The digital library initiative recently provided a rural Tanzanian nursing college with a digital medical library. The Ilembula Nursing College was selected for the site of implementation after six months of bilateral talks, a discussion of needs, feasibility and fund-raising. Nursing is of crucial importance in Tanzania, which is a country that suffers from a shortage of healthcare workers. The nursing profession is also a stable source of employment for many women. It has been said that “Development cannot be achieved if 50% of the population is excluded from the opportunities that it brings.” When Helen Clark, UNDP Administrator, spoke those words she was referring to the fact that women and girls are often excluded from educational opportunities in low-income country settings.
The Ilembula Nursing College is located in the Southern Highlands of Tanzania in the village of Ilembula. The region is known for its abundant agricultural fields, rolling hills, and colorful local life. It is also, unfortunately, an area with a high rate of HIV transmission. Misinformation and social stigmas against the purchase and use of condoms are part of the problem. This is especially the case in such a small community. Ilembula‘s location, at the junction of some of the country’s major trade routes additionally contributes to the problem. Thus, the nursing college and its adjoining hospital play a crucial role in HIV treatment and prevention.
Access to up to date medical literature, examination tutorials and diagnostic manuals means a lot for the training of these front-line health professionals. Sadly, access to such materials is a problem of extreme proportions in much of the country.
Rhoda Mhahilidza, a public health educator with the PeerCorps Trust Fund, was born in Ilembula. She was instrumental in advocating for the town’s need to have access to a wider variety of educational material. Her guidance in communicating with Ilembula Nursing College’s staff and her help in coordinating the project throughout its implementation were invaluable. Ilembula‘s digital medical library now has a little more than 40,000 pieces of medical literature and over 2,000 multimedia video lectures. In addition, there is an extensive collection of review material in biology, chemistry, physics, and mathematics, as well as various open-source software packages. This represents a total of about 3 terabytes of content.
All of this is being hosted on and served from a FreeNAS Mini file server very generously contributed by iXsystems, Inc. iXsystems is an American computer hardware firm specialized in advanced data storage systems using open source technologies. The FreeNAS Mini has features that ensure the integrity of the digital library content which are typically not found in other systems of its kind. This is particularly important in the unpredictable operating environments found in rural Africa, where power outages are frequent.
We confirmed before arrival the availability and type of computers that would be available onsite. The equipment that we brought, including the FreeNAS Mini, was transported to Ilembula by bus during an 11-hour journey from Dar es Salaam through Tanzania’s vast southern territory. All of the components were packed very carefully, with the storage disks in a carry bag and the machine itself placed in a heavily padded suitcase to ensure its safe travel. Despite the rough journey, everything arrived in good condition.
When we arrived at Ilembula we found the hospital and nursing college both situated in a very peaceful community. The Ilembula hospital was built in the 1940s, but it remains in good shape. The nursing college was founded in the 1960s and today about 220 young women, and also men, are enrolled. Many students live on grounds and use the current library as a place to study and conduct research for their assignments.
Visiting their campus and library, we found they had an impressive collection of books on a wide range of medical topics. Many of the books were however very old, with some dating back to the 1930’s. The library also contained 14 modern Dell workstations installed with Windows that were purchased recently. The computers were not connected to the Internet, but allowed for the use of installed programs.
The following day, we began the set up. The college’s Principal, Vice-Principal, Librarian, and IT staff joined us at the library, filled with excitement, curiosity and optimism. We began by selecting three of the fourteen computers that had been designated for the digital library. The number of machines supporting the system was actually limited by the number of Ethernet ports in our router, but three machines was a good number to begin with.
After checking that all components inside the FreeNAS Mini were secure after such a long journey, we installed the storage disks, connected the server to the router and a monitor and switched it on. The disks spun up without any obvious problems and after doing some testing we felt confident that the machine was ready for its life in service to Ilembula students.
The three Dell workstations were then installed with the FreeBSD operating system, which offers important features not found in the previous operating system. The machines were modern enough to make use of the very powerful ZFS filesystem so we did. We then configured the package manager to install software applications from a repository that had been previously created on the FreeNAS Mini. This meant that more than 20,000 open source software applications were available to install. Such software included office tools, typing tutors, math and analytical programs, scientific applications and many others.
We began the indexing process to enable rapid searches right away. The indexing tool that is used to provide fast and reliable access to the materials on the server is an open source program called Recoll. It allows full text-based search across many types of documents such as PDFs, ebooks, saved web pages and much more. For instance, if a user was interested in resources about pulmonary edema, he/she could type the keywords in and in a few miliseconds obtain a complete list of all resources in the collection containing information about pulmonary edema. This includes documents, videos and other material. The search is customizable and many other types of searches are possible. Recoll was selected because it is very simple to use and intuitive.
The initial indexing required several hours on each computer. We allowed these to run throughout the day, and used the time to conduct a preliminary survey of sixteen volunteer students. The survey consisted of five brief open-response questions, focused upon helping us understand the students’ habits in using library resources and the computers, as well as their comfort regarding the use of electronic materials for their studies.
The preliminary survey seemed to help a great deal on both ends. It gave us an idea of the students’ comfort levels toward using computers, and it helped us identify the priorities they would like to take away from the project. It also offered the students the chance to see the project in progress, and we invited them to join us the next day to try everything out.
By our third day in Ilembula the indexing was complete, everything was set up and stable, and we were ready to introduce the project to students and staff. Students were invited to stop in the library throughout the day to take some time to explore the new system and to ask questions. They came in groups of various sizes and were able to work in pairs at the computer stations. This was especially good because they seemed very nervous, and they could talk each other through things and help translate occasionally. With just a little bit of guidance, most students seemed to be able to learn the process for keyword searching of digital library content through Recoll and they enjoyed exploring the materials. They were pleased by the speed of the system and the large quantity and vast range of the resources that were available to them. They also explored the new operating system and programs that we had installed and seemed very pleased.
By the end of our first day of monitoring we had trained and observed about forty students using the digital library. We left for the night and returned in the late morning the next day to find the computers already up and running with two students searching for documents. The librarians had helped them log in without trouble, and they had already found some of the materials they needed. The afternoon continued with a constant trickle of students, some who were coming in for the first time, and others who were re-visiting, now with more specific topics for research or to show their peers the system. They seemed to be very comfortable using the digital library and teaching others without our assistance.
Our final day in Ilembula the entire town had suffered a power cut around 9:00am (09:00hrs). We were monitoring the computers when the power shut off, and due to the college’s UPS systems, we were alerted and able to ensure they were shut down properly. Nonetheless, we were unable to do any other work or observation while the electricity was cut, so we waited for the power to return. This provided us with the opportunity to talk with one of the teachers at the college, who shared his experience with the college’s longstanding difficulty in obtaining books. Most of the books they were able to purchase were from publishers who had released a new edition of the book and were hoping to get rid of extra, old copies, he explained. A reference book printed in 1992, for instance could be obtained for around the equivalent of about $5 USD, not including shipping costs to the village. To purchase relatively newer books (2001-2008) for the students to use in class could be as much as 100,000 Tanzanian Shillings per book — about one forth of a family’s monthly income in Ilembula. We were astounded to imagine the financial implications of trying to obtain 40,000 installation physical books even if such books were available in this part of the world.
Power was restored around 6:30 (18:30hrs) that evening, after we had left for dinner. We returned to the library and ensured everything was still working well. We also had the opportunity to work with a few students and teachers searching the digital library for materials. One student came and “checked out” several archived copies of websites and tutorials on tuberculosis and drug interactions, saving them onto a flash drive. We were really pleased to see that this worked well.
As we wrapped things up we performed two further updates — one, setting the indexing to continually update. We believe this process will really not be much of a burden to the system. We also set the FreeNAS Mini to shut itself off automatically each night at 10:00pm (22:00hrs) when the library closes, to avoid any forced-shut downs that might occur otherwise. Finally, the digital library already has a scheduled update! The school’s accountant and IT staff had asked for up to date resources on financial accounting and administering Unix-like systems such as FreeBSD. We plan to send several archives that were previously donated to the project as well as many open course ware lectures on a 1 terabyte disk that the Western Digital Foundation was generous in contributing to the project earlier this year.
We would like to thank iXsystems, Inc. for supporting the project with a FreeNAS Mini, the Western Digital Foundation for contributing a 1 terabyte USB hard disk drive, the students and staff of the Ilembula Nursing College for their help and warm reception and the Ilembula community for hosting us. We would also like to thank the nursing staff at the Ilembula Hospital for sharing their views and time with us. The project also benefited tremendously by having such a dedicated group of people from around the world donate their time, experience and passion: Jessica Bass (Intern with PeerCorps Trust Fund Centre for Rural Development); Rhoda Mhahilidza (Coordinator); and Teija Ruottinen (Advocacy and Fundraising). Mike Wilson served as Technical Lead.
Stay tuned to this space for more updates!