The Computerworld Honors Program
Honoring those who use Information Technology to benefit society
LOCATION:
Ottawa, N/A, CA

YEAR:
2007

STATUS:
Laureate

CATEGORY:
Healthcare

NOMINATING COMPANY:
Polycom

ORGANIZATION:
The IT Department, Inc.

PROJECT NAME:
Angola Hospital Project

Short Summary
As in many sub-Saharan nations, life in Angola, Africa is a daily struggle. Decades of civil war have left the country shattered, with a dearth of public services, frequent and deadly infectious disease outbreaks, active guerrilla organizations, and vast swaths of territory covered in land mines. To help ease the healthcare crisis in the country, Dr. Stephen Foster, a Canadian surgeon who provided his services there before, during and after the war, opened the Evangelical Medical Center Lubango in 2006. Dr. Foster recognized that the ability to communicate in a cost-effective manner with the outside world would help to raise the standard of healthcare in the region, so he contacted Norm Henderson, president of outsourced IT services company The IT Department, Inc. Henderson took great pains in raising funds, donating time, and soliciting a wide range of donated services in order to offer Dr. Foster a Voice over IP-based telephone system for his hospital.

The system is now up and running and offers the Evangelical Medical Center, Lubango staff of 106 the ability to communicate with rural clinics to offer advice; with physicians in almost any nation to ask for diagnosis and treatment help; and with donors around the world. And all of this communication comes at virtually no costs because the systems are Voice over IP.


Introductory Overview
Norm Henderson is the president of The IT Department, based in Ottawa, Canada, a company that offers outsourced IT services to a wide range of customers. And he’s no stranger to philanthropy, his company supports four charities in Canada with network infrastructure and Voice over IP (VoIP) services at minimal or no cost. That’s why when he was contacted by Dr. Stephen Foster, a Canadian surgeon who has been working in Angola, Africa for close to 30 years, he knew he’d find a way to help.

Angola is located in south-central Africa and bordered by Namibia, Democratic Republic of the Congo, Zambia and the Atlantic Ocean. A 27-year civil war has left the country in a severe humanitarian crisis, with an abundance of minefields and guerrilla movements fighting for independence. Angola is also the site of periodic outbreaks of infectious diseases, including devastating hemorrhagic fever. The country’s economic situation largely prevents any government support for social institutions, leaving hospitals without medicines or basic equipment, and schools without books.

The dire situation in the country compelled Dr. Foster to build a new hospital, the Evangelical Medical Center, Lubango with the funding assistance of Samaritan’s Purse and USAID. He contacted Henderson to ask for help in equipping the facilities with a telephone system to connect the hospital between buildings and to the outside world. Henderson immediately suggested a VoIP solution together with VSAT Internet connectivity.

“We started using Voice over IP technology using the Asterisk-based open source solution a few years ago when we opened up a help desk for our customers and needed a cost-effective telephone solution,” explains Henderson. “We partnered with Polycom for the solution and had so much success with it that we began offering VoIP to our customers. I knew the benefits of VoIP could easily be transferred to the Lubango hospital site.”

Chief among those benefits is the fact that with a VoIP + VSAT solution, the hospital can communicate with anyone in the world with only the subscription costs of the VSAT service. At several dollars per minute, a standard phone call out of the country would be exorbitantly expensive. In addition, the monthly satellite link cost is fixed, using a standard telephone solution, the monthly bill would be a very significant variable cost.

The effectiveness of the overall solution is further enhanced by interfacing the hospital’s VoIP system to the existing telephone network in Angola via gateway trunking to the hospital site, and to the rest of the world via the Internet to digital telephone trunking operated from the IT Department facilities in Ottawa.

Another VoIP benefit is that the overall VoIP system network is maintained from the IT Department Offices in Ottawa, and Henderson and his colleagues have the ability to reprogram the phones and add features remotely.

Henderson began a fundraising effort that resulted in $40,000 to spend on the project. He also partnered with Polycom for discounted prices on its SoundPoint IP VoIP endpoints, he donated several hundred IT Department service hours to make the project a success, and he personally oversaw the installation in Lubango, Angola.

The project came together in July 2006 and the hospital now has a total of 60 Polycom VoIP phones.

Today the Evangelical Medical Center is a thriving healthcare facility seeing 100 out-patients per day and performing 260 surgical operations in just two month’s time. And the staff of 106 can easily connect among buildings, to locations in the local town, and around the world using its Polycom VoIP phone system.


Benefits
Has your project helped those it was designed to help?   Yes

What new advantage or opportunity does your project provide to people?
The VoIP telephone system enables standard communication internally among hospital buildings and to the town. And because it is a VoIP architecture, it also allows for the unique ability to hold vitally important medical teleconferences with physicians in North America or anywhere in the world at virtually no cost.

Has your project fundamentally changed how tasks are performed?   Yes

How do you see your project's innovation benefiting other applications, organizations, or global communities?
Because a robust IP network was installed to enable the VoIP phone deployment, the network is able to be leveraged for other applications. The hospital will have the ability to send digital x-rays electronically over the network for analysis by radiologists in North America. Its physicians and medical staff have the opportunity to access medical education and medical information libraries online thanks to the VoIP network. And Henderson has begun considering the possibility of deploying Polycom video conferencing technology on the network to gain access to the Medical Mission for Children organization, which provides access over video to pediatric experts around the world for case consultations. None of these additional benefits would have been possible had a standard telephone system been installed.

In addition, now that a phone system is in place, the medical center receives frequent calls from government doctors who work in the town asking for advice. As knowledge is transferred, the standard of care for the entire region is raised.

The Importance of Technology
How did the technology you used contribute to this project and why was it important?
Voice over IP technology provides flexibility for the internal phone system and a wide variety of external connections without a lot of incremental cost. The technology makes communications between the hospital and remote parts of the world easier and much less expensive than a standard telephone system would. For example, the hospital has contacts in Brazil because Portugese is spoken in both countries and Brazil has very good medical resources. The IT Department can easily set up VoIP lines for Brazil and give Lubango immediate access to those resources at virtually no cost.

Originality
What are the exceptional aspects of your project?
One of the most exceptional aspects of this project is the fact that so much of what made it happen was donated. The first year of satellite connectivity was offered free, the IP PBX systems were donated, the Polycom SoundPoint IP VoIP phones were offered at reduced prices, and labor, air fare and shipping costs were donated.

The IT Department’s use of open-source technology also qualifies the project as exceptional. Open source provides tremendous flexibility. For example, cell phones are used surprisingly frequently in Angola, and the open-source IP PBX allows calls on the VoIP network to be sent to cell phones.

How is it original?
This is the only VoIP phone deployment at a medical center in the country of Angola.

Is it the first, the only, the best or the most effective application of its kind?   All of the above

Success
Has your project achieved or exceeded its goals?   Achieved

Is it fully operational?   Yes

How many people benefit from it?   29,500

If possible, include an example of how the project has benefited a specific individual, enterprise or organization. Please include personal quotes from individuals who have directly benefited from your work.
The VoIP phone project benefits residents throughout Angola on a daily basis by enabling their physicians to connect with experts in any medical specialty, without concern for cost, for advice and help in diagnosing and treating patients. This acts to raise the overall standard of healthcare in the country.

Dr. Foster comments: “When I contacted Norm Henderson for a solution to our communication needs I had a vision that we would be able to provide voice and image to anywhere, finally bringing Angolan professionals into the orb of their colleagues around the world.

We are already getting referrals and requests for opinions on difficult cases from several private clinics and the public hospital here in Lubango. We are planning to install Digital radiography by June this year to allow us to take advantage of two Canadian Radiologists who have volunteered their services. I have several patients for whom we are planning a replacement arthroplasty (total knee) with donated materials from Alberta. The surgeon in Canada needs the sizing details to bring the right prosthesis as we won’t have a full box of trial parts, so we will need to consult him by phone. We have been able to implant cardiac pacemakers by walking through the procedure over the phone with a consultant in North Carolina.

I foresee the day when we will have real-time video conferencing with consultants in Brazil about patient problems and ongoing Continuing Medical Education developing from these contacts. To say the least, the IT Dept. is changing the face of our world here in Angola.”

How quickly has your targeted audience of users embraced your innovation? Or, how rapidly do you predict they will?
Basic VoIP phone functionality has been accepted rapidly. The more advanced features are not yet being used, but The IT Department is planning another trip to Lubango within the year and training on advanced features will be a priority.

Difficulty
What were the most important obstacles that had to be overcome in order for your work to be successful? Technical problems? Resources? Expertise? Organizational problems?
Given the remote and developing nature of Angola as a country, many significant challenges were encountered.

Transportation of the containers with the VoIP technology solution took far longer than planned. Sea freight can take four to five months to arrive, and unfortunately some of the sea containers were pilfered in the port when they did show up. In order to expedite the delivery of a satellite dish critical to the deployment, a donor agreed to pay the substantial air courier charges. What was supposed to be a one-week delivery time turned into four weeks and because life and information tend to move more slowly in Angola, it was weeks before Henderson found out the problem was the satellite dish not fitting on the courier company’s in-country airplane.

Infrastructure and access to supplies were also challenges for Henderson and his team. Power supply was a big issue as the hospital infrastructure was not set up properly. And things as simple as bolts and mounting equipment were extremely difficult to find locally.

Weather also played a part in the obstacles The IT Department had to overcome. Angola is one of the most intense lightning areas in the world due to its high altitude and the fact that it is very exposed. Lightning storms caused significant damage to a satellite modem and network switch and organizing replacements took three months.


Often the most innovative projects encounter the greatest resistance when they are originally proposed. If you had to fight for approval or funding, please provide a summary of the objections you faced and how you overcame them.
This project thankfully was funded by individual North American donors who believed in the technology as well as in the need. On the ground in Angola, there were many who doubted that a charity hospital could be opened in Lubango with facilities and services equivalent to those in neighboring Namibia and in South Africa, and superior to the one expensive private clinic. The community is now fully supportive. The world-class Voice over IP telephone and satellite Internet system is a key element in distinguishing the Evangelical Medical Center Lubango as a facility fit to host, for example, the planned 2010 African Nations Cup football games. The necessity for a satellite earth station license was not apparent at the beginning of this project. A local supporter, Jembas Assistencia Technica Lda., approached the government telecommunications authority on our behalf and with their support, we were granted a no-cost, five-year license.
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