The ACTS clinic & Peebles Valley

Thursday and Friday of this past week I had the excellent opportunity to go with a big group from Meraka to Peebles Valley, a semi-rural area about 4 hours away from Pretoria where there’s a large AIDS clinic. There was a wireless mesh set up there to connect some of the various buildings that comprise the clinic & it’s associated hospice; partially this was for sharing of the clinic’s V-SAT (the only Internet connection available in the area) and partially to get phone service (through Voice over IP) working between some of the clinic buildings (previously, cell phones had been used, to enormous expense). This was working for a while, but without constant maintenance from people at Meraka it rapidly falls apart. It’s now recognized that in order for networks like this to function, they need someone locally who’s incentivized to take care of them. And that usually means turning them into some kind of business — a local Wireless ISP, or a local phone company. This is exactly what I’ve been working on the weeks I’ve been here — a “Wireless ISP in a box” that would allow easy deployment and maintenance of not only the networking side of things, but also the billing systems & other infrastructure needed to easily turn a wireless network into a (hopefully) profitable business for a local entrepreneur. The idea is an old one: give people the tools, let them build it themselves, and if there’s some money to be made it will become self-sustaining.

So hopefully a local businessperson can be identified at Peebles to keep the mesh working, because while we set a few things up again they’ll only fall apart without some oversight. We spoke with a few local guys who might be interested in doing something like this. The biggest bottleneck is the clinic’s V-SAT satellite uplink; it’s already at 70% capacity and that’s for the clinic’s medical use. So another uplink is required, and that can be tough. But it seems that there’s at least one guy working on brining a pipe in from the largest nearby town in the form of a series of high-bandwidth wireless relays on towers, so that could be promising.

The clinic itself was extremely interesting, I had the chance to talk to the clinic’s director a bit while he showed us around the place. The HIV infection rate in the area is enormous, I think he said around 30%, and the effects on the population are in some ways understandably devastating. But the effectiveness of the antiretrovirals the clinic is administering is the real amazing part: with proper care & early detection they extend the lifetime of a patient by decades. They actually built a hospice on site, but so few people died that they turned it into a specialized children’s clinic. And all of this is at a cost of around R150 ( = US$ 20) per month for the patients. They’ve currently got over a thousand patients on ARV’s, and have treated around 20,000 over the lifetime of the clinic (originally started in 1994, but that number is since the real ARV administration began in the early 2000’s). ARV’s are more expensive than this, of course, so where does that money come from? Primarily, the US government: 75% of the clinic’s funding comes from http://www.pepfar.gov/, championed by Congressman Howard Berman, who was actually out to visit this particular clinic because it’s so successful, in many ways a darling of the program (according to it’s director, who entertains a lot of visitors apparently). It’s nice to see a little positive foreign engagement on behalf of the US.

A hot-tin roof: node hacking in the winter sun. A shirt over the head is an excellent way to be able to see a computer screen in the middle of the day. Also note the sweet rusty cantenna, which works amazingly well.

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