Hi Eric, I'm working with Steve Conrad on the Heal Africa IT trip coming up soon. I'm pretty much the technical lead on the trip. I wanted to touch base with you on a few items that hopefully you can provide me with good information on.

First, just a little about me so you can know where my IT knowledge level is. I'm a enterprise server administration specialist for IBM global services, so pretty much I work as part of a team which provides steady state support for a few thousand unix and windows systems on account with one of the major investment companies in the country. I'm cisco certified (CCNA). I have extensive experience designing, deploying, configuring, and supporting extensive wired and wireless networks as well as phone systems including all the cabling install work. Pretty much my bread and butter for the past decade plus has been major enterprise infrastructure work for major healthcare and financial services companies. Oh yeah, and I have systems admin software development experience and DBA expertise as well.

Second, before getting into what I need to know, can you tell me a little about what projects you have been working on with them that are still open that you'd like help getting wrapped up? Also, what are the needs you are aware of that currently are not being met, or need to be beefed up, modified etc? If there's a few I'd love to have your opinion on which ones should take top priority.

Ok, so that said, here's what I'm working on now and planning on bringing over there. I have a new IBM system x series server, brand new and equipped with redundant disk drives and power supplies. With the server I'm planning on providing a samba file share for data sharing, and I'm planning on deploying OpenMRS on it today to evaluate it as a hospital-wide EMR. I've been working with Pytchen to gather information on what data is being charted now to find out if we can easily chart that. I may also be able to setup a mail server so that the staff with email can get it from a local server which will download from pop3 sources on the internet making mail access a lot faster than webmail options. IMAP is a possibility as well so that the mail can be stored server-side and backed up. I believe I've found a web based software suite which would allow Pytchen to easily administer users if this functionality was deployed.

We're also planning on running cable to get the hospital networked. I've proposed brining a couple Merkai outdoor with high gain omni antennas to add to the existing system and deploy a mesh network in the compound which will make it easier to do additional networking in the hospital as needed.

So, what I want to know is the following:

Based on the research you have done do you believe OpenMRS to be a good product for Heal Africa? I have looked through a whole mishmash of free EMR products and honestly none of them have been remotely impressive to me. I don't expect to find the quality that I'm used to with commercial EMRs, but all the web demos I've looked at for the free ones so far don't even come close to touching the commercial products and I'm really concerned about usability and product acceptance by the medical staff. I'm strongly inclined to leverage the highly skilled web developer community at Upperroom to roll our own modular emr and deploy it in phases with the most needed parts deployed soonest. That would be a lot more work, but in the long run it could be the best solution. I'd much rather deploy something that already exists though IF it will be a good fit. If it won't be a good fit then it would be best to not try and push a square peg in a round hole.

What is the state of the wireless setup now? Where are the APs located? What do I need to know to manage the APs, ie network addresses and username/password. How is Internet access handled now? I understand there are two paths to the internet, one through rawandatel and one via satellite. I'd like to get a network internet access setup going so that one or both (if possible) internet connections could be shared among all users. To this purpose, do they have a firewall there or would I need to bring one? Also, in your opinion what is the feasibility of setting up remote access to the Heal Africa network? I would love to be able to access the server remotely from the states even if it is very slow because this would allow people doing IT support for Heal Africa a way to develop and deploy EMR pieces remotely as well as a way to support remotely.

If they have a network there now, how is addressing and DNS handled?

Do you think they could benifit from a web proxy cache like squid (http://www.squid-cache.org/)?

As a US IT guy what are the pitfalls and frustrations I'm going to run into?

What kind of tools does Pytchen need that he doesn't currently have?

I think that wraps it up for now, I look forward to hearing back from you. Oh yeah, I have checked out your heal africa wiki. I'll make sure I keep good documentation while over there so that I can help provide updates to the information on the wiki.

Thanks! Erik Jerde erik@jerde.org

Cc: Judy Anderson judy@healafrica.org, Melissa melissa.ho@gmail.com, Steve Conrad stevec@cpconline.org

Hello, Erik. You must be excited to go! Apologies for the delay. I finally got around to reviewing all of my emails with Melissa and others and folding all of the bits and pieces of information into the wiki. The overview of various ICT projects is now up-to-date on the front page:

http://healafrica.ericnguyen.com

I'll create your account for it, shortly. Once you have access, feel free to add to it. I'm also open to more robust collaboration software, if you have something else in mind; it will be easy later on to copy over the handful of pages.

Side note: I just figured out how to watch edits to the wiki, using this feed:

http://healafrica.ericnguyen.com/feed.php?type=rss2&num=10

Okay, onwards to the actual content of the message. Most of your questions are now answered by the wiki, but I'll give brief answers and some links, here.

OpenMRS: As I note on the wiki, OpenMRS currently seems to be well-suited to the HIV Pediatrics Ward but not hospital-wide, since it doesn't manage aspects of the operations such as billing or calendaring. Also, depending on how long you are there, OpenMRS may be too lengthy of a project. You could probably get an installation up and running pretty quickly, but the slower tasks are to a) model the data, intake forms, and reporting properly, and b) training the staff to get them to trust the system enough to use it.

I saw a message from Steve mentioning that you would be focusing on getting the networking solid across the hospital and installing a robust, centralized file server. I agree that this is the first step, and will benefit the hospital greatly. In addition to this, you can move the mid- and long-term efforts forward by collecting information about the data the hospital takes in and puts out. I've scanned in the input forms for the HIV Pediatrics Ward and posted them on the wiki, for example; it would be great if you could get your hands on copies of the reports that that ward puts out. The same goes for the hospital in general. Once we have this data in some centralized place like the wiki, developing a hospital management system remotely becomes much more feasible.

Local caching of email and general web files sounds like a great idea, too. I certainly don't have more experience than you in these matters, but I will say that much of the internet traffic does seem to go to a few dozen big sites (webmail, mostly), so caching might help a great deal. Additionally, some references might be useful on-site. A copy of Wikipedia might be a good start, for example.

Melissa, when you have a chance, could you answer some questions that Erik had, too? I've put them on the wiki:

• Is there a firewall in front of the HEAL networks?
• Do the Terracom connections give the hospital a fixed IP address? (More generally, how feasible will remote server administration be?)
• How are addressing and DNS handled?
• Would the hospital benefit from a web proxy cache like squid?

There are other question marks here and there in the wiki text, as well. Please feel free to update it wherever you know answers of the top of your head.

As a US IT guy what are the pitfalls and frustrations I'm going to run into?

The big problem that I ran into was low bandwidth. This one aspect of working in Goma had a hundred unforeseen ripple effects that negatively impacted my workflow. It's amazing how much of my day-to-day knowledge comes from the cloud. I must do hundreds of google searches a day. In a low-bandwidth environment, I actually feel like I'm thinking a lot slower. I'll be working on something, go to look a piece of it up, and by the time I have what I need, I've forgotten why I went to get it. I found myself making lists…

Also, try to get everything you need, beforehand. A missing patch or upgrade in your software can cost you half a day or more of downloading. Power outages are also frequent, so expect your work to be interrupted. Extra power adapters or surge protectors are also useful; I had my adapter die during my trip, with disastrous consequences.

Okay, a few final notes: First, when are you leaving for Goma (if you haven't yet?) I have a laptop that I'd like to send over with you guys to leave there; It's a decent Sony Vaio, and I can FedEx it over to you. Also, there are a handful of miscellaneous projects that you can help move forward without too much effort. That scanner software for Fred Kahunde is a good example; It's just a download that takes us a minute, but is virtually impossible to complete, over there.

Good luck, guys! I miss Goma a lot, actually. My biggest regrets were that I didn't prepare well enough to be as productive as I could have been, while I was there. Hopefully, as we build our store of information, each ICT team will be able to do more and more for the community there.

Thanks, Eric

To: Eric Nguyen eric@ericnguyen.com, Erik Jerde erik@jerde.org

Cc: Judy Anderson judy@healafrica.org, Steve Conrad stevec@cpconline.org

Hi all,

Wow! I'm looking forward to hearing about everything you guys get done there. When do you leave and how long are you staying? Next time (i.e. after my qualifying exam in May), let me know when you are going, and I'll see if I can schedule one of my research trips (to Uganda) such that I can join you in Goma.

Quick administrative thing - Meraki is shipping me a replacement outdoor router for the one the one that stopped working. Who is going out next, and where should I send it once I get it?

On Meraki in general (this is for the techies, not Judy): the software on the devices is very good for sharing internet access, but not so good for setting up an intranet. People I have worked with have suggested taking the hardware and flashing it with a more vanilla linux installation, so you'll have more control over the routing and IP addressing. Alternatively, we could use the one of the Ubiquity LiteStation platforms. The list price (without antenna) is $189, but I think I could get them for about $99 by talking to the CEO directly. Or we could get a Powerstation ($159), which is is an integrated solution built into the antenna.

LiteStation: http://www.wisp-router.com/wri/itemdesc.asp?ic=PS2%2DD&eq=&Tp=

PowerStation: http://www.wisp-router.com/wri/itemdesc.asp?ic=PS2%2D18V&eq=&Tp=

Ubiquiti: http://ubnt.com/

(Context: my research group does work on long distance wireless links using 802.11 hardware, in particular for Aravind Eye Hospitals telemedicine network, aka WiLDNet.)

On EMR platforms..

It has come to my attention recently that the VA has released their EMR software as open source (called Vista, http://www.hardhats.org/ ). Since they are widely known to have one of the best EMR systems, it's worth taking a closer look. Instinctively - I'm sure they have integrated billing, but of course the system is designed for the Veteran's Authority, so it might be less flexible than we would need for the type of healthcare offered in Africa. Not all african patients are veterans of the US Army. I haven't had a chance to look at it more in depth - if any of you have, I'd appreciate any insights you might

I saw a message from Steve mentioning that you would be focusing on getting the networking solid across the hospital and installing a robust, centralized file server. I agree that this is the first step, and will benefit the hospital greatly. In addition to this, you can move the mid- and

Woohoo! This is great news - I keep thinking how hard it is to think about doing an EMR when we don't even have a network or file server. So it's really great that HEAL Africa is getting both the server and the experts to set it up!

long-term efforts forward by collecting information about the data the hospital takes in and puts out. I've scanned in the input forms for the HIV Pediatrics Ward and posted them on the wiki, for example; it would be great if you could get your hands on copies of the reports that that ward puts out. The same goes for the hospital in general. Once we have this data in some centralized place like the wiki, developing a hospital management system remotely becomes much more feasible.

It's early to worry about this but at some point it might be good to scope out hiring data entry people to input old records into the database. Someone in the pharmacy (his name slips my mind) has an excel sheet that maps patient names to visit dates and patient id numbers. They use this for patients that forget their id number (basically a sequence number and the year of their first visit), so they can look it up and find the file. There's a records room also near the admin block where two nurses administer and sort the records - basically distributing active records to the wards and the outpatient block. Active records are separately filed (i.e. stacked on a shelf) in the individual wards. For outpatients I think they leave them in the outpatient ward for about a week, in case they come back for a follow-up visit, and then they return them to the records room for filing. Each of the inpatient wards might also keep their own set of records for each patient. The Pediatric HIV clinic keeps its records entirely separate - they are on a bookshelf in Dr. Vindu's office. Each ward also keeps a log book that contains one line for each patient, numbered for each day of admission, and including name, village, symptoms/reason, diagnosis, and checkout date. And the id/serial number. At heal africa they use real logbooks - in many rural health clinics I've visited, they use the exercise books that the children use for school.

Local caching of email and general web files sounds like a great idea, too. I certainly don't have more experience than you in these matters, but I will say that much of the internet traffic does seem to go to a few dozen big sites (webmail, mostly), so caching might help a great deal. Additionally, some references might be useful on-site. A copy of Wikipedia might be a good start, for example.

You might want to give people a tutorial on how to use Outlook/Eudora to download their mail. Lyn and others are very familiar with this, but I suspect the average user is not. Wikipedia does a sqldump every day that you can copy locally, possibly including diff files, so you don't have to download the whole thing every time. Make sure you get the french version. I don't know if there is a sql version as well. For that matter if you could get access to a good medical encyclopedia, or reference e-books, that would be great. I'm looking at various software available for Palm pilots and smartphones as well. There are a lot of reference materials available - at least in English and German. There are probably some french things out there too. I was thinking it would be good to either find or set up a program where doctors could donate their old palm pilots for distribution in rural health clinics. I've been sharing my palm-based bible and various medical calculators with users in uganda, and they've been extremely grateful. In terms of references - my doctor subscribes to Epocrates for the Sx and Dx databases. They have a free Rx database, including most western country prescriptions, but not including the all the drugs used in Africa (e.g. Coartem).

Palm-based Medical Software: http://palmdoc.net/?page_id=1183 Epocrates: http://www.epocrates.com/

Melissa, when you have a chance, could you answer some questions that Erik had, too? I've put them on the wiki:

I forgot my wiki login. =P

Is there a firewall in front of the HEAL networks?

This is a better question for Pytchen. Even if there is a firewall in the Jubilee Center, I think there should be a separate firewall around the fileserver and any place where medical data is to be stored. I believe all the computers in the computer lab have the windows firewall enabled - I don't know if they have a separate firewall for the whole setup.

By the way, Steve probably explained this to you already, but the set-up is like this. If you look at aerial photos of HEAL Africa, you'll see a main hospital complex closer to the circle in the middle of Goma, and then a separate campus sort of diagonally across the street, with one long building and then a larger tall building. The larger building is the Jubilee Center, the long building is the pediatric HIV clinic and fistula ward (i don't know if they actually call it that), and there is a chapel next to the HIV clinic. On the third floor of the Jubilee Center they have an Internet room and attached library. The library is basically the size of a large walkin closet, and also houses the desktops and servers they use to administer the internet room. (this set up may have been moved out of the library and into this odd wooden structure in the middle of the internet room). There is a small antenna+router bolted to the outside of the building that has a PoE (power over ethernet) cable running into the library, which serves as their internet access point - it's basically a wifi link to the ISP. The Internet room has 7 desktops, all plugged into a hub shared with a wireless access point, which serves basically any laptops in that room. There's also a meraki outdoor router plugged into this hub, which is hanging on the windowsill, in line of sight to the other outdoor router on the corner of the main hospital campus. At the same time, several people also connect to the internet using MTN gprs usb cards, and there's the Terracom/Rwandatel PCMCIA evdo card (which is labeled Verizon Wireless). I guess the other advantage of the meraki routers is they also allow sharing of several internet connections across the wireless network. The main hospital campus is a little ways away from the Jubilee center, so it doesn't actually have a network connection, except through the mobile-phone-network-based wireless modems. You can contact Pytchen and Jacques (the sysadmins) by email directly: “Jacques Israel” jacques.israel@gmail.com, “Pytchen Kalonda” pytchen@gmail.com,

A picture of the wifi router and the meraki (also wifi) router is here: http://flickr.com/photos/melissaho/1163887726/in/set-72157601893109002/

You can't quite see the wifi router - just the top half of the antenna on the bottom left of the picture, which is white against a white background.

Do the Terracom connections give the hospital a fixed IP address? (More generally,

No fixed IP address - I think you get a new one each time you dial up. What we've generally done is to set up an ssh tunnel so we could remotely administer servers located behind firewalls. If you need it, we've got ssh-over-http proxy scripts somewhere. The merakis are administrable remotely as long as they are connected to the Internet.

How are addressing and DNS handled?

Automatic configuration from the ISP router, in general, same with the modems. Other computers get IP addresses via DHCP. I think from the ISP router as well. Wireless of course gets it's IP address via DHCP and assigns a different block of addresses.

Would the hospital benefit from a web proxy cache like squid?

Probably maybe? It won't be useful for webmail of course, but might be useful for download of documents, or if a bunch of people are looking at the same web sites. Especially when the Internet connection is down or excessively slow. But it's not critical. How does squid currently deal with blog content? It's generally much better with static pages that don't have odd meta tags entailing immediate expiration of the content…

As a US IT guy what are the pitfalls and frustrations I'm going to run into?

The big thing will be the power outages. I know the server you described has backup-everything, but US-based equipment just isn't designed to handle weekly several-hour-long power outages. In addition to networking the campus, the Internet room, and the hospital sorely needs some sort of battery backup system, preferably one that charges off of grid power, possibly one that also uses solar power (to reduce load on the grid). Right now if the power goes out all of the computers power off immediately - they don't even have UPSes. Which in general, are also not designed for frequent power outages. My best suggestion is to get a bank of deep cycle batteries (from somewhere local) and attach it to a charge controller for use as an all-hospital interim backup between when grid power goes out and when they get the generator started. You might even do two setups, one for the jubilee center and one for the main hospital. It might be also useful to get a voltage regulator, so you can clean up the power before sending it to the computers. We've monitored grid power voltage in various countries, and in addition to the power outages, there are frequent power spikes that could easily burn out any connected equipment. So whatever you plug into grid power, you should put some sort of short-able protection between the grid and your equipment. They have fridge-guards (~ $40) that work well for this type of thing, but a simple set up with a fuse (an lots of spare fuses) would work well too… and possibly be cheaper in the long run.

The other thing will be the lack of spare parts. So when the ld meraki router fails, you can't do anything about it until you get another meraki router. Or when your laptop power adapter fries unexpectedly, then you have to hunt around and probably even return to kigali to get a replacement. In the past 2 years or so my group has lost at least 3-4 power adapters that way. Also, if you haven't traveled a lot, you'll want to make sure all of your powered equipment is rated for 110-240v, and not just 110, or you'll need a step down transformer.

Random cultural things - attempting to communicate may be frustrating, unless you are fluent in french and/or swahili. And doing things can take a long time just because people have a different sense of time. Sometimes they are so busy doing a lot of things at once that even when you need them to be somewhere at a particular moment, they are nowhere to be found, because they are off doing something else that is absolutely critical. So it helps to be laid back at least until you figure out the rhythm of how things are done there. I know it is hard when you have a very specific schedule for a rather short trip. In general the HEAL Africa is very accommodating and understanding of the western-time-sense, so they'll work with your schedule as much as possible. If you tell them what you need at what time, and where and when you want to meet people, they will try to be there. But they also tend to schedule in morning/noon/afternoon blocks rather than hourly blocks. And they often forget to tell you ahead of time if they have things like exams or classes or vacations. =P As long as you don't get frustrated, I'm sure you'll be able to cope.

The big problem that I ran into was low bandwidth. This one aspect of working in Goma had a hundred unforeseen ripple effects that negatively impacted my workflow. It's amazing how much of my day-to-day knowledge comes from the cloud. I must do hundreds of google searches a day. In a low-bandwidth environment, I actually feel like I'm thinking a lot slower. I'll be working on something, go to look a piece of it up, and by the time I have what I need, I've forgotten why I went to get it. I found myself making lists…

Oh yeah - download anything you need to download before you come!

Hmm.. You should also teach people how to down load AVG updates and share them via USB key. For that matter you should disable autorun on all the windows computers, since that is the biggest target for trojan horses. And not just for cds, but for USB drive as well, since most viruses these days get spread by USB key: http://www.howtogeek.com/howto/windows/disable-autoplay-of-audio-cds-and-usb-drives/

Everyone I meet could do with some good anti-virus and spam/fishing training. I don't think people understand these threats nearly well enough.

Also, try to get everything you need, beforehand. A missing patch or upgrade in your software can cost you half a day or more of downloading. Power outages are also frequent, so expect your work to be interrupted. Extra power adapters or surge protectors are also useful; I had my adapter die during my trip, with disastrous consequences.

Yes! Spare parts are good. Extra batteries are good. Backup power is critical! Also make sure you bring any backup/restore cds you have with you. Even if you don't need them, someone else will. If it is easier you can store diskimages on a portable hard drive.

Second, before getting into what I need to know, can you tell me a little about what projects you have been working on with them that are still open that you'd like help getting wrapped up? Also, what are the needs you are aware of that currently are not being met, or need to be beefed up, modified etc? If there's a few I'd love to have your opinion on which ones should take top priority.

I think the thing not mentioned is that Lyn really wants a way to interface between her excel spreadsheets and her quickbook records. This would be solved by a good EMR system, but if there's a quick fix in the meantime, that would be good.

Oh.. hmm you might want to also get Pytchen to do a hard backup of the fileserver (at least any critical files) every night, actually physically shipping the data to some other city once a week or once a month.

And if it is possible, ask around and see if you can find where you can find good data entry clerks.

if we can easily chart that. I may also be able to setup a mail server so that the staff with email can get it from a local server which will download from pop3 sources on the internet making mail access a lot faster than webmail options. IMAP is a possibility as well so that the mail can be stored server-side and backed up. I believe I've found a web based software suite which would allow Pytchen to easily administer users if this functionality was deployed.

The best open source system I've seen for this kind of administration is GNU Horde: http://www.horde.org/projects.php

There's also squirrel mail but I really really dislike their user interface. The uphill battle you'll face with this is getting people to get used to using a local heal-africa email address instead of their web-based accounts. But maybe you can set up some sort of interim mailserver that downloads their email from gmail accounts? Or just teach them how to set up mail forwarding.

We're also planning on running cable to get the hospital networked. I've proposed brining a couple Merkai outdoor with high gain omni antennas to add to the existing system and deploy a mesh network in the compound which will make it easier to do additional networking in the hospital as needed.

There is one working outdoor router, and one burnt-out one, which Sanjit Biswas (Meraki's CEO/Founder) has promised to replace. By the way - Sanjit also asked me to come present to Meraki on what's been done in the Congo so far. I said maybe in May - it would be great if one of you could join me? or even just come give the presentation. But I don't know if you'll be passing through the bay area.

product acceptance by the medical staff. I'm strongly inclined to leverage the highly skilled web developer community at Upperroom to roll our own modular emr and deploy it in phases with the most needed parts deployed soonest. That would be a lot more work, but in the long run it could be the best solution. I'd much rather deploy something that already exists though IF it will be a good fit. If it won't be a good fit then it would be best to not try and push a square peg in a round hole.

If you have them roll out an EMR system, it would be great if they did it in compliance with the existing standards (e.g. DICOM, HL7, DC9, etc), just for future integration with other EMR systems. My suggestion would actually be that they start contributing to some existing open source EMR project (e.g. OpenMRS or Vista), so that their work could also be leveraged for other hospitals in developing countries.

What is the state of the wireless setup now? Where are the APs located? What do I need to know to manage the APs, ie network addresses and username/password.

I think the meraki login and password is on the wiki? If I remember the password I can also add you as an administrator. I think there are also 3 indoor meraki routers there, none of which are currently in use?

One frustrating thing about the jubilee center is that they didn't integrate ethernet cabling when they built it, and there are really good places to run wires. I think you'll have to either go with a wireless solution (not ideal for the long hallways and concrete walls) or just have lots of little wire nails so you can run the cables across the ceiling.

How is Internet access handled now? I understand there are two paths to the internet, one through rawandatel and one via satellite. I'd like to get a network

Sort of. There's the RwandaTel PC card, and then there's the ISP connection, which is via a wifi connection to the ISP in Goma. The ISP then has a VSAT connection that they resell to various NGOs in the area. There is VSAT equipment there, but they are no longer using that equipment - since subscribing directly to the VSAT service was extremely expensive, even for shared (and very congested) service.

internet access setup going so that one or both (if possible) internet connections could be shared among all users. To this purpose, do they have a firewall there or would I need to bring one? Also, in your opinion what is the feasibility of

Shorewall on a single-board computer would work well as a firewall. And as I mentioned before, meraki can share both connections opportunistically.

setting up remote access to the Heal Africa network? I would love to be able to access the server remotely from the states even if it is very slow because this would allow people doing IT support for Heal Africa a way to develop and deploy EMR pieces remotely as well as a way to support remotely.

Bear in mind that the connection is very slow. You may want a way to do delay-tolerant remote management. (Think Mars Rover programing with periodic occlusions.) So set it up so you can send commands in a batch, scheduling them to be run at a particular time. And set it up so you get maintenance information pushed to you on a regular basis.

You could try looking at the software we use for remote monitoring.. but I think it only publishes to our website, and is tailored for wireless network monitoring. If it approximates something you want though, I can get the source code for you:

http://tier-phonehome.cs.berkeley.edu/

Okay I think that about covers everything. Let me know if you have any additional questions. And if I can send a meraki router your way. :)

Melissa – http://www.ictdchick.com/blog

To: Melissa Ho mho@ischool.berkeley.edu, Eric Nguyen eric@ericnguyen.com, Erik Jerde erik@jerde.org

Hey Melissa (and Eric and Erik),

We did get a network of 5 Merakis installed at the hospital. However, like you said, they are really more geared toward internet as opposed to intranet. I am intrigued by the idea of flashing them to install new firmware. Do you have any links or info on how we could do that.

We have physical cabling installed through some of the hospital and Jubilee center. If we could use that in conjunction with ‘modified’ Meraki’s, I think that would be a potentially great solution.

Thanks,

Steve

To: Steve Conrad stevec@cpconline.org

Cc: Eric Nguyen eric@ericnguyen.com, Erik Jerde erik@jerde.org

I've never tried it but there's lots of other people that have.

The flavor of linux you probably want is OpenWRT. The software is probably monowall: http://m0n0.ch/wall/ http://openwrt.org/

This seems relatively simple: http://www.maco.sk/wireless/meraki/openwrt.html

You'll need a linux machine. If you don't have one, then you can probably download a vmware image and use vmplayer. http://www.vmware.com/appliances/directory/ http://www.vmware.com/download/player/download.html

Some complicated but thorough instructions: http://wiki.openwrt.org/OpenWrtDocs/Hardware/Meraki/Mini

I'll also ask around ask to what the best configuration (routing, etc) is for a local area network over mesh wireless.

You should also look at the Ubiquiti powerstations - which come with standard linux software instead of the complicated meraki stuff.

Melissa

To: Melissa Ho mho@ischool.berkeley.edu

Cc: Steve Conrad stevec@cpconline.org, Eric Nguyen eric@ericnguyen.com

The OpenWRT on the meraki hardware looks like a real good solution for the issues I've found with this hardware. I really like the meraki outdoor hardware, but the software is a major drag, even when upgraded to the pro version. I'm thinking I'll call Meraki and have them downgrade the existing network back to standard, then order 2 more outdoor units and get them setup with OpenWRT and get a document together on configuring them so we can easily add more as necessary.

Assuming that all works then the next step would be to either put together a system where someone in Goma can upgrade. I'm skeptical of this being able to come together, but we'll see what I can put together. If it appears to be too complicated then we'll have to find a way to get the units back to the states. Does anyone know if it is possible to ship to/from Kigali?

The Ubiquiti powerstations look real interesting, mostly because of the distance they claim to be able to cover. There was some discussion when I was there of trying to find a way to tie the Lusi's compound into the hospital network so that Lyn and could work from home more easily, especially in light of the hopeful deployment of some server-based apps. There is the problem of the big hill between the hospital and the compound, I wasn't able to get up on the top of the Jubilee center with binoculars to see if there might be a line of sight between the two places. Melissa, do you have any thoughts on covering that distance?

-Erik

To: Erik Jerde erik@jerde.org

Cc: Steve Conrad stevec@cpconline.org, Eric Nguyen eric@ericnguyen.com

I'll probably head out to Goma in August sometime. I'll have to go to Uganda to make arrangements for my long term fieldwork. And by November I should be situated in Uganda for a year, at which point I'll try to go to Goma about once a month.

In case it helps, you can refer to my research group's web page on getting point-to-point Wifi working over long distances: http://tier.cs.berkeley.edu/wiki/Wireless

Our longest link is 382km, between a couple of mountains in Venezuela. Basically - the wireless protocol can go about 70km without a problem, after which the throughput starts dropping off unless you adjust the ACK timeout. We (TIER) have a driver for wifi hardware that eliminates that problem by completely reworking the protocol. As long as you have a good enough antenna, a signal booster, and line of sight, you can go pretty much any distance. In any case, we (i.e. healafrica) doesn't need the modified protocol since we're not doing long distances. Later, however, we might be able to think about doing some links to the rural health clinics.

So the obstacle we'll have to worry about is line-of-sight+fresnel-zone. Which we can't do much about if there is a serious obstacle in the way (e.g. a hill). In our deployments we've gotten around that by putting a relay on the hill, but I don't know if we'll be allowed to do that here? And the Lusi's place is set in a little mini-valley, which compounds the problem.

We had discussed possibly doing a wireless link to their next door neighbors, who do have Internet access. But if you want a link to the hospital directly… you might have to build a tower somewhere on their property, and a tower next to the jubilee center. Which, depending on the height, would probably be prohibitively expensive. (e.g. a 25m tower in Ghana costs $15,000, and needs to be replaced every 5 years, because they can't find enough galvanized steel.)

The other way around it is to use frequency shifters and transmit over a non-line-of-sight band like UHF. But we'd have to make sure that's legal in the Congo - usually you have to license those frequencies, and this would require a big chunk of the UHF band.

Oh, and if it makes sense I can try to drop by Minnesota sometime this summer before I go to Africa again.

Melissa