might just about go as far as installing anti-virus software, but I doubt that. He is an end user, not a system administrator. He doesn’t install operating systems, particularly not different ones than the one supplied with the computer, if he wants it to keep working (sort of).

The “vertical programmes” and NGOs need to supply systems which are fit for purpose, in other words which are appropriate for use in the field, rather than being a liability. If he’d received the computer with Ubuntu installed, it would have stayed installed. If he’d received the computer with a lifetime antivirus subscription, automatic updates locked on, and free (to him) bandwidth to update it, it would be up to date.

Why do these organisations supply inappropriate systems to developing countries? I’m not qualified to comment, never having worked for one, and if you are, please jump in. I’ll publish another article about this at some point, with hopefully more educated opinions. But here are my uneducated guesses about what’s wrong with some organisations (governments and NGOs) and their use of IT:

• They don’t properly test their systems in the field;
• They don’t collect or respond to feedback on how well their systems work in the field;
• They are conservative. They stick with what they know, especially with IT, after getting their hands burned a number of times by expensive IT failures in the past;
• They don’t want to rock the boat of their cosy relationships with their IT suppliers;
• They don’t want to jump onto a “fashionable” bandwagon such as Linux;
• They don’t want to be seen to waste money by buying Apple kit, which is very expensive, even though it’s very reliable and easy to use, so probably justifiable;
• They have heavy investments in proprietary technologies such as Exchange, which ties them to Windows;
• They end up stuck with Windows as a consequence of the above;
• The larger ones, like most organisations, have heavy process issues which impede change
• They have understaffed IT departments with underpaid or underqualified staff, which also impedes change;
• IT departments, which should be enabling infrastructure, instead tend to exert too much control over the core activities of the organisation;
• The systems they deploy organisation-wide (e.g. Exchange, Domino/Notes, Windows) are not fit for low-bandwidth or disconnected users, but are still mandated

I would argue that governments and NGOs need to check whether their IT systems are working in the field, and if not, commit to investing in fixing it. Heads of programmes should be driving forces for change within their organisations, at every level, not afraid to cut red tape, subvert procedures, call for more funding for IT or calling for heads to roll, if it helps them to achieve their core mission.

I’m not advocating that they should be blasé about IT. Far from it. I think they should be wary of IT, and demand that it actually helps their projects, and helps as much as possible. They should not be afraid to ask (and potentially pay) outsiders to give constructive criticism of how their existing IT works and how it could be improved. They should not be afraid to do anything in their power to improve it. I’d recommend that the heads of programmes get together without their IT staff to discuss how they could all use IT better, and then present a combined front to the IT department.

I also think that these organisations should consider using an agile approach to IT in their programmes, which minimises their risk of project failure by:

• working very closely with end users (very similar to participatory development methodologies);
• not committing to big infrastructure up front; and
• by continuing to deliver useful incremental improvements in the programme throughout the IT project.

I’ll write more about agile development in a future post as well.

Footnote: jra’s blog is a great example of low bandwidth design. 25 kB to download. Well done that man. Puts me to shame.