[Sorry for possible cross-posting but this is a direct response
to Jeff's initial message on value of participation. D.N.]
Jeff Cochrane's thoughts on the potential impact of the Internet
should evoke a response at least as substantial as the recent long-
running thread on information systems development and use.
His query raises all sorts of issues that should be addressed - at
least discussed - and which, already, with only five responses (at
least here where even e-mail lags six to eight hours - plus the time
difference - after what seems like the many (majority?) of Afro-Nets
subscribers in the "real-time-world",) a typical pattern is taking
Of the five responses I have received (either on this commercial e-
mail service - one of two such in Eritrea - or on Eritrea's Health-
Net, which does its up/downloading less frequently than the commer-
cial services and which is slightly less reliable - but costs far
less) - three have been from Afro-Nets subscribers outside of Africa.
Sorry, I do not know where 'ncat.edu' is, but the address suggests
somewhere in the U.S. Lots of people do not include detailed contact
signatures with the messages, so it is hard to tell where the mes-
sages are coming from. Is this a strategy or an oversight?
Jeff's concern is about being able to contact/energize "scientists"
somewhere in Africa to be able to respond to a deadline -quickly- ap-
proaching request for a proposal - lots of money - for some sort of
research project, then to put the project together using contribu-
tions - no doubt called "input" from appropriately qualified people
in Africa by e-mail.
Does this sort of thing really happen? BBC's Future World envisions
this sort of collaboration, but does it really take place anywhere
other than maybe inside universities or other well defined, inte-
grated common-interest networks? Even then, I suspect people more
likely get together in group or individual meetings and/or phone each
As delightful often happens on Afro-Nets, the original focus of
Jeff's posting has widened beyond the original progenitor's intent.
Respondents have picked up par of the message and run with what they
think it means/is important to them. This may be frustrating to
someone who wants something very specific as an answer/response, but
is fascinating to readers/subscribers/voyeurs who may follow threads
without contributing to their progress or further playing out or com-
Abebe Kebede Dahiru (who is at the address I am sorry I cannot recog-
nize - ncat.edu - any more than s/he is likely to recognize mine (if
the "signature" is not included at the end of this message, I am liv-
ing/working in Eritrea, wrapping up a USAID/BASICS Project assignment
of just over a year to redevelop a national health information sys-
tem) nor whose address matches his/her name, so maybe someone is
sending it on his/her behalf) goes right to the crux of the matter -
the African Diaspora. S/He notes "Africans are not properly organized
to take advantage of [such] collaboration [as Jeff Cochrane suggests
could be possible]." Probably not a scientifically support-able re-
mark, but likely very true.
As s/he notes in the remarks about the "Diaspora", there are lots of
Africans living/working/studying/ getting PhDs, etc. and using e-
By definition, those who are part of the Diaspora are not in Africa
(or, if they are in Africa, they are not in their "own" country).
But many - dare I suggest MOST - of them are not living in Africa.
Nor, having gotten used to real-time internet access, full-time elec-
tricity, 24-hour, 50 channel cable tv, reliable telephone service,
potable water out of taps in the home, academic stimulation, daily
newspapers, a car or two, adequate education for their children, ac-
cess to good health care, etc. - the trappings of the "developed"
life - will they soon, eagerly, willingly, permanently return to
their "home" (or whatever the PC term for the originating/native/
source country is when "Diaspora" is used) country to deal or work
with the rigors of reality/development.
So, it is all well and good to try to put together a proposal with
"African" (Asian, Eastern European, Carribean, South American) scien-
tists. But need these folks be in Africa or need they only have ac-
cess to e-mail (a requirement for the proposal) and "African" sound-
I will bet that this thread will soon die because there are too few
African based and working in Africa to support it. I will be happy to
be proven wrong.
>From time-to-time the PRO-MED List puts together a profile of its
subscribers. While it cannot guarantee that everybody who is a "sub-
scriber" actually get his/ her mail or reads/uses/reacts to it, it is
interesting to see where the daily postings are being zapped to each
day. It would be interesting to see the same sort of profile for
If someone is even thinking about getting together a bunch of people
in Africa or anywhere else, surely it would be useful to know who is
receiving the messages. It will not be a scientific sample, but it
might be something that could be useful.
HealthNet is recognized, and rightly so, at least by people who live
outside the "deveoping world" as being a fabulous/potential model for
establishing/developing e-mail communications locally and interna-
tionally in the Less Developed Countries (or whatever they are being
called nowadays - places that do not have reliable/affordable e-
mail/internet access and, at the same time, have in proportion to the
population few computer users). Disciplines other than health - Jeff
Cochrane speaks of interviewing people involved in agriculture - but
he has posted his message on Afro-Nets - suggests to my health-
oriented, but unscientific mind that Health-Net/Afro-Nets (since the
message was posted there) may be leading the effort to get people
connected to e-mail.
Can HealthNet tell us (periodically) - let's call it a baseline num-
ber - how many systems they have world-wide and where they are? Can
they then tell us how many "users" there are in each country?
A disadvantage of e-mail or list-serve messages is that it is passive
- messages are sent; if the receiver has not "unsubscribed" (or if
the country's "sysop" subscribes to every available service on behalf
of each of the system's "subscribers"), it will appear to a list's
proprieter that that every subscriber has received messages - unlike
"hits" on a web sit that suggest actual people trying to get some in-
formation. So, the HealthNet users total number needs to be dis-
counted somewhat (having lived/used HealthNet in two countries, I
have found myself in a small number - less than 5 percent - of ac-
tual/active users in systems that counted dozens of "registered" ad-
dresses (and, having contributed to the confusion by installing the
HealthNet software on computers in the middle of nowhere where phone
service would "soon" be installed). Phones do not work. Computers do
not work (or people do not know how to work them). Electricity is un-
reliable. Training is not good (or not existent).
Confidence in using English is non-existent or insecure. How does a
health worker or even a "scientist" at an out-of-the-way place -
"Ministry" people decide on proposals, not line workers - "This mes-
sage is from a professor at a University in Europe. (S)he is an ex-
pert. How can I say what (s)he says is wrong?" The reasons for not
using e-mail are legion.
Those of us who routinely use it assume that "if you've got it,
you'll use it..."
How about basic (mis)understanding? My husband is at Big University
in Austroasia. (Like students in Universities in Developed Countries,
he was assigned an e-mail address along with his photo-barcoded-
supersecure student id.) His wife, who has (actually, whose male
boss, who cannot type and who does not have a clue how to use - and
little interest in learning because he is the boss - the computer on
which it is installed) a HealthNet e-mail address. She does not have
a drivers license, (she has no car). Her national id card is hand
written and has her black-and-white photo stapled to it. She uses a
computer at work (hence her possible access to Health-Net) because
the machine was donated by an international or bi-lateral agency and
has all sorts of installed programmes on it, but nobody has explained
what all those little pictures on the screen mean. "Push this button
and you can write letters..." is the extent of her training. She does
not have a personal computer at home, and is likely not to have a
What does this "Set Your Dial Mode: <T>one/<P>ulse:" mean?
"What is Your Affiliation? [Limit 25 characters]" Does someone whose
English is limited understand a word like affiliation? Does someone
who has little of no computer experience who has managed to blunder
this far into an installation programme know that <Enter> or MARTIAN
VISITOR or NONE OF YOUR BUSINESS is an acceptable response to this
query? (Which, in any case when the instruction "Be sure your modem
is on. This call will be free.." and the modem tries to dial one of
those "No Cost" U.S. 800 numbers) from outside the U.S. will result
at least in the computer's seizing, at least with a scary message
/tone from the local phone company).
Can - as a sample - HealthNet tell us about traffic FROM its users?
Maybe the gurus in Boston cannot track what goes on internally within
countries. But, I will bet that with very few exceptions, this is
minimal. Surely they should be able to tell us about numbers of mes-
sages - a breakdown by list-related messages and "real" messages
would be interesting - by country - that move from each through the
Boston node - would be interesting. This could be a hint - what else
could be measured? - of the interest/use of truly international con-
(I hope this is not too heretical stuff that will get me banned from
ever using HealthNet anywhere ever again.)
I am not sure where this all leads, and many readers will likely have
disconnected by now or at least cursed its length, since they may pay
by the second, more likely by the minute, but I hope that its more-
than-a-minute may be worth it to stimulate discussion. I am inter-
ested in, even fascinated, but puzzled by, so little use of HealthNet
or similar systems and what I see as substantial mis- or total lack
of understanding of its potential power and use.
Today is a Public Holiday in Eritrea. so I have had time to write
(In a week I will be gone from Ertirea, having completed my charge to
(re)develop a national, decentralized, computerized health management
information system in just over a year. So, if anybody wants to reply
personally, I will be at this address until 18 September. After that
I will use (and re-subscribe to Afro-Nets using it) my "permanent",
though currently sleeping, Compu-Serve address
[log in to unmask] (which I will reach from Botswana, until I
get something more permanent/personal).
Jeremy B. Clark
Health Information Systems Advisor
P.O. Box 5815
Office Phone: +291-1-127420
Home Phone: +291-1-184140
PLEASE CC: E-MAIL TO: [log in to unmask]
[log in to unmask]
[Note from the Moderator:]
We should appreciate if all contributions were signed with full name,
position and location of authors. Very often we have even to con-
struct the name from the e-mail address assuming that it is more neg-
ligence than strategy.
AFRO-NETS (incl. AFRO-NETS-digest) has at the moment about 450 direct
subscribers - people who have actively subscribed to the list. We
tried to find out how many more receive the contributions via their
local HealthNet nodes as 'conference' messages, but with little suc-
cess (nearly no response from the system operators). In Zimbabwe
'AFRO-NETS' is offered as a local conference at HealthNet Zimbabwe
with eight subscribers.
To get a list of AFRO-NETS subscribers you should send a message to
[log in to unmask] with text in the body:
>From the e-mail addresses you might have a clue about the locations
of the majority of subscribers - but it would be nice to know more
about the 'AFRO-NETS family'.
Finally - Jeff's message was originally posted on AFRIKA-IT but taken
over by AFRO-NETS due to its relevance.
Jeremy, thanks for your contribution and considerations. I hope it
will push some of our 'couch potatoes' to an active response.
mailto:[log in to unmask]
Send mail for the `AFRO-NETS' conference to
[log in to unmask]
Mail administrative requests to [log in to unmask]
For additional assistance, send mail to:
[log in to unmask]
Dieter Neuvians M.D. Health Systems Research
P.O.Box 2406 Southern African Region
Harare / Zimbabwe Tel. +263-4-733696
e-mail: [log in to unmask]
[log in to unmask]