e-Health : April 2006 Issue by i4d magazine

Vol. IV No. 4

The first monthly magazine on ICT4D

April 2006

Can computers feed the hungry? Rural ICT

Story telling for knowledge sharing - iConnect series Information for development

w w w. i 4 d . c s d m s . i n

e-Health in Africa

Some leading projects in ICT and health

ISSN 0972 - 804X

e-Health

The Stockholm Challenge Award 2006 Finalists in the health category

knowledge for change

The first monthly magazine on ICT4D www.i4donline.net

Contents

Vol. IV No. 4

April 2006

Features Rural ICT Can computers feed the hungry? Maithri Jansz

e-Health perspective

Healing touch to health Ajitha Saravanan, I. Akhtar Sahajad, Dipsikha Sahoo

Benefits from e-Health The little ‘e’ for the health system H. Dominic Covvey

ICT for global health Wireless technology for health Chris Albon

Dictionary Health Informatic, Peru Everything a physician should know! Lady Murrugarra, Franz Calvo, Armando Calvo, Johann Vega Telemedicine Telemedicine and the elusive network-effect Sanjay P Sood, Jagjit Singh Bhatia

Story telling for knowledge sharing e-Health in Africa Stories by: Ramata Soré, John Yarney, Almahady Moustapha Cissé, Michael Malakata

newsletter

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27 News info@i4

The Stockholm Challenge Award 2006 Some leading projects in ICT and health

Report by WHO on HIV/AIDS, March 2006 Global access to HIV therapy tripled in past two years Ajitha Saravanan

Rendezvous conferences curtain 31 Triple raiser, 17 March 2006, Bangkok, Thailand Providing a platform for Asian dialogue

Women’s ICT based Enterprises Workshop, 2-3 March 2006, Kolkata, India Promoting ICT based small businesses Jhumpa Ghosh Ray and Jhulan Ghose

Cisco-NISG 2nd Annual Public Sector Summit, 9-10 March 2006, New Delhi, India ‘Connecting government, empowering citizens’ Prachi Sirur

Sixth Annual Baramati Initiative, 9-11 March 2006, Maharashtra, India ICTs in agriculture Saswati Paik

Columns

35 ICTD project

Mailbox

Books received

45 46

What’s on In Fact

Cover image credit: http://www.maf.org/images/news/drc030610-ref5b.jpg

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Greetings from TakingITGlobal in Toronto. I hope this note finds you well. We are in the process of finalising our Annual Report for 2005, and are making mention of the various media outlets that covered our work during the year. We would definitely like to include i4d magazine! Jocelyn Sweet Development and Communications Coordinator TakingITGlobal, Canada jocelyn@takingitglobal.org

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i4d Editorial Calendar 2006 Month

Theme

January

ICT and evolution process

February

ICT and rural development

March

ICT Policy

April

e-Health

May

ICT and Microfinance

June

Cultural diversity, localisation and ICTs

July

Open content

August

Media and ICTs

September

ICTs and SME

October

Gender and ICT

November

ICTs for the disabled

December

HIV/AIDS

i4d | April 2006

Editorial Information for development

www.i4d.csdms.in

‘Health is wealth’

ADVISORY BOARD M P Narayanan, Chairman, i4d Chin Saik Yoon Southbound Publications, Malaysia Karl Harmsen United Nations University Kenneth Keniston Massachusetts Institute of Technology, USA Mohammed Yunus Grameen Bank, Bangladesh Nagy Hanna e-Leadership Academy, University of Maryland, USA Richard Fuchs IDRC, Canada Rinalia Abdul Rahim Global Knowledge Partnership, Malaysia Walter Fust Swiss Agency for Development and Cooperation, Switzerland Wijayananda Jayaweera UNESCO, France EDITORIAL BOARD

Health is a broad issue, so is the use of ICT in this sector. Health is a parameter of social development which is associated with many other socio-economic factors of any nation. Let’s see how health issues are, to a great extent, related to other social issues. We know that child mortality, maternal health and HIV/AIDS are the sectors which have been specially emphasized by Millennium Development Goals (MDGs) also. Sex determination and female foeticide and infanticide may affect the progress in reduction of child mortality in many regions. Child marriage and violence on women must have an impact on maternal health, and unwanted or forced sex may increase the risk of HIV infection. Therefore, a proper understanding of gender inequalities is very much required to promote the health issues like child mortality, maternal health and sexually transmitted problems like HIV/AIDS. At the same time, health issues broadly indicate the urgent need of promoting women empowerment also.

Akhtar Badshah, Frederick Noronha EDITORIAL TEAM Editor Ravi Gupta Editorial Consultant Jayalakshmi Chittoor Sr Assistant Editor Saswati Paik Research Associate Ajitha Saravanan Designer Bishwajeet Kumar Singh Web Programmer Zia Salahuddin Group Directors Maneesh Prasad, Sanjay Kumar

On the other hand, another major issue that needs to be immediately addressed is the awareness generation about the health related problems and their origin. For example, the blood related diseases like Thalassaemia etc are still not so known to many of the people and many a times, unnecessary rumors arise regarding the same. Here we must remember that health is a sensitive issue with which our ethical sense is very much associated. If a leprosy patient gets hatred from own society, he/she automatically may lose the moral strength to survive with the help of treatment.

i4d G-4 Sector 39, NOIDA, UP, 201 301, India Phone +91 120 250 2180-87 Fax +91 120 250 0060 Email info@i4donline.net Web www.i4d.csdms.in Printed at Yashi Media Works Pvt. Ltd. New Delhi, India i4d is a monthly publication. It is intended for those interested and involved in the use of Information and CommnicationTechnologies for development of underserved communities. It is hoped that it will serve to foster a growing network by keeping the community up to date on many activities in this wide and exciting field. i4d does not necessarily subscribe to the views expressed in this publication. All views expressed in this magazine are those of the contributors. i4d is not responsible or accountable for any loss incurred directly or indirectly as a result of the information provided.

Apart from the social issues, some functional issues are also associated with the issue of health. Health systems cannot function effectively without the help of well trained and adequately paid staff. In parts of sub-Saharan Africa shortage of such staffs is so acute that they limit the potential to scale up programmes aimed at achieving health-related MDGs. This issue must be addressed and actions are required to be taken to ensure proper training of health workers and also their job security. Policies and Programmes on health must be framed within a broad developmental framework that must prioritise growth with equity, social cohesion, social protection, empowerment of the poor, and protection of natural resources. The strategies for improving health should be firmly rooted in entire public policy and its implementation aimed at poverty reduction. In this context ICT has started playing a remarkable role in many countries. This issue will tell you about some of the interesting initiatives.

cc Centre for Science, Development and Media Studies, 2006

i4d is supported by: Ravi Gupta Ravi.Gupta@csdms.in

February 2006 | www.i4d.csdms.in

‘i’ Opener R URAL ICT

Can computers feed the hungry? We have often been asked the question ‘…at a time when many in the country cannot afford the basic necessities of life, is it being excessive to invest in ICT? Can you eat a computer?’ As preposterous as it may sound, perhaps it is something to reflect on; is it really a case of misplaced priorities? I decided to attempt to answer this question. To do this I had to take a journey out of my comfort zone. We travelled 230 km out of Colombo, down dirt roads that narrowed down to foot paths to reach a little school in the remote village of Mahavillachchiya. Here we saw bright smiling faces, so typical of our country, yet they lived in mud huts, travelled by foot or bicycle, had no pipe water and were exposed to harsh natural conditions.

ICT can do… Horizon’s Lanka Foundation of Mahavillachchiya, established back in 1998, has now become a buzz word amongst the ICT community of Sri Lanka. Why? If one visit this village, it is not difficult to understand why. Approaching a little 150 square foot mud hut one could not imagine to see much. There was a power line led to the house. That was promising. What we witnessed inside was truly amazing. In the

Enthusiastic School Children from Mahavillachchiya,

Horizon Lanka’s new computer lab building was recently inaugurated

midst of a sparsely furnished living room proudly stood a personal computer; and no, it wasn’t a show piece. Ruvini is 16 years old. She spends her spare time designing websites. She is currently on an assignment to design a site for a Sri Lankan association in Kuwait. She will be paid SLR 30,000 when the job is completed. Radhi, 17, has an assignment to create a digital map of Sri Lanka and is being paid SLR 8,000 a month. She has been guaranteed a job that will bring her a monthly income of SLR 25,000 once she completes her A/ Anuradhapura

Ls. Two students of HLF; two families whose lives have been changed.

Deeper into the wanni (jungle)… Travel further into this village, through jungle roads towards the border of the Villpatu National Park, you arrive in Kandurupitiya. Nothing good has ever known to have come out of this village. People would come there perhaps to buy honey at a cheap price or to find a child to be employed in their home. Literacy is low and many parents do not see the value of education. But with the determination of one school principal and few teachers and with the help of one PC, today there is a thirst for knowledge and a resolve to be educated. Kids who once skipped school and refused to learn are not only coming to school, they are even staying after school to learn more. Their lives have forever been changed. i4d | April 2006

e-Sri Lanka PC project showcased in Linux Asia 2006

So we ask the question again: Can computers feed the hungry, if electricity and water are provided or we provide a road? The obvious answer is ‘No’, but with that computer, as the kids from HLF are experiencing, wherever you are, you can generate income enough to buy a pump that will provide your house and fields with pipe borne water; buy a generator to provide electricity; build the road that will connect the village to the world. We are often too confused by the problem, so we can’t see that the solution may lie in totally in the opposite direction. At ICTA, our motivation is the smiles on the faces of villagers such as those we met in Mahavillachchya. Our vision is to make a difference in the lives of every citizen and every village and we believe we can do this through ICT – by creating a connected nation possessing an ICT literate workforce and heading towards a knowledge-based economy. Maithri Jansz Programme Manager-Strategic Communications ICT Agency of Sri Lanka, maithri@icta.lk

The village Mahavillachchiya Mahavilachchiya village is located 40 Kilometres away from the city of Anuradhapura and 230 kilometres from Colombo. Surrounded by the Vilpattu National Park. The even land stretches unto the Horizon Lanka hosting water reservoirs small and large including the Mahavilachchiya tank, one of the biggest in Sri Lanka. The flat fertile land provides the population every thing since farming is the livelihood of the most of the people here. It is the example of a successful e-Village programme. “The highest number of Internet subscriber in Sri Lank will soon be from this village,” says Manju Haththotuwa, CEO and MD of ICTA. April 2006 | www.i4d.csdms.in

e-Sri Lanka PC project of the Information and Communication Technology Agency of Sri Lanka (ICTA) was showcased at LinuxAsia2006 Conference at New Delhi, India. Linux Asia, Asia’s premier Open Source Conference for three days included topical sessions and forums along with technology workshops, networking events and special programs. Keynotes and sessions were presented by international experts and panels. Large number of professionals, government officials and undergraduates participated in the event. The objective of the e-Sri Lanka PC programme is to increase the number of households with PCs in order to improve the ICT literacy of the country.

Although Sri Lanka has witnessed a rapid growth in the industry in the recent past, PC penetration and usage are still at a less than satisfactory rate. A study done by the Department of Census and Statistics in 2004 revealed that only 4% of households possessed a PC at home. Based on the same study, computer literacy was 10% and the awareness of Internet too was very low with only 3% of households using the Internet at that time. Government has targeted to raise the ICT literacy to 60% within a period of three years. Through the e-Sri Lanka PC project ICTA is planning to implement a regional promotional programme highlighting the benefits of having a PC at home. ICTA’s approach and the project design were highly commended by the open source community that attended the conference.

e-H EALTH P ERSPECTIVE

Healing touch to health The ‘e’ in e-Health does not only stand for ‘electronic’, but implies a number of other ‘e’s, which together perhaps best characterise what e-Health is all about. The other factors are efficiency in health care, enhanced quality of care, empowerment of consumer and patients, encouragement among care givers and patients, ease of use, excitment and extension of scope of health care beyond convientional boundaries.

Source: http://www.cancer.org/docroot/home/index.asp

What happens if you have a computer and it will be connected to various medical equipment and core of the whole thing is that you have special application, which captures all the information of the patient? What happens if e-Health is a process ready to provide health care via electronic means, particularly over the Internet?

concerted effort, undertaken by leaders in health care and hi-tech industries to fully harness the benefits available through convergence of Internet and health-care’, following the definition provided by Intel. There are a number of Internet sites for providing services for the health care industry. Some provide patient health and medical content. Many sites serve multiple functions such as providing consumer information, hosting on-line support groups and providing business support services. Some consumer information sites are run by non-profit organisations such as the American Cancer Society that provide a wide range of contents.

Benefits of e-Health

The American Cancer Society website provides a wide range of

e-Health is an emerging field in the intersection of medical informatics, public health and business that provides the opportunity for the patients to maintain independence longer and for the providers to monitor a condition more closely. e-Health is a very important issue these days, but few people have come up with a clear definition of this comparatively new term. e-Health was rarely in use before 1999. e-Health had its place in most developed countries, and is being explored in many developing countries recently. It can be defined as ‘a

By utilising e-Health, patients can get treatments, sitting at their home without going through all tedious exercises. The ‘e’ in e-Health does not only stand for ‘electronic’, but implies a number of other ‘e’s. This put together perhaps best characterise what e-Health is all about. Some of the other ‘e’s are: More efficiency in health care, enhanced quality of care, empowerment of consumers and patients, encouragement of a new relationship between the patient and health professionals, extension consumer information of the scope of health care beyond its conventional boundaries, ease of use and excitement. With the advancement of ICT, use of ‘telehealth’ and ‘telemedicine’ is going to be familiar in both developed and developing countries. The concept is that the information to be transferred from patients’ end to the health specialist, sitting at other end, who reads the problems and sends the required suggestions and information back; this is the way how telemedicine works. Telehealth services can be preventive, curative and promotive. i4d | April 2006

Technological barriers are generally related to problems in communication. Telecommunications and connectivity issues such as bandwidth, telephone call charges, Internet access etc need to be addressed for growth and development of the services sector. Barriers in financial sector are seen mostly with respect to delivery of health services and the e-Business environment involving the foreign direct investment, facilitation of e-Commerce, etc. Often it is not clear if the quality of health information and services being provided in the online websites are reliable and if they are run by non-medical professionals, they could result in un reliable information. Another key issue is that e-Health is currently accessible only for the educated, healthy and wealthy. Is it creating another digital divide? To overcome some of these challenges and barriers, innovative experiments have been undertaken in Africa, Asia, Latin America and Eastern Europe, primarily to address the digital divide question in e-Health. Though e-Health has shown remarkable effectiveness for treating a variety of disorders, research has not shown the efficacy of any assessment instrument to rule out serious mental illness in the worldwide population, accessible through Internet sites. The next barrier is privacy. Many practitioners do not know how to completely ICT use among health remove patient files from their own computer hard drives or how to secure email transmissions to protect patients confidentiality. Legal protections for patients and practitioners are still in flux, while federal standards to protect the transmission and privacy of medical information are currently being developed. From the clinician’s perspective, it is more difficult to determine if a person is fully attentive or distracted during the interaction when using remote technology. The practitioners need to be trained or otherwise gain experience in the various possibilities for misinterpretation when offering service to the public with worldwide connectivity brought by the Internet. Of further importance is the clinician’s familiarity with colloquial expressions, idioms, and local variations or word usage, this can be crucial when working with mentally ill, suicidal or homicidal patients. Currently the e-Health world is still very much a ‘consumer beware’ environment. Identifying the appropriate e-Health site is not an easy task for most consumers. Health professionals can play an important role in helping patients in this issue. As such, the patients must take the opinion of other practitioners too.

e-Health practices and initiatives Ontario’s e-Health initiatives are designed to give the right person access to the right information about the right individual at the right time. The Ontario Laboratories Information System (OLIS) is among the first e-Health initiatives and will allow the secure electronic exchange of laboratory information province-wide. ‘e-Health International’, a journal which look at technology from April 2006 | www.i4d.csdms.in

the perspective of the health professionals and patients using it. It focuses on applied technologies i.e. technologies with practical applications that have the potential to improve both quality and access to healthcare. This potential can only be achieved through the international exchanges of both successes and lessons learnt. This is the mission of both e-Health International and of the International e-Health Association. e-Health-Care Foundation, an Indian based non profit organisation, is working on ‘e-Health-Care’ project. The project is to streamline the government’s antiquated health care delivery system with use of ICT. There are numerous projects being Source: http://www.icthealth.com/

Barriers in using e-Health

professionals in Ontario, Canada is a vibrant community activity

carried in various countries all over the world. Some of those are as follows: • The Zambian Electronic Perinatal Records System (ZEPRS) which funded by the Bill and Melinda Gates Foundation/ University of Alabama, 2002-2004 at Birmingham uses opensource software to builds records which containing details of perinatal patient records system for the Lusaka health district, Zambia. It uses high-speed wireless data network connecting 23 clinics and University Teaching Hospital (UTH) in Lusaka. It has replaced manual records, providing quick, secure access to the records, instant information on referrals, better follow-up, up-to-date performance indicators and longitudinal data for assessing interventions about the patient. • Anti-Retroviral Treatment Patient Management System (ARTworks) is supported by the ZEPRS, which is for HIV/ AIDS patients, being used in eight clinics in Lusaka. • The Collaborative HIV/STD prevention Trail (US National Institute of Mental Health, 1999-2005) is an application of technology to support a community-level prevention programme, which implemented in five countries: China, India, Peru, Russia and Zimbabwe. • Information Technology solutions provided by Research Triangle Institute (RTI) in the areas of Audio Computer Assisted SelfInterviewing (ACASI), Computer Assisted Personal Interviewing (CAPI), Data Management Systems (DMS), Laboratory Management Systems (LMS) and secure automated transmission

Source: www.telemed.no

of data from remote sites to a central data coordinating centre for monitoring and analysis. In India, some initiatives have already taken and some more might be implemented in near future. ICT for health in Orissa, Department of Health and Family Welfare, Government of Orissa, in association withâ&#x20AC;&#x2DC;The Health InterNetwork India project, World Health Organisation and UN house, Orissa. Voxiva India with the Programme for Appropriate Technology in Health (PATH) are implementing a pilot project called Acute Encephalitis Syndrome Surveillance. Ten public and private health care facilities are participating in the programme, which is an activity of PATHâ&#x20AC;&#x2122;s

health care organisations. Several organisations including WHO showcased their projects in an exhibition and poster session besides the conference.

Code of ethics Building confidence and sustaining trust is the core of electronic health. Anyone, who uses the ICT for health-related reasons, has a right to expect that concerned organisations and individuals, who will provide health information, products or services online, will uphold some guiding principles. The concerned organisation should have candour, where the people can check its credibility and trustworthiness online. Another quality required is honesty. The sites should be in forthright about all content used to promote the sales products of health or services. The quality must be taken care of. The people expect that the sites should provide accurate and highly reliable products and services.

Solutions and proven methodology to work

Delegates discuss opportunities in e-Health projects for developing countries at TTeC-2004

global Japanese Encephalitis project. Acute Encephalitis Syndrome Surveillance Information Management System (AESSIMS) in Kurnool district of Andhra Pradesh State works on phone and web based disease surveillance network, which allows officials to track cases of acute encephalitis and respond quickly to reported outbreaks. Concern Health professionals, programme managers and governments health staff can respond and communicate and share real time information on detected cases of encephalitis. The initiative of Family Health Information Management System (FHIMS) is another remarkable initiative in Andhra Pradesh towards computerisation of health information. The effectiveness of telemedicine, the component of the health care has been well accepted as an useful tool for enabling rural health care. The Tromso (Norway) Telemedicine and e-Health Conference 2004 (TTeC) was a key oppoutunity for citizen participation in e-Health and to discuss challenges for research, technologies and

Challenges are also faced in traditional modes of operation of the organisation. They are not restricted to e-health alone , but associated with many factors like globalisation, the increasing pace of change and greater use of market mechanisms by governments. Challenges also including perceptions that standards in developments are too slow, over-reliance on voluntary involvement from individuals or organisations and steady, long-term declines in the resourcing provided by governments and large corporations. However the continuing worldwide revolution in ICT offers some hopeful and powerful solutions through enabling new ways of interacting with citizens, improving services, streamlining processes, even revitalising democracy. An integrated approach to face the public, connecting disparate government agencies and functions to provide more citizen-centric services is a priority. Software giants with rich technological heritage have to work in this direction to strengthen the cumulative knowledge that have developed in delivering government and health bodies in eAwareness solutions. A flexible and sensitive professional team of deep knowledge and expertise in areas such as public safety, national ID and security, health and human services, and environmental management which help to develop quick and cost-effective solutions to the vast array of challenges, need to be trained. The solution is to put strategic use of available technologies effectively to resolve explicit nature of the problems that is regional specific and improvise on the existing ways of working. The absoluteness of Internet technologies will only be apparent when the derived benefits meet the real needs of people and make value addition to health services delivery. The problems faced in developing countries are much more complex as their root problems like illiteracy and ignorance, poverty and impoverishment, clothing and shelter which need to be addressed on priority basis, to bring connectivity and awareness in this direction. Benign governments and sensitive organisations have to come up with need based action policies to work strenuously in making the dream come true. Ajitha Saravanan, ajitha@csdms.in I.Akhtar Sahajad, akhtar@csdms.in Dipsikha Sahoo, dipsikha@csdms.in i4d | April 2006

B ENEFITS

FROM

eH EALTH

The little ‘e’ for the health system eHealth is innovated, and restructured electronicallyenabled health system producing better patient. It has created new facts of improvement in health though not without the pains and pangs of changes that it entails. A reflection from Canada.

H. Dominic Covvey Professor and Founding Director, Waterloo Institute for Health Informatics Research, Canada dcovvey@uwaterloo.ca

April 2006 | www.i4d.csdms.in

Those of us who have encountered the health system have seen computers at work supporting the activities of the admitting clerk or an assistant scheduling a clinic visit. In fact, most processes in today’s hospitals or physicians’ offices are to some degree assisted by software running on computers. It would be safe to say that trying to work without these systems would be unaffordable…there’s no going back to the world B.C. (Before Computers). Now, however, many are trumpeting the advent of ‘eHealth’, shorthand for ‘electronic Health’, an electronically-enabled health system. Is there something else going on here beyond the decades-old use of computers in the health system? The short answer is ‘yes’ and the difference is both qualitative and quantitative.

‘e’ for health We all know that the cost and quality of healthcare are big issues. The cost of care in Ontario, Canada is approaching 50% of the provincial budget, yet many hospitals generate deficits and some have had to curtail services. Even getting facilities repaired and extensions built is a challenge. Drug costs are going into the stratosphere, and wait lists are a political as well as personal issue. The promise of eHealth includes, but looks well beyond, the commonplace computer support of day-to-day work in the admitting office or clinic. eHealth is nothing less than a rethought, innovated, and restructured electronically-enabled health system producing better patient outcomes efficiently. eHealth is the result of applying a tool of the genre of the airplane. The airplane didn’t just let us travel. It enabled us to get somewhere far away and back home the same day. It enabled fresh seafood dinner in land-locked Saskatoon, overnight global

couriers, just-in-time inventories, and thousands of previously impossible new businesses. eHealth is the result of making similar innovative use of Information and Communications Technologies (ICT) to maintain our health and manage our illnesses.

Applying eHealth - some examples Consider a few examples to see that eHealth means a transformed health system. eHealth enables a Psychiatrist in London to interview a patient in Moose Factory and an elderly patient to be monitored at home via communications lines. It enables a Radiologist in England to read CT images from Kitchener using a Picture Archiving and Communications System while local Radiologists sleep. A hyper-specialised surgeon using tele-surgery equipment in Toronto can operate on a patient in Nova Scotia – no travel required. Patients can be followed up without visiting the clinic through ‘virtual visits’ made possible by interactive voice response and Internet technologies. These solutions change how the health system works, allow measurement of its performance, and even improve the quality of the services provided. So, the excitement about the little ‘e’ comes from the opportunity it gives to realise new ways of doing things and of doing better things in our health system. ICT is a tool for change, introducing new flexibilities that enable designers and planners to break out of the old, expensive manual box that tightly limits what we can do. So, why not just pull out all the stops, put the pedal to the metal, and full speed ahead to eHealth? Like most earthly things, there are issues, obstacles, and side effects that make the realisation of eHealth challenging. Some of these are at the human

The institutional-level barriers are similar: resistance to change, unwillingness or inability to invest adequately in the required technologies, lack of qualified people who can innovate, and something called the ‘legacy problem’- replacing existing systems is expensive and dislocating. Barriers at the provincial level include the megadollars needed to create even basic capabilities like secure communications links among organisations, the dearth of capable people to design, build and maintain province-level systems, the need to engage many constituencies in change processes, and the dependence on consistent, quality data from the other two levels. To realise the promise of eHealth we are going to have to overcome all these challenges.

A closing thought Source : http://www.teknia.fi/upload/files/WellTeknian_eHealth_laboratorio.jpg

level, some at the institutional level, and some at the regional or provincial level. Anyone born B.C. knows about the human-level problems. These include, lack of knowledge about systems, resistance to changing the way we do things, lack of confidence in the positives of eHealth and consequent avoidance of personal and financial investment, and concerns about adverse effects of systems on privacy and jobs.

After decades of research and development, we now have the wherewithal to think outside the box created by human-mechanical-spatial limitations. We now can alter the fundamental operating economy of the health system, and, given this, we must proceed into eHealth. However, how we proceed, where we go, and how fast we realise our objectives is totally dependent on knowledgeable, responsible, dedicated, thoughtful and innovative people. The path to eHealth is through qualified people, and we are not awash in qualified people. J (This article is reprinted from The Record in Kitchener-Waterloo.)

Showcasing ‘e’ happenings of India i-Quench.org/edevelopment, a very recent personal weblog, is a growing, participatory, collaborative and informational initiative dedicated to furthering the cause of ICTs for development in India in the areas of health, education, poverty alleviation, agriculture, micro-finance, e-Governance, trade of goods and services, market-based information dissemination - all leading to ICTs-supported holistic community development. The weblog endeavours to showcase the latest news, events, best practice cases, concepts, products, services and initiatives in ICTs for development in India thereby striving toward knowledge transfer, access to information needs, knowledge management, networking and promotion, and a systematic management of information from each stakeholders’ perspective. Although the content in the weblog is India-centric, it showcases the contributions and participation of governments, MNCs, other private organisations and funding bodies from across the globe. This weblog is therefore extremely keen to showcase products, ideas, articles, services and opinions from a global audience, especially where there exists potential elements of being implemented or replicated in the Indian context. The potential for ICTs-supported developmental activities in India is enormous and badly untapped. 70% of the population is

rural. This statistic alone can be turned around on its head to represent a huge, untapped emerging market driven by volume. It is not surprising that MNCs and private organisations are slowly waking up to this fact and driving investments in the areas of health, education, agriculture, egovernance, micro-finance, information and knowledge management. This is all about empowering 70% of a nation of a billion people to become educated, healthy and skilled individuals contributing to economic growth. The theme of a recent Confederation of Indian Industries(CII) and World Bank conference in Hyderabad, India, on December 21 and 22 2005, ‘Emerging Opportunities at the Bottom of the Pyramid - Transforming the Indian Rural Economy through Profitability,’ sums up the importance of shifting focus toward more traditional markets. At this conference the World Bank reiterated its commitment to allocate US $1 billion towards rural empowerment in India and was looking forward to entering into partnerships with corporates in such initiatives. In light of the potential of ICTs to bring about change in the communities we live in it will be of enormous interest to organisations and individuals the world over to become a part of this gradual revolution. http://i-quench.org/edevelopment/

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ICT F OR G LOBAL H EALTH

Wireless technology for health Today wireless ICTs are improving the economic and health outlook of many local citizens by facilitating communications and development services. In countries like Cambodia and Uganda, wireless ICTs are connecting patients and doctors separated by thousands of miles.

Technology is improving fast from the personal computer to the Internet in the lives of millions by providing near instantaneous access to information. In the health field also high speed electronic networks allow health professionals to better manage the available physical and human resources, stay informed on the latest research and best practices, and achieve greater accessibility to their patients, thereby raising the level of public health. Since the introduction of ICTs in the health sector, in first world nations have seen a dramatic and sustained improvement in health standards. The lack of a wide spread communication infrastructure in the developing world is a primary contributor to the growing health divide between the first and third worlds.

Bridging the health divide Technology is not the solution to global public health; instead technology is a facilitator for other health and economic improvement programmes. Traditionally, advocates for health development programmes have enthusiastically touted large– scale projects applying first world models to third world environments. The success of health and economic development programmes requires the strategies and applications that are appropriate for the developing world.

A wireless bridge

Chris Albon Researcher, Miami USA chris.albon@gmail.com

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Wireless Information and Communication Technologies are any technology capable of interactive communication over long distances without a physical link (or wire), including, but not limited to, mobile phones and Wi–Fi. The advantages of wireless ICT in health and economic improvement programmes are manifold. A single wireless station can cover a large area, reducing the cost and the risk of theft of capital (for example

- the theft in copper telephone lines). In recent years wireless technology has exploded in the southern hemisphere. Uganda, for example, has few land based phones and these have proved to be unreliable due to damage, or theft of the telecommunications infrastructure. Most new users, therefore, are now turning to mobile phones as their primary form of communication. Even in war-torn Somalia, with a government of only nominal de facto power, wireless technologies introduced by entrepreneurs have exploded in popularity. In fact, a new World Bank report notes ‘77% of the world’s population already lives within range of a mobile network.’

The power of wireless Public health improvements are not the sole domain of health care providers and medical professionals. The health and economics of a region are fundamentally intertwined. The growing use of wireless ICTs is having a powerful economic impact on the developing world. On the national level, one study argues that ‘mobile phones raise longterm growth rates, that their impact is twice as big in developing nations as in developed ones, and that an extra ten phones per 100 people in developing countries increases GDP growth by 0.6 percentage points’. Furthermore, there is little need to promote the use of appropriate technologies, the ‘world’s poorest people are already rushing to embrace mobile phones, because their economic benefits are so apparent’.

Practice of telemedicine The World Health Organisation defines the practice of telemedicine as ‘health care using interactive audio, visual, and data communications’. In the developing world, telemedicine through wireless ICTs is

improving the health of many by providing access to services mean cases which present particularly rare or complicated problems previously unavailable. requiring doctors in specialised fields can be diagnosed and treated. The telemedicine projects are allowing doctors world wide to In such cases first world specialists evaluate diseases or injuries and treat dozens of patients from all over the country without travelling recommend treatment, all without leaving their own hospitals in to each village individually. For rural residents, the programme has Europe and America. improved their access to health care and health information. They can eMail a doctor at any time with health questions and expect a Wireless for knowledge exchange response within days. Wireless ICTs are also facilitating the flow of health knowledge to In the Cambodia, NGOs have established the Markle clinic, developing world, health professionals. Some health services are which uses a dedicated satellite dish to communicate with other pioneering the use of personal data assistants (PDAs) by doctors health facilities. ‘A nurse visits the Markle clinic once a month for a and clinicians. These PDAs can use wireless communication in two four-day stay, during which he examines and photographs patients ways. First, since PDAs are used as a portable research library, they and measures their vital statistics … The resulting report is e-Mailed provide doctors with a one stop reference guide while in the field. to doctors … who collaborate [before] making a diagnosis and Wireless ICTs help doctors keep current on the latest research and developing a course of treatment’. Even studies by automatically updating more isolated towns are benefiting from the PDAs’ medical library and even wireless ICTs. For example, in one region, facilitate continued medical wireless equipped motorcycles drive past education while on field each of the fourteen computer equipped assignments. Second, PDAs, in schools in the region, automatically conjunction with wireless ICTs, downloading and storing e-Mails which, have been used to provide low cost upon return to the Markle clinic, are and rapid health surveys. emailed to doctors. A survey conducted To fight against tuberculosis on a similar clinic in Rovieng reported that (TB) in the developing world is the ‘100% of the sixty-three patients … difficult drug regime, for which responded that they were ‘very satisfied’ four tablets should be taken five or ‘satisfied’ with their experience’. These times a week for six months. Dr telemedicine projects are allowing doctors David Green, a medical practitioner and consultant in Cape Town, to treat dozens of patients from all over South Africa, launched a pilot study the country without travelling to each that found that 71% of his TB village individually. For rural residents, the patients had access to a cell phone. programme has improved their access to Dr Green uses SMS (short health care and health information. They Credit : http://www.glit.org/GL/images/MA_EKG3.JPG messaging service) to send text can e-Mail a doctor at any time with reminders emphathetically to health questions and expect a response patients to take their drugs. The project has been declared as an within days instead of weeks. Wireless communication does not have to use the latest international best practice World Health Organisation. technology. In most cases simpler technologies are just as effective in improving long distance health care. In rural Uganda, community Challenges health workers are using walkie–talkies to coordinate maternity health While the case for aggressive adoption of wireless ICTs is strong, services. The walkie-talkies are allowing ‘health personnel to call there are numerous challenges to overcome for successful and get practical advice even when no vehicle is available. This implementation. If ignored, these challenges will cripple any benefit Ugandan telemedicine program has been a resounding success, to wireless ICT deployment and therefore must be met with innovation and support at all levels. reducing maternal mortality rates by 40% over the last 3 years. Localisation : If wireless ICT programmes are going to be Even the explosion of camera phones is being explored as a telemedicine tool. For health care providers, leg wounds are an successful, they need strong community input and involvement to especially expensive problem, since transportation must be provided define priorities and issues. In many regions, inhabitants have more in order to get the patient to a hospital for examination and treatment. pressing concerns such as famine, about which John Daly remarked A pilot project studying on remote leg–wound evaluations made ‘they can’t eat computers, telephones won’t make them well’. At the using mobile camera phones. The images were transmitted to a Consensus Project the same conclusion was reached by the panel of three experts who each independently evaluated the economists, which listed seventeen priorities for the world’s wounds. The study was a success reflecting a high level of development resources. Increased ICT funding was not on the list. Wireless ICTs should be ‘pulled’ by the desires of the local consistency in evaluations made by the three experts based on the populations, not ‘pushed’ by top down develop programmes. It transmitted images. Telemedicine is also connecting health professionals in the first should know how to adopt technology efficiently looking into the and third worlds. North-South alliances between health providers problems from bottom to top. To say, wireless ICTs are socially more

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appropriate. Illiteracy is prevalent in the developing world and this has been a major obstacle to the wide scale computer penetration. Mobile phones, on the other hand, do not require the user to read and thus are being adopted quicker by developing world users. Infrastructure : Technologies do not function in isolation, but build upon other technology infrastructures. One such infrastructure is energy. A principle challenge to wireless ICT programmes is providing electricity without access to the power grid. This is especially true today since most wireless ICTs were designed for use in the developed world, where access to power is found in abundance. Programmes using wireless ICTs must develop a detailed plan for accessing or generating power before implementation. Some innovators are developing technologies, which circumvent this problem by using the sun or a hand crank to produce electricity. However, only the simplest of these technologies (due to their low power use) have made a wide scale penetration. Affordability : Wireless technologies, with the notable exception of radio, are still in their infancy and therefore the costs of these technologies are substantial. In Uganda, the initial purchase price for a mobile phone is US$100 (Phipps), over one month’s income for the average Ugandan. Programmes must address the cost of these technologies, not only for the immediate future, but also for their sustainability in the longer term. Wherever possible, innovation and public-private partnerships should be used to offset the cost of wireless technologies.

Regulation: Government regulation and involvement is one of the greatest impediments to wireless ICT adoption. In many African countries it is necessary to obtain a license to use Wi-Fi bands, the de-facto standard in wireless data communication. Furthermore, government interference promotes monopolies. However, there is strong evidence that competition is a primary cause of technology penetration. In the Democratic Republic of Congo and in Ethiopia, the average annual income is $100. However, the ‘number of phones per 100 people is 2.0 in the former (where there are six mobile networks), and 0.13 in the latter (where there is only one)’. In fact, Somalia has the cheapest cell phone rates in Africa, mainly because of a distinct lack of government telecom regulation.

Conclusion Today wireless Information and Communication Technologies are improving the economic and health outlook of many local citizens by facilitating communications and development services. In many developing countries like Cambodia and Uganda, wireless ICTs are connecting patients and doctors separated by thousands of miles, thereby increasing health care availability in rural regions. Wireless equipped PDAs are making low cost, high-speed health surveys possible, and in urban areas, mobile phones are reducing TB patient non-compliance. By acknowledging and addressing challenges, such as localisation, infrastructure, affordability, and regulation, wireless ICTs can help build successful development projects.

Some initiatives for AIDS community using ICT AIDS Education Global Information System (AEGiS) began in the mid-1980s. It is a web-based reference for HIV/AIDS-related information. Through a keyword-searchable knowledgebase, AEGiS offers information via HIV/AIDS specific publications and news sources from around the world. The African Counselling Network (ACN) is a network of individuals interested in the development of counselling in Africa. The ACN website provides information for counsellors and other mental health specialists, and access to counselling and psychology journals and other counsellor education resources. The site provides information on AIDS Resources and AIDS Counselling. The Uganda Ministry of Health has launched a web resource for health professionals, managers, and the general public in Uganda and the rest of the world. The website is a way of promoting the policies and activities of the Ministry of Health to the outside world. The web site is a great resource of information on the Uganda health sector, and also an exhibition of applicable health strategies and programs for developing countries. Canadian Physicians for Aid and Relief (CPAR) is a non-profit, non-sectarian organisation that is inspired by the vision of a healthy plane. To address the information and communication, CPAR is developing a telecentre in Lira with community outreach centres in Gulu and Apac districts. Trainers will provide educational programmes for youth, women’s groups and health care workers who are interested in learning how communication technologies can be used to improve their knowledge and skills at work and within their home. April 2006 | www.i4d.csdms.in

Gender and HIV/AIDS web portal has been developed by the United Nations Development Fund for Women (UNIFEM), in collaboration with the Joint United Nations Programme on HIV/ AIDS (UNAIDS). This portal is a one-stop online resource centre on the gender dimensions of the HIV/AIDS epidemic. UNIFEM has played remarkable role in global recognition that HIV/AIDS is an integral gender issue and that the fight against the pandemic need addressing the specific gender dimensions of prevention, mitigation, care, treatment and support. HealthNet Uganda is a computer-based telecommunications system that links health care professionals around the world and to each other. The HealthNet service is provided by SATELLIFE whose mission is improving health through enhancement of connectivity among professionals in the field via electronic communications and exchange of information. HIV InSite, based at the University of California San Francisco, launched in 1997, provides medical, prevention, and policy information to an annual audience of nearly 4 million physicians, researchers, policymakers, and others from over 150 countries. It has used a fast-loading, low-graphics format to facilitate access for users with low-bandwidth Internet connections. The Development Gateway’s Population and Reproductive Health (POP/RH) portal is an Internet initiative of the UNFPA and the Development Gateway Foundation. The Portal is a community-built Internet database of shared population information, including data, research, publications, projects, ideas and dialogue about population and reproductive health issues. Source: WOUGNET

Story telling for knowledge sharing

e-Health in Africa Presenting a series of locally written articles with southern perspectives on the impact and the use of ICTs for Development. The iConnect series enters its second year of collaboration and we are pleased to share stories from Africa on e-Health written by southern people.

In collaboration with:

www.iConnect-online.org is a knowledge sharing platform for Information and Communication Technologies (ICTs) in sustainable development. iConnect draws content from its partners, links resources and expertise and encourages collaboration. For the International Institute for Communication and Development (IICD), the host of iConnect, this is a way to share experiences, lessons learned and ideas, and interact with communities and people with an interest in development and the applications of ICTs. These experiences can lead to a better understanding of the actual benefits of ICTs for Development (ICT4D). The core of iConnect will be a series of locally written articles on the impact and the use of ICTs for development. The articles have a strong focus on fact finding; objective information on ICT4D practices from a southern perspective: Southern content written by Southern people. i4d is the iConnect partner for Asia, disseminating the articles to their readers. For the full text of the articles, please visit www.iconnect-online.org.

Health through the Internet in Burkina Faso: CAMEG makes generic drugs accessible By Ramata Soré Created in 1992, CAMEG, the purchasing centre for essential generic drugs and medical goods, began operation in 1994. CAMEG uses Information and Communication Technology (ICT) to make health services more democratic. ICT greatly improves the circulation of health information and strengthens cooperation between establishments in Burkina Faso, which is ranked near the bottom of the list by the United National Development Programme. To fulfill its mission of ensuring quick and effective access to essential drugs for all, CAMEG invested in ICT. “Those investments were part of an infrastructure modernisation policy,” said Edmond Traoré, computer specialist for CAMEG. Continuity of service, quality, price accessibility, protection of users and guaranteed supply are ensured. CAMEG makes available a range of more than 500 products through telemarketing and its website. Everyday, staff of the central agency at Ouagadougou contact CAMEG sections around the country to determine their needs. Edmond Traoré says that with the website, “The objective is to give some visibility to CAMEG. The site has been in place since 2004 to provide information to everyone concerning health care at the least cost.” The website makes it possible for clinics and other health facilities to order products. Individuals cannot place orders. “We are a wholesale vendor. Only people who need antiretroviral drugs (ARV) can place orders,” says Edmond Traoré. Clients are required to contact a doctor registered with CAMEG to obtain a prescription

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and possible renewals. Drugs are only delivered in strict observance of this procedure. “It is dangerous to promote the sale of drugs on the Internet without proper precautions. That would open the door to all kinds of abuse,” he adds.

Making ARV available CAMEG began delivering antiretroviral drugs (ARV) in April 1999, on the recommendation of the Heath Department. CAMEG became involved in the distribution of ARV because of the spread of HIV/AIDS and difficulties of access to treatment, in terms of cost and availability. Until then, private firms controlled the sale of ARV and the average cost was excessive. CAMEG’s involvement, although limited, enabled many sick people to obtain ARV. On its part, CAMEG has made a commitment to continue negotiations with suppliers to reduce the cost of drugs even further.

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The use of Information and Communications Technologies has led to improved use of generic drugs in Burkina Faso. Increased use by the population of generic drugs has prompted the opening of new health units. The private sector can also use the services of the central drug purchasing facility. With increased demand, CAMEG has decentralised its distribution structures by opening warehouses in four regions, Centre, Hauts-Bassins, North and East. Lazare Bansé, director of CAMEG, says, “Annual sales have grown from 240 million francs in 1995 to more than two billion francs in 2004. The average annual sales increase between 1995 and 2004 was 37 millions.” According to Edmond Traoré rotation of truck deliveries have been reduced, ‘which will mean fewer stock disruptions and reduced gasoline use.’ As a promotion tool, the web is an advertising support for CAMEG, making possible the creation of virtual marketing windows bearing a corporate identity. In this way, CAMEG has used its site to establish contacts with numerous international partners and to build cooperative structures in all parts of the world. The CAMEG site makes it possible for users to quickly find information about e.g. catalogues and pricing. By displaying this value-added information on its website, CAMEG captures the attention of potential clients.

Pioneering Internet role CAMEG’s pioneering Internet role was recognised in 2005, when the CAMEG website www.CAMEG.net was awarded two prizes. It received a bronze Gambré for third place in the national business category and CAMEG also received a special award from the World Health Organization (WHO) as the best website in the health field. Despite this recognition, the CAMEG site does have room for improvement, including access to purchase orders online and updating of data on a regular basis. ICT also plays a role in the health sector in overcoming distances in terms of surgery. Recent developments in high-speed Internet

connections have made remote surgery possible. At present, such technology is not available in Burkina Faso but this is an area where CAMEG could make investments in, keeping up with its record as a pioneer in many other partnership structures. An encouraging sign is the creation of a Burkina Faso section of RAFT, the Francophone African Network for Tele-medicine, which has just completed a training workshop in March 2006 in Ouagadougou. The International Institute for Communication and Development, IICD, is an important partner in this network and a major project in tele-radiology was successfully launched in our neighbour country, Mali with the help of IICD. Progress in the health field through the use of new technologies can be a reality in our countries thanks to knowledge sharing between developing countries, with professional support from international partners - because illness has no borders. For further information contact iConnect coordinator Sylvestre Ouédraogo, sylvestre.ouedraogo@univ-ouaga.bf

Delivering continuous medical education through ICT By John Yarney There is only one reasonable option open to Dr. Ivy Osei (real name withheld) when diagnosis or management of her patients is beyond

her – referring them to health facilities located 315 kilometres and 182 kilometres from her station. “Some patients come back with a note from the specialist asking you to continue treatment as you have been doing,” says Dr. Osei, of her referrals to two of Ghana’s teaching hospitals — the Korle-Bu Teaching Hospital and the Komfo-Anokye Teaching Hospital. “If you had quick access to a specialist, it will help you first of all, and the patient who will not have to travel out,” she elaborates. Dr. Osei is one of the three doctors at a public hospital which serves a mining town of a population 270,000 in Western Ghana. Aside issues relating to service delivery, there are just too few doctors at her station to permit any of them to take some time off to upgrade their skills.

Geographical gaps These conditions are not just peculiar to the mining town Dr. Osei serves in, but are replicated across most parts of the country. According to Dr. Ken Sagoe, Director of Human Resources of the April 2006 | www.i4d.csdms.in

Ghana Health Service, the country presently has just about 2000 doctors to serve its population of 20 million. But beyond the huge disparity in relation to doctors and patients, there are other geographical gulfs. Administrators of the Ghanaian health sector identify with the needs on the local level in the health sector and have put in place some measures to address these needs. “We work in an area where practice is based on evidence, and evidence changes by the day,” said Dr. Ken Sagoe, on the need for continuing training. “Without updating, your patient cannot get the best benefit,” he elaborates. One of the programmes to meet the training needs of practitioners is the Continuing Medical Education (CME) for health professionals at the local level. Implementers of the CME programme appreciate the role of ICTs in offsetting some of the setbacks encountered in the CME programme. According to Dr. Sagoe, his outfit has been working for 2 years on using ICTs to deliver training to health practitioners. They are considering the directed approach, where step by step training is put on CD ROMs, and other audio visual formats are provided to practitioners. Users can go through the step to step approach, answer questions, and their answers are reviewed under different sections after each lesson.

eHealth policy The health authorities are looking at ICTs beyond the CME. A draft policy on eHealth has been formulated. Framers of the policy have pencilled down four areas in which ICTs can be used in the health sector. They include implementation of telemedicine systems, the development of health information and management systems, the deployment of ICTs to facilitate the spread of health and medical services to rural and under-served areas and the use of ICTs to support medical education and training. Civil society also has been actively pushing for use of ICTs in health delivery. The Ghana Information Network for Knowledge Sharing (GINKS), the International Institute for Communication and Development (IICD) with other collaborators have been in the forefront of this campaign. While civil society continues it activism for eHealth and health practitioners wait for the benefits that the draft policies promise to bring when it comes on-stream, patients in rural communities - like the mining town Dr. Osei serves in - still have to travel to furlong medical facilities when the practitioner needs another opinion on diagnosis or treatment. For further information contact iConnect coordinator John Yarney, john_yarney@yahoo.co.uk

ICT and Health: Tele-radiology, a cure for a shortage of specialists By Almahady Moustapha Cissé Mali, one of the poorest countries in the world, is in the midst of solving a health specialist crisis, especially radiologists, through the use of tele-radiology. Launched in 2005, thanks to four-year funding with a budget of 100 million CFA francs from the International Institute for Communication and Development (IICD), the teleradiology project is revolutionising medical practice in Mali. Tele-radiology, or long-distance radiology in Mali, results from an observation by Doctor Mahamadou Touré, a radiologist doctor at the hospital in Point G – one of three university hospital centres in Mali – who is responsible for a tele-radiology team. Mali is a sprawling country with a land area of 1,204,000 km² and a population estimated at nearly 12 million people. In medical terms, there is an uneven distribution of human resources. According to Dr. Touré, of the 20 radiologists in the country only one is based

in the interior, at Ségou, a city located some 220 km from the district of Bamako. “It was because of this realisation that the tele-radiology project was begun in 2005 between the hospital at Point G and three regional hospitals at Mopti, Sikasso and Ségou. Later, when a radiologist moved to Ségou, that city was replaced by Tombouctou,’’ said Dr. Touré. “We are now in the middle of the test phase,’ continued Dr. Touré. ‘If our partners continue to support us, in the next phase we will gradually be able to include all the other regional hospitals.”

Objectives The main objective of the tele-radiology project is the transmission to the radiology service at Point G of all x-ray photos and other radiographies requiring specialist opinion, and, in particular, to provide results within 24 hours for normal cases and within two or three hours for urgent cases. The process uses the internet to send radiographies made in the regions for expert examination and interpretation. “Here at Bamako, we can interpret radiographies made in the regions to assist in the phase of diagnosis,” added the project director. As part of the project, doctors in the three participating hospitals take x-rays of their patients. The images are sent by internet to Bamako, the capital of Mali, where the central service specialists are located. When the images are received, specialists examine and Interpret them and, depending on the urgency, send the results to the treating physician on a priority basis.

239 consultations Since the start of the project to March 26, 2006, Dr. Touré proudly states, “there have been 239 consultations, including 23 urgent cases.” Speaking to iConnect, Dr. Touré recalled two cases in particular as significant examples of the value of this powerful use of technology.

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“These were cases where radiology played an absolutely essential role. In other words, the radiologist’s eye helped the regional doctors to find a way out of an apparent impasse.” The first case came at the start of the 2005-2006 school year. It involved a nine-yearold schoolboy in Mopti, some 630 km into the centre of Mali, who was unable to eat. The examining doctor took an x-ray but the cause of the problem was not clear. He sent the x-ray by internet to the team at Bamako. “After consultation,’ says Dr. Touré, I was able to tell him that there was a blockage at the level of the esophagus. The only solution was to use fibroscopy. That means inserting a tube into the esophagus until contact is made with the foreign body and, using forceps, it is either removed or pushed down.” Since there was no fibroscope at Mopti, the child was brought to Bamako. During the fibroscopy, the tube dislodged the obstructing matter. It was a piece of meat. Within a few hours, the young boy was eating normally. The second case, in November 2005 at Mopti, was the story of a man who, after breaking the Moslem fast at twilight, complained of feeling very sick. He was twisting in pain and went to see a doctor, who took an x-ray that didn’t show very much. The doctor sent the x-ray by internet to Bamako. “When the message arrived, I was contacted and returned to the office to see the radiography,” said Dr. Touré. “After examining it, I called the doctor and told him, ‘I think this man has perforated his digestive tube.” “The doctor replied that he would operate immediately. During the night he called me to say that he had operated successfully, but that it was the man’s appendix and not his stomach that was perforated. That was an urgent case that called for immediate action.” Dr. Touré says, “I hope you will understand why we are very proud of our system.” The director also disclosed that most of the cases that are submitted from the regions involve radiology of the thorax. “That is because,’ he stated, cases of the thorax are very complicated and difficult, both for the doctors and for us as radiologists.”

Tele-radiology, a factor of development According to Professor Abdel Kader Traoré, Director of Mali’s National Support Centre in the Fight against Sickness (CNAM),

“tele-radiology will improve responses to health problems in the regions. As an indirect effect, it will also improve the health of the population and, in doing so, will contribute to development.” Before the introduction of tele-radiology, doctors in the regions were faced with a dubious choice, says Professor Traoré. Either the doctor was stymied by the image and said, “we will close our eyes to that and diagnose as best we can, and the patient remains here.’ Or, the patient was told, ‘If you can afford it, you should go to Bamako for an x-ray that will be examined by an expert and your condition will be much clearer.” “Now, thanks to tele-radiology, in either case, we are able to see a solution.” Dr. Romain Rolland Tohouri, a specialist in ICT and Health, echoes that broader vision, he says, “More and more, tele-medicine or long-distance medicine is becoming a reality. It is an effective means of extending medical and diagnostic services to remote regions.”

Benefits at three levels Tele-radiology offers three great benefits. First, for the patient, it improves the clinical diagnosis, reduces the number of transfers to Bamako and reduces the cost of treatment. For the attending physician, tele-radiology offers greater assurance in treating a patient, reduces the feeling of isolation and, above all, opens the door to distance learning or coaching. Finally, for radiologists, tele-radiology provides access to knowledge of regional pathology. In each case, the patient pays a flat rate of 2,500 CFA francs, compared to 5,000 to 10,000 CFA francs at a private clinic. After its first year of operation, the tele-radiology team has great hopes for the future. “We hope that IICD or another partner will help us to serve the other regions,’ said the project director, ‘because in Mali the need for radiology is immense.” Dr. Mahamadou Touré told iConnect, “We want this experience to become government practice as part of our national health policy. We have strongly urged that approach and the government health planning group is working to achieve that.” And there is a ray of hope on the horizon. In a pragmatic move at a meeting with the directors of the six (6) primary regions of Mali and the district of Bamako, the national director of the Health Planning Group (CPS), Mr. Salif Samaké, invited the participants to include different aspects of ICT in their operational programmes. In the opinion of Mahamoudane Niang of REIMICOM, the Mali computer network for medical information and communication, known as Kénéya Blown, “The importance of ICT in terms of health and development will only be achieved when the greatest numbers of institutions are connected to the network.” For further information contact iConnect coordinator Filifing Diakite, filifing@journalist.com

Telemedicine Project to improve Zambia’s health delivery By Michael Malakata People living in rural areas in Zambia struggle to access timely, quality specialty medical care primarily because specialists and physicians are located in urban areas and some have trekked to work in other countries. However, owing to innovations in computing and telecommunications technology, many elements of clinical practice April 2006 | www.i4d.csdms.in

and public health can now be accomplished through telemedicine, even though the patients and health care providers are separated geographically. This, however, requires capacity in terms of telecommunication and computer equipment, which has been lacking especially in rural areas.

Origins and trends Tele-health is not a technology but a system that applies largely diverse information technologies to solve the problem of delivering health services over a distance. Tele-health can be achieved through various strategies among which are telemedicine. Although terms are coined rapidly these days, tele-health strategies, however, are not new. They have been used for many years in form of telephone and fax machines. In recent years, with the improvements made in information access, technology and communications systems, use and usefulness of tele-health has expanded. In a time of limited health manpower and expert consultation resources, increasing health information resources and faster communications, tele-health has become an interesting option for smaller or remote medical facilities and health departments for providing both routine and specialised services. Telemedicine or tele-health enables patients-providers to exchange information which leads to an appropriate diagnosis and treatment plan, which can then be administered by less highly trained health staff or even the patient alone.

Telemedicine, however, uses a hybrid of technologies incorporating elements of television, telecommunication and engineering so that services could be delivered on a combination of technologies with a variety of equipment. The project is being funded by the Zambian government and the Swedish government through Swedish International Development Agency (SIDA) and about ZK 2 billion, which is almost US$ 630, 000 would be spent says Chinyama. “This project is likely to cushion the disparity in health care delivery systems as we promote equity in health as enshrined in our health reforms policy which we are implementing now,” the Ministry of Health spokesman Victor Mukonka says. The special location at UTH will have doctors on call for telemedicine 24 hours daily. “Not every case (patients) will be examined in the selected sites via telemedicine, but only those cases where the local medical staff has literally no idea over it,” Mukonka disclosed. By now the telemedicine project in Zambia would have been functional had it not been for the government’s dissolution of the Central Board of Health (CBoH).

Disparity urban-rural

Halted project

Realising the disparity in health provisions between the urban and rural people, the Zambian government through the Ministry of Health, has selected Lundazi district and Chipata General hospitals in Eastern province as centres for a telemedicine project with the University Teaching Hospital (UTH), the country’s biggest hospital as the main (special) centre of the project. UTH and the two districts in Eastern province would be used as a pilot project and should it become successful, Chinyama says the second phase of the project would spread to Chirundu in Southern Province, Chainama and Chongwe district in Lusaka Province, and Mumbwa district in Central Province. Computers, digital cameras and other telemedicine equipment have already been installed in all three hospitals for the first phase of the project. The equipment, according to the coordinator of the project Collins Chinyama, was bought from China where the project was first tested.

CBoH was a board that implemented health programmes on behalf of the Ministry of Health. Its dissolution halted the project as the board’s workers were being fused into the Ministry of Health. Exploiting telemedicine strategies, according to Dr Robert Mtonga at UTH, would boost the country’s health delivery system, which among the benefits includes: • The reduction of costs by facilitating diagnosis and treatment of selected patients on sight rather than in an expensive hospital setting. • Specialised treatment will be administered to the patient despite their locality. • Poverty alleviation: If necessary referrals will be prevented, the saved money will go to children’s education and food production. • Reduction on government expenditure arising from patients’ transportations. • Low mortality rates because physicians and other medical practitioners in rural and remote areas will be able to receive technical advice from consultation. • Congestion in urban hospitals will be reduced resulting in adequate bed space for urban patients and improving the knowledge base and experience on the remote sites of less highly trained medical staff. Technological development, however, is necessary if the implementation of telemedicine is to be a success in Zambia. Zambia has struggled in implementing the telemedicine project for about three years but there has just been debate about its implementation with little work done to improve it on the ground. The setting up of the project in country would help to save lives of people who have been dying in hospitals owing to lack of quality specialty medical personnel and equipment to undertake good diagnosis. For further information contact iConnect coordinator Tovin Ngombe, tngombe@yahoo.co.uk

i4d | April 2006

D ICTIONARY H EALTH INFORMATIC , P ERU

Everything a physician should know! ‘Dictionary Health Informatic’ concentrates mostly on the urban and rural cities of Peru and focuses on areas of information resources, communication networks and training.

Lady Murrugarra ladym@upch.edu.pe Franz Calvo franzcalvo@hotmail.com Armando Calvo acalvo@upch.edu.pe Johann Vega jvegad@amauta.rcp.net.pe Instituto de Medicina Tropical Alexander von Humboldt, Universida D Peruana Cayetano Heredia, Peru April 2006 | www.i4d.csdms.in

Instituto de Medicina Tropical Alexander von Humboldt, Universida D Peruana Cayetano Heredia, Peru initiated a novel programme ‘Dictionary Health Informatic - Everything a physician should know’ concentrating mostly on the urban and rural cities of Peru, focusing on areas of information resources, communication networks and training collaborating with Consejo Nacional De Ciencia Y Tecnologia – Concytec and Centic Red Iberoamamericana De Telemedicina De Telemedicina E Informatica Medica. The programme liberally receives fund from voluntary and pro bono work from authors and partners.

Media: Internet network

Credit : http://www.med.nyu.edu/cih/images/Greta_Ana.JPG

The electronic format has revolutionised the way people use the dictionary to search and retrieve information as the electronic format makes the Health Informatic Dictionary so easy to use, its audience comprises of all kinds of readers beyond the confines of the scholarly community. The methodology aims to promote multi-sectoral approach to ensure public community access points at minimum cost, such as post offices, libraries, and schools for disadvantaged groups, and those living in rural and remote areas. The information can be accessed from the following link: www.upch.edu.pe/tropicales/

Snapshot of the programme The Instituto de Medicina Tropical Alexander von Humbold - Universidad Peruana Cayetano Heredia (www.upch.edu. pe/tropicales) in partnership with Consejo

Nacional de Ciencia y Tecnologia e Innovación Tecnológica (www.concytec. gob.pe), and with collaboration CENTIC working this effort to create a ‘Health Informatic Dictionary’, the members of the Tropical Medicine Institute have been united ‘Alexander von Humboldt’ with other members of the Peruvian University Cayetano Heredia and colleagues of different institutions in this generous effort. Now, in the first year of the new millennium, we have learnt a great deal from the work, on how learners use dictionary and benefited from suggestions from many professionals in health and education. Telehealth, the telemedicine and the cyber medicine are in Latin America and Caribbean, there is no doubt that in short term one better quality and ampler cover of the services of health will contribute to public and deprived incipient. Their

utility. Because the great majority of the content of Internet is written in Spanish. This phenomenon is not only quantitative but also qualitative.

Social impact of the programme • The advance of the use of medicine computation and the vigorous incorporation of Internet to the knowledge of the health force to know a language common in the art the electronic communication, is necessary to have a basic information to speak this new ‘language’. • Between our priorities the activities have been indicated developing that tend to grow in this important educative methodology and qualification as it is the electronic communication. • The users need to be able to find the information they need quickly, understand it once they have found it. This dictionary arranges and presents information in clear way. This defining vocabulary (listed on page 238 of the Dictionary) includes all the items used in definitions. Learners can be sure that, the definitions in the dictionary will pose no problems. • We are confident that the Health Informatic Dictionary will provide invaluable reference tool and study aid at school and college, for all who require clear, concise, and accurate information.

Challenges faced

Credit : http://www.wagpet.com.au/upload/dsc01296.jpg

developments will depend on the efforts that all the actors make, from the end user to the President of the Republic, happening through the professionals of the health, the respective companies of telecommunications and governing institutions. These new technologies allow, with greater effectiveness and efficiency, a more transparent approach between: government and citizen, government and companies, citizen and doctor, student and professor, etc.

Aspects of behavioural change This Dictionary, with more than 3000 definitions, profusely illustrated, tries to approach medical informatic, the professionals of the health. The existing hyperlinks in most of the definitions send to the reader the related terms, enriching the meaning of the term, looked for. The terms of the dictionary thus will be of greater

Women Connect! project in Uganda The Women Connect! project is an initiative based at the Pacific Institute for Women’s Health in Los Angeles, USA. The project’s mission is to bring about greater empowerment of women through the effective use of communication strategies in media and technology to improve women’s health and well-being. Women Connect! provides technical assistance to women’s NGOs in developing countries in using media campaign and information technologies strategies for outreach and advocacy. Source: WOUGNET

• Need the technology for acquisition, communication, processing and interpretation of personal health data. • Need to invent and implement ways to motivate individuals to modify their acquired lifestyle by the use of this technology. • Must embed this into the existing society as an accepted service for personal health and disease management. • Need to Continuing the technological innovations, the dictionary is now available as an online publication designed to take full advantage of this powerful and accessible medium.

Project in Chittagong, Bangladesh to bring computers and Internet to schools On March 16th 2006, a ceremony at the Kala Kakoli school launched a fifteen telecentre projects bringing computers and Internet to schools and their communities in the Chittagong area. The project is part of a nationwide project by an international NGO, Relief International - Schools Online (RI-SOL) which has partnered in Chittagong with the Mahmudunnabi Chowdhury Foundation, a philanthropic organisation promoting technology, education and youth development in the Chittagong area. The RI-SOL project is funded by the US Department of State’s Educational and Cultural Affairs Bureau, the Hewlett Foundation, the Global Catalyst Foundation and other private donations. The project promotes use and integration of Information and Communication Technologies into secondary education. The opening took place as part of America week in Chittagong and was attended by USAID Deputy Director, Beth Paige. The ceremony was attended by more than eight hundred onlookers, including staff from other schools in the project, government officials, businessmen, and members of local councils. Source: Nazrul Islam, RI-SOL in a posting in BytesforAll Group

i4d | April 2006

T ELEMEDICENE

Telemedicine and the elusive network-effect Safe landing for telemedicine in developing countries, but has the baggage been left on the other side of the digital divide?

Sanjay P Sood Head of School C-DAC School of Advanced Computing, Mauritius sood@spsood.com

Jagjit Singh Bhatia Director-in-Charge Centre for Development of Advanced Computing (C-DAC), Punjab, India jsb@cedtm.stpm.soft.net

April 2006 | www.i4d.csdms.in

ICT-an enabler of medical service

Telemedicine, the emerging phenomenon

‘Networking’ is ICT’s forte and ‘interactivity’ is its spirit. In tandem, networking and interactivity have also been catalysing economic and social ‘networks’ of individuals, professionals, cultures and communities. Overt potential of these diversified networks is their ability to connect and empower distinct groups by allowing them to access, share and exchange information that is crucial for socio-economic development to transform societies into information societies. Most of the applications of ICT like Internet, email and information systems enhance connectivity and linkage, i.e. peer-to-peer networking (also called peer networking). As ICT has a crucial role to play in education, it also has an equally vital role to play in healthcare. When we talk of applications of ICT in healthcare, it’s ‘telemedicine’ that reverberates the most. Telemedicine is a subset of e-Health which itself is a broader application of ICT in healthcare. Telemedicine has all the ingredients to boost socioeconomic development by means of delivering healthcare services and information in underserved urban and rural communities. For countries like India, those are icons of agrarian society, the benefits that applications like telemedicine offer are highly significant. The spectrum of benefits of telemedicine ranges from improving local access to speciality care, enhancing primary-care services up to increasing availability and access to medical education and health information resources. While dissolving barriers such as distance, time, geography, weather, and economics, in various forms telemedicine brings services to clients rather than clients to services.

Virtually, all healthcare delivery systems in the developing world are confronted by some intransigent healthcare issues and there is plenty of evidence that posts telemedicine as a potential solution to many of those. Furthermore, the need for telemedicine in developing countries has also been justified by many researchers, it has also been mentioned categorically that telemedicine may have a more profound impact on the healthcare scenario in the developing countries than in the developed ones. From over two decades, telemedicine has progressively been echoing assurances for tackling these unbending issues. International agencies have designed and deployed numerous pilots in some of the world’s most resource limited settings. These pilots have yielded nothing apart from some practical lessons. On the contrary, some studies have even highlighted under-utilisation of potential even during the pilot runs. The lessons those have been learnt but are yet to be applied, to give birth to sustainable initiatives, capable of bringing about development at large scale.

Network effect and medical services Being a direct application of ICT in healthcare, networking and interactivity are the overriding attributes of telemedicine. Telemedicine furthers interactivity by linking healthcare service providers and consumers otherwise separated by a distance. Hence telemedicine can also be seen as a concept that networks peers and professionals related to healthcare. These networks are established between: • Physicians and Physicians (for second opinion or tele-education), • Paramedics and Physicians (for teleconsultation),

Credit : http://ime.healthpartners.com/Images/CM/4680.jpg

• Patients and Physicians (for telediagnosis), • Patients and Paramedics (for telehomecare), • Patients and Pharmacists (for telepharmacies). Logically, quite like telephone, Internet and instant messaging services, telemedicine is also a networking technology and should ideally display ‘network effect’. Network effect is the property because of which a service or a product increments its value to not only the customer who goes for it but also to the existing subscribers. In the case of telemedicine, each additional network that joins an existing telemedicine network, has the potential of increasing the probability of interactivity in the existing network, exponentially. As a networking technology, telemedicine thus extends the reach of healthcare services and network effect that should show up in telemedicine can be explained through the following example. Let us suppose that a super speciality ‘Hospital A’ has ten peripheral hospitals as its telemedicine consultation centres and there is an another ‘Hospital B’ covering a different speciality that has a set of other ten peripheral hospitals as its telemedicine consultation centres; now if ‘Hospital A’ and ‘Hospital B’ are linked via a telemedicine linkage each of these two super speciality hospitals shall be able to effectively provide specialised services to all twenty peripheral telemedicine consultation centres. With mere one additional linkage each super speciality hospital is able to extend its reach to ten more peripheral hospitals. Soon after appreciating this resilient peculiarity of telemedicine, a pertinent question gets phrased, involuntarily. Then why is telemedicine stagnant in the developing countries? It is worth mentioning here that linearly rising curves about number of patients being treated through a telemedicine facility are not all that is expected from a technology like telemedicine which, in fact, is as promising as telephone and Internet technologies. Based on its inherent traits, if performing well, telemedicine as a networking technology to grow exponentially. Hence such questions are legitimate, primarily because telemedicine like any other networking

technology should have not only been growing but it should have proliferated and evolved rapidly. A quick single line logical answer to the question raised earlier could be: perhaps because the network externalities (effects) in telemedicine in developing countries are missing. This kind of an answer prompts us to probe further. The next question in the series would be why are network externalities missing in the developing world? The quest to find the answer leads us to two major excuses, these are: • Utility of existing telemedicine services: Main factor responsible for a networking effect is the utility of existing services. The present situation with respect to the utility of telemedicine facilities in developing countries is dismal. In this case, major inherent reasons are – i) lack of technology savvy clinicians, ii) existing local workload iii) attitudinal issues, iv) slow adoption, v) inappropriate organisation’s approach for implementation (topdown or bottom-up) etc. • Nature of telemedicine networks: Linkage is the other crucial enabler for engendering networking effect. Firstly telemedicine networks in the developing countries are insufficient to cover the country in entirety. Secondly, telemedicine networks in developing countries are isolated and discrete, there is virtually no common feature in terms of their design, deployment and operation. No show of homo-geneity in telemedicine networks makes these networks as genetically dissimilar entities which cannot interact, socialise or mingle. Lack of similarities shows up in various forms, some of these are instinctive traits and these are: i) nature of communication modalities being used, ii) lack of interoperability of devices, software and systems, iii) no common set of protocols or guidelines for enforcement, iv) provincial boundaries and regulations governing these networks, v) no schemes for reimbursements, vi) regional or national divides (knowledge and digital), vii) lack of or missing evaluation schemes.

The diffusion No doubt, telemedicine has showed up to be another customary technological import from the OECD countries but there may be some more for us to receive. But during the effort to cross the divide, some constituents have perhaps been left behind and those constituents are expected to influence adoption and diffusion rates of the technology in the developing world. Upon contrasting the issues pertaining to telemedicine in developed and developing countries and as per the published reports, issues pertaining to linkages are favourably handled at the design and deployment stages in the developed world. We can understand that telemedicine networks in the developed countries may also facing some issues but those are instinctive in nature. As regards the developing world, non-instinctive issues like cultural issues have to be resolved locally, merely waiting for those from the other side of the digital divide to hand-hold for crossing over these hurdles. Such an expectation may conversely increase nothing but the divide. Besides all other concerns, it may also be kept in mind that network externalities (effects) get introduced primarily from the belief that they are common to upcoming applications of ICTs. Such applications experience issues, which are different in nature from the issues, that are applicable for common technologies and are usually solved by the users themselves. i4d | April 2006

Vol. IV No. 4

April 2006

Information for development w w w. i 4 d . c s d m s . i n

Agriculture Online agri-market for Andhra Pradesh The Government of Andhra Pradesh, India is going to introduce online screenbased spot trading platform for buying and selling of farm produce in all the 305 Agricultural Market Committees in the State.

use new tools to overcome problems facing poor farmers across the continent. The network will gather relevant information and host electronic discussions on its website. The main aim is to promote dialogue on policy issues such as biosafety and the conservation of genetic resources. It will encourage researchers, policymakers, farmers and the media to share information and discuss how biotechnology can improve agriculture.

http://www.newindpress.com/Archives Login.asp

e-Commerce

http://www.scidev.net

Education Solution to keep children at bay

The proposal was mooted by the National Spot Exchange for Agricultural Produce (NSEAP). The NSEAP is hoping to solve all problems faced by the farmers by creating a user group of APMC commission agents, farmers, banks, agriculture universities, fertiliser companies, seed manufacturers and Government procurements agencies.

kindergarten through 12th grade. Cosmeo is located at http://www.cosmeo.com and costs $9.95 per month or $99 per year. Other features include interactive quizzes, a digital encyclopaedia and a digital photo library.

Norfolk schools (UK) are taking precautionary steps to stop children accessing unsuitable sites on the web. About 17 schools in the county have signed up to ‘securus’, a software package designed to detect, record and report all aspects of PC misuse including issues such as cyber bullying, racism, pornography and predator grooming. The service searches for inappropriate words and phrases in all applications and monitors for harmful activities, whether generated internally or externally, online or offline. Parents of the participating schools with the system are to get a home version free of charge. http://www.eveningnews24.co.uk

Novel structure for IT business An Indian business process outsourcing (BPO) player, is offering unconventional; BOT - Build-Operate-Transfer model to its outsourced services clients. The Mumbai based organisation, Omnitech InfoSolutions is said to making good bargain in the business. It has come up with a proposition, where it builds the facility, hires employees and runs the operation for a certain period. It claims to give benefits of a customised operation exactly tailored to the specific need without the hassle of running a captive unit. Recently Omnitech has also launched a hardware-software appliance ‘OmniMonitor,’ to monitor IT infrastructure and applications in real time. http://www.hindu.com

http://www.hindu.com

Online network to boost biotechnology research in agriculture The UN Food and Agriculture Organisation will launch an online network this month to boost biotechnology research and policy development in Africa. Accordingly Agricultural Biotechnology Network for Africa (ABNET) will be formed to enhance interactions among the African biotechnology community so that they can April 2006 | www.i4d.csdms.in

Website launched for parents to guide children in their studies A new Discovery Channel homework Website was launched for parents to refresh the knowledge of math and history to guide their children in their studies. Cosmeo, a new online subscription site from Discovery Communications, offers a range of tools from a WebMath equation solver to educational videos and subjectspecific Brain Games. Launched recentally, the site targets Web-savvy children from

Extol to launch ICT solutions The Extol group is planning to launch four solutions by the end of the yearincluding Artificial Intelligent, frauddetection system and forensic server for security purposes. Extol also plans to expand its business by stepping up marketing efforts for its managed security solutions (MSS) suite of services, which comprise of hardware that detects, reacts and protects ICT systems from computer-related security threats. http://biz.thestar.com

The i4d News

GP-to-GP data transfer in making the way easier for general practioners General Practitioners in UK are benefited from GP-toGP data transfer system, according to a new survey conducted for InPS (which supplies Windows-based clinical systems for Primary Care). The survey also highlighted GPs’ caution over how Practice Based Commissioning will work and its effect on Practice finances, as it rolls out in England in 2006. It showed many GPs welcome plans enabling pharmacists to handle non-critical patient consultations, so freeing up GP appointments. The online survey, done in March, targeted GPs in practices across the UK, with a total of 390 responses.

http://www.egovmonitor.com

Livelihood Quincy farmland to see high tech boom

http://www.publictechnology.net

e-Governance Rural e-Governance initiative by Vortex Technologies Ltd Vortex Technologies Ltd, an enterprise solutions developer has announced the launch of probably the first-of-its-kind rural e-Governance initiative, Softrack.net 2.0, at Hyderabad in India. Softrack.net, has features that allow monitoring of rural issues and grievances besides the flow of funds through schemes like MPLADS. Andhra Pradesh State Assembly Speaker K.R. Suresh Reddy, who unveiled the new solution, mooted a proposal to introduce e-Petitions wherein the people in rural areas could directly send their grievances to the authorities as well as legislatures using Softrack.net. There is a need to introduce concept like e-Petitions wherein the grievances can directly taken up in the Assembly. http://www.hindu.com

e-Seva, friendly citizen service e-Seva has come a long way since 1999 in Andhra Pradesh, India and it has proved to be the best example for government-tocitizen service. Instead going to one department to another, multiple government services are provided under a ‘single window.’ It is particularly of value to less-affluent and lessinfluential people, who do not enjoy the luxury of servants or peons who can spend time standing in queues. The ambience is good, the place is clean, less noisy and there is an air-conditioned environment,

The index will hold basic identifying information on all children in England and contain the names and contact details of practitioners providing specialist and targeted services to a child. The system is hoped to improve the reliability and quality of public services for all children, young people and families by early detection and intervention.

uncluttered by dilapidated furniture. There is access to drinking water, facilities like Automatic Teller Machine (ATM). The services are offered at dozens of centres, each with several counters, in a publicprivate-partnership model. http://www.financialexpress.com

Health Intel on innovative move in health sector There is always a room for vast opportunities for the IT industry to flourish around healthcare. Intel group has identified health as an area of special study and the job of its digital health group is competing enough to fill the lacunae. Software developers attending Intel’s Developer Forum (IDF), in April, noticed the critical plight of medical staff inspite of 90 percent the of the 30 billion healthcare transactions being carried via mail, fax or phone in every year especially in US. Immediate urgency was sought into areas that helps in improving communications between doctors and patients, managing drug delivery and asset management, maintaining electronic medical records and to develop and deploy standards that would help to integrate desparate medical systems with ICT utilities. http://www.bangkokpost.com

IT enabled child welfare The government of UK has outlined details of regulations that will enable it to begin trialling a new information-sharing index for children.

Microsoft Corp. and Yahoo Inc., the two technology giants, are planning to build massive data storage centres amid the farm fields of Quincy, rural central Washington, USA. The developments come as Microsoft, Yahoo, Google Inc. and Time Warner Inc.’s America Online, as a part of efforts to compete for customers loyalty.The Quincy area is attractive to Microsoft for a number of reasons: space availablity, access to power, and proximity to the company headquarters. Tech companies are intending to take work as far as India and China. It would be interesting to see the changes that comes to Quincy from that of a rural enterprise into a technologically informed town in the next five years. http://www.cnn.com

Women Day, empowers women through ICT In Bangladesh, Women’s Day was distinctly contemplated on empowering women through ICT (Information and Communication Technology). ICT has a strategic link with poverty reduction. Moreover it is expected to increase resources in their hands to be self reliant, empowered and reduce discrimination against them. Micro-credit for selfemployment schemes were also detailed that enhances the women’s decisionmaking capacity. Likewise, for any amount of earnings, women need to get some expertise in ICT which, will help them to earn more and to be more empowered with effective inter personel skills.The view gained strong support of Government of Bangladesh as well as of the non governmental organisations (NGOs) country wise. http://www.drishtipat.org i4d | April 2006

The i4d News

Open source Open source software for education projects A whole raft of new projects was unveiled by James Clark, the manager of the Software Industry Promotion Agency’s open source department, at the function, Asia-Pacific ICT Awards 2005. Clark spoke of the one million notebook for students project, which will be based entirely on open source and open standards and, which is a part of the programme by MIT to bridge the digital divide and provide access for all. It is expected that with enough students going home and turning their machines on, it will enable them to remain connected through the school server or even the Internet. Clark explained that the software for the Thai system would be basically the same version that MIT and Red Hat were working on, a low-memory footprint version of Linux. http://www.bangkokpost.com

Technology A-Data Technology unveiled USB and solar disk thumb drive Taiwan-based A-Data Technology has unveiled a USB memory stick that doubles as a portable VOIP (Voice Over Internet Protocol) phone. It allows a user who is on a holiday or working on the road to plug it into virtually any Internet-connected PC and use it to make their VoIP phone calls. Also equipped with an MP3 player and video player functions. It comes in three storage capacities. Users can load their phone books and other information on the device, and use it anywhere they can plug it in. http://infotech.indiatimes.com

Cisco’s integrated Internet solution for security Thailand SME sector, increasingly relying on the Internet, urged for an integrated network firewall that looks into security system as well. To address the need, Cisco has turned up with its ASA 5500 series of firewall/router in cooperation with anti-virus experts Trend Micro. Unlike most other firewalls, the new unit not only has the usual firewall, virtual private network and SSL VPN (encrypted VPN) facilities, but adds a subscription-

April 2006 | www.i4d.csdms.in

An innovative keyboard for non-English community by HP Labs, India A gesture-based keyboard [GKB], was developed by researchers at HP Labs India. The pen-based technology will allow users to compute in their own respective languages even without prior knowledge of English or typing. This is hoped to benefit more than 1.5 billion non-English speaking people, including Indian, Nepalese, Sri Lankan, Bangladeshi and other phonetic script users. The device is expected to be manufactured and distributed by a third party, based on technology licensed from HP. http://www.hindu.com

based anti-X system from Trend Micro that will help prevent many viruses, Trojans, spam and phishing attacks.The system is designed to augment desktop-based security solutions rather than replace them. http://www.bangkokpost.com

Telecentres Telecentre move in Rwanda The Government of Rwanda has earmarked a total amount of US$1billion (Frw560bn) to be invested in establishing and promoting telecentres in the country. The State Minister for Communications Eng. Butare pledged government’s commitment to ensure the spread of ICT to rural areas, in a bid to supplement poverty reduction strategies. “The government’s commitment is envisaged in the integrated ICT policy of NICI II that emphasizes communication access to rural areas. It is clear that the telecentres will help in closing the communication gap among the rural people and the government is ready to invest in the establishment,” Butare underscored. Telecentres’ project would be accelerated to enable people in rural areas access information. They are also enhanced to provide multi-purpose services through information, skills and consultancy, and business support by reducing the cost of doing business and business transactions between companies. The project is also aimed at transforming Rwanda into an ICT literate nation. The project is a way of improving access to information to enhance educational standards and to foster human resource development of Rwandans. This is also expected to lead to job-creation, sustainable growth and increase

investments in poor people to facilitate their participation in the development. http://allafrica.com

Nortel, Bharti signed to host contact centre at Delhi, India Bharti Tele-Ventures has signed a five-year managed services agreement with Nortel to host contact centre services for more than 19.7 million Airtel subscribers. Nortel will create a Network Operations Centre (NOC) in New Delhi. Once the project is implemented, Airtel users can dial a single number from anywhere in India, to be able to speak in English, Hindi, or four other regional languages to complete routine transactions and subscribe to new services. Nortel has also designed the architecture for future interactive video response capability. http://www.thehindubusinessline.com

Telecommunication Vodafone to takeover Venfin Vodafone, Britain based celluar operator is to finalise its takeover of VenFin by acquiring the few of its outstanding shares. Investors holding 373,4- million shares readily accepted Vodafone’s bid of R47,25 a share, a generous 41% premium to VenFin’s previous trading price. With acceptances received for 98,5% of the stock, that leaves just 1,5% yet to be handed over, Vodafone is to invoke section 440K of the Companies Act to force the owners to sell those shares so it could take over VenFin’s assets and delist the company. A circular and a surrender form has already been sent out to the reluctant shareholders. http://allafrica.com

The i4d News

Microsoft in making of self-sustaining rural India IT major Microsoft Corporation (India) Pvt Ltd is going to launch a rural portal shortly within next three to six months. The company is looking at partnerships to develop the portal with relevant information. The company has unveiled a self-sustaining kiosk model initiative aimed at taking IT benefits to rural India. It is a public-private partnership, called as Saksham (meaning self-sustaining in Sanskrit), on which the portal is being developed. Market linkages will be strengthened in association with ICRISAT and other institutes. The company is looking to set up over 10,000 kiosks in Andhra Pradesh. Similar experiments are being conducted for sugarcane in Tamil Nadu, Kanchipuram silk sarees, food processing industry in Gujarat. http://www.financialexpress.com/fe_full_story.php?content_id=122190

Single tower plan by cellular operators Cellular operators have agreed to share infrastructure to bring down set-up costs. The infrastructure sharing would begin in Delhi and then in Mumbai, after which the model will be replicated in other parts of the country. A working group under a Joint Secretary in the Department of Telecom will work out the modalities of the infrastructure sharing. The group will be headed by a joint secretary in the Department of Telecom and would have officials of the service providers as members. Sharing infrastructure would mean having a single tower where all the operators can install their equipment and each tower costs around Rs 35 lakh. http://www.thehindubusinessline.com

Wireless Broadband business to boom in Thailand Broadband Internet use is all set to overtake dial-up access this year in Thailand. In line with the growth in broadband, the percentage of users on dial-up connections dropped from 39 percent in 2004 to just 30 percent last year. The most common activity online is email (24 percent), followed by information searching at 22 percent, while games and chat were used by 13 percent of respondents. e-Commerce has been done by most users, with 69 percent indicating they had purchased something line. The most common service was reservations (20 percent) and buying movie tickets (19 percent) and software (16 percent). Those connected via broadband typically spent

between 500 to 1,000 baht a month for service. ADSL/xDSL accounted for 87.6 percent of connections, while cable modem had 4.6 percent and ISDN 4.4 percent. http://www.bangkokpost.com

‘EU Intranet Cooperation Forum’ to combat cases of incitement to hatred The European Commission proposed ‘TV without Frontiers’ Directive to use a ‘EU Intranet Cooperation Forum’ to challenge programmes, which stimulate seditious hatred. This issue has been discussed by Europe’s broadcasting regulators at a meeting in Brussels today. The regulators supported the Commission’s proposal to launch a new EU Intranet Cooperation Forum as an effective means to combat clear cases of incitement to hatred in broadcast and audiovisual media services whilst meticulously respecting the fundamental freedoms enshrined in the EU Charter of Fundamental Rights. European Broadcasting Regulators also discussed the modernisation of the TV without Frontiers Directive and the amendments to step up the fight against incitement to hatred. http://www.publictechnology.net

General Check on child pornography by Internet and financial firms A group of financial institutions and Internet firms have joined together to form a coalition against child pornography.

The organisations involved in the coalition aims to share information about commercial child pornography sites and ensure that payments for images are not passed on. It will also issue, cease and desist notices to websites. Thereby, it tries to restrict profit, from selling child porn within two years. Net users are appealed to report on such sites to local watchdogs. The website of the International Association of Internet hotlines, hosts lists of reporting organisations in many countries. http://news.bbc.co.uk

Microsoft cautions malicious bugs at Internet Three new bugs have been discovered, that are on its way to invade Internet. Microsoft has cautioned net users of all the three bugs, which would produce patches for the vulnerabilities in its next security update, due on 11 April. Those using the patched versions of IE bundled with Windows 2000, Windows XP and Windows Server 2003 are vulnerable to these bugs. The first of the problems discovered in Internet explorer, simply will make the browser program crash, if used for visiting a specially crafted webpage. The other two vulnerabilities are potentially more serious because they can be used to take control of the victim’s computer. Microsoft urged users to avoid websites they did not trust and refrain from opening attachments on e-mail messages from unknown senders. http://news.bbc.co.uk

Scientific tempered online forum for women An online forum, AGORA to support women’s contribution towards scientific progress has been launched by UNESCO and cosmetics company L’Oreal. Though all Internet users can access the forum entries, only members of partnership can contribute to the website. AGORA will focus on topics such as science education for girls and women, women on science and sustainable development, bioethics and diversity. The forum aims to strengthen ties among community members, and provide space for discussing crucial issues facing the world. http://allafrica.com i4d | April 2006

Rendezvous egov A SIA 2006, DL A SIA 2006, ATF 2006: C URTAIN R AISER ,17 M ARCH 2006, B ANGKOK , T HAILAND

Providing a platform for Asian dialogue Centre for Science, Development and Media Studies (CSDMS), India in association with Ministry of Information and Communication Technology and Ministry of Education, Royal Thai Government, recently organised the ‘Curtain Raiser Ceremony and First Meeting of the Programme Advisory Board’ of the forthcoming triple conference – egov Asia 2006, digital LEARNING Asia 2006 and the Asian Telecentre Forum 2006, to be held between 26-28 April, 2006 at Rama Gardens Hotel, Bangkok, Thailand. Held as an evening programme, at the luxurious Lilavadee Room of Rama Gardens Hotel, Bangkok, the ceremony and the meeting drew participation by more than 40 delegates, comprising honourable members of the Programme Advisory Board, representatives from supporting partners and institutional partners, senior executives and leaders from the IT industry and members of press and media. The meeting started with an ‘Opening Address and Welcome Note’ by the Chairman of the Programme Advisory Board, Kraisorn Pornsutee, Permanent Secretary, Ministry of Information and Communication Technology, Royal Thai Government.

Dignitaries expression In his speech, Pornsutee emphasised the increasing awareness of governments and communities about the enormous potential of ICTs for fast-forwarding their developmental process and realisation of the undeniable need for mutual learning and knowledge flow. He expressed the overriding importance for creating enabling opportunity for encouraging new learning paradigms and intellectual networks through platforms, such as that provided by the forthcoming triple conference - egov April 2006 | www.i4d.csdms.in

Asia 2006, digital LEARNING Asia 2006 and the Asian Telecentre Forum 2006. A detailed presentation about these triple conference by Ravi Gupta, Director, Centre for Science, Development and Media Studies (CSDMS) and Convener, egov Asia 2006, digital LEARNING Asia 2006 and Asian Telecentre Forum 2006, followed immediately after the Chairman’s opening address. Speaking on the background of this triple conference, Gupta explained the relevance of these events in context of various initiatives of CSDMS (viz. egov, digital LEARNING and i4d magazines and portals) and its commitment towards promoting and advocating ICT-led development societies across the Asia-Pacific

gave his consent for the same, while enquiring details of the Grand Inaugural Ceremony.

Open floor discussion An open floor discussion followed thereafter, wherein the members and representatives of the Programme Advisory Board where engaged by the session moderator, the Chairman himself, to invite remarks and suggestions. While all of them endorsed the draft plan, some valuable feedback came forth from some of the members, which were accepted with due respect and acknowledgement, to be shortly incorporated into the overall programme. Views and suggestions were also invited by the Chairman, from members of the IT industry who were present at the meeting. Although many of them refrained from putting forth any comment, sighting their role as observers, a few valuable inputs did come in, laced with words of inspiration and intent of the industry to provide support for the conference.

Conclusion region. Highlighting the remarkable momentum and popularity that this event has already generated for itself across various countries and stakeholders of the region, Gupta gave a vivid portrayal of the 24 national and international organiations associated with these events in diverse roles and capacities. Following this, he presented the details of conference programmes, covering each plenary and parallel session, the invited speakers, paper presenters and special workshops of the conference. Delivering his valuable comments on the conference agenda, the Chairman, Kraisorn Pornsutee appreciated the draft plan and

The meeting concluded over some reassuring words from the respected Chairman, about the strong commitment of Thailand to carry forward the eGovernment and ICT for Development vision of the country, irrespective of whatever political turmoil the country has to go through, and also pledged to lend their helping hand in building capacities of Asian countries. A press meet followed right after the meeting, with the esteemed presence of the Chairman Kraisorn Pornsutee, Ravi Gupta and members of the media. A cocktail and dinner followed the ceremony, providing valuable networking time for the delegates and an opportunity to socialise.

Rendezvous W OMEN’ S ICT- BASED E NTERPRISES W ORKSHOP , 2-3 M ARCH 2006, K OLKATA , I NDIA

Promoting ICT-based small businesses The falling cost of technology has generated self-employment opportunities for women in ICT-based enterprises, but great expectations need to be tempered with a realistic assessment of the country’s IT infrastructure and the need for women to further enhance their entrepreneurial aptitude. This emerged from a workshop held on 2 & 3 March, 2006 in Kolkata on the scope of women’s ICT-based enterprises in West Bengal and Bangladesh that was organised by Change Initiatives in collaboration with the Institute for Development Policy and Management, University of Manchester. Around 40 prospective women entrepreneurs attended the workshop. In over two days they obtained snapshots of the opportunities and constraints in ICTbased enterprises from development practitioners and researchers from the government, private sector, NGOs and banks. There were three invitees from Bangladesh who spoke on the initiatives in the field of ICT-based enterprises in the country.

The issues highlighted The opening session of the workshop laid bare the issues that needed to be discussed at. Speaking on behalf of Change Initiatives, its president, Sibaji Roy, and vice-president, Mukul Mukherjee, explained the significance of ICTs in the context of globalisation and the need to make the entry of women easier through support from the government and financial institutions. G.D. Gautam, special secretary, department of IT, government of West Bengal, said in ICTs the main component is the media through which information passes. This puts ICT-based enterprises in forefront of the knowledge revolution. He said ICT impact can be assessed both in terms of improved

productivity and increase in the quality of life. Gautam Burman CEO of Webel Technologies Limited stressed the factors behind sustainable ICT development. These factors were taking ICTs to the grassroots, making IT training compulsory in schools; strengthen communication infrastructure and promoting sustainable development by diversifying into more products and services.

Technology options The workshop explored a range of technology options that were available to the women entrepreneurs. Enakshee Jha, who runs Kasturi Netcom, an enterprise applications company, said there were innumerable opportunities available for women in the data-entry space. She suggested that workspace could be efficiently utilised to even operate multiple ICT-based enterprises. A single room, she said, could be used for both a DTP enterprise and as well as an STD booth. Anupam Basu of IIT Kharagpur said for the women entrepreneurs there was DTP,

web-page design, computer training, developing academic and study materials and imparting it through computers to make the learning process more interactive, setting up information centre, setting up studios with web cameras and developing education materials for the blind children. The participants, however, stressed the need for an appropriate survey to assess local demand. Souri Chatterjee, business manager, ILF&FS Education and Technology Services said information is a commodity, which can be brought and sold in the market. He then gave examples of ‘commodities’ in the information sector, such as agricultural information, e-Governance information, entertainment and telemedicine, information on job opportunities and value added services like consumer rights, environment and booking of long-distance tickets. Shantanu Sengupta, general secretary of the NGO Grasso, spoke on mobile telephone as a technology option. Grasso itself runs a mobile telephone franchise in rural West Bengal. By taking mobile telephony in remote rural regions through franchisees, an entrepreneurs, Grasso has strengthened the communication infras-tructure of West Bengal at the grassroots, along with generating self-employment. According to Sengupta telephone is one of the strongest mode of communication. Telephone network development in rural area will automatically lead to rural employment. He also emphasised on developing communication skill in vernacular language. Women can also take part in marketing and product development.

Support opportunities The technological options on offer need to be buttressed by appropriate support from banks and the government. Swaraj i4d | April 2006

Chatterjee, faculty, staff training college, Bank of India elaborated on different aspects of bank support. For instance, banks give loan from fixed capital equipment such as room, furniture, equipment etc and also for working capital. Making a project proposal and submitting it is essential before getting a loan from banks. This project proposal should consist information on market survey, budget and expected profit. Looking at ITC-based enterprises from the perspective of a smallscale unit, D. Baidya, Small Industries Services Institute (SISI), Government of India, discussed the procedures to set up an SSI, such as acquiring a trade license, undertaking a market survey and preparing a project survey. He emphasised planned business activity, teamwork and development of a network and skill management. Similar views were echoed by Aloke Banga of the Entrepreneurship Development Cell, Government of West Bengal. Banga emphasised identification of the problems of the locality, area potentiality survey, identification of customers and target group.

The entrepreneurial spirit Beyond ICTs, the speakers referred to the need for the entrepreneurs to take risks. C.L. Mukhopadhyay of the Department of Technical Training and Education, West Bengal Government, emphasised on development of skill through proper training before establishing a business. He was of the opinion that awareness needs to be created among the women for taking up such training pro-

Bangladesh, through reflect research methodology. The concept of ICT was incorporated very recently since mid 2005. Availability of information will enable to fight poverty and both protect and increase ones’ assets. ICT also empowers women through development of skill and self-confidence. Arfatul Islam a journalist from Bangladesh presented a case study on how poor Bangladeshi women can change their destiny with the help of mobile phone. Operation of mobile phone was taught to poor women at the end of 1991. Now these women have immensely gained from the use of mobile phone. They have been able to set up a network through which they can collect information and apply them in their small business activities. He also said that this could be successful even in India if the call rate is cheap.

Feedback session The feedback session was done to get different viewpoints of the participants regarding the workshop and also their area of interests. Around 16 participants have been considered for further follow-up. Most of them possess a sound knowledge in computers and are well acquainted with DTP. It has been observed from their feedback forms that they are mainly interested in setting up DTP based business. However, some of them have also done multimedia, FOXPRO, DOS, FA, etc., and other computer programming courses. Very few of them are even doing MCA. They are interested in setting up own training centres, small scale call centre, BPO jobs and even in KPO activities like financial accounting. The feedback form also contained provision to find out investment needs and financial capabilities of these aspiring entrepreneurs. It has been mainly observed that investment need ranges from INR 25,000 to INR 1,00,000 (A US Dollar fetches about INR 45). As far as the financial capability of these aspiring entrepreneur, it has been found out that around six of them are capable of investing INR 10,000-15,000 initially. One of them already has own computer training centre and can provide with room and computers. Rest of them is either not well acquainted with investment need or they are not capable of investing any amount and need to take loan from bank.

Conclusion A session in progress

grammes. Banga told the participants to develop their unique qualities. He told them to understand their environment and offer unique solutions. One’s idea has to be unique in order to attain selfidentity, he said. Baidya regretted the lack of entrepreneurial attitude in West Bengal especially among women. He also stressed on profit motivation.

The Bangladesh experience Zakir Hossain Sarker of Action-Aid Bangladesh presented a case study on how ICTs has helped the marginalised section in rural April 2006 | www.i4d.csdms.in

The workshop is part of the work being undertaken by Change Initiatives and the University of Manchester to facilitate ICT-based enterprises for women in West Bengal and Bangladesh. The workshop findings will be the basis for a handbook in Bengali for women’s ICT-based enterprises. The handbook is aimed at prospective women entrepreneurs in West Bengal and Bangladesh. In addition Change Initiatives has planned a range of media dissemination activities to promote the activity. J For more details write to changeintiatives@gmail.com Report by Jhumpa Ghosh Ray and Jhulan Ghose Change Initiatives, Kolkata

Rendezvous C ISCO -NISG 2 ND A NNUAL P UBLIC S ECTOR S UMMIT , 9-10 M ARCH 2006, N EW D ELHI , I NDIA

‘Connecting government, empowering citizens’ Cisco Systems and National Institute for Smart Government (NISG) co-hosted the Summit in which over 120 delegates across the country comprising senior officials participated. The event was also graced by top brass officials of IT concerned field abroad.

Objectives and issues raised The objectives of the summit included (i) providing a framework for developing state-level infrastructure strategy that supports e-Governance roadmaps, (ii) presenting and discussing business models and technology options for top-priority ICT infrastructure issues, (iii) addressing key implementation challenges of state-level ICT infrastructure, (iv) sharing lessons from different jurisdictions inside and outside India to leverage best practices, (v) providing an opportunity for feedback and discussion on the national e-Governance roadmap blueprint and (vi) exploring trends and issues on key ICT infrastructure issues such as data-centres, storage and wireless. Brijesh Kumar, Secretary, Department of IT, Government of India (GoI) inaugurated the summit. Speaking on the occasion, Mr. Kumar stressed on the necessity to manage the infrastructure efficiently as the security issue related to the IT infrastructure. In his address, R. Chandrashekhar, Joint Secretary (e-Gov) DIT, explained about India’s National e-Governance Plan (NeGP). He said that some 25 e-Governance projects in mission mode are to be launched shortly by the Government of India. One of the 25 projects is that of MCA 21, which would enable companies to file returns electronically. Other projects include setting up of common service centres (CSCs) and assigning unique ID to below-poverty line families. J. Satyanarayana, CEO of NISG, addressed the inaugural session of the summit. He expressed the hope that the Public Sector Summit 2006 would enable sharing of knowledge and experience of countries on the various facets of establishing a robust and scalable infrastructure for e-Government, Sudhir Narang, Sr. Vice President, Government and Service Provider Businesses, Cisco Systems, India and SAARC, informed that Cisco has been collaborating with Governments all over the world in their e-Governance efforts including India. He announced that Cisco has committed US$5mn to NeGP for setting up e-Government lab facilities in each state of India.

Policy recommendations Recommendations to department of IT included (i) assistance to departments from concept to solution; (ii) drafting clear policy for last mile connectivity, bandwidth charges, content management, security policy, standards and architectures, (iii) information sharing,

(iv) Central MMP on Data Digitisation; (v) link rollout of CSCs to state e-Governance readiness to institutionalise them; (vi) providing exposure of e-Readiness reports among bureaucrats and politicians (through seminars, media etc.), and (vii) consolidating best practices for business models.

Panelists’ voice The summit concluded with a discussion deliberating on issues such as the role of regulator in e-Government, how to promote development of right content, e-Readiness and the role of CIO. Mr. Jeff Kaplan elaborated on the concept of e-Governance to include integrated services for citizens. Ms. Joan McCalla identified some of the CIO challenges and how to respond to them. Ms. Zohra Chaterjee emphasised on the need of making people realise the need to have CIO, especially in India. One way to do it is to link state IT funds to CIO. Ho Chuan-te presented an interesting definition of IT in Taiwan. He said that IT is ‘India+Taiwan’. According to him, the government of Taiwan is encouraging its citizens to come to India to learn. He suggested that the third Public Sector Summit should have representation from the highest level of government, attended by the Prime Minister of India. This will give the required push to e-Governance.

Conclusion Dominic Scott, Principal Consultant, Public Sector- Asia Pacific, Cisco, informed that CISCO had organised the summit to provide a forum for central and state governments and consultants to share ideas and international experiences. The large workshop component provided the delegates an opportunity to interact and debate on the national e-Governance programme. The summit concluded with the common resolution of daring to dream. J Prachi Shirur, prachi@csdms.in i4d | April 2006

April 2006

ICTD Project Newsletter to afford these services at a price that makes them sustainable from a business perspective. The growing innovations in the use of Information and Communication Technologies have opened up new era of information dissemination. However, the objective of such initiatives needs to focus on satisfying the information needs of the poorest among poor and those who face difficulties in access to information necessary for improving and securing their life. The state of Gujarat, today, already is among the leading states to invest money and resources for IT implementation in governance and citizen services. Achievements have already been made in the policy, infrastructure, application development, data-warehousing areas and endeavors are on to achieve more in the areas of industry, networking, content creation and information management.

Background of the Village Information System

An n-Logue kiosk, one of the early e-Governance initatives of the Govt. of Gujarat, pictured here with the entrepreneur operating it.

Village Information System â&#x20AC;&#x201C; attempting to transform rural governance Access to information becomes a key to healthy and dynamic democracy to ensure participation of all in development. The challenge lies in ensuring easy flow of public information to rural citizens irrespective of caste,

class, gender and literacy level. The satisfaction of information needs of the rural communities is challenging but possible. The most under-served â&#x20AC;&#x201C; the rural poor â&#x20AC;&#x201C; live in the most expensiveto-serve areas, and they are often unable

The Gujarat state government took up the challenge of setting up e-Governance programme by providing computerbased services to its people through projects such as e-Dhara, Mahiti Shakti, Talim Rojgar and Jan Seva Kendras. The state government is now planning to strengthen the e-Governance programme and link it with various development initiatives through ICT based services and bring it to the doorsteps of rural communities and in the process bridge the digital divide. Gyanganga, a pilot project to serve rural communities, was developed on the basis of public-private partnership. Gyanganga provided first experience to rural people of Gujarat to access information through Internet services

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and thus introduce them to a new world of possibilities. Encouraged by the performance of Gujarat State Wide Area Network (GSWAN), the state government has decided to take the programme further to the doorstep of the rural people and to bring them closer to the government.

targets to bridge the digital divide between the urban and the rural sectors, and to convert right to information into a reality through access to digital information, providing communication hubs at villages, and, thus, empowering people through access to global communication and information.

computer based education, horoscopes etc. These services would be provided through a Village Computer Entrepreneur (VCE). This project aims to provide a state level portal to the rural citizens of Gujarat for simplified, effective, efficient, integrated, faster, economical, anytime-anywhere and

The state government is now planning to enlarge the use of ICT in rural areas through its ambitious e-Gram and Village Information System (VIS) projects, with initial coverage of 1400 villages across the state. As a pilot phase, Government has decided to cover 100 villages of Patan and Mehsana district of North Gujarat. The VIS would run on the backbone of the n-Logue and GSWAN connectivity. These services provided under the VIS project will be easy and simple to access with minimum associated costs. Citizen services offered will be (i) e-Governance Services, (ii) Internet based Information Services, (iii) Commercial Citizen Services. It also

e-Governance Services would cater to providing various citizen centric government services like submission of application forms for issuance of caste certificate, income certificate, domicile certificate, birth certificate, death certificate etc. Internet based information services would cater to providing various citizens centric public information services such as information on agriculture, meteorology, animal husbandry, health, education, etc. It would also include messaging and Internet services like Internet surfing, eMail, chatting, video conferencing, etc. Commercial citizen services would cater to providing various commercial citizen services like digital photography,

transparent services for their needs and empower them with knowledge.

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VIS to be piloted in 100 villages Five talukas covering 100 villages in the two districts of Patan and Mehsana in North Gujarat have been selected for the pilot phase of the project. The selection of these villages is based on the following criteria. â&#x20AC;˘ population is more than 1000 in a village; â&#x20AC;˘ the connectivity through N-Logue/ BSNL is possible; â&#x20AC;˘ villages must be covered under Jyoti Gram Scheme (Rural Electrification scheme);

â&#x20AC;˘ villages should not be covered under the e-Gram Project of Panchayat Department. While the project is being supported under the ICTD Project, it is being implemented by the Gujarat Informatics Limited (GIL) in coordination with the Dept. of Panchayati Raj, Govt. of Gujarat. To co-ordinate, monitor and control the execution of the project during the various stages of its development, an organisational set up has been built up that includes steering committee (Government of Gujarat), project coordinator (Government of Gujarat), project team (Government of Gujarat), project leader of solution provider (SP), project team of SP, quality assurance group of SP. The project would interface with the existing applications, databases, and processes where applicable; the master data may not need to be duplicated and also data would be consistent. The architectural and design features of VIS would enable adoption of multiple delivery channels. The delivery channel would be kiosk terminals in the village and PC terminal at the data centre.

Community involvement To assess the information and communication needs of rural communities in the project sites keeping in mind the region and its people, a Needs Assessment study was conducted through the services of Saline Area Vitalization Enterprise Ltd. (SAVE) and Geographis Private Ltd. The study has identified variations in the information needs according to gender, caste and class, occupation and age. The study covered an assessment of the informational and occupational needs of women, youth, marginalised and BPL families with adequate representation of illiterate rural citizens. One of the important learning that has occurred during the study was that the information needs of the community are highly dependent on the regional variations and differ across the 100 villages.

Community participation has been a officials. The computerised land records feature of this project. The Gramsabhas which till now are available only from have been organised in villages to brief the Taluka offices will be made available local people about the project. These from the Village Panchayat offices. The VIS project would enable meetings were organised with the support of village Talatis and Sarpanches transparency to governance through of the respective villages. Falia or cluster implementation of e-Prima application meetings followed this. The purpose of developed by NIC. e-Prima facilitates the meetings was to convey information easy maintenance of records related to about the project and obtain their views income/expenditure of Panchayati Raj on required information and current Institutes (PRIs). It provides details sources of information. Various regarding grants received and categories of people were covered in generated from centre, state, own funds. these meetings viz. farmers, women, Information collected through this students, scheduled caste, etc. The system would help to monitor the works exercise facilitated selection of potential carried out for developmental works in samples for personal interviews to arrive the PRIs and at the same time to bring at common views of local people on transparency in the maintenance of existing systems. The information panchayat funds. The Village Computer Entrepreneur required for the study was collected from three main primary sources, viz. (VCE) would be selected for each of the discussions with different stake-holders, villages. This would ensure timely group discussions at village level availability of varied services to rural and individual surveys. The following methodology was adopted for data collection from pri-mary sources. The project team inter-acted with three groups of stake-holders namely service administr-ators, service providers Discussion with service users in a Gram Sabhas (village level meeting) and service users.

Technical features of VIS The National Informatics Centre (NIC) is partnering on the project for the software development. The VIS project is being interfaced with the existing applications, databases, and processes where applicable. This would mean that the master data is not duplicated and also data is consistent. The database is being created from the existing records available at the village panchayats and being verified by the Village Panchayat Government

masses and also help sustainability of the project by providing various Internet based services and commercial services in addition to the government related services. Connectivity: The Gujarat State Wide Area Network (GSWAN), the largest IP based e-Governance infrastructure network in Asia Pacific connects 25 districts and 225 talukas through 12,000 nodes in Gujarat. GSWAN is capable of voice, video and data transfer. The

37 www.nisg.org

• Commercial services would save time, money and effort of the villagers to get the services, as they would be available at village itself. • Parameterisations of data in the database to facilitate easy consol-idation at taluka, district and state level would help government to get an overview. • The MIS reports at taluka, district and state level on consolidated data would help to assess and improve on the existing process. • It would generate employment opportunities in the villages, by training the rural people to operate the kiosks and involve them in the product selling in the villages.

Expectation from VIS

Discussion with service users in another village meeting

capacity network is being further strengthened from 2 MBPS to 8 MBPS between the state capital and district headquarters and being strengthened from 64 KBPS to 2 MBPS from district headquarters to taluka headquarters. However, the GSWAN connectivity is currently available only up to Taluka/ Mandal Headquarters and not available at Village level. It is currently feasible to provide Dial up Internet Connectivity in the Pilot sites through BSNL (Dial-up Internet) and through N-Logue (Wireless Internet) based on Cordect Technology. It is currently not possible to have Broadband/GSWAN Internet connectivity in the pilot sites. Internet connectivity through N-Logue (Wireless Internet) and BSNL (Dial up Internet) have been explored. A mix of Dial up and Wireless Internet connectivity will be used in the pilot sites as they are the only currently feasible connectivity options.

Communication strategy A communication and publication strategy will be adopted during project kick off. It would involve direct communication with the rural masses in various clusters consisting of about 4-5 villages. The communication would be in form of ‘Bhavai’, local folk drama,

which would directly relate to the rural masses and communicate with them in the language that they understand. It would help create awareness of ICT among rural masses who would be more willing to use various ICT based services once they have some basic knowledge of IT.

Benefits of a democratic set up The main stakeholders of this project would include rural citizens of Gujarat located in the selected Talukas for VIS Implementation, various offices of Government of Gujarat, Gujarat Informatics Ltd. (the implementing agency), village computer entrepreneur (VCE) selected for operation of computers and providing ICT services in the selected 100 villages, vendors/ agencies involved in implementation of VIS. • The VIS Project has the potential to provide single points of contact for various services in simplified, easy and more efficient manner. • Linkage to the existing database for retrieval and computations would ensure correctness of the transaction; it would thus benefit both the villager and the government. • Validation of the data to avoid misuse is another major feature of VIS.

38 www.nisg.org www.nisg.org

In a nutshell, VIS would help to bring ICT to rural areas in the state of Gujarat and improving the quality of life, facilitating improved production and marketing of agricultural products, and providing equal and growth oriented opportunities for education, health, employment and entertainment to rural industries. Since a modular and parameterised approach is followed in VIS, that would facilitate easy replication at multiple sites. The parameterised database approach would be helpful to further facilitate multiple site deployment with minimal customisation. The project is expected to launch during mid-2006.

References • Detailed Project Report of the Village Information System project prepared by Gujarat Informatics Limited • Needs Assessment Report of the VIS project, Prepared for Gujarat Informatics Limited by SAVE in association with Geographis. For further information contact : ictd@nisg.org NISG and i4d reserve the right to reprint article produced for the ICTD section of the i4d magazine and website, with due credits to NISG and i4d. Please write to the editor for any request of reprints.

T HE S TOCKHOLM C HALLENGE A WARD 2006, 11 M AY 2006, S TOCKHOLM , S WEDEN

Some leading projects in ICT and health On 11th May, the City of Stockholm will experience a grand prize ceremony in the City Hall where finalists of six categories will participate. One of those categories is ‘Health’. Around 100 finalists will participate in the Final Event of the Stockholm Challenge 2006, on May 8-11, 2006 for the world’s best ICT projects. The finalists will gather for closed workshops on the 9th May to share their experience with academic and industrial members of the Swedish Programme for ICT in Developing Regions, SPIDER. On May 11th May, the City of Stockholm invites the finalists to a grand Prize Ceremony in the City Hall. The winners in the six categories (culture, economic development, education, environment, health, public administration) and the winner of the WSIS Challenge Award will be announced in the presence of hundreds of guests and world media. Here is the brief about the finalists in the category Health areas. • Community Health Information Tracking System, Philippines: The Community Health Information Tracking System Project, fully implemented in the target communities since September 2004, was carried out to improve health care delivery in the public health sector in the Philippines through the development of a computerbased information system for community health centres using open source software and local capacity building. • Electronic Medical Records Exchange (EMRX), Singapore: The EMRX, organised as a collaborative Working Group amongst the healthcare organisations participating in the sharing of medical records, led by the Deputy Secretary for Health, enables the sharing of electronic medical records across healthcare establishments such as April 2006 | www.i4d.csdms.in

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hospitals, to improve patient safety and enable better co-ordinated care. The EMRX project has established a national platform for sharing of EMRs across healthcare institutions over a relatively short period of time. The records of more than 680,000 patients are available through the system today. Training of Medical Staff through Continuous Medical Education, Romania: This project aims to increase medical practitioners capacity to manage HIV/AIDS cases, by increasing and updating their knowledge through training and information provision. PatchWorx an Online Support Community for Children Facing Illness or Disability, United States: This is a global online support community for children facing critical illness or disability. Automating the Humanitarian Supply Chain with Humanitarian Logistics Software (HLS) an Helios, United States: Fritz Institute’s Humanitarian Logistics Software is a supply chain software solution which uses state of the art technology and best practices from the private sector for increasing the speed of disaster relief delivery thus reducing human suffering and saving lives. SIMpill real time medication compliance management, South Africa: This project monitors, using wireless (GSM) technology, and supports patients on critical long term medication to improve compliance with chronic medication. Tools for Implementing HIV/AIDS Programmes in Southern Africa: It is an interactive multimedia CD-ROM based HIV/AIDS Information Toolkit used by

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HIV/AIDS Activists and professional to fight the epidemic in Southern Africa. Health Information Systems Programme (South Africa) or HISP SA: It develops and implements Health Management Information Systems (HMIS) in South Africa, while simultaneously being a core group in a global south-south-north network dedicated to using Free and Open Source ICT for health. HISP India, India: HISP is project about the strengthening of health information systems to support health management, especially for the district and sub-district levels. HISP India is one of the nodes in the global research and development network of the University of Oslo, Norway which has taken up initiatives in Health information Systems in various countries of the developing world. OpenMED@NIC, India: OpenMED is an open access archive for Medical and Allied Sciences where authors and owners can self-archive their scientific and technical documents. Patent Wars on AIDS Drugs, India: Patent Wars on AIDS Drugs is a multinational, multicultural online collaborated project by teenagers, working towards disseminating knowledge regarding the plight of HIV/ AIDS patients in certain countries with respect to accessibility. SAHANA Disaster Management System, Sri Lanka: It is an integrated set of pluggable Free and Open Source, web based disaster management applications that provide solution to humanitarian problems in the aftermath of a large-scale

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disaster such as the Asian tsunami and the Asian earthquake. NIRPHAD, India: This project aims at empowering poor rural women in 3 districts of the State of Uttar Pradesh to achieve their human rights through socio-economic development by using the ICT approach for awareness and increased living conditions. World CME, Australia: World CME provides free (academic) medical education, and continuing professional development programmes for doctors in World Bank designated ‘low income countries’ and heavily discounted medical education for ‘middle income’ countries. Europe Against Drugs, Ireland: Under this project, concerned citizens are working together to reduce demand for illegal drugs in line with UN Conventions on Narcotics whilst combining family support and treatment. TEMPOREÂ® MEDICAL TELECONSULTING SYSTEM, Italy: This is a medical tele-consulting system, useful for helping the rescuers team to take critical decisions in emergency situations transmitting, from and towards centres of medical excellence, medical information on the patients about many specific pathologies. Let’s talk about AIDS, Ukraine: It is the only electronic bulletin of its kind, published twice a month in English, Russian and Ukrainian to raise awareness about HIV/AIDS epidemic in Ukraine, CIS and the East European region among communities, NGOs, citizens and governments in general, and in particular, on human rights of the HIV+ people, proper use of resources and more commitment to fight the rising epidemic. FADE - Foundation for Alcohol and Drug Education (Digital Development Initiative), New Zealand: The project is lauched by the Foundation for Alcohol and Drug Education (FADE), it is a digital initiative that focuses on the use of ICT with the aim to increase impact and reach to assist communities with alcohol and drug issues. MindYourMind.ca, Canada: www.mindyourmind.ca is an innovative

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web site for youth, by youth, designed to inspire them to reach out, get help and give help during times of stress, anxiety, depression, and suicide or self harming behaviours. Medical Missions for Children.s Global Telemedicine & Teaching Network, United Nations: It serves critically ill children in underserved communities around the world. Telemunicipio Saludable, Italy: This project aims to create an associate net, composed by the municipalities and the civil society, to promote and facilitate through the digital technologies the exchange of the best practices regarding the assistance, the prevention and the social-sanitarian education, intended for women in their fertile age. China National TB Programme Health Promotion Toolkit, China: This project has initiated to prepare a set of 8 CDRoms containing a variety of materials for different media, designed and tested with rural people in China, to combat the spread of TB. Telecare, Remote Outpatient Care Anytime Anywhere For Chronic Diseases, Singapore: This patient-focused project allows Singapore health clinicians to closely monitor and timely manage the health of outpatients with chronic diseases on a daily basis through ubiquitous technology such as Internet portal SMS and low-cost health monitors from locations outside of SingHealth medical facilities, thus reducing emergencies and complications among these patients. WELLCOM, eHealth Services for Turku Citizens, Finland: Under this project, for defining cost-efficient, citizen-centred eHealth practices and an eHealth strategy, innovative service models using modern ICT are tested in four selected service units of the Turku Health Care Department. Operation Village Health, United States: This cross-cultural programme provides eMail-based physician support to Cambodian health workers in two remote sites, through leveraging of an expanding Internet infrastructure, allowing Harvard-affiliated specialists to share their

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knowledge and collaborate with underserved communities on the other side of the globe. ICTs for the Rural Development of Mountainous and Remote Areas of Northern Pakistan, Pakistan: This project aims to explore the potential benefits of telemedicine, advanced medical diagnosis, advice of medical specialists and accessible information on healthcare through telecommunication and Internet-connection, that can be delivered to the poor, particularly women and children, in a remote and backward region of a developing country in a sustainable manner. Young Nigerians Science and Health Tele-Academy, Nigeria: This is a youth leadership programme that equips rural information workers with appropriate ICTs, empowering them to collaborate with their digital peers, leading educators and health professionals to research, document and disseminate information on HIV/AIDS and water borne diseases. AIDS Treatment Information Centre, Uganda: It utilises modern ICT - Ericsson PABX Backstage Soft-Phone - to provide free valuable active and proactive information pertaining to antiretroviral therapy (ART) to healthcare workers (HCW) in rural and urban Uganda, and Africa at large, with the objective of improving quality of care and the ultimate goal being individual patient benefit, society and community preservation by improving the quality of life for the HIV positive patients. Virtual Leadership Development Programme, United States: Available in five languages, this is a thirteen-week, blended learning course that uses a flexible mix of material formats and delivery methodologies to guide teams of health professionals in the developing world to develop action plans for improving their services to clients. Zorgloket Eindhoven, Netherlands: This is the one-stop-virtual help if anyone has questions about health care and wellbeing in the city of Eindhoven, s/he will always get an answer.J Source: http://event.stockholmchallenge.se/ finalists.php?id=health i4d | April 2006

Books received Cisco Systems has shared series of publications carrying essays from various ICT innovators. Here three books of that series are being showcased which might of interest to our readers. Connected Workforce Thought Leaders: Essays from innovators in business mobility Published by: Premium Publishing, London Edited by: Simon Aspinall and Anja Jacquin Langer ISBN 0-9546445-9-X Pages: 144 To keep balance with the changing pace of the work environment, mobile technologies can provide a true potential in the workplace. This book has showcased fourteen informative articles to understand the potential of this emerging technology for improving the workplace in terms of efficiency and productivity. This technology can make the workforce act as an environment of connected intelligence. With the increasing mobility of the society, the decentralized markets, organisations and societies are being emerged. In this trend, the scope of availing more sustainable advantage lies with those organizations that change their business models and processes to embrace. The essays in this book have highlighted such opportunities and also on the main providers of mobility. The essays have truly visualized that ‘how the future unfolds will depend on the ability of service providers and businesses to work hand-inhand to shape mobile solutions and incorporate them into business processes’.

Connected Cities Thought Leaders: Essays from innovators Published by: Premium Publishing, London Edited by: Simon Willis ISBN 0-9546445-1-4 Pages: 116 City – the new connected republic of the 21st century is the central focus of this book. The articles have covered some main cities of the world such as Dubai, Barcelona, New York, Stockholm, Milan, Wroclaw, Manchester, Hamburg and Hillingdon. Three themes have been covered by this book: (i) changing nature of work and increasing importance of collaboration in the successful enterprises, (ii) the kind of information exchange required for the city to change, April 2006 | www.i4d.csdms.in

(iii) new pervasive social infrastructure for new model of ‘polis’. The essays have ultimately highlighted the fact that the emergence of a economic and political phenomenon, i.e. the city as the connected republic of this century. The authors have redefined their role in the globalising information economy in the essays. The readers of this will get the information about the rapid growth of the amount and the speed of connectivity in the past one decade which is a change, much faster than the previous revolutions.

Connected Government Thought Leaders: Essays from innovators Published by: Premium Publishing, London Edited by: Willi Kaczorowski ISBN 0-9546445-8-1 Pages: 152 At this age when we talk about eGovernment to redefine the government roles and activities towards the development process, this book has provided pertinent essays from innovators on the way to enhance the role of the citizens in a connected world. Fourteen essays in total have been provided in this book in three sections. The first section is on the e-Government strategies of some countries which are at the forefront of the e-government initiative, such as Australia, New Zealand, USA and South Korea. The second section has discussed the significant issues in those countries which take up the middle ground such as the Netherlands or Portugal. The last section includes those countries which are being industrially developing and have achieved or have the objective to achieve a considerable improvement in their international competitive position. The authors have provided a positive approach towards overcoming all the challenges that are expected to be faced in the process of achieving the goal of connected government. This book has made an attempt to convey the message that all over the world the concept of connected government as a significant part of the transformation of the public sector can be put into reality as the next step of e-Government. Reviewed by: Saswati Paik, saswati@csdms.in

R EPORT

BY THE

WHO

HIV/AIDS, M ARCH 2006

Global access to HIV therapy tripled in past two years Despite gains in overall numbers on treatment, ART access in lowand middle-income countries in Eastern Europe, Central Asia, the Middle East and North Africa was lower than in other regions. A new report by the World Health Organisation (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) shows that the number of people on HIV antiretroviral treatment (ART) in low- and middle-income countries have tripled to more than 1.3 million in December 2005 from 400, 000 in December 2003. In July 2005, the G8 nations endorsed a goal of working with WHO and UNAID to develop an essential package of HIV prevention, treatment and care with the aim of moving as close as possible to universal access to treatment by 2010. Between end-2003 and 2005, HIV treatment access expanded in every region of the world. Sub-Saharan Africa and East, South and Southeast Asia, the regions most heavily affected by the epidemic, achieved the most rapid and sustained progress. More than 810, 000 people in sub-Saharan Africa, or 17% of those in need of ART, had accessed treatment by the end of 2005. Well over half the people on ART in the developing world live in this region. This substantial increase in ART availability in subSaharan Africa occurred despite considerable regional challenges. East, South and Southeast Asia recorded significant gains in ART access from end-2003 (70, 000 people) to 2005 (180, 000 people), with coverage in the region expanding more than 75% in 2005. Thailand was a major driver of this increase, particularly during 2004 and the first half of 2005. Latin America and the Caribbean, with more than 315 000 people on ART (up from 210 000 at the end of 2003), is providing treatment to approximately 68% of its population in need – the highest coverage of any region in the developing world. Thirteen countries in this region provide treatment to more than half of the population in need. Despite gains in overall numbers on treatment, ART access in low- and middle-income countries in Eastern Europe, Central Asia, the Middle East and North Africa was lower than in other regions, with just 21 000 people in Eastern Europe and Central Asia and 4000 in the Middle East and North Africa receiving treatment as compared to 15 000 and 1000 respectively at the end of 2003. Virtually all countries in these regions are experiencing low-level epidemics that involve difficult-to-reach populations such as injecting drug users (IDUs) and sex workers.

Between 2003 and 2005, global expenditure on AIDS increased from US$ 4.7 billion to an estimated US$ 8.3 billion. Significant proportions of this funding were provided by the US President’s Emergency Plan for AIDS Relief, the Global Fund to Fight AIDS, TB and Malaria and the World Bank. During the same period, the price of first-line treatment decreased by between 37% and 53%, depending on the regimen used. The report has taken account of women and vulnerable section also. One notable area of concern is access to therapy to prevent mother-to-child HIV transmission, which remains unacceptably low. Between 2003 and 2005, fewer than 10% of HIV-positive pregnant women received antiretroviral prophylaxis before or during childbirth. As a result, 1800 infants were born with HIV every day. Each year, over 570, 000 children under the age of 15 die of AIDS, most having acquired HIV from their mothers. In 2005, 660 000 children under the age of 15 were in need of immediate ART, representing more than 10% of unmet global need. Nine out of ten children needing treatment live in sub-Saharan Africa. While an estimated 36 000 injecting drug users (IDUs) were receiving ART by the end of 2005, more than 80% (30, 000) of these are in Brazil. The remaining 6000 patients were distributed among 45 other countries. These figures suggest a large unmet need, particularly in Eastern Europe and Central Asia, where IDUs represent 70% of HIV cases but just 24% of patients currently on treatment. WHO’s contribution to realising the goal of universal access will be based on a set of priority interventions in the following five strategic directions, known to be able to significantly influence the epidemic in different epidemiological context: • enabling people to know their HIV status through HIV testing and counselling; • accelerating the scale-up of treatment and care; • maximising the health sector’s contribution to HIV prevention; • investing in strategic information to guide a more effective response; and • strengthening and expanding health systems. Source: http://data.unaids.org/pub/PressRelease/2006/20060328-PR3by5_en.pdf Ajitha Saravanan, ajitha@csdms.in i4d | April 2006

Rendezvous S IXTH A NNUAL B ARAMATI I NITIATIVE , 9-11 M ARCH 2006, M AHARASHTRA , I NDIA

ICTs in agriculture

The Sixth Annual Baramati Initiative on Information Communication Technologies (ICT) and Development was held in Vidya Prathishthan’s Institute of Information Technology (VIIT), Baramati from 9th to 11th March, 2006. This year, the focus of the conference was on ICTs in agriculture. In the inaugural session, VIIT Governing Council Chairman, Sharad Kulkarni said that the process of exploring avenues is in progress, through which governments, NGOs, and entrepreneurs can focus on eAgriculture. In his speech he mentioned the history of establishing the engineering college in Baramati. In 1992, Sharad Pawar, who is at present the Chief Minister of Maharashtra, dared to dream of translating 128 acres of barren land into a prominent centre of education. He mentioned some of the initiatives taken by this institution in terms of IT-enabled ‘affordable’ services. Montek Singh Ahluwalia, the Deputy Chairman of the Indian Planning Commission was the keynote speaker. He threw some hard challenges to the 6th annual Baramati Initiative on ICT and Development. He pointed to the importance of the agriculture field in India and termed IT one of those ‘defining technologies’ that bring about a drastic change. He mentioned that India has done extraordinarily well as supplier of IT to the world, this nation has responded incredibly April 2006 | www.i4d.csdms.in

rapidly, as part of the global supply chain of IT, but our record of applying IT to our own society back home has actually been quite poor. The first technical session was on Innovative Practices showcasing the Benefits of ICT for the Agriculture Sector’. Krithi Ramamrutham, of IIT-Bombay, described aAQUA, a corpus of quickly-updated, demand-driven agricultural information, translations repository. ‘Aaqua’ stands for ‘almost all questions answered’. It aims to make online forum allowing ‘questions from the grassroots to be answered by experts in the field’. Peter Smeets, Alterra Landscape Centre in the Wageningen UR in the Netherlands spoke on e-Agroparks in the Netherlands. The paper of Amol Goje, Director of VIIT was presented by his colleague which focused on the importance of community FM radio in agriculture. Helmut ewes from Agrista, Durban discussed about the prospect of technology in agriculture sector. S.P.Wani from ICRISAT, Hyderabad discussed the organisational activities of ICRISAT in agriculture using ICT as a major tool. The second session was on ‘Role of ICT in Facilitating Agri-finance and Agriinsurance. R.Balakrishnan, Executive Director, NABARD described the activities of NABARD in micro credit and also described its ICT based services in rural areas

in India. Edwin Moyo of Zimbabwe, the CEO of the Trans Zambezi Industries Ltd, shared his views and experiences in using ICT in agriculture. Suresh Sethi, Country Head – Transaction Banking Group, YES Bank Limited presented his paper entitled as ‘Role of ICT in Agricultural Finance and Insurance’. In his paper he mentioned about the ‘Infothela’ project, an initiative of IIT, Kanpur. The paper of Sonu Agrawal from Weather Risk Management Services Pvt. Ltd. was on ‘Financial Services in Rural Areas and Role of Technology. Prashanth from Basix discussed the role Basix in micro credit and livelihood using ICT as a tool. Vineet Rai from Aavishkaar India Micro Venture Capital Fund focused on role of technology in delivery of financial services. Question from the audience floor was raised regarding the scalability of the project by Basix, it was replied that the project is scalable. Another question was regarding the experiment made so far on estimating crop

damage with the help of satellite imageries. The reply received that the experiment will be done in this year itself. The last session of first day on ‘Research on use of ICT in agriculture’ was moderated by V.P.Sharma, Director, MANAGE, Hyderabad. Gopi N Ghosh, Assistant FAO Representative and Resource Person, Food and Nutrition Security Community

discussed about knowledge management in food and agriculture, with example of functioning of UN Solution Exchange. ‘Gramya Vikas: A Distributed Collaboration Model for Rural Development Planning’ was the theme of the paper by J. Adinarayana, Gopesh Tewari and Anand Vadlamani from Agro-Informatics Lab, Centre of Studies in Resources Engineering, IIT Bombay; the paper was presented by J Adinarayana. V.P.Sharma presented his paper ‘Cyber Extension: Innovative Uses of ICTs for Agriculture, Lessons from Case Studies’. During the question-answer session, suggestion were provided to make Krishi Vigyan Kendras (Agricultural Science Centres) in India more market oriented, ensuring more transparency of the finance spent for ICT projects in agriculture and initiating public monitoring for food security with the help of ICT. On the second day of the conference, there was a field trip to nearby KVK and sugarcane factory. Then the technical sessions were started. The first session was on ‘Government and e-Agriculture: Government Support for e-Agriculture’. V.P.S.Sharma, Dean, College of Agribusiness Management, GB Pant University described the thrust agribusiness sectors and government initiatives in context of the State of Uttaranchal (India). T.C.Benjamin, IAS emphasized on the need of computerisation of land records and government support in this regard, with special reference to ‘Mahabhulekh’ project in Mumbai. Askar Abubakirov from Ministry of Agriculture, Kazakhstan, described the national projects set up by the regional network offices of his country. D.B.Deshmukh presented the status and potential of e-Agriculture in Maharashtra. M.Moni, DDG, NIC, New Delhi narrated the ICT dissusion for sustainable grassroots development in India. S.Sharma, Director, IASRI, New Delhi explained in his paper the ICT initiatives in IASRI. During the question answer session, the questions were raised regarding the reliability of the data from ‘Mahabhulekh’ on crop information. Benjamin explained the same. The second session of this day was on ‘Corporate Experiences – Trade Facilitation through ICT’, the moderator of this session was Frida Youssel, Coordinator for UNCTAD (the UN’s Conference on Trade and Development) finance and risk management commodities branch. The paper on ‘Manobi’ project of Senegal

was presented by Malick Ndiaye. SPIC agribusiness was narrated by Narayanan, Head, Agribusiness, SPIC and trade practices in Canada was explained by Apurva Mehta, Senior Advisor, Trade, Consulate General of Canada, Mumbai. Meher Baburaj, Chief Operations Officer, NCDEX, highlighted National Commodity Development Exchange. Joseph Massey, Deputy Managing Director, MCX shared his experiences in trade facilitation through ICT. There was a discussion at the end on the security in transaction through Internet and also the future plan or possibility of opening rural kiosks by SPIC. ‘The Power of Collaboration: Success Stories’ was the theme of the last technical session. The vision of Agriwatch was presented by Meenakshi. Swetank Gupta, CEO, Gramdoot Seva Kendra explained the project ‘Gramdoot’ in Wardha District. Rural credit and supply chain management system was described by Rohit Nagotra, COO, Ekgaon Technologies, Sashi demonstrated the technicalities of the system. P.Krishna Reddy,z Head, e-Sagu Project, IIIT, Hyderabad and Ganesh Rao, Vice President, Moerheim Roses India Pvt Ltd also explained how the collaboration practices may serve the agriculture sector, sharing their experience in this field. At the last session, the report on ‘Say Yes to Agribusiness’ by Sharad Pawar and ‘New Era of Economic Development – Maharashtra’ by the Union minister for Finance, India, P. Chidambaram were launched. The plenary session on the future of e-Agriculture was moderated by G.Chandrasekhar, Associate Editor of Business Line and Sharad Kulkarni. Addressing the plenary session, the Union Minister for Finance, India stressed on the need for technology bound development in farm sector at Baramati, Maharashtra. He identified five key components- water, credit, technology and market, required to transform the agrarian sector into a profitable exercise that will attract investments. Describing the current state of co-operative sector being in shambles, the finance minister expressed his confidence that all state governments will sign the Memorandum of Understanding (MoU) of Rs 14,500 crore scheme to revitalise the co-operative credit structure. Rana Kapoor, Managing Director and CEO of YES Bank presented the valedictory address. Saswati Paik, saswati@csdms.in

i4d | April 2006

What’s on Africa

Italy

03-05 May, 2006 IST-Africa 2006 Conference and Exhibition CSIR International Convention Centre Pretoria, South Africa

25-27 October, 2006 1st World Congress on Communication for Development, Rome http://www.devcomm-congress.org/worldbank/

http://www.ist-africa.org/Conference2006/

Kenya

Australia

Switzerland 29- 30 September, 2006 Technology transfer from universities: a critical appraisal of patents, spin-offs and human mobility Lausanne http://www.eastchance.com/

Syria 24-28 April, 2006 2nd International Conference on Information & Communication Technologies : from Theory to Applications (ICTTA’ 06) Damascus, Syrian Arab Republic

09-11 May, 2006 Cebit Australia 2006, Sydney

17-21May, 2006 ICT e Africa 2006 Conference and Tutorials, KICC, Nairobi, Kenya

http://www.cebit.com.au/

http://www.nepadcouncil.org/ICTeAfrica2006/

ICTApplicationforPeoplewithDisabilitiesAgingPeople.pdf

5-7 June, 2006 9th Annual E-Health and EHR Congress Carlton Crest, Sydney

Norway

Tanzania

12-14 June, 2006 Tromoso Telemedicine and e-Health conference (Ttec06) Tromso

10-12 July, 2006 IEEE 4th International Workshop on Technology for Education in Developing Countries Iringa

http://www.iir.com.au/conferences/

Austria 12-14 July, 2006 10th International Conference on Computers Helping People with Special Needs (ICCHP 2006), University of Linz, Austria http://www.icchp.org/

27-29 September, 2006 Interactive Computer Aided Learning (ICL), Villach

http://www.telemed.no/index.php?id=196385

http://www.cs.joensuu.fi/tedc2006/index.htm

Oman 14-16 May, 2006 USTDA Making Connections in the Middle East and North Africa, Shangri-La’s Barr Al Jissah Hotel, Muscat http://www.trademeetings.com/ ssMeetingDetails.asp?meetingId=145

http://www.icl-conference.org/

Singapore

Brazil 19-22 April, 2006 VII Free Software Workshop Centro de Eventos FIERGS, Porto Alegre

http://ictta.enstretagne.fr/dox/Workshops/

19-23 June, 2006 The EUSEA2006 Conference and Exhibition, Shangri-La Hotel

Thailand (CSDMS Events) 26-28 April, 2006 Digital Learning Asia 2006, Bangkok www.DLasia.csdms.in

26-28 April, 2006 eGov Asia 2006, Bangkok www.egovasia.net

26-28 April, 2006 Asian Telecentre Forum 2006, Bangkok

www.eusea2006.org

www.asiantelecentreforum.net

20-23 June, 2006 Communic Asia, 2006

6-8 June, 2006 Asia Commons: Asian Conference on the Digital Commons, Bangkok

http://fisl.softwarelivre.org/7.0/

Cambodia 10-13 May, 2006 CAMBODIA ICT WORLD EXPO 2006 Natural Cultural Center, Phnom Penh http://www.idg.com.vn/ENG/Events/ ICT_in_Cambodia_2006/media_center.htm

Canada 30 April-3May, 2006 e-Health2006:e…for Everyone! Victoria, B.C. http://www.e-healthconference.com/

http://www.communicasia.com/ show_statistics.htm

Spain 10-12 May, 2006 eHealth 2006 High Level Conference and Exhibition, Malaga http://www.ehealthconference2006.org/

25-27 October, 2006 eChallenges e-2006 Conference, Barcelona http://www.echallenges.org/e2006/

http://www.asia-commons.net

United States 19-22 August, 2006 The Second International Conference on Environmental Science and Technology (IC EST 2006), Houston, Texas http://www.aasci.org/conference/env/2006/ topics.html

Get your event listed here. www.i4d.csdms.in/events April 2006 | www.i4d.csdms.in

IN FACT

Every 3.6 seconds someone dies of hunger!! One of the main reasons behind the illness of the people in the world, especially among the poor is hunger and poverty. According to World Food Programme (WFP), the world produces enough food to provide every man, woman, and child with enough to eat. Yet, 852 million people suffer from chronic hunger.

Hunger • Six million children under the age of 5 die every year as a result of hunger. • Every year 15 million children die of hunger. • For the price of one missile, a school full of hungry children could eat lunch every day for 5 years. • The World Health Organisation estimates that one-third of the world is well-fed, one-third is under-fed one-third is starvingSince you’ve entered this site at least 200 people have died of starvation. Over 4 million will die this year. • The Indian subcontinent has nearly half the world’s hungry people. Africa and the rest of Asia together have approximately 40%, and the remaining hungry people are found in Latin America and other parts of the world. Hunger in Global Economy. • In the U.S. hunger and race are related. In 1991 46% of AfricanAmerican children were chronically hungry, and 40% of Latino children were chronically hungry compared to 16% of white children. • One out of every eight children under the age of twelve in the U.S. goes to bed hungry every night. • It is estimated that some 800 million people in the world suffer from hunger and malnutrition, about 100 times as many as those who actually die from it each year.

Malnourished • More than 840 million people in the world are malnourished — 799 million of them live in the developing world. • More than 153 million of the world’s malnourished people are children under the age of 5. • Malnutrition can severely affect a child’s intellectual development. Malnourished children often have stunted growth and score significantly lower on math and language achievement tests than do well-nourished children. • 183 million children weigh less than they should for their age. • One in twelve people worldwide is malnourished, including 160 million children under the age of 5. • Lack of dietary diversity and essential minerals and vitamins also contributes to increased child and adult mortality. Vitamin A deficiency impairs the immune system, increasing the annual death toll from measles and other diseases by an estimated 1.3 million-2.5 million children.

• The infant mortality rate is closely linked to inadequate nutrition among pregnant women. The U.S. ranks 23rd among industrial nations in infant mortality. African-American infants die at nearly twice the rate of white infants. • Half of all children under five years of age in South Asia and one third of those in sub-Saharan Africa are malnourished. • In 1997 alone, at least 300,000 young children were saved by vitamin A supplementation programmes in developing countries. • Malnutrition is implicated in more than half of all child deaths worldwide - a proportion unmatched by any infectious disease since the Black Death.

Poverty • In the Asian, African and Latin American countries, well over 500 million people are living in what the World Bank has called ‘absolute poverty’. • While every country in the world has the potential of growing enough food to feed itself, 54 nations currently do not produce enough food to feed their populations, nor can they afford to import the necessary commodities to make up the gap. Most of these countries are in sub-Saharan Africa. • Most of the widespread hunger in a world of plenty results from grinding, deeply rooted poverty. In any given year, however, between 5 and 10 percent of the total can be traced to specific events: droughts or floods, armed conflict, political, social and economic disruptions. • Nearly one in four people, 1.3 billion - a majority of humanity live on less than $1 per day, while the world’s 358 billionaires have assets exceeding the combined annual incomes of countries with 45 percent of the world’s people. UNICEF. • 3 billion people in the world today struggle to survive on 2 dollars per day. • To satisfy the world’s sanitation and food requirements would cost only US$13 billion- what the people of the United States and the European Union spend on perfume each year. • The assets of the world’s 3 richest men are more than the combined GNP of all the least developed countries on the planet. Source: http://www.friendsofwfp.org/site/pp.asp?c=7oIJLSOsGpF&b=246300 http://www.care.org/campaigns/world-hunger/facts.asp http://library.thinkquest.org/C002291/high/present/stats.htm

i4d | April 2006

The LARGEST Indian conference and exhibition on ICT and Education

India 2006

23 - 25 August 2006 The Taj Palace, New Delhi

www.digitalLEARNING.in/DLindia

LARGEST

Indian conference and exhibition on e-Government, 23 - 25 August 2006, The Taj Palace, New Delhi

The