Network Installation for Heal Africa Hospital

Installed and tested by Paul Bakes as part of the Australian team September 2008

The Australian medical team identified the need for basic network (LAN) functionality in the hospital after one of their regular visits in 2007. They reported the benefits for Heal Africa administration if there was sharing and central storage of relevant hospital data. David Kelly, as part of his audit of administrative functions within the hospital, also identified a similar need. There is already a limited network in the Jubilee Centre.

Consequently a strategy was developed, in conjunction with David, to provide the interim infrastructure for this LAN at the end of his stay in Goma, September 2008. During subsequent visits, we will expand this modest start and also work with Heal Africa staff to help them identify the benefits a LAN might bring to their various roles within the hospital.

Multiple visits by IT personnel will be required in order to complete the networking project and to continue training Pytchen to maintain it. It is anticipated that close liaison with David Kelly will be vital to success and coinciding IT trips with his visits may be advantageous.

The ultimate goal is to provide the hospital with a reliable LAN that facilitates day to day work procedures. A comprehensive Patient Management software package is desirable as part of the completed package. However in the short term, we have started with the modest goal of getting enough cable installed to allow the following:

• QuickBooks to be centrally located, allowing staff to work with one, up to date data file
• A central backup location for important hospital data
• An automatic backup routine for this data
• Basic network communications for relevant workstations

It is recognised that most cabling in this first round is only a temporary solution for the hospital until new buildings are completed. It is important to stress that the current stage is only the first step in what will be an ongoing process. Consequently, the cabling this trip has not been installed in any permanent fashion in order to allow for easy removal when buildings are demolished. It will take time to achieve our ultimate goal – to provide the hospital with a LAN that allows effective management of patient progress through the hospital and the required administrative procedures that facilitate this patient care.

A temporary network Communications Centre (Comms Room) has been located in the residents’ room in the back corner of the main reception building. There is no science involved in the choice of this room; it is purely a pragmatic decision for the short term. The equipment installed does not impact the designated use of the room for the residents. The room also provides a roughly central location from which to run cables in both directions. It is preferable that a permanent comms location be incorporated into the rebuilding process.

A cable runs externally from the comms room to the hospital administrator’s office (Patrice). It is not a “pretty” solution, however it achieves its purpose. A 16 port switch is located in the administrator’s room. It is a larger switch than is necessary at present but it allows for additional computers to be connected in the rooms adjacent to the administrator’s office including the pharmacy. A more suitably sized switch will be brought next trip allowing the larger switch to be relocated.

Further cables run internally from the comms room through the roof space to the Laboratory, Dr Kimona’s office and the 2 Reception offices. Cables are simply run through the ceiling and terminated in each room. A further 3 cables continue across the walkway to the next building. One cable is terminated in the accountant’s office (Fannie) and the remaining 2 are terminated in the billing office next door.

No patch data cabinet and panel have been provided. Each cable is directly connected to a switch.

A small, home user style Network Attached Storage device (NAS) has been installed on the network. It is a Netgear ReadyNAS device and is located in the hospital administrator’s room, attached to the 16 port switch mentioned above. The NAS has 2 x 500GB hard drives installed in a mirror RAID configuration. The NAS uses Netgear’s X RAID technology and therefore is not a true RAID 1 device, however it is easily managed by software installed on the administrator’s notebook computer. At present, the NAS is purely a backup device.

A laptop computer has also been located in the hospital administrator’s room. It acts as a server for the hospital network. This will be replaced with a more adequate solution when the time is right and the new buildings are complete.

A router is located in the residents’ room. It currently performs none of the normal router functions apart from providing DHCP services to the network. It also comes with a built-in 8 port switch that is used for network access within the Reception building. An additional 5 port switch is also attached to the router to provide additional network ports for the building.

All the hardware in the resident’s room is connected to a surge protector. It was purchased in Australia and consequently may have little further use around Heal Africa. However, it will protect the hardware until more permanent power protection solutions for the network are investigated and installed.

Recently, 2 Cat 5 cables were run underground between the Jubilee Centre and the Hospital. The first section of this link terminates in a meeting room near the chapel. The second section is a pair of cables that run to the hospital from this meeting room. However after initially having successful communication between the hospital and Jubilee, there is now no communication link. I have tested the cables to determine the cause of the fault. Both runs of cable are faulty. That is, both cables that run from Jubilee to the meeting room are damaged and both cables that run from the meeting room to the hospital are also faulty.

I am not sure that is it worth the trouble and expense to replace these cables. A better, more robust solution should be researched instead. However I think the question needs to be answered first: Is a link between both buildings necessary, is it part of the overall business plan? Once this can be answered satisfactorily, a solution can be found if required.

During our stay, a number of notebook computers were delivered for the residents. The computers are approximately 3 years old and have been sourced from USA or Canada. These are to become personal computers, with a small amount deducted from the doctors’ salaries each month. It is mandated by Heal Africa that the doctors become computer literate. Another 3 or 4 new computers were brought to Heal Africa when a staff member returned from holidays in the US. There appeared to be no strategy in the dispersal of these computers. One was given to Fannie (hospital accountant), another to Stewart who is not an employee of Heal Africa.

Care is needed if computers are donated in greater numbers because of the extra workload that could be placed in Bizi’s lap. If something goes wrong with these computers Bizi and his team will be the front line of support. They already have a big workload with maintenance around the Heal Africa complex.

Once again I suggest that a corporate policy be developed to specify issues like IT goals and strategies for Heal Africa, who has access to Heal Africa IT resources, computer support. It would also be useful for Heal Africa to have some written guidelines for donations in general, but computers specifically.

I recommend that serious consideration be given to internet provision at Heal Africa. The current “corporate” wireless service runs at dial-up modem speed and provides internet capacity for up to 10 networked computers in the Jubilee Centre and any number of wireless connections. All these computers accessing a slow connection result in a very frustrating internet and email experience. Doctors and other hospital staff are required to come to Jubilee to check email and research on the internet. I believe that productivity would be increased with a faster connection. Of course there is the need to balance this with the potential for abuse that a faster internet connection may bring. It may be that the best solution for Heal Africa would be to provide two separate internet connections – one for the hospital and the other for Jubilee.

Some research into internet requirements for the whole organisation is needed with follow up discussion at leadership level to determine what is in line with corporate goals. However initially, I feel that the current connection could easily be moved to the hospital and would be satisfactory for 2 or 3 computers to access the internet and email on that side of the road. A faster connection would benefit the administrative users in the Jubilee Centre. If it is viable to install a broadband connection in Jubilee, the on-going cost could be subsidised in part, by a small contribution from each of the project offices that utilise it. Visitors who make regular use of the system should also contribute to the cost as the primary purpose of any internet connection is for organisational use not for visitors.

As noted above, the current link between Heal Africa’s 2 sites is broken in multiple places. Repair is not an option. Replacement cables will be required. Assuming that this link between the 2 sites is required as part of the corporate plan, I recommend that an optical fibre cable be used rather than copper. Unlike copper cable, optical fibre is not susceptible to lightning strikes and has redundancy built in. I also recommend that it be re-routed so that it is not running under trafficable areas where damage can occur (and has already happened). I will investigate the purchase of 150 metres of fibre cable and get it terminated in Australia so we do not have to find someone in Goma to attach and test the pigtail terminators.

It might be possible to run optical fibre cable either under or above the road to the hospital. However I will investigate the possibility of a wireless transmitter on the Jubilee side and a receiver on the hospital side. If this path is taken, it will be necessary to mitigate for potential lightning strikes. Lightning has already claimed a similar device installed previously.

A Patient Management System is being written by an acquaintance of David Kelly in Sydney. At present it is planned to be a database written in MySQL. Further discussion will be required to determine server requirements, location and whether we can teach Pytchen to maintain it. Otherwise it would be necessary to purchase an “off the shelf” package. I will monitor progress and postpone a recommendation until I have more information.

• Installed interim copper cable backbone for the hospital running from the temporary comms room to the administrator’s office
• Installed cable to various offices for connection to the network
• Network hardware installed: switches, router, temporary server, surge protectors and a backup device
• Installed QuickBooks on the server to allow central storage of the accounting data file
• Install backup script to backup all central data to the network storage device

• Tested link cables between Jubilee and hospital
• Installed 2 cables to Virginie’s room to allow internet connection
• Tested a number of faulty laptops; repaired some with hard drives, reformat and replacement power adaptors
• Repaired 2 desktop computers with replacement power supplies
• Upgraded RAM in some of the Internet centre desktop computers
• Installed software on laptops provided for some Jubilee staff by various donors

• Copy QuickBooks data to central location. Accounting staff were not ready for this to be completed during the initial visit
• Dedicated file server for the hospital
• Administration software for the hospital
• Connect various office computers to the network; provide or locate suitable computers in some cases, eg. both reception offices, laboratory
• Run cable into pharmacy from administrator’s office, provide a computer and connect to network
• Check feasibility of providing a network connection to Jo Lusi’s office
• Faster Internet connection
• Adequate link between Jubilee and Hospital if this is deemed strategic

• Future IT trips that focus on hospital administration should be scheduled to coincide with David Kelly’s visits
• New buildings incorporate computer cabling along with electrical cable
• A suitable data/comms centre location to be incorporated into a new building or found in one of the current buildings
• Direction to be given regarding the importance of a data link between the hospital and the Jubilee Centre
• The various support centres outside Congo help provide an adequate internet connection for HEAL Africa
• Consideration be given to a “corporate” IT policy that can give guidance to the many well meaning visitors/staff who like to donate resources and also to give direction regarding maintenance procedures