Cool Technology

Things have been quite busy lately, so much so that I've not had much time to think about writing.* In the midst of all of this I received a nice little piece of equipment that has turned my iPad and iPhone into a cool little guitar amp simulator.**

* I have a piece coming up about IT management, communication and being responsive.

** And another piece about Christmas in August

I read a few weeks ago a review of the amp simulator software AmpliTube by IK Multimedia coming to the iPhone and iPad, the review was quite positive in the overall quality of the amp simulation. I was familiar with the software and I was very curious to try it on my iPad. The price was right, they have a free version and the full app runs around $20 US. Cheaper than flying to the UK to buy a new guitar amp.

To make it work required that I also purchase a special cable to allow me to plug my guitar in to the iPad. There are a couple of such cables on the market and based on the reviews, I chose the iRig unit. The challenge was to actually get the iRig to me here in Eldoret. As will be explained later, I managed to to do that and this morning I was able to briefly test things out.

I'm impressed and pleased overall. It won't replace a full amp, but it is much better than my little Vox amPlug headphone amp and my initial reaction puts it ahead of my Line 6 Pocket POD. I am looking forward to loading up the AmpliTube software on my iPhone for a cool little portable amp.*

* As an add-on, I recently received a Klipsch iGroove powered speaker unit for my iPhone, in concept it is the same as the Bose Sound Dock, but cheaper. The nice thing about the iGroove is the line-in jack on the back of the unit.  I can plug in my iPad or my laptop and enjoy much fuller audio than through the small internal speakers.  And I am able to send the output from AmpliTube to the iGroove as well giving me the ability to kick up a bit of a racket. Ahhhh, overdrive.

None of this means that I'll forgo buying an amplifier anytime soon, but for now this will keep me occupied.

Urgh!!!!

I just finished and was ready to edit a post about Starting a Global Health IT Project when the browser crashed. Frustrating because my Internet connection was not going great which resulted in the "autosave" feature not really being able to save my the post. So, much of the work is lost and I'll have to essentially start again.

I'm a technologist and I appreciate technology. I also hate it when it doesn't work the way it is supposed to. Such is life and I gotta get over it. Still, it is frustrating. Urgh!

This does highlight issues related to cloud computing. I like the idea, I like that I ought to be able to get my data, content and stuff over the web and be able to access it anywhere. However, if I don't have an Internet connection or it is running slow, then the cloud becomes an impediment to getting my work done.

I do use Apple's MobileMe service and they offer sort of a hybrid model.* I have a local iDisk that houses a copy of my cloud-based files on my laptop. I can sync the iDisk and move my files up to the cloud. So I can access files from another Internet connected computer and I can still get access my content if I don't have a network connection.

* There are probably other services that do the same things as MobileMe. I've not looked because for now I'm happy with the MobileMe service.

I think I'll have to find an offline tool to compose the blog and then upload it when it is done. Having a local copy will hopefully keep me from losing work and being frustrated over the whole process. URGH!!!

Sunday Morning Pancakes

This is a bit late in coming, since it is Tuesday night and I first started this post on Sunday morning. I got distracted with some other things and have not had the time to get back writing. Work has been busy, things are beginning to come in to focus and we are beginning to get some information out to the team.*  But this post is not about work or ITIL or strategic plans.  No this is all about PANCAKES!

* I'm no huge fan of work related surprises. I think it is best to let people know what is coming. Besides the stuff we're doing is pretty positive. 

On a previous shopping trip, I happened to stumble on a very very rare treasure. A bottle of Canadian Maple syrup. Oh, it isn't the best stuff in the world, but it is the real deal. I was pretty excited by the find and quickly put a bottle in my shopping cart. I thought to myself, soon you will be enjoying a great breakfast treat, a little bit of home.

This past Sunday was pancake Sunday. I mixed up some pancake mix using an Alton Brown recipe.* I had to make some modifications. For example, the recipe calls for butter milk, but I've not seen the stuff here, so I had to make due with regular milk.

* Alton Brown's Good Eats is a true geek show. Sort of cooking meets Mr. Wizard.

The other challenging bit has to do with my overall weak cooking skills. I am more comfortable when I have the necessary hardware like measuring spoons and cups. I have managed to find a one-cup measuring cup, but no measuring spoons. Without this equipment, I am generally hesitant to try a new recipe. However, this time I would not let the lack of measuring spoons stop me. For I had a bottle of maple syrup that needed pancakes.

So, I followed the recipe as best I could, used milk instead of butter milk, and soon I was ready to put batter to griddle.  Well, I currently lack a nice size griddle so instead I use a teflon coated frying pan. With all this, lets make a nice plate of flapjacks.

It took some time to get the heat right and to get the cooking time down.* Overall, it all worked out pretty well, not perfect, but a good start. I was pleased with the outcome and for a few minutes I was transported back to the USA. Now if only I could find some bacon. Pancakes are great with bacon.

* Seriously, you would think that pancakes should be easy and not this complicated.

Making Things Work

I've been busy these past few days doing work on the ISC Strategic Plan. I have sort of worked out the framework for the plan and have begun the work of putting together the pieces. The framework itself is beginning to evolve as I read and research things. One of the things I have decided to consider more seriously is actually implementing aspects of ITIL.*

* I've gone back-and-forth on this a few times.  Conceptually, I get ITIL and think would be great to implement. I just have no experience in an actual ITIL implementation and no real time to go get trained.**

** I can only assume the costs of bringing out an experienced consultant to be way too expensive.  I'm happy for any volunteers. 

The change in my thinking has come about through a small bit of research into ITIL and by taking the plunge and purchasing a couple of ITIL books.* I've skimmed both books and I'm now reading the "Service Design" book more carefully. This post is not about ITIL or what I have learned thus far, it is about how was able to get the ITIL PDFs to work on my iPad.**

* Those books are expensive. I think they could help a lot of initiatives like AMPATH, but the costs of the books are hard to justify.


** Such a long wait to get to the point.  Feeling wordy today, apologies.

One of the things I really appreciate is being able to buy eBooks and load them on to my iPad.  I make extensive use of both the Apple iBook and Amazon Kindle iPad eBook reader apps. They're both pretty good, not great. I also make heavy use of GoodReader and iAnnotate reading PDFs. Between the four apps, I'm pretty well covered.*

* Okay, it really sucks having four different apps, I'm still hoping for the one single app that does everything to my expectations. 

That the ITIL books are available as encrypted PDFs posed a bit of a challenge. None of the aforementioned apps support Adobe's Digital Edition encrypted PDFs. If I had to order the actual books, I would have no idea how long it would take to get to Eldoret. And I assumed the shipping costs to be a bit on the crazy side.  Fortunately, "there is an app for that." I found another application that will allow me to read the ITIL PDFs on my iPad.

The app is called the 'Txtr Reader" and it is available for the iPad. The app itself is pretty basic. The navigation is not that polished, the PDF rendering (for small text) in not great, there is no support for annotations or bookmarks. But after downloading the ITIL book, then uploading to the Txtr server, then downloading it back to my iPad, I can read instantly.*

* You can add getting content on to the device as a negative.

Another plus, is that all of this is free! From what I can gather, Txtr is in the business of selling eBooks (many in German, but they have English titles as well). They are using the razor-blade business model.  Give away the software/service and charge for the books.*

* It really bugs me that I have to have a Kindle device to get a Kindle email address so I can send my own content up to Amazon, so I can get it to my iPad while being charged for it.**


** I do like toys, but I'm really in no mood to buy a Kindle. 

So, it was all a bit complicated, but in the end I got it too work. And for the ITIL stuff, I am committed to starting to implement some of it and helping the guys here get to the point where they can finish it after I am gone.

Tumaini

I attended a special event at The Tumaini Children's Center this morning. The Tumaini Center was started at the beginning of this year (2010) to help the many street children in Eldoret.* The street children roam the streets in search of food, money, and friendship. Estimates reported by Tumani indicate that there are over 3000 street kids in Eldoret.**  Many are orphaned and still others come from families who are simply unable to provide for their children.  

* The mission of the Tumaini Children's Center is to help improve the lives of street children in Eldoret by empowering them with hope, knowledge, skills, opportunities and resources necessary for them to find a health alternative to street life.

** There are roughly between 190,000-220,000 people in Eldoret. 

Today's event was a photography show where the featured photographers were 8 street children (ages 17 and under) who were given cameras and after some basic training in photography were asked to photograph their lives. The photos were amazing and I wish I had a few to share with you.* To see literally a snapshot of their lives was a pretty moving thing.  

* I also wish I could get them published. Though their work may not be up to the quality standards of say "The National Geographic", the images that are captured should be seen by a wider audience. 

The event was fun, there was some dancing, some introductions, followed by the gallery event.   I toured the event and met some of the photographers. They were very proud of their work, they were able to articulate something special.  They did take just snapshots, a few mentioned something more deep about what they saw through the viewfinder. 

Fortunately, I was able to capture a bit of the day and have posted a few of the photos here. 

Getting back to the Tumaini Children's Center, the efforts by the folks involved is really a labor of love. The center runs on very little money but they do a great deal with very little. They offer outreach services on the weekends, the center itself open three days a week so the children can come in for some food, access medical, educational and social services, and enjoy a safe sheltered place for a few hours. 

The hope is that the center will continue to grow in a sustainable way and be a full-time asset to Eldoret. 

Cool Fun

Now that I have my iPhone working again, I am once again using it all the time.* Which also means that I'm tuning in to iPhone app stories and reviews.

* While I'm a huge fan of my iPhone, I am not going to get into a religious war over the "best" smartphone platform.** If you are a fan of Andriod, cool. Some other smartphone, more power to you. I like how my iPhone works and really enjoy the applications available for it.


** I also don't partake in religious wars over Unix editors (I'm an emacs fan, but can sort of use vi) or other things. I appreciate it when I find value or usability in a tool, an OS and really appreciate the difference between my Strats and my Les Paul. 

I admit am not always up-to-date on things and probably behind the curve on a number of apps. That being said, I freely admit to getting very excited when I discover a new app with a high coolness factor.  One such recent discovery is 'Starmap'.

I like the idea of looking at the stars, but I am in no way close to being a hobby astronomer. The best I can do is find polaris.  I've often thought about buying a telescope, but have not yet done so. For me, I enjoy looking up at the stars, wish I could better identify things and I look forward to getting the chance to see the Milky Way again.

When I heard that the Persied meteor shower should be in view this week, I got a little excited.  After reading a Wired article about how best to view the meteor shower, the article's instructions were pretty simple, locate the constellation Perseus around midnight.*

* This is for folks in the Northern Hemisphere, Eldoret by virtue of being located 30 minutes north of the equator put me just barely in the north.

Sounded simple enough, except I had no idea where to find the Perseus constellation. Ah but there are Smart Phones and entrepreneurs abound. The Wired article also included a iPhone app recommendation for the Astronomy-challenged like me in the aforementioned Starmap app.* A quick $12 purchase and I was all set.**

* They was also a recommendation for Android users.


** $12 US seemed expensive when I first saw the price, but the reviews for the app were stellar and I decided to purchase the app anyway.

Starmap makes use of the iPhone 3GS (and 4) built in compass to help average folks locate and identify celestial objects in the sky. The first night I used it, I had so much fun. I quickly identified Mars, Venus, Saturn and a few other stars.*  It was all very very exciting.

* I could clearly see Mars' red color without the aid of a telescope or binoculars.

As for the meteor shower. Well, I missed out. The midnight viewing made it quite tough for me. I'm usually up at 5:00 AM, which means that by 22:30-23:00, I'm out for the night. Oh well, I hope that I can glimpse the Leonid meteor shower in November.  Until then, on clear nights, I'll be using Starmap and this may result in my buying a telescope.

To Be Done

A bit of break through today. I was able to answer the “what is to be done?” question.  Ready?

Well... not just yet.

I mentioned in earlier that it would be nice to do a full ITIL implementation. Though I still don’t fully understand it all, I have learned enough to formulate a framework for what needs to be addressed. Before revealing all that, a bit on ITIL.

ITIL in a nutshell, is a set of best practices on IT Service Management. What is service management? According to the ITIL folks...

“The primary objective of Service Management is to ensure that the IT services are aligned to the business needs and actively support them. It is imperative that the IT services underpin the business processes, but it is also increasingly important that IT acts as an agent for change to facilitate business transformation.”  

In short, IT can both support and drive an organization.

The Informatics Core of AMPATH has done an amazing job collectively supporting the efforts up until now. With the decision to fully embrace the mission of delivering primary health care, the informatics group here in Kenya and in Indianapolis recognized that a more structured organization was needed to meet the needs of the changing mission.  As mentioned earlier very little focus was paid on some basic infrastructure things that most IT operations take for granted.  There simply wasn’t time; attacking the health care problems and the related issues took center stage.  And now it is time to put some of that into place, while not stopping the other work.


I’ve been on the job now here in Kenya for just over three weeks. And in that time, I have just moved beneath the surface of things. I know enough now to be able to prescribe the framework of what we need to do. The specifics will start to come in over the next few weeks.  The framework recognizes the mission of AMPATH and the vision for the ISC core.*

* Our vision, "We will be massively successful as the Health Care Informatics Services provider in Western Kenya." **


** The vision was actually expressed over cheeseburgers at a local place called "Sizzler's Cafe."   I wrote down the vision statement on a napkin, taken word-for-word.  Oh, I should add that the cheeseburgers at Sizzler's Cafe are quite good, I highly recommend the “chilly burger with cheese."

So the framework...

In the next two years, the ISC will improve the overall service delivery in terms of capacity management, availability management, service continuity management.  In addition, we will look to improve service support in the areas of incident management, problem management, project management, change management and release management.  We recognize the importance of measuring the impact of the changes to demonstrate that this effort will add value to the organization, so part of our efforts will include developing evaluation tools.  Given the work that will be undertaking, we hope to start addressing issues related to financial management, service level management and configuration management.

Simple right?  Well, the devil is always in the details and I'm not yet sure what all those details are. I will expand upon each area of the framework in the coming days so you will know what exactly this all means.*

* Gives me something to write about and hopefully will keep you, the reader, riveted!

I am excited tonight, this is something we build on and use in creating the strategic plan and operationalize that plan.

Standard Operating Procedures

One of the things that I did manage to accomplish last week was putting together a guide to writing a standard operating procedure (SOP).* It was a good exercise and the initial result should contribute to making the AMPATH ISC more organized and ordered. There is a great deal of tacit knowledge here and we need to make that information more formal or explicit.

* I mentioned previously about not knowing where to start things. I do not want to give the impression that nothing has been started.  We have started the process of identifying current IT projects, planning new IT and IT management projects and are working to revamp the IT procurement process. As we embark on just these few things, we find other areas that need attention. And those other areas reveal additional things. I guess it is like painting, if you paint one room, you then notice that the floors need to be redone, the other rooms need work to.  

Establishing SOPs is just one thing being introduce to help meet the day-to-day operations challenges at AMPATH. Other things on the list include implementing more standard project management practices, change management and service management.* No truth to the reports of implementing TPS Reports.

* It would be nice to do a full ITIL implementation**, but I don't fully understand what that entails and from what little I do know, I think it is a too big an enchilada to try all at once.  


** The Information Technology Infrastructure Library, a nice set of best practices and a bit of a rage these days.  Also of interest (and the subject of a future post) is the concept of Enterprise Architecture.

The plan now is to distribute the SOP guide to the rest of the team for feedback and comments.*  And begin testing the guide on some simple SOPs. The feedback and comments along with the testing should help make for a good first version of the guide. I have stressed continuously here at AMPATH and in my previous position that such documents should be considered living and be open to revision.

* Our own little RFC (Request for Comments). It is always worth sharing, the hope is that the feedback will make things stronger.

Why there were no such guidelines in place is a topic for another time. Maybe next time. For now, I have to get ready for work.

Perspective When in the Forest

As I stated earlier the biggest issue I faced lately given the number of things needed to implement, I feel a more than a little overwhelmed.  Worse than that, given all that is needed, it is tough to figure out exactly where to start. Starting with one thing soon reveals that another piece is missing.  To address that other piece soon reveals a whole other set of things to do.  It can really drive you nuts. No choice is ideal and all choices bring about some element of compromise.

When you're in the middle of all of this, you can truly get lost in the forest. And last week some perspective on things would have helped out a great deal. But instead, on friday, I left feeling really ill-at-ease with things and more than a little overwhelmed.

The feeling carried over through the weekend, it really affected me. I tried to have some fun, I did have the chance to spend some time chatting with friends back home and the routine chores helped distract me a bit.  However, the challenges of work never completely left my mind. It troubled me through this morning.

I realized this morning that I needed a meeting with myself to find some small piece of perspective. To organize things and try to map out the week ahead.  I had to remind myself that Rome wasn't built in a day and the journey of a thousand miles begins with a single step.*

* Actually I learned today that this is not the correct translation of the Lao-Tzu quote. The Quotations Page website has a nice translation of the actual quote.

So, I took 20 minutes this morning to meet with myself and examine the past week, what things happened and what was accomplished. I also spent some time mapping out the week ahead.  I found some measure of relief through this exercise. Recognizing some progress has been made. There is stil much to be done, one big exercise is the strategic plan, and this will begin to dominate my days over the next few weeks.  All-in-all not great but not a disaster either.  Call it a work in progress.

Perspective, its a good thing.

Struggling to Put into Words

I've been struggling a bit, trying to put down in words what I have been going through over the past several days. I tried to write the perfect blog, set down something very eloquent, but ended up with a huge pile of nothing. This is how I end up with writers block, and I'm not even a writer.

So rather than try to force something through, I thought I would just write about not being able to write anything meaningful.* I think it will be therapeutic and hopefully not too annoying.

* The idea for this is actually something I recall reading about Bono of U2. In an interview he gave back during the Unforgettable Fire period, he spoke about this very subject. When suffering from writers block, Bono mentioned that he would being writing about having a block. If I recall the article correctly, I believe this helped him write the song "The Unforgettable Fire".

I think I ended up in the position not because I want to write the perfect entry, but rather I simply felt overwhelmed with what needs to be done. The informatics operations have been in place for a number of years and the folks here in partnership with Regenstrief have done some amazing things. However, a lot of basic infrastructure things that are so critical as operations expand were overlooked.  AMPATH is moving towards being a major deliverer of primary health care to a good chunk of Kenya. For the ISC to support that effort, requires that all those overlooked infrastructure elements must now be put into place. The only trouble is the AMPATH train is not going to slow down or stop to allow us to fix things. Work continues and all the amazing things are still needed.

So given this and other constraints I really got a bit lost trying to sort everything out.  Writing about it was too hard,  and honestly I just wasn't able to organize my thoughts in to anything coherent.*

* I think I had four or five drafts of various different blog posts.  None of them were very good and most were beginning to sound like rants.  There is some content that will be reused (it wasn't al a rant).

Today things are a little better, I was able to get some perspective and managed to notice some positives. So I hope things are again looking up. Take it day-by-day.

Catching Up

Some things I am thinking about writing about over the next few days include:

• The referendum
• Project Management
• Standard Operating Procedures
• What is to be Done* 
• Buying a POTS phone

* I know this to be the title of a political pamphlet by V.I. Lenin.**  The pamphlet is Lenin's call to organize a vanguard revolutionary party to direct the working class of Russia.  I read the pamphlet once and don't remember much of it.  What has always stuck with me has been the title, I really like it.

** I recently learned that Lenin was inspired by a novel of same name written by Nikolai Chernyshevsky.

The Small Things

Sometimes the small and silly things can make a huge difference. Tonight was a case in point. I finally got my iPhone unlocked so I can use it here in Kenya. There is much rejoicing right now; I'm really acting like a kid at Christmas.

I really wish AT&T were more understanding about people leaving the country for an extended period of time (like say 2 years) and their desire to use the iPhone outside of AT&T's zone of control. I completely understand that they have subsidized the cost of my phone and I am more than happy to pay them the subsidy. It is only fair. But when I called them asking to have my phone unlocked due to my leaving the country, they flat out refused to help me. This was after offering to reimburse them for the subsidy. They wouldn't do a thing for me.

I really appreciate my iPhone, it is a great device. It works well in my environment and the apps actually help me in my everyday life. Since AT&T were going to be no help to me, I figured that I would simply unlock the phone. Trouble is, the iPhone Dev Team folks had not released their jailbreak software for my phone.* All of which meant that I spent the last three weeks using a very basic Nokia phone, while my iPhone became essentially an iPod Touch.

* The Dev Team guys are great, I really appreciate their hard work and even happier that the Library of Congress stated that jailbreaking is A-Okay.

Ah, but then a couple of days ago, the Dev Team came through and released the jailbreak code. They did a great job, the whole process was effortless and soon after jailbreaking, I unlocked my phone, swapped out SIM cards and life is very very very good again!

Yes, it is silly and very nerdy of me to get so excited. But since I cannot have pancakes for a few more weeks, I need something!*

* I have some maple syrup and vanilla extract coming soon. Hope my friend can find the maple extract too, but the syrup is unexpected and much appreciated.

So, I go to bed tonight with my iPhone active once again. I need to add some minutes so I can make a few calls, but that won't happen until I am jailbroken from the IU house.

On the Kenya Referendum

All the AMPATH expats are "confined" to the Indiana University housing compound tomorrow and possibly on Thursday.  Kenyans are going to vote on a new constitution tomorrow and if it passes (as it is expected to) the outcomes could bring forth an entirely new Kenya. Being here is pretty exciting, how often can you be witness to a wholesale change in the governance of a country.

So why the lock down?

Well the story begins in the aftermath of the last major election. The vote count lead to accusations of voter fraud nearly lead to the country exploding.  In towns in and around the Rift Valley (including Eldoret), a number Kenyans went to war against each other. I wasn't witness to the events and I have only heard a few stories. I cannot imagine how terrifying it was for locals who were caught in the middle of the insanity.

No one really expected the violence and so many were caught off guard.  I believe that prior to the last election, the AMPATH folks had most of the expats leave the area.  Or the evacuated most everyone shortly after things got a little crazy.  This time, as with the last election, no one expects anything bad to happen, but for safety's sake, they want to keep everyone out of harms way.

I have mixed feelings about this.  I have work to do and don't like being "forced" to stay home.* Also, a part of me is interested in seeing what could be history in the making. I expressed a wish that I could be a photo journalist for a day or two to record the events.

* I want to be home when everyone is at work. It is not fun playing hooky when everyone else is.

So tomorrow, I'll be at the housing compound. Since everyone will be around it should make for a great wiffle ball game and dodgeball (both are planned). I'll have some fun, do some work and wonder what is going on down the road in town. I hope nothing more than people voting.

Pancakes, Digestives and Potato Crisps

Starting my third week in Kenya and I have begun to feel a bit homesick for things back home.  I miss seeing my friends, baseball, pizza, my bicycle and pancakes.  I've really been craving pancakes lately and it is not like there is an IHOP anywhere nearby.*  So what is a new expat to do?  Make them from scratch and be happy.  Not so fast, there is no maple syrup here, nor the log cabin imitation stuff.  What  is available is Google and the power of the Internet.  Searching around, I have found a few recipes for homemake pancake syrup.  Back on a role!

* International?  Right!

Not so fast though, all the recipes call for vanilla and maple extract.  I have seen the vanilla extract but none of the stores here carry the other stuff.  Doh!  All is not lost, I can get the ingredients that I need, though I will have to wait for a bit.

I have learned that the AMPATH expats rely on a regular caravan of things from USA via the regular back and forth of new trainees.  If you can get what you need to someone coming over, life becomes less hard.  So, I have been ordering some stuff and asking friends to send some other things to Indianapolis for eventual transfer here.  It is not the most efficient, but it works.

Some colleagues from Indianapolis are heading out to Eldoret towards the end of August.  So, I have enlisted them to bring me some luxury items* including the maple extract.  Other friends from the New York area will help me get other things to Indianapolis and I'm really grateful for their help.  I will make pancakes!  It may take a few weeks, but it will happen.  I will report back on my success.

* I have in mind a longer post on luxury items and the way we go about getting things to Eldoret.

Life is not all depressing, I have found things that I know I will miss when it is time for me to leave Kenya.  Two things immediately come to mind, digestive biscuits and chilli lemon potato crisps.  The biscuits are pretty well known and common.  Quite tasty with a cup of tea (the chocolate covered ones are a new favorite of mine).  The crisps are a local product and this is one of those things that people will definitely have to bring back to me after I have left.  They have a nice spicy kick and go well with either a cold coke or a cold bottle of Tusker (a not so bad lager).

All-in-all things are not so bad and there is some potential.* Not that this makes up for missing my friends, but it could be worse. So I am keeping positive.

* I may have a lead on a shop in Nairobi where I can get my guitar amp.