The first fix began this past March when Mailman returned to the research project's headquarters in Kampala with a new Dell quad-core server and a modern relational database that's under a royalty-free licensing arrangement from Health Metric Systems in Palo Alto, Calif.
Each of the nine remote malaria project facilities across Uganda had already been equipped with a computer and other equipment, including solar panels and inverters that power the computers in the absence of modern electrical power grids. That gear was brought in about two years ago by UMSP partner institutions.
But the new improved database and central server dramatically exposed the weaknesses in the courier-based data-transfer system.
"I was sitting in a meeting while they talked about how they were happy with how they could now get their data into reports easier, but they were still having delays of several months just getting the collected data from the field offices," Mailman says. "They had a data collection problem which was as big as or bigger than their original database problem."
Brainstorming for a better idea
"If we were in the U.S., we'd be getting connected to the Internet and sending the data in real-time," Mailman says. "But here there's often no electricity, and the computer they were using may be the only one in the entire clinic."
Running a landline for an Internet connection was prohibitively expensive and would have taken up to 12 months to install, if it was even possible, he said. There are Internet cafes in larger towns around Uganda where data-entry staffers could have transmitted the data, but that would have introduced the potential for computer viruses and confidentiality issues. "That could have caused massive problems for their simple IT systems," he said.
A second option was out, too. Because the project operates on a shoestring budget, there was no money to pay for expensive satellite phones to transmit the data.
Mailman also considered using generic cell phones to connect to the remote computers so they could transmit the data, but dropped that idea quickly. The concern was that with so few PCs available, having unrestricted cell phone access might be a lure for unauthorized users to use the cell phones to transmit their own e-mail or other files. This could potentially expose the core IT systems to viruses and other technical problems in remote locations where repair help was not easily available.