The new breed of health programmers

Eleven years ago, Regis Rwirangira did not know what to expect when he walked through the doors of a cyber café in Butare town. At that time he was a senior two student at Groupe Scolaire Officiel de Butare, one of the best public schools in Rwanda and yet had never typed on a keyboard or clicked a mouse. His mission to open his email address was a success and that was the first time he got connected to the world of technology. “It was so amusing to create an email account. For me, ICT was basically about sending and receiving emails,” Rwirangira said. Now 27 years old, the pages have turned. His dream of becoming a skilled computer programmer has become alive. Rwirangira is a K.I.E (Kigali Institute of Education) alumnus who attained his Computer Science degree in 2007. Soon after, he worked as an IT technician for SOS Rwanda, a place where he gained IT experience before he was enrolled by RDB-IT (former Rwanda Information Technology Authority, RITA) in November 2008 to be trained in advanced programming skills. “I had a dream of one day becoming a programmer. Even as we studied Algorithms in S.5 Mathematics, which was very confusing, I didn’t know it was a basic in programming,” Rwirangira said, “but right now, it is so easy after learning it over and over again.” Rwirangira last week was part of a team of 10 Rwandan software developers who graduated after an intensive 11-month course called eHealth: Software Development and Implementation (EHSDI). The course was funded by the Canadian based International Development and Research Centre (IDRC), and involved advanced computer programming for healthcare applications. With the responsibility of developing and implementing a new medical record system known as OpenMRS, they are part of the country’s mission of creating an eRwanda. The new Rwanda is ambitiously transforming its economy into an information rich and knowledge based economy. Information and Communication Technology (ICT) has become the socio-economic fabric that is enabling the country to become sub-Saharan Africa’s ICT hub. Through scientific research and training of software developers, OpenMRS will be the foundation of an eHealth system that will ensure the efficient and effective running of many health centers across the country, including rural clinics. Rowan Seymour is one of the highly skilled mentors from Ireland. He holds a PHD in Computer Science and has been committed to training the 10 EHDSI students throughout the year. He said the students have been empowered and are now very capable software developers. “We are trying to empower Rwandan students to take ownership of the software they have developed. Instead of depending on already developed software from abroad that is often expensive, they can build their own to fit the needs of various institutions,” Seymour said. OpenMRS was pioneered in Rwanda by Partners In Health (PIH) at Rwinkwavu Hospital in the Eastern Province. Rwinkwavu Hospital is the largest health facility in the country that successfully uses OpenMRS. The medical record system has been adopted by the Ministry of Health and implemented by TRAC Plus and other health facilities countrywide for data storage. Since all these initiatives intend to serve the citizens effectively and efficiently, the eHealth project is a step for all health entities to effectively access and store data in an organized way. According to Christopher Bailey, the Healthcare Informatics Coordinator from the World Health Organisation (WHO), ICT is about helping people. He said there is a need to put an emphasis on using electronic records to improve clinical care. “ICT is a revolution that is having an impact on the rest of the world,” Bailey said, adding that, “if you save one life, it shines a light to the world.” The Ministry of Health Permanent Secretary, Agnes Binagwaho further cited ICT as an important element of Rwanda’s renewal from its crashed status over 15 years ago. “In Rwanda we’ve learnt that our greatest asset is our people, and our past experience only makes people look forward,” she said. Binagwaho emphasized the need for ICT ownership to avoid being trapped in another era of colonialism, and to enable a properly integrated eHealth infrastructure. “ICT can be a problem if we don’t control it. If not careful, we’ll be in another era of colonialism that’s why we must take ownership of it, involve it in every sector, organize it in everything and make the health sector function,” said. Some of Rwanda’s ambitious ICT dreams and targets still remain at large, seemingly impossible to achieve but initia; steps have already been taken and achievement is manifesting itself through these young software developers. After nine months mentoring the EHDSI students, John DeRiggi looks back at a job well done. Coming from the USA, DeRiggi is a professional software engineer who is yet to return to work for his former employer, RAND Corporation-- globally renowned for providing objective research services and public policy analysis in the various fields of Public health, Education, National Security and ICT. “At first, I thought the curriculum was too ambitious. The big challenge was conveying all this information to students in a language that was not theirs,” DeRiggi said. Consequently, creative methods were deployed, where students were motivated to interact and present information to other students in Kinyarwanda, French or English. DeRiggi said that students were not locked to one type of programming topic. “The course comprised of over 75 percent basic programming and database, otherwise, they would not be able to grow in their careers,” DeRiggi said. Of the 10 Rwandan programmers two are female. Regarding this, DeRiggi said that this was a small achievement, given that computer programming is a predominantly male industry worldwide. Michelle Kayiganwa, a young female graduate believes she can work anywhere with the skills she has acquired. She developed software modules in her project called Data Quality that was adopted by TRAC Plus to correct missing data of HIV/Aids patient’s weight, age, and necessary information. “It’s important because there is need to do a follow up on a patient’s improvement. When hospitals use only paper files, it becomes problematic to find a patient’s monthly data, but OpenMRS can do this efficiently,” Kayiganwa said. She agrees that programming is not easy but she has successfully completed the course through hard work. “In the future I intend to implement more healthcare software not only for HIV but also in other areas of healthcare,” she said. Another student Benjamin Muhoza, 28, who is very smart and well-spoken, will replace DeRiggi as a mentor when he leaves. He looks at such success as a natural transition and one of the direct effects that come with training in technologies. “Teaching is one of the best investments you can give to students. We found good students, trained them, paid them and now they are able to impart knowledge to others in turn,” DeRiggi said. Patrick Nyirishema, the Deputy CEO in charge of ICT/RITA at Rwanda Development Board (RDB) said this was the best investment that the students would get for their careers. “It’s not every day that you get people who have got skills that turn into dollars,” said Nyirishema. Nyirishema said there was, “a need to brand our country. Using Rwanda as a model for other countries, they have built a team of young software developers as the first key step on a journey that is just getting started.” He further disclosed that RDB-IT is eager to scale up the ICT projects, with the full support of the Ministry of Health as they continue to attain the country’s realistic vision of becoming the biggest ICT hub in Sub-Saharan Africa. anyglorian@yahoo.com