What follows is a travelogue by WorldVistA director Chris Richardson from San Francisco, California to the recent World Summit on the Information Society (WSIS) meeting in Tunis, the capital city of Tunisia located in northwest Africa. WorldVistA is a group ‘focused on further developing and supporting the growing global VistA [electronic medical record] community.’
(Editor’s note: dates are in VistA format � 305 is the year 2005.)
Tunis Journal � 3051113 � The Pre-Board
Gentle readers;
This is a journey which holds a lot of exploration and discovery about the differences and similarities between various peoples. Having run the gauntlet of the Bay Area Rapid Transit system to find the my way to the San Francisco Airport, I found a large contingent on BART heading toward football game (49ers vs. somebody). Sitting there listening to them discuss the various players casually and making comment about the players in a familiar way as if the players were an extended family. The fans got off and the Opera Ladies got onto BART as we made our way to the San Francisco Airport.
One of the Opera Ladies was a retired VA Nurse Administrator and she told me of the time she was stationed in Libya, (now under different management). She had traveled through Libya and Tunis, and Algeria to Cairo. She noted a marked difference in the number of beggars. They seemed to be non-existent in Libya, but teaming in Cairo. Well, little things mean so much, even if it is an observation from decades ago. All things are deeply inter-twingled.
Having made it through the maze of security, it was fascinating to see the range of special treatment they give to those unlucky few who happen to fit the suspicious profile, namely me, your humble servant. They have a machine which send seven puffs of air at you very quickly and you must stay very still while they analyze the results. Usually when this happens there are a lot of mirrors around, now the midway has met the terminal. Next they will start charging us for these unexpected diversions. Best to not give them any ideas.
Tunis Journal � 3051114 � The Road to Rome and Tunis
I have gotten off of the flight from San Francisco and have sought power to replenish my laptops. The 220 volt/50 cycles tastes just great and my laptops are lapping it up. So I sit here in Frankfort waiting for my flight to Rome. And from there, I am off to my last leg on Alitalia. While I sit here, I think of the extent of the Roman Empire which reached this far into Germania. The Southern extent of the empire was beyond what is now Tunisia. To be able to travel this great distance in such a short time, was unheard of. It took me minutes to get over the Austrian Alps, Hannibal’s mileage may vary.
The trip that would have taken the Vandals months to make will be made in a single day with me arriving to my hotel on the South-side of the Mediterranean at Hammamet. This is new territory for me, but the rest of my life is new territory. The journey I do now is easier than that of the Caesars and the Goths because of all who have come this way before, bringing new technologies to cut the time and reduce the dangers.
So it is for the VistA community. Those who have lead the way are making it easier for those who will follow. Those who join today also make the way cleaner and easier for those who follow. Those who are using VistA in new areas will make the model adapt to new situations which it has not done before, solving new problems and becoming more resilient and more reliable.
Now on to Rome. I got an Exit Row!! On this leg from Frankfort to Rome, there was no more than 10% of the seats filled. Empty! Where was this when I was flying from San Francisco? I slept a little, resting up for the next situation which was about to befall me.
Ah, the eternal city, the hub of the Universe (at least back before the Christian era), those seven hills, that airport with very few people one can ask direction from. And the clock continues to tic as I run hither and yon to identify the actual gate my plane is at, because I have moved out of the comforting support of Lufthansa, over to the tender mercies of Alitalia. My Italian is confusing to them and their Italian is difficult for me to grasp, but it appears as though I have followed enough signs to at least be in range of the plane that will take me to Tunis. But, my ticket says, “must check in” and I have no boarding pass only the flight coupon. That means I have to seek out another desk to get the boarding pass. That last hurtle passed, I collapse into a chair in the waiting area and struck up my first chat with a WSIS participant from Boston. A lady with the MIT Networking group who was going on to Israel after the conference.
On the plane, I met Eva Hillerova, from the Czech Republic. She is a manager for the IZIP group, an 18 Billion Euro program to modernize and expand the engineering and manufacturing industry. She has introduced me to a Czech reporter who wants to speak to me. While battling the effort to get my WSIS badge, ran into —– who specializes in sustainable efforts. From the article she showed me, there is a major medical record aspect. Eva got me in touch with Dr. Petr Benes, a publisher and film maker who is chronicling the efforts of the Czech delegates at the conference. She wants to make sure that I get interviewed for Czech TV. She would like to see more Open Source solutions and liked our focus on building support community.
So, tonight I sleep in Africa.
Tunis Journal � 3051115 � The Road to WSIS
Strangely enough, I over-slept this morning and wasn’t feeling all that great. But I was up and ready to go by 0930 and found out from the desk that the bus came by in 25 minutes and I should wait outside. Well, I did and got a great look at some of the local plants and critters. It was very much like Florida in many respects. To make an already too long story short, I missed that bus because I should have waited out by the guard house and not at the hotel front. But perhaps it was meant to be. While getting the feel of the place, I met Khaled Hammad (www.sda-web.org), who was manning one of the Egypt Pavilion booths. I found Dr. Molly Cheah and her daughter at the UNDP booth. It was there that I was able to hook up my laptop and download my mail. Hopefully, this journal will go out this morning.
Here is something compelling from the UNDP booth, “One Laptop per Child”, a project to generate $100 laptops for the children of the world. I got to see some mock ups and a working prototype. For $100, it will not be bad. They will be showing the full operational model when it is announced by Kofi Annin. As it turned out, Dr. Mary Lou Jepsen, was on my flight from Rome. She is the CTO of the company that is going to produce these cheap PCs (http://laptop.media.mit.edu).
While at the UNDP booth, I met Allen Ballochan Tuladhar, the chairperson of Forum for Information Technology Nepal (FIT Nepal, http://fitnepal.org.np). He may be interested in helping with the translation of VistA into the language of Nepal.
Later I attended a session on “Economics on the Net” and met with Professor Robin Mansell, from the London School of Economics and Political Science (actually Sheila Robinson was also on this panel). Also presenting at this panel was Marc Miletich of the Austrian Republic who spoke of Sonovista (http://www.sonovista.com), a community involvement project which has resulted in television footage which is produced by the people of this community, Engerwitzdorf, and the things that they are most proud of. It has been an interesting experiment and perhaps the participation is part of why such volunteer efforts work so well.
All of this and the conference has not even started yet. The next 4 days will be busy.
Tunis Journal � 3051116 � The Search for IZIP and the loss of Energy
This morning started by my finishing my previous report about 0500 this morning and my getting about an hour’s sleep, (a situation I am well on the way to correcting). I was at breakfast at 0630, but realized that people had been down here since 0600 (a situation I will adjust for tomorrow, the 17th). We made it to the buses by 0720 and were off on our new day adventure at WSIS. The bus trip was an opportunity to find out about the Pax Warrior. It is a finite selection decision set of situations. The game offers the student the situation of the UN Commander at Serievo and there are consequences for the various new situation and the new choices that the UN Commander would have been confronted with.
OK, we arrive at the WSIS for the first day of the general sessions. My task is to try to speak with as many different groups as possible and look for opportunities for support for the WorldVistA activities. Toward finding funding, I had an idea that with the Czech government currently trying to do an electronic health record, that perhaps WorldVistA might be a good source of aid for them in accomplishing their goals. I had burned a copy of the WorldVistA release which can be brought down from Source Forge, along with a disk of VA VistA documentation and the Entity Relationship Diagrams (also available from the VDL (the VA’s VistA Documentation Library) ) to give them an idea of the breadth of the VistA model. But first, I would have to find their booth! I had looked for the Czech Booth yesterday half heartedly, but today I would look in earnest to find them. But first, I would have to clear the security. We got off the bus to find a small sea of people waiting to clear the security.
This was a many colored, sea of people from all nations. What else was there to do, but dive in. Once in this sea of people, I was able to strike up a conversation with a number of them and actually got some offers of translation help from the national representative Ms. Mathilda Jacinta Takaku, Minister Counsellor of the Permanent Mission of Papua, New Guinea to the UN. Her address is in New York. Another person in line heard me talking and expressed his interest. As it turned out, Pino Mavengere, MB.Chb. MBA, is the Program Director of Health for Strategic Business Development for SAP Africa (Pty) Ltd., (http://www.sap.co.za). SAP is huge in software all over the world. It will be interesting to see how this plays out. Well, that got me through the security line.
Now on to find the Czech Republic. I went through the booths and failed to find them. The documentation was not clear as to where everything was (and to be honest, I think I heard that they were late registrations for a booth and probably were not on the published list). So they were adrift out there in a sea of nationality booths. I finally asked at the Information Booths and they sent me to other Information Booths (the buck passes here). Finally I found someone who looked official and asked them. They knew someone who would know, a well dressed man who turned out to be one of the directors of the meeting. It was amazing following him. He could not go twenty feet without being hailed by someone who was a long-standing acquaintance. But he was true to his task and I wish I had his card because I think by dropping this gentleman’s name, I could have gotten in to see the President of Tunisia. Eventually he was stopped by a gentleman, Mohamed, who did know where the Czech Booth was (he thought). Mohamed lead me around for a while greeting still more dignitaries and finally passed me off to an usher who knew someone who helped set up the booth. Ah, some progress at last! (I think).
The usher introduced me to the last lady in the chain, and we where off. Now, you must get this picture, this young lady (probably in her early twenties) is off like a shot through a maze of people that would make a bizarre look organized, being followed by a 6 foot, 5 inch guy with a pack as big as Santa Clause’s on his back trying to keep up with her. She is the rabbit and I am the over burdened fox. I do manage to keep up with her as she weaves her way through the crowd. She looks back once or twice amazed that I am still up with her. We zip past the US Booth and viola!, there is the Czech Booth.
I thank her for her help and she is off without her faithful follower this time and soon blends into the throng. Exhausted, I enter the booth and ask for Eva Hillerova, and she comes right out and ushers me into the conversation booth and we start talking and I offer her the disks that I had made up the night before and started in telling her what was on the disks. She stopped me and asked me if I wanted something to drink and said that there were some people she wanted me to speak with.
My orange juice was shortly followed by two people, Ing. Petr Hanzlic’ek, Informatics Department, of the Ministry of Health of the Czech Republic, and Michal Javornik of Masaryk University in Brno, Institute of Computer Science. These were the techies, and I discussed the aspects of the environment that VistA runs in and answered their questions. I started up the CPRS demos and ran them (these were included on the disks that I provided).
Leaving the Czech booth, I decided that it was only polite to stop into the US booth. The booth seemed to be split in two, USAID and a group that was pushing the adoption of international emergency notification (across all media, Television, Radio, Internet?, and Email?). One wonders how that might work…Now disasters are usually local, fire/flood/tornadoes/hurricanes. Who are they going to broadcast to?? How do you know that that person is in the effected area? Television and Radio broadcast is pretty local, but email and Internet are anywhere in the world. Are they hoping to flood the Internet with Fear, Uncertainty, and Doubt for every little neighborhood fire? Or are they keeping tabs on us as to where we are and what our email and Internet usage is?? Interesting ideas to ponder.
With that task out of the way, I went to find a meeting being presented by the Club of Rome. I got there just as they were closing down, but I got the opportunity to exchange cards with Professor Raoul Weiler, the President of the Brussels-EU Chapter and member of the Executive Committee (he will be coming to California soon and promised to get in touch with me) and Takeshi Utsumi, Ph.D., P.E., the Chairman of GLOSAS/USA, and is the Founder and VP for Technical and Coordination of the Global University System (GUS) (http://www.friends-partners.org/GLOSAS). I had been introduced to Professor Weiler by email from Joy Tang of 1Village just prior to this trip.
I spoke with a number of other countries about the availability of Open Source Software and the WorldVistA Community and how it is growing. Some of these countries were, Cuba, Denmark, Turkey, and others. At the Turkish booth, I met a Mr. Kamil Aksoy, the Business Development specialist for Havelsan, a defense contractor in Turkey. I mentioned that I had worked on the Department of Defense’s version of VistA and that it was still running. I pointed out that health was a very big industry which is usually still stable after peace breaks out and this was a means of getting into that industry (we will need support infrastructure to support the hospitals and clinics once the systems are up). Perhaps this is an opportunity to start beating swords into plowshares. One can only hope.
While talking with Nicholas Kimolo, the Technical Director of Circuits & Packets Communications Ltd., Nairobi (now that won’t fit on a button, but here is their web site, http://www.circuitspackets.com ) about the Open Source VistA offering, a gentleman came up to me and asked if I knew Ilya Eric Lee. I was dumbstruck ( already a bit dazed from a busy morning and early afternoon) but said that of course I knew Ilya. He had stayed at my house in Pittsburg (California). Well it seems that the man asking the question was a co-worker with Ilya at the Academia Sinica in Taiwan. His name is, Tzu-Chiang Liou (http://openfoundry.org). He is a really nice guy (hey, any friend of Ilya is OK by me). It was pleasant to chat with him for a few minutes.
Well, my energy levels were running down and I needed to get some rest so I went over to the UNDP booth to catch up on my email. There I ran into Bruce Parens, the Father of the Open Source movement. He had heard of WorldVistA and offered his support in getting our wares out into the Open Source community. He is a very pleasant individual. It was a joy to speak with him.
I was fading fast (and missed the reception this evening). But it was time to retire and sharpen my ax for the next day’s efforts. But fate was not to be so kind. A gentleman that had joined us for dinner the night before called me over to his table at the hotel (I am back in Hammamet by now) and introduced me to Nestor Misigaro, the Director General of the Agence de Regulation et de Controle des Telecommunications of Burundi. I gave him my 5 minute thumb-nail of what VistA is and how it might help Burundi and how we would love to have their participation in the VistA Community. He was amazed and excited at the prospect. He said he would make sure that this would be looked at by the proper people in the Burundi government.
Well, it is time to take the hill and head for bed. Tomorrow comes too quickly.
Tunis Journal � 3051117 � Just When You Thought It Was Safe To Go Back Into The Conference… The Saga Continues
When completing this journal in the early morning hours of the 17th, I didn’t realize that I would over sleep a bit. It turned out that I only had a few minutes to run down to the breakfast room and get something to eat and get to the bus. My bag was packed and I took it to breakfast. Grabbing a quick plate of potatoes and some powdered eggs, I wolfed down this repasts, I hurried to the bus which was already partially loaded. But I did make the bus. There was a seat next to Sheila so we sat and chatted. This was her last day at the hotel so this was the last time to discuss issues with her. We talked about possible applications that VistA might have. These included support for midwives and methods of providing a decision tree of when external help may need to be called for. Once a woman in labor gets into trouble, her survival rate drops after the first hour. Sheila has some contacts that she want me to talk with about the possibility for helping in these and similar situations. We promised that we would continue to communicate by email. Sheila suggested that I speak with Richard Fuchs of the Canadian IDRS. It took me a while, but I did find him an he spoke to me about getting in contact with the Shuttleworth Foundation.
While at the Jordan booth telling them about VistA, a distinguished gentleman came up and asked for my card as well. He turned out to be Najeeb Al-Shorbaji, Ph.D. Coordinator of Knowledge Management and Sharing for the World Health Organization (http://www.emro.who.int). He lives in Cairo, Egypt. He said that the UN has spend hundreds of millions to accomplish what we are offering for free. He is very interested in helping us.
In my travels among the booths, I came upon an idea. The VA-VDL is very difficult for people to pull that documentation piecemeal. Why not just get a DVD dump of the VDL and have it managed out on the web by an international organization such as the International Network for the Availability of Scientific Publications (http://www.inasp.info). To that end, I spoke with Sarah Durrant, the Head of Information Delivery. She said she could find the contacts we would be able to coordinate with to make this happen. She thought it was a pretty good idea.
I got back to the UNDP booth and there was Richard Stallman giving an interview, very much in the moment. I was still jazzed about the excitement I had stirred up in the gentleman from the World Health Organization. Not bad for a day’s work. Two more days to go….
Tunis Journal � 3051118 � The Beginning of the End
This was a less hectic day in many respects. Molly asked me to watch her session at 0900, but I had some items to get sent out before I could go watch her talk. Email was heavy and it took longer to answer and send out the files I needed to. This was a slow beginning but things sped up quite a bit.
I dropped into a meeting about the success of the current series of these two WSIS meetings. There was a stellar group that was on the panel. Part of the critique of the meeting was that there seemed to be business as usual, and there was a marked lack of people under the age of 25 involved in the planning group.
I got to Molly’s meeting just as it completed and the next meeting was a shoot-out panel on the topic of Open Source and the Market Place. It was an interesting mixture of members on the panel, Richard Stallman, Bruce Perens, Robert Kramer (CompTIA), Shane Wall (Intel), Louis-Dominique Ouedraogo (UN Official), Mark Shuttleworth (Ubuntu Foundation). It was marvelous theater. It seemed to be people with hair who were for Open Source and those without hair who were against it. Those against Open Source seemed to be (Robert Kramer and Shane Wall) were holding the Tobacco industry approach that software should be a choice (yeah, so they should be able to feed off the stupid, just like the tobacco industry).
I spoke with Douglas Mbiandou of Objis, (http://www.objis.com), a java programmer and system integrator based out of France with offices in Tunis and elsewhere in Africa. He is anxious to see VistA in action, so I helped him to download the free demo from Source Forge. He has many business projects that he would like to pursue with CARE2X or VistA, but he needs to learn about it more. He is on his way and I am sure we will hear from him on the list.
I spoke to FAO and met Eliane Najros, the Project Coordinator for the Dimitra Project (http://www.fao.org/sd/dimitra). Now why would the Food and Agriculture Organization be interested in VistA? Well, they are not,…. Yet! It seems that your poor chronicler was once on the road to going to work for FAO, in Rome, for the Fisheries Division (what I studied for in college). I was done out of the job by then-President Ronald Regan when he killed funding to the World Bank. I explained to the official I spoke with that VistA is a tool kit for solving problems and ordering information.
Tunis Journal � 3051119 � The Exodus � Where Did Everyone Go??
This morning started simply enough, but there was a major move in progress. I was leaving the Iberostar Belesare and the wonderful meals (breakfast and dinner). My last meal was very pleasantly spent with the gentleman from the Indian booth. This was a very good meeting for him as well.
This was a short day. The locals were let into the hall and just about any give-aways disappeared. The booths were being dismantled as we were preparing to go. Pictures of the folks occupying the booths were forming up and being snapped. Some of the pictures were carried back to San Francisco. While walking around the UNDP booth, I met Tuul Davaa, the director for the Academic Link NGO, based in Mongolia. Her contacts are with the universities. She mentioned that Mongolia has lots of land, but few people (+2 million people who live in all of Mongolia).
While I was helping clean up, I ran into a couple of Iranians, one was Hojat Modirian, Computer Engineer, http://modirian.net) who were shooting some film. I told them about VistA and the possibilities. I gave an impromptu interview about VistA, but it was all Hi-8 quality. This was for local consumption for their bosses.
I went over to the Israel Booth and met Raphael Morav, the Deputy Director of Economic Affairs, Department 3, with the Ministry of Foreign Affairs. We spoke for a while and he saw that there were some interesting connections which the VistA model might solve for them.
Before we split up, we made contacts with each other. I spoke with Vladimir V. Grebnev, the Network Facilitator for the Central Asia and Russia Environment and Sustainable Development (CARNET, http://www.caresd.net), member of UNDP. He said that he would take word of VistA back home to Kyrgyzstan.
Tunis Journal � 3051120 � All of a Sudden, There I Wasn’t…
Well, 0500 came way too early. Collecting my things, I got down stairs to get a taxi. I use the term “taxi” only tentatively. The night clerk grabbed my bags as he went out into the street to flag down a taxi. There was nothing in the street except a police cruiser that kind of just slid on by. As it passed, I thought, “Well, there goes my ride…”.
Way down the wide avenue, there was a set of headlights, kind of swaying to the left and the right as it sped down the multi lane roadway. It kind of rumbled up to the night clerk. The driver jumped out and spoke in rapid Arabic. I kept saying the airport and I wasn’t sure I wouldn’t end up back at Hammamet. Even though we did not have a single word in common, we still made it to the airport in pretty much record time and it only cost me 5 Dinar from the hotel. Leaving from Hammamet would have cost me about 120 Dinar. So I am not unhappy with the situation.
Well, they said to get there 2 hours ahead of time, and wondered around looking for my gate on Lufthansa, (oh, wait, I got bit by this before!, look to see if an affiliate was operating the flight, yup, the flight was actually operate by TunisAir. OK, that helped to narrow things down a bit. So I arrive at the check-in for my flight to Marseilles, France. The only guy there speaks no English and I speak no Arabic. He wonders off, so I stand there and wait. A couple of Tunisians came right us and got in line ahead of me (like I didn’t exist). Oh well, different cultures different rules (little did I realize that I was wearing a trump-card around my neck which would get me favors that they only dreamed of.
Twenty minutes after the gate was supposed to be open, a lady came along to man the desk. She saw me standing in line and point for me to go over to another set of gates and was saying “Special, Special” to me. I looked down and I had my conference badge on and there was a special line for the WSIS attendees. Not to look a gift favor in the mouth, I gathered up my tents and fled to the special line. Things changed quickly.
The lady and her daughter behind me realized that the WSIS badge was a passage out of Tunis Purgatory and dived into her luggage to recover her and her daughter’s badges. We need those stinking badges. We got through the lines and passport control fast. Once through the passport controls, I looked for my gate, but there were some TunisAir Hostesses who steered myself and the other WSIS delegates off to the TunisAir Lounge where we had free juice and I had opportunity to talk to some more folks about VistA. Once getting to the gate I recognized the lady and her daughter from line in the check-in. She was headed for Boston and had 40 dinar she didn’t want and could not spend. So I took the money offered and went off to buy some food for the trip. I was able to get change in Euros and brought back the change to her. Then she and her daughter could spend to get a decent meal in transit. The food items get better as you get to Europe.
The flight to Marseilles was short and uneventful. I ran into a gentleman from Hungary, an atomic chemist who is getting ready for retirement. He and I spent some pleasant time sitting and waiting for the next flight. Little did we know that the flight we were waiting for was moved to another gate. We ran to the new gate and made the flight. As we got onto the plane, the aircraft attendant took away one of my bags, the one with the food in it. When I got off the plane in Munich, I failed to reclaim the bag. Well, when I got to my gate, I reported the missing bag, but it didn’t reach the gate in time for the departure. I waited and was the last one on the flight. My bag caught up with me the day after I got back. By the way, this is how I was able to get a kilo of dates into the country with the help of Lufthansa (I declared them, but they weren’t with me when I went through customs).
As I got on the plane, I realized that I did not have an aisle seat. Yup, a center seat, ouch. Another lady was offered a jump seat. And I offered her my seat in exchange. They would not let me change, but I was able to trade with the lady on the aisle. She turned out to be, Nishita Bakshi, a research Associate of the “As You Sow” Foundation, (http://www.asyousow.org) based in San Francisco. Gee, I just can’t quit.
Well, the trip was great. I met a lot of friendly people from a lot of different countries and I hope, gentle readers, you have enjoyed this journal. Peace.