26 5 / 2013
2013 Tanzania Pilot Documentary
After returning from our pilot program in Tanzania, our documentarian Mateus Falci put together a film documenting our work in Tanzania, in collaboration with the Association of Private Health Facilities in Tanzania, Bienmoyo Foundation, and the Dar es Salaam Institute of Technology.
Credits to Mateus Falci for filming and producing.
26 3 / 2013
How We Select Our Partner Organizations
The partner organizations we work with are one of the most critical parts of the Tech in the World fellowship. They are our fellows’ generous hosts during their stay abroad, our collaborators in tackling important issues in global health, and the ultimate caretaker of the software solutions that we develop for them. The selection of good partner organizations and cultivation of strong partnerships are essential to a successful and rewarding fellowship trip.
Realizing this, we invested a fair amount of time into developing our selection criteria for partner organizations, to maximize both the learning experience and opportunity for impact. We want to share our current thinking, so that our selection process is both understood and transparent, and so that other humanitarian efforts (especially related to technology) may benefit from our thinking. Of course, these criteria will surely change over time as we continue to learn more from our experiences.
Our approach to partner selection is heavily influenced by our philosophy on technology for development (ICT4D). We believe that the actual technology development itself is only a very small component of the entire process of applying technology to development issues. Before technology development, great efforts must be taken to fully understand root causes, develop a theory of change, and assess available resources, among other preparations. Once the technology has been developed, much time and energy must be invested into maintaining the technology (e.g., bug-squashing and server administration), growing adoption, managing deployment, and so on. We recognize that what comes before and after the development of technology is more important and significantly more difficult than building the technology — in our experiences, we find that the vast majority of failed ICT4D projects do not fall short on creating a functional technology, but on the other crucial aspects of ICT4D. We are determined to do the best we can to avoid the same pitfalls.
The most valuable resource that Tech in the World fellows bring to the table is the ability to develop software technologies quickly. Our most limited resource is the amount of time we have on the ground. Due to our short stay, we do not have the bandwidth to conduct needs assessments or long-term maintenance. Regardless, we would prefer these to be handled by local organizations, for a more sustainable impact. Thus, we want to collaborate with partner organizations whom we believe have both the local understanding and an accurate needs assessment as well as the resources (technical and otherwise) to maintain the technology. This framework of thought leads us to our guidelines and criteria for evaluation of potential partner organizations.
- Locally based, with local staff. We prefer to work with local organizations, who have a strong understanding of local conditions and needs. We also believe that local organizations will afford a more rewarding experience for fellows, as they will have more exposure to local conditions.
- Moderate size and history. This is a heuristic for the stability of the organization. We seek long-term partnerships to build upon each year’s efforts, and a stable organization gives us greater confidence in the value of investing in a long-term relationship. A partnership with a more stable organization overall will have less risk.
- Existing understanding, appreciation, and usage of software technologies. It is important to us that our partner organization (or a close affiliate) has a strong understanding and appreciation of technology, so that they can intelligently determine feasible projects and identify effective uses of technology. Without this, it is far too easy to propose technological projects that are either infeasible or unlikely to be effective.
- Proposal of well-defined, close-ended software projects. We want to work with partner organizations who already have a good idea of what projects they would like to have completed. Our fellows do not have the bandwidth nor the local understanding to identify these projects for our partners. The projects must also be well-defined such that there is a clear completion point, so that we can accurately assess development costs and ensure that we complete the projects during our stay.
- Resources and commitment to long-term maintenance. It’s crucial that our partners have both the means and the desire to actually make full use of whatever software we develop for them.
At this point, we will take the opportunity to explain the extent to which our partners for the Tanzania pilot met these criteria. The dual partnership with the Association of Private Health Facilities in Tanzania (APHFTA) and Bienmoyo Foundation proved to be excellent. APHFTA was local organization that provided the perspective
- APHFTA is a local NGO based in Dar es Salaam, with regional offices around the country. They are the largest network of private health clinics in East Africa and host gatherings like the East Africa Health Care Federation Conference. The staff is entirely local, and so had a strong understanding of local conditions and needs.
- APHFTA has been around for nearly 20 years, and manages a growing network of over 550 clinics in Tanzania.
- Bienmoyo has been working with APHFTA closely over the past two years to develop mMaisha, a electronic medical record system for maternal health for APHFTA’s clinics. Bienmoyo’s Executive Director, Lushen Wu, has both software engineering expertise and a deep understanding of APHFTA’s needs (having lived in Tanzania for much of the past two years) while APHFTA’s staff has learned much from managing and deploying this software system.
- Lushen, our primary point of contact before arriving in Tanzania, was able to identify a number of feasible projects for us to complete during our time there. The membership database we managed to complete was something that APHFTA had wanted for a while — they had even approached a local software development firm at one point to get a price quote (too expensive)!
- Lushen and Bienmoyo Foundation provided the necessary technical expertise to maintain the software and deployment servers after our departure. Furthermore, we had strong commitments from Dr. Ogillo, CEO of APHFTA, and Dr. Kaushik, CEO of Hindumandal (a large hospital in Dar es Salaam) to push the adoption of our SMS reminder application (although admittedly, these commitments were not obtained until the actual pilot program rather than during the selection process).
We hope that this information may provide useful for both understanding our thought process at Tech in the World and for planning partnerships for other similar endeavors. Please do contact us or leave a comment with further questions or comments!
06 2 / 2013
Tanzania Pilot Conclusion and Summary
The Tech in the World team arrived back to the US a week and a half ago, on January 26. Since then, we’ve all been thrown back into the whirlwind of classes, school, and catching up with friends. We’ve also gotten a bit of time to reflect on the trip and crystallize many of the things we took from the trip.
Summary of the Pilot
To summarize the pilot, our time spent in Tanzania can be roughly broken down into four categories:
- Most of our time was spent developing software solutions for APHFTA. We ultimately completed a membership database, an SMS reminder application, and some data visualization tools.
- We grew a strong relationship with the Dar es Salaam Institute of Technology and spent six sessions there, getting to know the students and leading workshops on web security, web development, parallel programming, and online learning resources.
- We had the amazing opportunity to meet a wide range of people working in technology, health, and development during our stay in Tanzania, including local Tanzania developers, staff at D-Tree International, researchers at the Ifakara Health Institute, the Dar Teknohama Business Incubator, the Country Director of the World Bank, a Program Manager with the Clinton Health Access Initiative, and volunteers from the US.
- We traveled on the weekends, spending our first weekend exploring Dar es Salaam, another weekend in Zanzibar, and another weekend on safari in northern Tanzania.
Before we left for Tanzania, we had a two-day pre-departure training program (see Day 1 and Day 2). We were very fortunate to have the company of our documentarian, Mateus Falci, who released two videos on the pre-departure and arrival in Tanzania and our first week in Tanzania. Mateus is currently working on a longer documentary of our trip that should be released within a month!
Finally, the entire team is extremely grateful to all of our donors and funders for their generosity. Without them, this trip could not have happened!
Key Takeaways and Learnings
I think there is much that each fellow took away from the trip that cannot be easily verbalized, and perhaps will not even emerge until more time passes. But there are a few key learning experiences that we want to share with everyone.
Perhaps one of the most important learning experiences of the fellowship program was the opportunity to see first hand the conditions in a resource-constrained environment and the unique challenges of developing and deploying softwares solutions in a developing country. Whenever you develop any kind of product or solution (software or otherwise), it is critical to understand the end user, existing behaviors, and the setting in which the product or solution will be used. Working in Tanzania and visiting the clinics there allowed us to see with our own eyes that electricity and internet infrastructure are not reliable, computer literacy is low, and the general mindset toward computers is completely different from what we are used to in the developed world.
Understanding these unique conditions is crucial to being able to develop effective solutions for regions like Tanzania. There are endless accounts of people with good intentions from developed countries attempting to design a solution that ultimately does not solve the problem or fails to become adopted because they did not have a good understanding of local conditions. Although we certainly do not claim to be experts in any way, I think we all have a greater appreciation for the differences that exist between the developing and developed world, and the fact that and awareness and understanding of those differences are paramount to developing and deploying effective solutions.
The experience of getting to know our peers studying computer science at local universities was also an eye-opening experience that we could not have had without traveling to Tanzania. It was amazing to connect with students learning a similar curriculum, excited about the same technologies, and working on impressive projects to improve their country. It was a meaningful experience to get to know these students and learn about their unique opportunities and challenges.
There are still many more experiences and moments that we bring back with us that we could possibly share in a post.
Going in the pilot, the main questions we wanted to answer were:
- Would the fellowship provide a meaningful experience to the fellows?
- What would we get out of the fellowship trip that we could not experience in the US?
- Is one month sufficient time to develop and complete a software solution?
After pilot program, I can confidently say that the pilot was a success, as the fellowship far exceeded expectations in terms of personal growth and learning, the trip taught us much that we could not have possibly learned without going abroad (see the takeaways above), and we were able to complete three software projects for our partners.
Looking ahead, we are excited to continue growing Tech in the World and preparing for our inaugural class of fellows for 2014. In the coming months, we will be raising awareness of the applications of computer science in global health, building out our fellows selection pipeline, developing an additional overseas site for next year, and gathering more resources for an expanded pre-departure training program.
If you want to see all the details, you can find much of what we are currently thinking in a 10-page proposal we just recently submitted to the Harvard President’s Challenge:
01 2 / 2013
Pilot Software Overview
We have written much about the various meetings and excursions we had, but neglected to share our software development work, which is what we spent the majority of our time on! Now that we’ve completed our software work, we can show you the finished products!
APHFTA Membership Database
APHFTA manages a membership of over 550 private health clinics in Tanzania, for whom they provide a number of services, including advocacy, knowledge-sharing, and clinical staff training. They have a number of different programs that member clinics can enroll in, including ones around HIV/AIDS, diabetes, and a Medical Credit Fund. To gain access to all of these services, every member clinic must also pay an annual membership fee to be a part of APHFTA.
Previously, APHFTA had been managing all of its membership information through various Excel spreadsheets dispersed throughout the staff. Membership services, the finance department, and the program heads all had their own spreadsheets which they would occasionally send to each other to share new information. Furthermore, only the most commonly used information (e.g., contact information) was kept in Excel, whereas any other detailed information had to be looked up in a large binder.
We created an online membership database for APHFTA, where they could manage all of their information on their membership facilities. The membership database was built on top of Django Admin to take advantage of the many features that came built-in.
We helped the APHFTA staff merge many of their Excel spreadsheets and import the data into the new database. Now, APHFTA staff could manage all their membership data in one centralized location online, which meant that their zonal offices in other parts of the country could see the latest data and contribute their own new data. Staff could also filter facilities by location, services offered, and programs enrolled and manage fees and payments for each facility. The IT staff at APHFTA could also assign permissions to each user to limit their privileges for security (e.g., only allowing the finance department to modify payment information). Finally, Excel reports could be generated using a report builder, where you could filter to a subset of facilities and select only a subset of columns to export.
SMS Reminder Application
Both Dr. Ogillo, the CEO of APHFTA, and Dr. Kaushik, CEO of Hindu Mandal, a large hospital in Dar es Salaam, were very interested in the development of a lightweight web application that would send SMS reminders to patients to show up for appointments and to take medicines. APHFTA’s existing software platform had an SMS component, but was targeted only at maternal health (i.e., pregnant women). Dr. Ogillo and Dr. Kaushik wanted a software application that focused only on the SMS component and could be generalizable to any patient with any condition.
We created a web application that doctors and nurses could use to automate SMS reminders. We built this application on top of the existing mMaisha platform and sent SMS messages through Clickatell’s SMS gateway. On this application, doctors and nurses could register patients and schedule appointments. The system would automatically send out a reminder SMS before the appointment and a followup SMS if the patient was marked as having missed the appointment. Patients could also be sent SMS for a number of different use cases, and could also be associated with a medical condition or medicine regimen to receive SMS reminders on a regular basis. We also included a reports section to visualize the number of SMS reminder and followup messages sent.
mMaisha Reports and Data Visualization
APHFTA’s existing electronic medical record system, known as mMaisha (note: developed by Bienmoyo Foundation) had been logging and recording all kinds of information throughout its operation over the past year, which could be used to understand the usage of the system and improve its usability. However, much of that data was simply sitting in the database, and without some form of data visualization, was essentially inaccessible.
We developed a number of different data visualization charts and graphs using Highcharts. The data that we visualized included the number of form submissions over time, separated by individual facilities and type of form (such as patient registration); form errors broken down by form type (to see which fields were failing form validation most often); page views over time, broken down by module (an internal unit of organization) and facility; and data completeness by facility.
We also developed a new system that would automatically measure the amount of time every user spent on each page of the website, which we also visualized to show the parts of the site that were getting the most usage, in terms of time.
We had also invested a few person-days into overhauling mMaisha’s Continuing Medical Education (CME) module, which had been partially developed but was not fully functional. We ended up having to shift our resources away from CME as new requirements arose for our other projects. We agreed to de-prioritize development of the CME in favor of completing the other software despite the sunk cost.
From here on out, we are continuing to work with Bienmoyo Foundation to hand off the software we’ve developed to them, and we are keeping in touch with both APHFTA and Hindu Mandal to ensure a smooth adoption and integration of the new software. The latest news from APHFTA is that staff has already successfully adopted the new membership database and has been enjoying its new features!
31 1 / 2013
Pilot Financials Summary
For the sake of transparency, we want to share the summary of our finances for the pilot program.
$2,000 - Harvard School of Engineering and Applied Sciences, Nectar Fund
$678.12 ($700 before fees) - Awesome Foundation Knowledge Chapter
$1,500 - GoodVentures Donor Advised Fund
$2,000 - Omidyar Network
$4,114.80 ($4,300 before fees) - Individual donations (tax-deductible thanks to sponsorship by Bienmoyo Foundation)
$1,500 - Resolution Project (stipulations prevent its use toward the pilot program)
$8187.30 - five (5) roundtrip tickets to Dar es Salaam, Tanzania
~$2,000 - approximately 30 nights at Safari Inn for five (5) people (expenses covered by our partner, APHFTA)
This leaves us with $2105.62 to distribute a stipend of $421.12 to each fellow to cover various miscellaneous costs, including visa fees, vaccinations fees, food, and local transportation in Tanzania.
In future years, we are hoping to have more financial resources to allow for a more generous stipend to our fellows. This year, unfortunately, one source of funding fell through at the last minute and decreased our total income. However, we are still glad to have covered at least 90% of each fellow’s costs.
We are also planning on having our partner organizations make a larger financial contribution to fellowship expenses in future years. Code For America has a similar model, in which the cities cover 100% of the fellows’ salaries, and donor money is only used to pay for the administrative staff salaries and other expenses. We believe a greater financial involvement from our partner will increase commitment and engagement from both the fellows and partners, resulting in higher-quality work and a better experience.
24 1 / 2013
Tech in the World Goes on Safari!
After our amazing 3-day adventure in Zanzibar, we were certainly aware and appreciative of investing some of our time in team-bonding away from the office. We had also found ways to travel on a budget. (Again, Tech in the World does not fund these trips but encourages fellows to do this if possible.) Our first destination was Arusha, the major city in the north of Tanzania, about an hour away from Mount Kilimanjaro and a few hours away from the cluster of famous national parks such as Serengeti, Ngorongoro, Tarangire, etc. We were fortunate to book a flight through a new, low-cost airline called Fastjet, and for the same price as a ten hour bus ride (~60 USD), got a 45-minute plane ride!
Upon landing, the first thing we noticed was the stark change in climate. Situated at a higher elevation, the air was much cooler and dryer than the hot and humid weather we are used to in Dar Es Salaam. After a pleasant one hour cab ride from the airport, we arrived in Arusha. We spent the night in a hotel booked by the safari company, excited to embark on three days of safari the next day.
Our journey began at 9 am Saturday. The first day’s destination was Lake Manyara National Park. Our driver for the trip was a friendly man in his 40s named George and he was accompanied by Bruno, a former soccer player and excellent cook.
For those who don’t know, safaris are booked as a package and costs cover paying for the driver and the cook, the food, the national park entrance fees, the campsite fees, and other similar items. The campsite was located in a small town about 3 hours away from Arusha called Mto wa Mbu, which literally translates to River of Mosquitoes. The campsite was a mix of camp and lodge. Our tents were set up in a nice grassy area but we also had access to bathrooms, showers, and a nice pavilion to eat our meals.
After dropping off all the tents and food at the campsite, we set out for Lake Manyara National Park. Just a ten minute drive from our campsite, Lake Manyara National Park was a great place to start our safari. Though it is on the smaller end in terms of national parks, it is home to 11 different ecosystems and the beautiful alkaline Lake Manyara. Upon entering, we felt as if we were in Jurassic Park. About 100 meters past the gate we were greeted by Blue monkeys, in the heavily forested area.
A few minutes later, we stumbled upon four elephants. At this point, we all realized at the huge difference it is seeing these animals in their natural habitat as opposed to a zoo. Though all five of us had seen elephants before, there was something more unique and exciting about getting so close to these animals in a completely open environment.
This feeling of excitement definitely carried over for all our sightings. After elephants, we drove a few minutes down the dirt road and were soon watching baboons groom their young! This is basically how the day went. Animal after animal, ecosystem after ecosystem, we were so impressed at the high density of animals and biodiversity in such a small area. George was constantly giving us good insights and using his eagle eyes to point out animals far away and ones close by that were not immediately visible. We saw the beautiful Masai giraffes, impalas, zebras, Vervet monkeys (distinguishable by the males’ bright blue scrotum), flamingos and many more.
One of the most impressive things about Lake Manyara was driving through these eleven different ecosystems. We’d be in a dense jungle then ten minutes later in a woodland then ten minutes later on a beautiful plain then in the bush and on and on. It was truly a great way to kick off the safari and got us incredibly excited for the next day. That night we had dinner together with George where we shared stories about our families and our backgrounds. George made us all laugh when he creatively described how some Tanzanians think the Chinese choose their children’s names (I’ll let you guess what it was!). The pavilion also featured a nice screen projecting soccer match after soccer match which kept us hanging out there for a while. We slept two to a tent rather comfortably with the sounds of nature to lull us to sleep and the crow of a rooster to wake us up.
For the second day, we rose for an early breakfast and got on the road toward Ngorongoro Conservation Area. It was a beautiful one hour drive, even further up elevation wise. We drove up the first set of mountains, known as the wall of the Eastern Rift, which led us to the uplands. The uplands consisted of these beautiful rolling hills dotted with farms, forests and small villages. Our destination was Ngorongoro Crater, a huge volcanic caldera that contains a lake and beautiful expansive plains surrounded by large, densely forested mountains. It is one of the world’s few unbroken calderas. As you can see in the picture, the view from the rim of the crater is an amazing sight, and the wildlife living inside is even more impressive!
After a long one hour drive along the rim, passing several Masai villages, we finally arrived at the small road that descends into the actual crater. We were immediately greeted by zebras, wildebeests, gazelles, and impalas grazing side by side with the cattle and goats of the Masai people.
(Note: Ngorongoro is a conservation area, not a national park, thus people are allowed to live there as long as their way of life does not negatively impact the wildlife.) The crater never ceased to disappoint us. We saw so many animals up close that we had only seen from a distance at Lake Manyara, proven by the fact that Sal expended all his camera battery at Lake Manyara taking zoomed in shots of zebras a mile away when the next day they were mere feet from our car. Aware of Sal’s dying love for lions and the rest of the group’s intense interest in spotting them, George was determined to get us a meeting with the king of the jungle. In true George style, he did not disappoint. Leading us right to the action, we arrived by the small creek where a pride of lions was about a quarter of a mile away. We saw them through the binoculars and were convinced that this was the best view we were going to get of them. However, as George surely knew but we did not, the pride was getting ready to get water from the creek and relocate to the shade. The only way to get there was by passing through our car and the many others stopped along the road. One by one, the lions passed right by us, some stopping to sit in the shade provided by the cars, others completely ignoring the human spectators admiring their slow and lethargic walk. With the camera out, I felt for a little bit what it might be like to work for a nature show. With confidence I started holding the camera quite low near to them, though George wisely advised me not to get too confident. This proved important a few minutes later when I had a lion growl at me as it walked by, not pleased with the close contact paparazzi. Luckily, I got that on film too.
After watching them walk by us, we waited for an hour hoping to see the lions hunt one of the many clueless wildebeest and buffalo hanging out near the creek, but alas, they were full from their kill the day before and just wanted to rest. A nice lunch was had by the hippo pool where we saw plenty of hippos wading in the water as we ate our usual box lunch of chicken, veggies, chapati, sweet bread, banana, and juice. Though the animals were stunning, the scenery of the hippo pool reminded me of just how beautiful the crater was. The lush green mountains, the expansive plains, the beautiful trees: it certainly looked like the perfect home for wildlife.
George’s determination to show us as much as possible did not end there. Though we were tired and dozing off at times after our lunch, George was determined to show us the all too rare Black Rhino. They were numerous 50 years ago but they have been heavily poached since then for the medicinal benefits of their horn. According to information posted at the visitors center, there are only about 28 rhinos left in Ngorongoro. Our chances were low. George would drive for a while, stop the car, gaze into the distance, look through the binoculars, then keep driving. We were confused, not sure where George was taking us next. After about an hour of driving and stopping and looking, we were pretty sure the black rhinos would go unseen. But once again, George came through and he stopped the car one last time, pointed about 200 yards away, and sure enough there were four black rhinos. Through the binoculars and camera zoom we saw them play and interact with each other. It was an incredible sight, and something that sadly might not be around for much longer. This was the epic conclusion to the day in the crater. The drive back was as scenic as the drive there. We drove around a different part of the rim, equally as lush, and had a beautiful drive through the uplands and down back to Mto wa Mbu with the sun setting behind us.
The third and final day was in Tarangire National Park. By this time, the only thing I still had a burning desire to see was more elephants closer up. Well I was definitely in the right place. Tarangire is known for its high density of elephants, and no reputation could have been more fitting. About twenty minutes into the park we arrived upon about fifteen huge bachelor elephants crossing the road. Twenty minutes later, we hit the jackpot. We came to the banks of the Tarangire River. There, right below us, we saw about a hundred elephants. The young ones were playing in the river, the older ones were casually eating grass, the mothers were always keeping an eye on the children. It was quite a sight to behold. We sat there for about an hour just observing this huge number of elephants.
After lunch we left Tarangire and headed back for Arusha. We said goodbye to George and Bruno and grabbed a cab to the airport. On the drive there, we finally got to see the famous Mt. Kilimanjaro. Its snow covered peak lay above the clouds, only a faint outline distinguishing it from the sky above it. Though we weren’t climbing it, seeing the mountain certainly filled us with a sense of awe and satisfaction at this overall amazing journey.
I left Northern Tanzania moved by its natural beauty. It is the home to the ancient human footprints found at Laetoli, our earliest known ancestors to have walked upright. The existence and preservation of the places we went struck me as natural perfection frozen in time. Of course our ancestors came from here, I thought. The climate is perfect, the soil is rich, the wildlife is magnificent, the biodiversity is immense! This is where the human species is meant to reside! And then I quickly remembered my imminent return to frigid Cambridge and that left me with an even deeper appreciation of this paradise on earth. I can only hope that we continue to preserve these natural wonders for places like these are truly heaven on earth.
17 1 / 2013
Journal: Back from Paradise (a.k.a. Zanzibar)
Wow. The team has been to heaven and back. Before I say anything more, take a look at this picture:
A panorama of the Indian Ocean, right outside our bungalow in Kendwa. Click on the picture or here to see a large size picture.
The team took a trip to Zanzibar this past weekend and had one of the most amazing experiences of our lives. (Note: This trip was paid out of our own pockets — Tech in the World strongly encourages such trips, but does not provide financial support). I’ll share a few of the highlights of the weekend and a few pictures.
We set out early Friday morning to catch a 7am ferry from Dar es Salaam to Zanzibar that lasted two hours, and met up with a local who drove us to Kendwa, about an hour north of Stonetown. There, we were greeted by what can only be described as paradise on Earth.
We were staying in a small budget bungalow about 50ft from the water’s edge. The bungalow’s occupancy was only seven, and it was located at the end of a row of beach resorts, so we were pretty much the only people at our part of the beach. There was a small restaurant 10 feet outside our front door, in between our bungalow and the ocean and a small massage center next to it as well. There was rarely anyone else at the restaurant — it was as though we had our own private resort! And the water was like nothing we had ever seen before — incredibly clear, a gorgeous color of blue, warm, and less than 10 seconds away from our front door.
We arrived, romped around in the water, swam out into the ocean, had a delicious seafood lunch, and soon set out on a boat for a two-hour snorkeling trip. The clear blue waters beckoned us to jump in, but when we did so, we found our bodies continually nipped and stung by something in the water! We guess that it might have been sea lice or something — Josh afterward said that he initially thought he had jumped into a pool of acid! Nevertheless, we set aside the physical discomfort and enjoyed the amazing water and the marine life within.
The crowning point of the entire day was the sunset cruise on a dhow. We all clambered aboard a traditional Arabic boat with a magnificent sail for a two-hour cruise up and down the coast for just the five of us. On the top deck, we bathed in the sun’s kiss, dove again and again into the shimmering cerulean sea, and had the opportunity to reflect on our entire journey. We could hardly believe how far away we were from Boston — on a dhow in the Indian Ocean enjoying one of the most beautiful sunsets we had ever seen.
The night fell, and the sky was blanketed by a sea of stars. We laid in the sand and stared into the universe up above and pondered the significance of our existence and the possibility of intelligent life out there. In the face of such mystery and mystique, it is no wonder that for millenia humans have romanticized the jewels of the sky or come to believe in a higher power. The power on the beach went out, and as Sal commented, “it was as though someone turned on the sky,” leaving us with only starlight and the murmur of the sea. It was hard to tear ourselves away.
The next day, the sun rose and the beautiful water was still there, only a few steps away from our doorstep. It was hard to imagine what it would be like to live here — would we just get used to the splendor around us? We took a refreshing jog up and down the coast, had breakfast, got massages at the massage center, swam more in the ocean, walked up the road inland to buy jackfruit, mangos, and a pineapple, feasted again at lunch, and simply relaxed. It was a well-deserved respite from the long hours we had been working in Dar.
In the afternoon, we took a van back down to Stonetown, one of the tourist highlights of Zanzibar. Again, we managed to find budget accommodations in a quaint part of the old town, only a few hundred meters from the house where Freddie Mercury was born. We lost ourselves in the famously byzantine narrow alleys of Stonetown, guided only by the direction of the setting sun, and emerged on the waterfront just in time to catch another gorgeous Zanzibari sunset. For dinner, Sal and I haggled with local fishermen at the fish market for grilled octopus, calamari, barracuda, lobster, and other seafood, while Mateus, Christian, and Josh enjoyed a nice dinner at a nearby restaurant called Mercury’s.
On our last day in Zanzibar, we took a guided tour of Stonetown, which had been a significant trading hub for spices and slaves in the past. We took a guided tour of the town, of which the highlight was seeing the old slave market, where thousands of slaves had been held and auctioned off — it was a grim experience to walk into the slave chambers and see the cramped quarters they were forced to live in. Another gratifying lunch with a beautiful view of the ocean, some local shopping for sourvenirs, and soon we were back on the ferry to Dar. It was hard to believe how much we had accomplished in three days in under 250 USD per person.
It was a funny experience to land in Dar and feel like we had come back home — we’ve really become familiar with the city and enjoy its quirks and local flavor. We will surely be sad to leave this place when the time comes. Only 8 more days left here — and still plenty of exciting work left to be done for APHFTA and DIT! (and still a safari!)
15 1 / 2013
A Note from the Documentarian: Explaining the Team’s Computer Science Work as I Understand It
While I have been working on filming the team’s activity and work, I have also learned much about computer science, programming, tech, health informatics, etc. just from being around the team during their work and their meetings. I thought it might be helpful to describe their work from my perspective, as someone who has no prior knowledge of these things.
The four students that make up the Tech in the World team are all very talented computer programmers. They are basically doing work for free that NGOs or governments would pay in the $30k range for. Their work consists of four separate projects and a lot is being demanded of them in this short time. However, they put in hours of work everyday to deliver on all fronts, and so far they are on the right track.
- They are writing an SMS reminder app that will help doctors automatically remind patients about appointments, taking their meds, checking for symptoms, etc.,
- They are helping improve a continuing medical education platform for nurses.
- They are supplementing a maternal health software by writing new code that will allow it to generate new reports and make it easier to use.
- They are perfecting the membership database they made for APHFTA to suit the staff of APHFTA’s needs and preferences.
They work like horses and I’m amazed at what they are able to do. In addition to this work, a lot of our days consists of meeting with different local people to help us understand our work. The most important meetings are the ones at the Dar Es Salaam Institute of Technology. The team often gives a guest lecture about some programming aspect that students there are interested in but don’t have as part of their curriculum. We also have meals and informal meetings with local programmers, expats working in NGOs here, and doctors in local clinics which all help us better understand the work we are doing and the impact it can have.
All in all, Tanzania has been super friendly to me. The food is great, living is fairly cheap, I haven’t been sick except for a few stomach bugs here and there, and the other Harvard students I am here with are really great company and people I would have otherwise never met. I am so happy to be here and can’t wait to see what the rest of the trip has in store for us. Thanks for reading!
10 1 / 2013
Journal: A Weekend in Tanzania
Tech in the World Fellow Salvatore Rinchiera shares his reflections on the team’s first weekend in Dar es Salaam, one week after landing in Tanzania.
It’s been an incredible week for Tech in the World. We’ve been outstandingly fortunate to have already gained support from members of the local tech community. We are quickly becoming familiar with the Tanzanian culture, slowly learning the language, and eagerly exploring what the city has to offer. As we follow one adventure to the next, our journey has been shaped by the pleasant surprises scattered throughout the most unexpected of places. For example, just recently, we’ve stumbled upon the growing niche of filmmaking here in Dar es Salaam. 7 days are behind us, and each has greatly exceeded our expectations. However, there’s a saying here that if you compliment the moonshine maker, he’ll add water to your moonshine. But, if you complain to him, he’ll work harder to make it better. So I suppose I’m obligated to say that I’m not sure how many more shirts I can afford to sweat through.
With that, here’s a recap of our first weekend in Dar.
This weekend, we were short 2 members. Brandon was attending his father’s wedding in China, and Christian had yet to join us. After a busy week of work, Mateus, Josh and I were keen on exploring the new world around us. To kick off the weekend, Lushen introduced us to Upanga Sports Club, a local squash club that holds social events and offers Indian cuisine for both members and non-members. It was Bingo night and we needed to make sure that Tanzania knew just how much Tech in the World dominates at our beloved sport. That night, we met up with Brian as well as his friend Sama, a successful filmmaker in Dar es Salaam who focuses on producing music videos for local clients. There we chatted about international and Tanzanian film over samosas, dal makhani and a variety of other Indian dishes, a very popular cuisine in Dar. Sama graciously agreed to introduce Mateus to the filmmaking industry in Dar es Salaam, offering to help him film around the city.
On Saturday, much to our excitement, Professor Moses invited us to a wedding at a nearby church. Although most weddings are conducted in Swahili, this one was in English since one of the two couples had family from Uganda where Swahili is less prevalent. The Lutheran church was the first we had visited since coming to Tanzania. It was simple, spacious, welcoming, and adorned with lights and cloth in celebration of the marriages. After the ceremony, we followed the procession outside where we continued to enjoy the band’s music and the warming presence of the couples’ family and friends who seemed undaunted by the unrelenting Tanzanian heat. Afterwards, Professor Moses kindly invited us to lunch where among other things, we discussed the differences between the American and Tanzanian education system as well as differences in university culture. We also discussed plans to further our relationship with DIT.
Sunday we prepared nervously for our first trip on a dala dala, the name for one of the privately owned buses that swarm the streets of Dar es Salaam. You will often find them filled to three or four times their seated capacity. We’ve been told that you haven’t had the true Tanzanian experience until you’ve ridden a dala dala. Thankfully, we would not be going on this quest alone. We had the help of Sam Kilewa, Harvard ‘14 to guide us! Sam, who lives 45 minutes outside of the Dar city center, invited us to his home. We took Sam up on his kind gesture, excited to see another, suburban side of Dar with the guidance of a native to make the experience all the more memorable. There was no denying that we were most excited about finally eating a home cooked Tanzanian meal. We were not disappointed. His family prepared us an incredible lunch which was by far the best we’ve had since arriving at Tanzania. We indulged in delicious helpings of pilau, a seasoned riced dish typically served on festive occasions, duck, a plantain based dish, and ugali, a maize based dish whose flavor is based on the accompanying dish, in this case, a goat stew. It was definitely a big change from chips maiya, a french fry omelette that is often referred to as the national dish of Tanzania due to its popularity and ubiquity in restaurants and on the street. Stuffed from our amazing meal, we took a walk around Sam’s farm where we saw bananas, goats, chickens and ducks.
Josh, Sam, Mateus, and Sam’s mother with a delicious home-cooked Tanzania meal!
The next adventure was to the Serena hotel where we started off New Years Eve with an all you can eat buffet. There we met up with Wharton business school students who had been visiting Tanzania to work with APHFTA for the week. We also met Allen, a local software developer who had worked on mMaisha from the start. He talked to us a little about the beginnings of mMaisha and later took us to a scene where we would spend midnight. Although there was a bit uncertainty about exactly when the clock struct midnight, we joined in on the staggered outbursts of cheering and celebrated a new year in Tanzania.
On the technical front, Josh and I worked on creating visualizations for mMaisha usage metrics. By this point, we had already finished developing the first version of the database. Considering that we had planned to work on this application for the entire month, it was a small victory for the team. However, the reason for the speedy development was a result of gaining a deeper understanding on the requirements, not some burst of productivity. It was a lesson on how expectations may change rapidly and a good introduction to adapting while we’re here. By Tuesday we had a solid first version of the report charts and prepared to dive into new projects with the entire team.
We look forward to what future weekends hold for Tech in the World!
The view from Sam’s house in the suburbs of Dar es Salaam.
09 1 / 2013
Journal: Day 15 in Tanzania
On Monday, our team visited the offices of D-Tree International, gave a 2.5-hr workshop on web security at the Dar es Salaam Institute of Technology (DIT), and met with researchers at the Ifakara Health Institute (IHI).
On Monday, we had an incredibly packed day full of exciting meetings. It’s so incredible to learn from such a diverse group of people: an international NGO, local university students, and a local research institution. We have a great time at these meetings and events, but we limit the number of meetings we have out of the office to ensure we have enough time to build good software for APHFTA. So far, I think we’ve been striking a great balance.
In the morning, Christian and I headed out to the Tanzania offices of D-Tree International, about a 45-minute taxi ride north of Safari Inn, where we are staying. D-Tree is an NGO started out of the Harvard School of Public Health that creates mobile applications that guide point-of-care clinical decision-making. Christian and I had the fortunate opportunity to meet with D-Tree’s Tanzania Country Director, Director of Field Operations, and IT Manager, who took the time to show us their latest Android-based maternal health application.
Christian and I were both thoroughly impressed by D-Tree’s maternal health application. In particular, we were impressed by its usability and its ability to provide immediate value to the user. The app provides (in our opinion) a very usable registration data input flow using a module from Open Data Kit. Once the data has been entered, the application will automatically and immediately identify risk factors and recommend treatment or referral to a hospital, based on standard protocols in maternal health. For example, a health worker using the app may input data for a woman during her second antenatal care visit, and if the app finds that her weight actually dropped since her first visit, it will automatically notify the health worker. This is all done without any need to look over the data to identify risk factors, or even the need for a skilled professional in maternal health. We were impressed that D-Tree’s app provided immediate clinical value to its user, while at the same time having data collection as a natural side effect. In contrast, many current mHealth solutions focus only on data collection.
We found the mobile application an interesting contrast with mMaisha, the web-based software that we are working on at APHFTA. On one hand, a mobile application requires less training, needs less infrastructure, and is cheaper, which means that it can be more widely deployed and put in the hands of more people. On the other hand, a web-based software is vastly more powerful and can provide many more features not available on a phone.
Web Security Workshop at DIT
Meanwhile, Salvatore, Joshua, and Mateus spent the afternoon at the Dar es Salaam Institute of Technology (DIT) leading a workshop on web security, attended by over 60 university students. In our discussions with DIT students last week, we noted that many were interested in a workshop on web security, so Salvatore and Joshua spent some time putting together a presentation on common security exploits. The 2.5-hour presentation covered SQL injections, cross-site scripting, cross-site request forgeries, password hashing, HTTP GET vs POST requests, front-end validations, and session hijacking.
In addition to the presentation, Salvatore and Joshua also wrote code for a basic website that is vulnerable to basic security exploits. The students had the opportunity to exploit these vulnerabilities to learn how they worked, and also to see the code changes needed to protect a website from these vulnerabilities. Overall, the students thoroughly enjoyed the presentation, and we are planning on returning again soon for a seminar on Kohana, a popular PHP framework!
Lunch with Ifakara Health Institute Researchers
After our meeting with D-Tree, Christian and I met with Isaac, Daniel, and Zach, three researchers at the Ifakara Health Institute. These three were extremely bright fellows with computer science backgrounds developing various technologies for health in Tanzania. Two of them told us they worked in “mobile surveillance,” a field they assured us was not at all what it might sound like but was something involving real-time data collection and visualization.
Zach, Brandon, Christian, Daniel, and Isaac at lunch!
They were very excited to meet with us and keen to impress upon us the unique challenges of developing technology for health in Tanzania. Many current cutting-edge technologies are designed in a Western setting, where the challenges differ significantly from those in a resource-poor settings like rural Tanzania. For example, one particular notable challenge for many implementations of technology solutions in Tanzania is poor internet connectivity. Although the telecommunications industry has made enormous strides in providing cellular data access to the majority of the country, the coverage is still sparse enough that it is a significant headache for data collection and transmission in the field.
This is just one of the unique challenges that technologists at IHI face in their daily work, and they were appreciative of the fact that our team has come to Tanzania to experience these challenges, because it is easy to be unaware of them when developing technologies remotely from the States. In particular, Zach expressed his belief that our team would better innovate effective technology solutions, now that we have had a chance to see first-hand the environment where they would be deployed.
Otherwise, the team has been doing phenomenally and having an amazing time here in Dar es Salaam (apart from a few upset stomachs…). We have a few favorite go-to places for lunch and dinner now, discovered an amazing bread called chapati, fallen in love with a delicious dish called chips mayai, and picked up a few words of Swahili. We plan on doing a blog post covering some of the more routine moments of our trip sometime!