Since its early beginnings in 1994 as one of the first jointly developed US-Russian Internet services, the F&P project has grown to represent a consortium of over 150 organizations and individuals working to promote US, Russian cooperation and exchange. Our web servers accommodate more than two million accesses each month and the various email listservers and other communication services handle over one million transactions each month. The service has received a number of Internet awards and honors including designation by the Ventana Press as one of the top 30 sites on the Internet and numerous other ratings among the top 100, top 200, top 1%, top 5% of all services on the Internet. It has attracted funding from several sponsors including the US State Department, NATO, the International Science Foundation, Sun Microsystems, and most recently the Ford Foundation. While never our aim, it has attracted attention from the highest levels of our governments and was selected in 1996 to be featured in the Gore-Chernomyrdin Commission meeting as an example of the Internet's usefulness in fostering scientific exchange.

We have recently launched a new version of Friends and Partners which we invite the reader to view at the following URLs:

Russian site: http://alice.ibpm.serpukhov.su/friends/
US site: http://www.friends-partners.org/friends/

The Friends and Partners idea has grown to include other nations during the past year. During the summer of 1997, we launched the new Friends and Partners China project with a friend in Beijing, Dr. Rongsheng Xu of the International High Energy Physics Institute who is one of the pioneers of Internet development in that country (he established the first Internet connection in China); and we also launched a few months later the Friends and Partners Romania effort - working with friends in the Transylvania region of that country. We are currently working on similar ventures in Georgia, and, hopefully soon, in Uzbekistan.

Prepared by: Greg Cole

• PACIFIC/ASIA GROUP
• [[TINA: Ben Haraguchi's mission statement is to be inserted here.]]
• Tak, can you please send me more information on this statement? Perhaps I've overlooked it in the materials you sent, but I couldn't find it upon lookinf for it.
•  
• [[TINA: You can find it at <http://www.friends-partners.org/GLOSAS/Tampere_Conference/Pilot_project_parties/FSUN/Mission_Statement.html>.]]
  
  

  ---

• MINCS-UH http://square.umin.ac.jp/kiuchi/ohp/
• [[Tak, this information is in Powerpoint. Can I get a text version?]]
  [[TIMO: Pls print from the original web site.]]
  
  Note from Tina: since we can't control the pagination of a Web document like we can one that's word processed, it might be a good idea for Timo to take this Web document, once it's in final format, and insert the needed portions into it so all information can be printed together and come out on consecutive pages. This is just a suggestion.
  
  [[TINA and TIMO: Yes, that is the idea, but we don't need to concern with the page numbering, since this is in the 3-hole binder anyway.]]

  ---

  
  
• Need info. for the below two headings
• NORTH/SOUTH AMERICA GROUP
  
  [[TINA: We don't have for this group yet.]]
  
  

  ---

• EUROPE/AFRICA GROUP
  

1. RUSSIA
   
   [[TINA: Pls check the outline number for the above -- I don't think you need it here, since is it within the Europe/Africa Group.]]
   
   • MIRNET PROJECT
   • Late last summer we submitted a $6.5 million proposal to the National Science Foundation and to the Russian Ministry of Science to establish a high performance "next generation Internet link" between US and Russian scientific communities. The proposal was submitted under the National Science Foundation's High Performance International Internet Services Program (HPIIS). We are currently awaiting the NSF's approval of of this five year project to establish a six megabit high performance Internet connection between Chicago (the StarTAP international switch) and Moscow. We have already received commitment from the Russian Ministry of Science to co-fund this with the National Science Foundation.
   • This link will give Russian researchers access to the U.S. vBNS (and other associated peer next generation networks) and US researchers access to top Russian networks and scholars. It is to support high performance applications only (no commodity Internet traffic).
   • This is a very exciting and highly visible project given its roots in the Gore-Chernomyrdin commission meeting last summer and their recommendation to establish the link. Our role in this project, after establishing the telecommunications link, is to manage/promote it, assist with applications development, and work to ensure that it is fully utilized. Over the course of the 5 year grant, we are expected to manage the growth of the link to 45-155Mpbs capacity. We believe there will be many good projects resulting from this new infrastructure and the new communications capabilities it will provide.
   • By the end of the five year project, it should be possible to accommodate many simultaneous classroom lectures (full-motion, compressed audio/video) between US and Russian classrooms, provide for many remote instrumentation/control laboratories, enable massive transit of data, 3-dimensional imaging applications, new data visualization capabilities, and, in general, establishment of new programs of joint US-Russian research and exchange.
   • This project is being developed by a consortium of several institutions. The Friends & Partners center in the US (the Center for International Networking Initiatives at the University of Tennessee with the Telecommunications and Network Services Division) is the lead institution in the US on the proposal to the NSF but the Oak Ridge National Laboratory is also involved through their several US/Russian linkage programs. In Russia, our Friends and Partners Foundation is working with the Moscow State University and the Russian Institute of Public Networking (RIPN) (responsible for coordinating many academic networking efforts across Russia). RIPN is the organization that secured the $500K annual commitment from the Russian Ministry for the MirNET link - essential as the NSF requires roughly equivalent cost share from both countries for this project.
   • The timeline for launching this project will be decided upon official award notification. We are hopeful that the MirNET link between Moscow and Chicago will be formally launched in late spring. The summer months will be used primarily for testing and preliminary applications development - but also for conducting a marketing effort to identify and communicate with US-Russia researchers already working together on projects which might benefit from the new capabilities. By fall of 1998, we hope to be fully operational and, by early 1999, seeking to increase the capacity from its beginning point of 6 Mbps - to a second stage of 10 Mbps. Over the course of the 5 year project, we must manage the growth of the link to full DS3/OC3 capacity (45 and then 155Mpbs) and arrange financing to pay the associated costs for increasing this capacity.
   • We have produced a suggested list of the institutions in the Moscow and St. Petersburg areas which are targeted for initial use of the Russian portion of the link. In the U.S. all academic institutions with access to the vBNS will be able to use the MirNET link.
   • While Russia's current fiber infrastructure will permit researchers in Moscow and St. Petersburg regions to utilize MirNET initially, it is our plan to expand access to this capability as the project grows. Indeed, through our work with the Russian Civic Networking Program, we are working to establish relationships with academic institutions across Russia and will try to build on these relationships to provide access to MirNET.
   • We chose the title "MirNET" for this project reflecting the three distinct but closely related meanings of the Russian word Mir. It has common and simultaneous meaning in late 20th century of "world" and "peace" - but, in late 19th century and before the 1917 revolution, it referred to sense of "community" in Russian villages. This word with its several meanings represents important concepts behind all of our work with Friends and Partners. Many people will, of course, associate the name with the Russian space station - which is legitimate too - as it represents many years of productive Russian and American scientific collaboration.
   • It is obvious that the MirNET effort is only beginning - but we are reasonably confident of its rapid start-up and must begin work now establishing new partnerships for its growth and development.
     
   • Prepared by: Greg Cole
     
   • MirNET: http://www.friends-partners.org/friends/mirnet/ (US site), http://www.friends-partners.ru/friends/mirnet/ (Russian site)
     
     

     ---

   • JOINT CULTURAL HERITAGE WITHOUT BORDERS
     
   • This presentation presents the remote lectures about Russian Culture, Art and St.Petersburg history, based on virtual reality technology.
   • The idea of the joint multicultural educational project is, that Russian secondary Schools and Universities students under the supervision of Russian lecturers develop the multimedia lectures for foreign students. sort of virtual tours around St.Petersburg, its Museums and sights. Each Web-lecture contains an interactive round panorama of the sight or Museum, the hypertext in English or Russian, the slides, the video. Foreign students or students from other countries under the supervision of their lecturers develop the similar virtual tours to their cities for Russian students.
   • In addition after each lecture the students from different countries can discuss the topic of the lecture in real time mode via Internet.
   • The proposed scenario of the lecture is as follows: Foreign students type the URL and they get the map of St.Petersburg with the icons of 2-3 round panoramas. They click the round panorama of Nevsky Prospekt and they can "look" around and see the buildings on the street. They click the building of Kazan Cathedral and they get the round panorama inside the Cathedral. They can "look" around inside the Cathedral; click some Icons or objects and get the HTML pages about those objects. They can click the icon of video camera and they get a short narrated video tour in Real Video format. Somewhere inside the Cathedral they see the figure of "Robot". They click the "Robot" and they can ask questions about the Cathedral to Russian students, who are physically in St.Petersburg and who are waiting for the questions of foreign students in agreed period of time. The students can ask questions in English by text or/and by voice
   • In the same manner the foreign students can develop a virtual tour about their town. We are sure, that the project will be interesting and important for the schools of the future, because developing the project the students from different countries learn to work in one team, learn modern multimedia and Internet technologies, study the cultural heritage of our countries. We have developed the samples of multimedia lectures already. You are very welcome to make virtual tours around St.Petersburg, its famous Cathedrals and State Russian Museum at http://www.lanck.ru We recommend to use IE 4.5 browser and higher to avoid the problems of manual installation of the necessary plug-in.
   • Aim of our presentation is to find understanding of the proposed project in the Schools and Universities in other countries and discuss the real ways to develop the project jointly.
     
   • Authors: Dr. Andrey Narvsky, Director;
     Stas Spiridonov, IT Manager;
     Artem Shkadov, programmer;
     Maxim Manylov, programmer
   • Lanck Software, Ltd.
     Department of Multimedia and Distance Education
     of St.Petersburg State Marine Technical University
     3 Lotsmanskaya Str.
     St.Petersburg 19008 Russia
     Fax 7 (812) 325-8480
     E-mail: asn@lanck.ru

1. UKRAINE
   
   
   [[TINA: Pls check the outline number for the above -- I don't think you need it here, since is it within the Europe/Africa Group.]]
   

   Mission Statement of Pilot Project for
   Electronic Distance Education Development in Ukraine
   (Copy of listserve distribution on 3/12/99)

   <<March 12, 1999>>
   
   Dr. Ihor B. Katerniak
   ik@LITech.net
   
   P. Tapio Varis, Ph.D, Professor
   tapio.varis@uta.fi
   
   Docent Antti Kasvio
   ttanka@uta.fi
   
   Timo Portimojarvi
   hotipo@uta.fi
   
   Mr. Larry Forgy
   Lforgy@worldbank.org
   
   Ben I. Haraguchi
   haragucb@arentfox.com
   
   Alexandre Rivas, Ph.D.
   alexandr@ibrati.com.br
   
   Robert J. Rodrigues, M.D.
   rrodrigues@paho.org
   

   (1) Dear Ihor

   Many thanks for your msg (ATTACHMENT I).
   
   I am very much delighted to receive your excellent mission statement of your Electronic Distance Education Development in Ukraine Pilot Project (ATTACHMENT II). I greatly appreciated your superb excerpt out of our previous materials.
   
   Pls put this in your web, after correcting some typo and refining English phrases, so that everybody can access to it. Timo’s Tampere web and our GLOSAS web will then link to this.
   
   (2) Dear Tapio Varis and Antti Kasvio:

   Pls start considering to formulate the pilot project proposal of your Europe/Africa operation -- you may utilize/include this Ihor’s write-up as the starting point.
   
   (3) Dear Ben Haraguchi:

   Pls refine/improve the mission statement (and later the pilot project proposal) of your Pacific/Asian operation as referencing to this Ihor’s write-up.
   
   (4) Dear Alex Rivas and Robert Rodrigues:
   
   Pls start considering to formulate the mission statement of your North/South America operation.
   
   (5) When I visited Larry Forgy of the InfoDev last January, I informed him that the end-result of our Tampere event is to come up pilot project proposals which will be submitted to the InfoDev. This is for conceptual development category and usually in the rage of US$500,000 -- as you saw in the RFP of the University of Philippines/Open University which I distributed previously.
   
   (6) As mentioned in my previous distributions, the goal of those proposals is to firstly establish broadband wireless and satellite Internet networks in those regions. This will then benefit the advancements of telelearning and telemedicine.
   o reach this stage, and when the above mentioned fund is obtained by each regional group;
   

   • (a) conduct a GLH for demonstration of various delivery system in the region,
     
   • (b) conduct experimental global distance education courses,
     
   • (c) make system design of the proposed system in the region, as taking examples from the MINCS-UH in Japan and adding the TCP/IP capabilities to it,
     
   • (d) develop advanced multimedia web teaching materials in conjunction with asynchronous and synchronous computer- and video conferencing,
     
   • (e) develop the networks of facilitators to take care of students and administrative functions, etc.
     

   The Pacific/Asia group (headed by Ben Haraguchi) will make a preliminary discussion on the Item (6)-(a) and (b) in the afternoon of 3/22nd at the office of the Institute of International Education (IIE) in Washington, D.C. This is to explore the possibilities of exchanging courses between Montana State University/Bozeman and the University of Philippines/Open University through Burns Telecommunication Center at the former.
   
   (7) Dear Ihor:
   
   Referring to your question, you may visit Prof. Kiuchi’s web site on the MINCS-UH at <http://square.umin.ac.jp/kiuchi/ohp/> -- for slide show. I am now talking with satellite group how to combine MINCS-UH technology with the TCP/IP technology.
   
   The main purpose of our Tampere event is to brainstorm how to raise necessary funds for the establishments of the proposed broadband Internet.
   
   I will soon follow up the pledge made by Soros Foundation to cover your travel expenses.
   
   Thanks again for your mission statement -- you always do excellent jobs!!
   

   Best, Tak

   ****************************************
   ATTACHMENT I
   

   Date: Wed, 03 Mar 1999 19:18:32 +0200
   To: Tak Utsumi <utsumi@www.friends-partners.org>, Tapio Varis <titava@uta.fi>
   From: Ihor Katerniak <ik@litech.net>
   Subject: Electronic Distance Education Development in Ukraine
   Cc: Oles Saban <saban@uar.net>, Serhiy Gvozdiov <serhiy@peterson.lviv.ua>,
   George Farnbach <farnbach@libertynet.org>,
   Dianna Derhak <derhak@derhak.kiev.ua>, Mykola Tomyn <tomyn@usa.net>,
   ihor@lim.lviv.ua, tpc@lim.lviv.ua
   
   Dear colleagues,
   Enclosed please find the concept of Electronic Distance Education Development in Ukraine (EDED). Your comments, additions and questions are welcome.
   

   Dear Prof.Topio Varis:
   I would like your know your opinion about following issues:
   It is possible to get information concerning other project, which are going to be developed within the group? Are you planing to create a European Coalition, which would join interested institutions or individuals for creating Global University/Europe?
   What place can Ukraine have in European/African Pilot Project?
   Have the roles been distributed among the participants of the group headed by you?
   Do not hesitate to send your request, for we are ready to participate actively in the Project development.
   

   Dear Tak,
   Can you provide us with the technical information on broadband for Euro African Project?
   Are there any chances for obtaining financing for the EDED that is being developed by the Ukrainian Coalition?
   Are there any news from Soros Foundation concerning reimbursement of travel and accommodation expenses for Ukrainian participants in the Tempere Conference?
   

   With best wishes,

   Ihor

   ****************************************
   ATTACHMENT II
   
   M E M O R A N D U M
   

   TO: Takashi Utsumi and Topio Varis
   FROM: Ihor Katerniak, Director of the Technology Promotion Center
   RE: Business, Medical and Telecommunication Coalition (Ukraine)
   SUBJECT: Electronic Distance Education Development in Ukraine
   DATE: 11.03.99
   

   Draft
   Electronic Distance Education Development in Ukraine
   Pilot Project
   

   I. Business, Medical, and Telecommunication Coalition/Ukraine (Mission Statement)
   
   The Ukrainian Coalition for Information Infrastructure in Education and Health Care "Business, Medical, and Telecommunication Coalition/Ukraine (BMTC/UA)" was created in 1998 by the initiative of Dr. Takeshi Utsumi (Chairman of the GLObal Systems Analysis and Simulation Association in the U.S.A., President of Global Univercity in the U.S.A.), and Dr. _hor Katerniak, (Director of the Technology Promotion Center, Ukraine). Today the Coalition unites the representatives of the business and medical schools, hospitals, specialized secondary schools, and technical experts in telecommunications from various regions of Ukraine. The mission of "BMTC/UA" is to promote the ideas related to the use of broadband technologies for distance learning, knowledge transfer and collaboration through the international partnership in business and medicine.

   The main tasks of the Coalition are as follows: The main tasks of the Coalition are as follows: The main tasks of the Coalition are as follows: The main tasks of the Coalition are as follows:
   
   The main tasks of the Coalition are as follows:
   

   • • promote the development of global distance learning and TeleMedicine;
     • expand partnerships at the regional and international levels;
     • establish business contacts with the institutions, which are able to assist in maximizing the network capacity and satellite connection;
     • elaborate the pilot project of Electronic Distance Education Development in Ukraine;
     • seek for the means necessary to reach the goals and expand the project;
     • monitor and asses the results of the project effectiveness.
     

   The local network and management infrastructure, technological base will be provided by the Technology Promotion Center (TPC), which was created in April 1996 in the partnership of Philadelphia University City Science Center /UCSC and Lviv Institute of Management for promotion of new technologies in the system of management through informational assistance and metodological provision for project management; the system of education through introduction of innovational methods of education, development and design of new educational programs for distance learning; the system of production through licencing and small business development; the system of commerce (electronic
   commerce) and services (tourism) through introduction of multimedia and Internet technologies. TPC assists universities, schools and businesses to use multimedia, telecommunications, and networking technologies to enhance their programs and services.

   The first actual step of Ukraine entering the International Coalition for Global Information Infrastructure (GII) in Education and Health Care was the participation and presentation of BMTC/UA (Dr.I.Katerniak with technical assistance Dr.A.Saban) "Global Lecture Hall (GLH)" videoconference on NEW TECHNOLOGIES AND DISTANCE EDUCATION from Manaus, Amazona, Brazil (October 21, 1998) and Emerging Electronic Distance Education (EEDE) in Ukrainian Interactive Workshops and Demonstrations in Lviv, Ukraine (October 22, 1998) as face-to-face meeting for discussing with people from various regions of Ukraine who can benefit most from our next step of development (web-site is located at <http://www.uar.net/conference/>). It was an extraordinary historical event; panelists are located from Tokyo, Japan to Lviv, Ukraine, spanning almost 18 hour time zones. ____/UA’s participation in the Internet Active Conference has attracted great interest on the part of business circles in the U.S.A., UK, Spain, Italy and Germany in adjusting partnership relations in distance learning development.

   Hence, today we have talented Ukrainian experts experienced in Computer Mediated Multimedia Systems (CMMS) [e.g., ShareVision, NetMeeting, etc.] through telecom media [e.g., TCP/IP-oriented Internet, etc.] and established international relations which make us sure in practical imlementation of broadband technologies for expending distance education to Ukraine.
   

   II. Electronic Distance Education Development in Ukraine
   
   BACKGROUND
   
   Processes of economic globalization, which are developing especially rapidly on the verge of the second millennium, are closely connected with science consuming high-tech production, knowledge transfer, advanced management and the development of modern telecommunication and information technologies. Availability of a high scientific and technological potential in Ukraine and a great number of talented people, capacity of Ukrainian market and unique opportunities for introduction of investment projects requires intensive use of telecommunication technologies for the development of international partnerships both in science and in business, as well as in cultural understanding, and exchange (including tourism). With the present conditions of economic transformation in Ukraine and the budget deficit, special attention should be paid to restructuring, introducing new methods of management and involving out-of-budget funds and donor organizations to the development of education and health care, which are the priority for society. The new quality level, availability, base on international exchanges and standards can provide with the latest electronic means of information and transfer and telecommunications.
   
   Today the fields of education and medicine lag seriously behind other areas in the use of new technology and telecommunications, even though the emerging global information society will depend on knowledgeable consumers. Digitalization and the growing use of computers are creating new forms of illiteracy and poverty, and new forms of discrimination may emerge between countries and groups equipped to enter the information and knowledge society and those who are not.

   Emerging Electronic Distance Education (EDE) offers many advantages to the participants and the world as a whole. Promoting EDE allows for the sharing of ideas, values and knowledge throughout the world. It opens up areas of communication and cooperation previously unrealized, contributing to world peace. The individuals, whom we help to educate today, will be our leaders tomorrow.

   Right now there is a possibility to use the UARNet existing channels of satellite connection with the admission capacity of 384K/512 Kbps (Mordent/Stockholm) for implementing the Ukrainian Project. Though, this connection is too overloaded today and is not enough to use it in telemedicine.

   The Goals of Electronic Distance Education Development in Ukraine are:
   

   1. Create Global University/Ukraine. Broaden the scope of educational services with implementation of the latest technologies and give an opportunity to use all possible sources and resources of worldwide information network effectively.
      
   2. Install information networks with two-way broadband (45 Mbps) digital satellite channels for TeleMedicine and distance learning; connect Ukraine to the developed countries of the world (U.S.A., Finland, U.K., Switzerland, Japan, etc.).
      
   3. Establish partnership relations with educational and medical institutions in other countries for the two-way international exchange of knowledge, professional experience, medical and technical know-how, and establish a new affordable means of providing development training and assistance.
      
   4. Develop the network of Centers for technical and information support in all regions of Ukraine.
      

   It will be able to provide students, managers of public and private enterprises, unemployed people, and other interested parties, within as well as outside of Ukraine, with equal educational opportunities. It is intended to broaden the scope and increase the quality of educational programs using the scientific and technical resources of the participating universities, institutes, academies, and providers of professional development courses. Also, it will give a chance to people with Ukrainian origin living abroad to study different subjects in their native language.

   There have been many distance education conferences around the world which have been visited only by participants who can afford to attend, - thus excluding many who can make valuable contributions. Conversely, the aim of our Ukrainian Project is to serve people in Ukraine who often cannot attend such meetings and conferences.

   The main directions of activities:
   

   1. Education.
      
   2. Health Care and TeleMedicine.
      
   3. Knowledge transfer.
      
   4. Business development.
      
   5. Culture and tourism.
      

   The development of educational, business and cultural activities together with the TeleMedicine will make it possible to share the expenses which will be quite large. For instance, transfer of X-ray photographs with high dividing capasity (600-1200dpi) requires broad-band Internet via digital satellite channels, which is too expensive.

   1. Education

   A purpose of this project is to explore the educational potential of the Internet in Ukraine. Traditional and formal higher-education has many merits – but it has many limitations as well. Our hypothesis is that the Internet makes possible a different kind of learning -- more interactive, less exclusive, less expensive, more flexble , and perhaps more creative and fun.

   In the conditions of economic reforms in Ukraine, the specialities related to professional development and establishing close international partnerships are in greatest demand, such as management of organizations, medicine and engineering. Besides, great demand has been noticed for obtaining additional knowledge by the students of secondary schools and universities motivated by critical conditions in the labor market of Ukraine (about 350 unemployed persons per one workplace in some regions of Ukraine).

   Virtual Business School (VBS)

   MISSION STATEMENT

   Lviv Institute of Management (LIM) was created in 1989 as a private, self sustaining, not-for-profit institute to assist growing private business in the region by educational, training and consulting services. LIM was among the first institutions in the former Soviet Union where the MBA program was launched.

   To achieve a multiplication effect in delivery of the best quality academic and training programs, to facilitate really interactive cooperation between companies and business school, LIM commits itself to development of distance learning system.

   The goal is to provide new models for distance learning not only to residents of Ukraine but to people all over the Central/Eastern Europe (CEE) so that they may be able to take advantage of leading business schools development and direct access to managers of leading companies.

   SYNOPSIS

   The economic situation in the region and the level of business education development argues for creation of global educational system (virtual business school - VBS). The reasons are:
   

   1. Real gurus in business training and education are always in shortage, and specifically in our region. VBS will build a unique team of trainers and professors.
      
   2. Slow change of economic systems in the CEE is partially explained by lack of professionals with market oriented thinking. A new and different approach to business education will help to train a critical amount of business people.
      
   3. Business education is strongly based on American textbooks, that is why is too much theoretical. Distance learning methodology will bring speakers from real businesses without taking them from their companies. It will enhance the writing of case studies and textbooks, based on local experience.
      
   4. People who really need business education are so busy that almost no other type of teaching aside from distance learning is convenient for them.
      
   5. VBS will consolidate all professionals who are really dedicated to the highest standards of business education and market oriented development. That gives us a chance to consider VBS not only as an educational center, but also as a public union for the reformation of the existing economic systems.
      
   6. VBS will naturally integrate business people from CEE into international partnerships through participation in the same type of programs.
      

   Activities

   The project is based on the existing network of business schools in the CEE. Resources of five leading business schools, united in a group during the seminars in 1998-1999, known as "Lviv Initiative", will be used as a base for VBS (LIM, IMI-Kyiv, Kyiv-Mohyla Academy, Kyiv Financial Institute and Dnipropetrovsk Business School). Geographically they cover Ukraine from East to West. Central Europe will be represented by the business school of Jagellonian University (Krakow, Poland), Lublin Business School (Poland), CEU (Budapest, Hungary) and Economic University (Prague, Czech).

   On the basis of the group of the five institutes, joint curriculum and teaching materials will be developed. Each school will contribute with the strongest parts of its program.

   The important role of supervising will be up to the Global and American universities, currently cooperating with LIM and IMI - Wayne State University and Carnegie Mellony University. Both American Schools have well-developed systems for distance learning and will play the role of technical and methodological tutors. The telecommunication industry of the CEE countries will be evaluated jointly in relation to instructional delivery.

   In January 1999, an algorithm for the distance learning in "Innovations and Project Management" was developed (authors: Dr.I.Katerniak and Dr. G.Gamota) for manaders of R&D and technology based companies.

   Ethics of business communication (Cultural and Business Ethics, Self Management and Business English, or any other foreign language chosen by a trainee). Foreign language learning is very time-consuming. Unfortunately, having studied a foreign language for quite a long period of time, having attended various language courses and programs, professionals still feel lack of skills, practice and experience to apply the foreign language effectively in business environment. To increase their proficiency, the Distance Education Program in Foreign Language for Business Purposes should include the integral parts of foreign language knowledge, i.e. effectiveness, fluency and accuracy. All classical language teaching curricula have been focused mainly on accuracy. As a result, there are so many people today knowing too much about a foreign language but knowing too little of how to use it effectively for their professional purposes. First and foremost, the DEP in FLBP is designed for and oriented on in-service «students» wishing to improve the effectiveness of their skills in business foreign language.

   In the social sphere one can see raising demand for major in Human Resource Management.

   2. Health Care and TeleMedicine

   This direction of the Coalition activities is hold by the Lviv Institute of Management being the regional office of American International Health Alliance, Lviv Regional Clinical Hospital, Lviv Railway Clinical Hospital, Specialized Secondary School for children with heart diseases, Lviv Medical University, Galytska (regional) Psychiatric Association, and Association of private medicine, which has its departments in all regions of Ukraine. Two modern centers of women’s health (that provides with breast cancer screening (mammogram)), and of neonatology have started their activity. It has been envisaged to broaden the activity in neonatology in other cities of Ukraine (Kharkiv, Kyiv, Odessa, and Donetsk).

   Accumulated experience and established contacts in the sphere of Health Care could and should be used and disseminated in Ukraine through the system of Electronic Distance Education (Interactive Medical Workshops and Conferences) and TeleMedicine.

   The Health Care Activity has been mainly focused on medical diagnosis, consulting, data transfer (e.g., ECGs, X-rays, heart sounds) and some medical education programs. Today telemedicine can apply telecommunications and medical technologies to provide with information exchange between a physician and a patient, or between two physicians in geographically separate locations and to facilitate the exchange of information for medical, healthcare, research and educational purposes.
   
   The Internet enables us to practice TeleMedicine and it can be of equal potential value to more developed and just developing economies. The growth of Internet access and use now means that patients, medical professionals and organizations can jointly benefit from the available information and support. Internet can be used for:
   

   • • medical information access;
     • medical training;
     • health care and support for patients;
     • remote diagnosis and consulting;
     • emergency/epidemic support;
     • preventative care education.
     

   Immediate access to medical databases.
   Health care institutions in Ukraine can use computer systems to store their medical records and databases electronically. Doctors can retrieve information about their patients when it is necessary, print out prescriptions to their patients and keep their electronic record.

   Tele-consultation and training.
   TeleMedicine network will offer an opportunity for consulting between doctors and other medical professionals in health care (via telephone, email, videoconferencing, etc.). Distance education can also involve a small rural hospital, whose doctors/nurses are able to "attend" a consultations conducted by a professor at the big teaching hospital (special and important for TransCarpathian region of Ukraine).

   TeleMedicine services are able to offer an opportunity for training and education. It is also apparent for us that an efficient and effective health care infrastructure requires not only access to expertise, but it should also provide health care professionals and the public with medical training programs focused on prevention of illnesses, hygiene, and other basic requirements for a physically healthy society.

   Although much of the more sophisticated technologies such as virtual reality are still expensive, the cost of some technologies is dropping, so that TeleMedicine should become more affordable to more people, regions and countries than ever before.

   In the present critical conditions of economic transformation and budget deficit, we have indicated the necessity to develop managerial skills in the system of health care and its reformation. Lviv Institute of Management arranges seminars and workshops for managers and doctors of medical institutions in Health Care Management, Privatization in accordance with the acting legislation and exchange of experience on the regular basis.

   TeleMedicine has many social and economic benefits, it can generate new sources of revenues for service providers and equipment suppliers and can optimize the use of available human and capital resources in Ukraine. Such applications as TeleMedicine should be of interest to telecom operators since they generate additional traffic over existing networks and offer the opportunity to extend limited networks.

   The impact of telemedicine on health care structures in Ukraine can be significant. It also raises regulatory issues concerning legality, liability, confidentiality, competition, etc.

   3. Knowledge Transfer

   Ukraine possesses great scientific and technological potential. The basic priorities in its innovation development are aircraft and rocket construction, biotechnologies and medicine, informational technologies and new materials. The market of latest technologies is shaping now and it requires highly developed technologies. Possibility to use teleconferences for promotion of common research and development, information exchange and understanding is under consideration now. The project has to create a certain support system for the scientists who have no access to the modern literature and possibilities to participate in the meetings dedicated to the field of their scientific interests.

   4. Business Development

   Closer integration of scientific and business communities, and the development of technology-based small businesses result in need for additional business knowledge for companies in Ukraine's transitional economy. How international knowledge and experience can be successfully applied in Ukrainian legal and economic conditions, and how innovation structures and funds can be supported. Availability of teleconference technologies and well-developed information network can assist in establishing business contacts, in starting and providing business in Ukraine, it may become the foundation for introduction of such projects as Virtual Business Incubator (consulting, training anf information support in partnetship with Busines Incubator Development Program (BID/USAID)) and electronic commerce. It will allow to hold conferences involving venture capital, organize multimedia meetings of shareholders, which is of special interest in Ukraine nowadays, and processes of privatization and post-privatizational management.

   5. Culture and Tourism

   Ukraine is approaching the top 20 most visited countries in the world. In spite of the complicated economic situation Ukraine finds itself in, the tourism sector reported a profit in 1998, returning Hr 3.2bn to the state budget (according to State Tourism Committee, Feb. 17, 1999). Lviv is city of outstanding monuments of architecture and works of art.

   Last year (1998) the ensemble of the historical center of Lviv was inscribed on the UNESCO List of World Heritage Cities. A great number of foreigners are eager to visit Lviv (both for business and pleasure) and it is essential for them to better know the city facilities. Virtual City-Lviv Project may be of great help for them in finding all necessary information and in giving the general vision of the city. So, using the up-to-date possibilities of information technologies we can start implementing the "Virtual City-Lviv" Project with 3 dimensional (3D) rotating image of glittering cathedrals, picture galleries, museums, the opera theatre, hotels, restaurants, business centers, etc. The web can be made in HTML and VRML techniques and therefore can be used via Internet therefore being available worldwide.

1. AFRICA
   
   • USAID Leland Initiative, Africa Global Information Infrastructure Project: http://www.info.usaid.gov/regions/afr/leland/
     • Leland Initiative: Africa GII Gateway Project: Project Description & Frequently Asked Questionshttp://www.info.usaid.gov/regions/afr/leland/project.htm
     • USAID Leland Initiative: National Internet Gateway Designhttp://www.info.usaid.gov/regions/afr/leland/techdsgn.htm
   • Timo: Pls download them and print.
     Tina: Pls just indicate the above URLs in our temporary web site for the handout.
     
     

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   • Telehealth in Twenty-First Century Africa: African Knowledge and Ideas as Integral

      

     When it comes to ending hunger, economic growth is not enough. Africa needs growth with equity. Hunger will not be overcome just by growth in GNP or in food production; poor people and poor women in particular must have access to food. [Africa needs] to invest in [its] people - in their good nutrition, in their health, in their education - to invest in ways that improve their lives. Freer markets and a strong place for the private sector are also crucial. But they are not enough. We need to invest in farmers, not just in farming. -- Statement of Catherine Bertini, Executive Director, World Food Programme, FAO Regional Conference for Africa Addis Ababa, 19 February 1998; http://www.wfp.org/info/ED/speeches/FAO_Addis.html
     
     

     Introduction
   • The initial contact of a sick rural African with a doctor is often a visitation to an indigenous healer, and the African mother is the first to know that a family member might be ill. Traditionally, most African women space childbirth by two to three years and derogatory terms are used to describe those who might give birth too frequently, for example, kpendevi dzila, in Ewe. Following delivery of a child, specific foods are provided to the nursing mother, for example, palm nut soup in Ghana. Indigenous medical knowledge in sub-Saharan Africa also includes the practice of dipping specific twigs as herbs in locally distilled liquor, such as akpeteshie, for treatment of chronic backaches and some stomach ailments. Furthermore, in the indigenous African Knowledge and Ideas system, a piece of the forest was set aside and mythologically assigned as the place of worship of their gods and nothing was extracted from that land. That idea, common among the Ewes in eastern Ghana for example, which should have formed the basis of forest conservation and reafforestation campaigns, is now under threat due to the primordial agricultural production system and general environmental disequilibrium. Moreover, indigenous African Knowledge has catered to the upliftment of other civilizations. The African's eating habits gave rise to Western medicine's hypothesis that high fibre diets may reduce the incidence of colon cancer in men and also to lower blood cholesterol levels. Similarly, Western scientists have hypothesized that the barks, roots and gums of plants which the Maasais of East Africa snack on might be responsible for the low incidence of heart conditions among the ethnic people whose diets are high in saturated fatty acids; American society is now accustomed to the phrase It Takes a Village (Clinton, 1996) not only to raise a child but to protect and advance a community's civilization although many are unaware it is an African adage. Communal health maintenance by indigenous structures has ensured establishment and maintenance of public places of convenience, protecting rivers and streams, clearing of farm roads, dispute settlement, enacting and supervision of laws and taboos, among others. There are no village mayors, police posts, post offices, or health clinics in many rural communities of sub-Saharan Africa. Rural communities often are managed through the Indigenous Governance system, a representative body whose membership is drawn from all the village clans. The Indigenous Governance system shares the task of policy making, security, and health, among others. The indigenous health council would consist of traditional birth attendants and other "medicine people" or health personnel, such as herbalists, and more recently faith healers. However, health policy in sub-Saharan Africa has taken little recognition of the region's own health knowledge system and has produced an alien health system that serves very few well.
   • There is a general presumption that sub-Saharan Africa would necessarily "enter" the next millennium with other regions of the world simply because a new date would have arrived. There has even been a prediction of a New African Renaissance to be on the horizon. The Twenty-first Century, however, would be characterized by intensification of globalization through the unprecedented revolutions in information and communications technologies (IT), improved nutrition and health through application of biotechnologies in designer crops, drugs and gene therapy, and precision farming aided by space technology on earth, among others. It is in light of such characteristics that health policy in Twenty-first Century sub-Saharan Africa should be examined. The majority of sub-Saharan Africans, some 70% of the population, are rural dwellers whose livelihoods have been negatively and disproportionately impacted by macroeconomic policies that emphasize commodity export and which insinuate alien policies without regard to the social realities of the region. Rural development in sub-Saharan Africa has, for too long, been dependent on ideas, goals, implementation, supervision and evaluation of alien origins. The strength of any human civilization is its human resource base and knowledge system, however, governments in Africa have devoted all their resources to the extraction of natural endowments or apportioned the most fertile lands to the production of crops of little domestic use, for export, without equal regard to human capacity development. Obviously, attempts to substitute indigenous African Knowledge and Ideas with external knowledge in the development process have been expensive failures.
   • "Africa" has become a cue for diseases, plagues, hunger and famine, high rates of illiteracy, infant mortality, dangers of childbirth and related issues of perinatal health, among others; issues which do not affect other civilizations to the same extent any longer. African women give birth anywhere - on farm roads, in markets and at commuter stations. Political and ethnic upheavals have killed, maimed, orphaned and widowed many. Most rural Africans still gather mushrooms from the wild like diamond gems and mill grains on rocks. People and domestic animals drink and bathe in the same creeks and ponds as if it were in the Garden of Eden except that Paradise was long lost. Rural Africans use hoes and machetes as primary tillage tools; tools which were inherited from forebears and have not undergone innovation for about 400 years. These Stone Age technologies mean most Africans "sharpen" agricultural tools on rocks while elsewhere farmers employ Global Positioning Systems in precision farming. Many farmers in Africa add nothing to agricultural lands, and with reduction in the fallow period, less fertile land is available, leading to encroachment on previously uncultivated lands and awakening of agents which harbour or cause strange diseases such as Buruli ulcer. Reliance on rain-fed agriculture has meant erratic harvests with accompanying food crises. Rural Africans also carry their produce on their heads and walk several miles to markets, some damaging their vertebrae permanently. The hard labour to which rural Africans have been subjugated induces hernias in many.
   • The indictment of healthcare policy in Africa would read further: That Africa has the highest population and urban growth rates in the world and its population is growing faster than food production; the proportion of its food insecure people is by far the highest in the world. Sub-Saharan Africa is the only region with growing nutritional problems (Missiaen, 1997). One-third of sub-Saharan Africa's population is chronically undernourished and has remained unchanged for about three decades and its underfed populations will reach 300 million by the year 2010 (FAO, 1996). Petroleum or Gas Bars, meanwhile, are cleaner than public eating places which are located close to gutters filled with raw sewage and stench. Consequently, a large number of people, particularly children, are prone to and die of infectious diseases, if they survived the staggering 95 deaths per 1000 childbirths in the region. African women constitute 10 percent of the world female population yet 40 percent of all pregnancy-related deaths occur on the continent, including about 22,000 deaths from unsafe pregnancy intervention procedures (PAI, 1998). In some African countries, as much as 70 percent of the female population has been mutilated and exposed to complications associated with pre-modern procedures such as Female Genital Mutilations (PAI, 1998) and, 35-year-olds are grandmothers. In 1996, about 10,000 people were killed, and close to 50,000 were seriously injured in traffic accidents in South Africa, of whom 40 percent were pedestrians (Interim Report on the Arrive Alive Campaign, 1998). These accidents are often due to poor roads, unimaginative driving skills, drunk-driving and rickety vehicles. Primary Health Care philosophy which should have been multi-component has been reduced to a policy of vaccination. African countries are still unable to make healthcare a priority and its budgetary allocation has either remained static or been gradually reduced over the last three decades - at about 4% of national budgets (Muna, 1997). At the same time, global financial institutions have suggested and enforced closure of many of the tertiary health care structures and imposed user-fees and paid prescription on the people, as these poor countries depend on external funding as in almost all economic sectors.
   • Visitations to the dentist are rare in Africa but indigenous "chewing sticks" have not been formulated into active-ingredients of dental care.
   • The New African Renaissance would be an illusion if policy makers, multi-lateral development agencies and, indeed, citizens of the region are not able to develop realistic models of sustainable development. There should be no hype within the Africanist psyche regarding sub-Saharan Africa's ability to function as an equal partner in the emerging future. Genuine efforts are required to redeem the region from its human predicament. There has been renewed optimism, on the other hand, that the chronic human indignity, economic malaise and environmental degeneration of Africa are about to be reversed. That the revolutions in information and communications technologies (IT) would engender a stable milieu on the continent, within which economic upliftment and resurrection of human dignity could occur; as if sub-Saharan Africa had already sown the seeds which these technologies would nourish to bud and blossom. For that to occur, it is presumed that global knowledge, when delivered to Africa's deprived communities, would enable rural sub-Saharan Africa to govern itself, build the human resource capacity it needs, improve health care and delivery, prevent and resolve crises and, utilize and manage the natural environment more efficiently while engaging in income-generating activities.
   • Twenty-first Century Africa, if its civilization is to be reckoned with, would rely on the extent to which its peoples are able to participate in the global economy. That would require an unambiguous definition of its human resource capacity requirements and the process of building such. A critical requirement of a capable human resource base is communal health, which is the central element in the indigenous African Knowledge system. That would include a web of physical, psychological, economic and social elements of the individual, household, and the community. Thus, the definition of health within the indigenous African Knowledge and Ideas framework is multi-dimensional.
   • The challenge for the Africa Telehealth Consortium is development of IT systems which would enhance the quality of life of the African, physically, psychologically and economically. This treatise analyses essential elements of the concept of health within the indigenous African Knowledge and Ideas system as basis for proper blending with knowledge from the external sphere and how the process of modernization and diffusion of such a blend could be facilitated by IT. The essay argues for customized IT systems that are realistic, given the infrastructure, social, and inherent educational standards of sub-Saharan Africa. It surmises that the impact of IT in creating a healthy population would be in the transformation of sub-Saharan Africa into a continuously evolving and learning society. The goals would be creation of community-oriented innovative IT systems to serve as channels for the diffusion of the blend of indigenous and modern knowledge systems for human capacity development toward sustainable livelihoods. That the first president of the African Telehealth Consortium is the Dean of School of Public Health at Harvard University is more than a coincidence. The bulk of the Consortium's responsibilities would be in developing and delivering knowledge through educational campaigns aimed at improving health.
     
   • Knowledge Capital
   • For IT to positively and infinitely impact the pursuit of livelihood security in rural Africa, including human health, Africans should be able to interact with global knowledge capital for application in solving local problems. Knowledge and ideas, as capital, have become the most strategic assets in development (Soedjatmoko, 1989) and indeed, "knowledge, more than ever, is power" (d'Orville, 1996: 484). For, ability of a community to collect, process, synthesise, disseminate, and utilize information through modern information and communication technologies, and to communicate with itself and with other communities locally, regionally, and globally will determine its potential to develop coping mechanisms in the challenges of meeting its people's needs (d'Orville, 1996; Njinya-Mujinya and Habomugisha, 1998). The 1995 Copenhagen Declaration on Social Development recognised the need to facilitate access by poor peoples to such technologies for social development, moreover, the capacity to communicate is expected to become a human rights issue (d'Orville, 1996). Hence the international community has dedicated much of this decade to Africa's Connectivity issues, including the Global Knowledge for Development (GKD) real and virtual fora, the Global Connectivity for Africa Conference (Addis-Ababa, Ethiopia, June 2 - 4, 1998), several Listservs and programs, and now the Africa Telehealth Consortium's.
   • The nature of communication devices and systems in providing knowledge for development in Africa however requires more concerted, imaginative, customized, forceful and sustaining efforts than laying of fibre optics to connect hospitals locally or even to external bodies alone. If IT is to improve the health status of the rural African, where people can make informed decisions, the constituents of the African concept of a healthy community ought to be understood.
   • The morbidity indices of rural Africans imply a knowledge gap or the know-how to assist in the diagnostic practices of the indigenous healer, knowledge to constitute the active ingredients in traditional "chewing sticks" into marketable dental products, investigation into the herbs of indigenous medicine, formulation, packaging, and determination of optimum dosage levels and interaction with other drugs. Knowledge is also required to design and to cheaply manufacture devices such as solar energy-powered hand-held motorised hoes to assist the production process as tractorization schemes have been expensive failures. Rural Africans need knowledge to convert household waste into organic land replenishment agents, and to sink wells on farmlands as irrigation projects have failed to water farmers' fields. Other dimensions would include knowledge to cultivate mushrooms from simple inputs instead of hunting for mushrooms from the wild like diamond gems.
   • However, no amount or form of external knowledge alone is capable of redeeming Africa, particularly rural Africa, from its human and environmental insecurity issues without the participation of the indigenous African communities themselves. Indigenous African Knowledge has served its peoples quite remarkably, even if not in a glamorous manner. That knowledge system has provided the basic necessities of life - food, clothing, shelter, health, and education - to its inhabitants for thousands of years.
     
   • African Knowledge and Ideas in Sustainability
   • Indigenous African Knowledge has been employed almost wholly by rural Africans to make all agricultural tools, heal the sick, build shelters, produce their own textiles and clothing, manufacture furniture, kitchen and household utensils, develop and maintain their own culture of language, music and art which transmit values, meaning of life, syllable, tenses, rhythm, and spirituality, resolve disputes, and provide moral guidance to its peoples, for generations upon generations. Indigenous African Knowledge has catered to the upliftment of other civilizations as well. The African's eating habits gave rise to Western medicine's hypothesis that high fibre diets may reduce the incidence of colon cancer in men and also to lower blood cholesterol levels. Similarly, scientists at McGill University in Montreal, Canada, have hypothesized that the barks, roots and gums of plants which the Maasais of East Africa snack on might be responsible for the low incidence of heart conditions among the ethnic people whose diets are high in saturated fatty acids; American society is now accustomed to the phrase It Takes a Village (Clinton, 1996), not only to raise a child but, to protect and advance a community's civilization although many are unaware it is an African adage. Communal health maintenance by indigenous structures has ensured establishment and maintenance of public places of convenience, protecting rivers and streams, clearing of farm roads, dispute settlement, enacting and supervision of laws and taboos, among others. There are no village mayors, police posts, post offices, or health clinics in many rural communities of sub-Saharan Africa. The Indigenous Governance system, a representative body whose membership is drawn from all the village clans, shares the task of policy making, security, and health. The indigenous health council would consist of traditional birth attendants and other "medicine people" such as herbalists, and more recently faith healers.
   • The binding element in indigenous African Knowledge and Ideas though is the Indigenous Governance structure which is the repository of such knowledge and has ensured the practice of whatever that was not destroyed of indigenous African Knowledge in the last 400 - 500 years. The thought that aspects of indigenous knowledge and ideas can be effective in isolation of the governance structure is a hoax perpetuated by alienation of the African intellectual and administrative community from their own roots, and passively encouraged by others who have arrogated to themselves the expertise of rural development even without a vague comprehension of the rural realities.
   • Yet this is not an attempt to romanticise indigenous African Knowledge. Regardless of how glorious one might wish indigenous African Knowledge were, the efficacy of that knowledge system by itself pales before the security needs of modern Africa. Indigenous African Knowledge systems have not evolved for some 400 years, since Europe first made contact with indigenous African cultures (Odhiambo, 1997). Other factors, such as rapid population growth, global climatic fluctuations, international trade and financial practices, an educational system in Africa which has been culturally irrelevant and which has alienated African intellectuals from cultural roots, among others, have combined to weaken the potency of indigenous African Knowledge. Education has had little positive impact on the evolution or reformulation of indigenous African Knowledge. Despite the growing evidence of the importance of investing in health and its relationship to development, many African countries are still unable to make healthcare a priority budgetary item
     
   • Intellectualization of African Knowledge and Ideas
   • Health policies in Africa have understood neither Western nor indigenous models of health. The need is for the development of a knowledge system which is a blend of Africa's own indigenous knowledge base and that from beyond its realm or Global Knowledge; a synthesized knowledge which would be translated into practical policy tools and which would undergo continuous evolution locally for its relevance to local people's needs. This requires a new partnership arrangement between the North and the South, between political leadership and civil society, between formal and informal sectors, between formally literate and illiterate, and between urban and rural communities. It requires a judicious blend between technological advances and indigenous cultures and peoples, and between human and the natural environment. About 80 per cent of diseases in Africa which are water-borne or water associated (Ayensu, 1997), therefore intellectualization of African Knowledge and Ideas should lead to provision of village wells which would eliminate such situations. Further, if biotechnology has any role in Africa, it would be in the screening of food crops and food products for presence of micro-toxins that cause diseases such as liver cancer from aflatoxins while technics such as plant tissue culture would lead to production of unlimited quantities of high yielding and disease-free planting material of vegetatively propagated food crops, such as cassava, yams and other root and tuber crops, bananas and plantains - staple food crops of rural communities.
     
   • African Brain Enrichment
   • African intellectuals should express the full potential of their indigenous backgrounds and let their minds be nourished by it, and in return reformulate indigenous practices with ingredients of the modern knowledge system and let the process loop back in an auto-feedback mechanism. There would be no improved health care and delivery, be it via the telephone, fax, email, or Internet, if the concept of health in rural Africa is defined casually. Health in rural Africa should be placed within the broader context of indigenous African Knowledge systems and not be fished out, or solutions would be designed for the 20% of the African population whose needs have often determined national policy and technology acquisition (Ayensu, 1997). The role of the African intellectual would be to define the basis of indigenous African communication systems for technology, culture and education to be brought into synchrony for an effective IT-led healthcare agenda. A virtual network among African intellectuals and its interaction with rural African communities would convert the infamous "brain drain" symptom into brain enrichment and convergence, regardless of geographical location of members. That would be the appropriate means to intellectualize indigenous African Knowledge for sustainable livelihoods. For example, 'A Directory of Medical Doctors in Africa, searchable by country and medical specialty, is available on the World Wide Web. However, such browsers need to be customized for the peculiar healthmap of rural sub-Saharan Africa. African intellectuals should be able to create a healthmap which would assist, among other things, in isolation of epidemic outbreaks and provision of rapid response measures.
     
   • Teleconnectivity in Africa: The State and Goals
   • African bureaucracies have operated the radio, television, and print media only in the singing of praise to authoritative and repressive regimes, and not as two-way knowledge channels that listen to the majority populations. There has been no improvements to the indigenous methods of communications for mobilization and rulership. African policy makers and technical experts have not been able to place the gong-gong, a central element of rural communications in Africa, in development of national communication systems. The town crier's tool, the gong-gong, has not been coupled to the megaphone. Therefore the issue of stakeholders in the deployment of IT for health should be of concern, aside of the content and hardware.
   • Rapid advancements in IT may herald unprecedented potentials for the resolution of the knowledge hunger in rural sub-Saharan Africa, however, teledentsity, the principal index of IT utilization, is only 0.48 telephone per 100 people in sub-Saharan Africa, excluding South Africa. The region's rural peoples (70% of the population) share only 228,000 telephone lines (d'Orville, 1996). In Ghana, for example, teledensity is 0.31 lines per 100 people nationally but some 40% of the nation's population, or 7.2 million, in four (Volta, Upper, Northern, and Brong-Ahafo Regions) of the ten administrative regions share only 3,800 telephone lines, or 0.06 lines per 100 people. Similarly in Mali, there are less than 18,000 main phone lines in operation and, 100 people share less than one telephone line. The Ghana Government's Telecommunications Policy for an Accelerated Development Programme 1994-2000 seeks to meet short-term demands in telecommunications by providing 100,000 new lines but businesses are the priority of that program and overall demand is estimated at 300,000 - 500,000. The government has acknowledged that network growth of about 35% pa would be required to meet even the lower end of demand estimates. That is, a network growth rate of almost two times the level achieved by some more advanced economies. The government's connectivity target for rural Ghana, even if achieved, would mean one public telephone line in each village of 500 people, which is far less than the modest five lines per 100 population recommended by the International Communication Union. Considering that the investment cost in telecommunications in Ghana is about $1,500 - $4,200 per line, the chances of health reform via IT are unrealistic except innovative methods in communications are devised.
   • What is needed is a poor person's teleconnectivity system which, in this case, would enable an entire community to share units of the convergence of television, radio, telephone, Internet, CD-ROM, and print media, to offer new prospects in the delivery of sophisticated information to the previously 'uneconomic' regions of the world. That is, IT systems in health - preventive and care - in rural Africa should be adapted to local realities. The impact of IT on rural health demands planning at national and regional levels so as to make these tools relevant to socio-cultural needs. Such an effort would permit integration and dissemination of all data on Africa, as well as, extend the oral storytelling of the African traditional system. The pitfalls in oral tradition include the irrecuperable loss of the constituents of indigenous medicinal concoctions since the practice has been shrouded in mythical incantations. An archive is the most precious gift a generation bequeaths onto the next therefore oral traditions of information storage and retrieval in Africa should be viewed with scrutiny in the age of IT. Njinya-Mujinya and Habomugisha (1998) suggested establishment of rural information or data banks in Africa The advent of IT in rural Africa should seek to tie the notion of telecentres into rural information archives, to document indigenous livelihoods and as a means to redressing the booklessness state of rural Africa, and as a process towards the intellectualization of African tradition. Essentially, such an approach would integrate formal health practices with educational programs and continuous learning systems. Thus the role of national library systems, university faculties of health, medicine, home science, and communications, and associated national bureaucracies of education, and information services or their variations, should be revised to reflect the need for modern information storage and retrieval systems.
   • Information and communications technologies are tools which are supposed to facilitate human activity and interaction but which, if devoid of cultural relevance, do not take root. The argument is for partnership between Northern and Southern intellectuals in creation of a hybridized knowledge system which IT as tools would impact as knowledge channel for diffusion and reaching rural communes. This would allow decoding of indigenous practices into those capable of meeting peoples' needs in a globalized world, in a manner that benefits all - human and non-human.
   • Some of the elements associated with a culturally integrated telehealth management system include women and children's health, rural agriculture, population growth rate and environmental consequences, public hygiene, road traffic accidents, and emerging diseases, are discussed in the following sections.
     
   • Elements of Rural Telehealth
     
   • Rural Agriculture
   • The indigenous African Knowledge system was conversant of agriculture's place in the progress of human civilization, and the main activities of rural peoples in the region revolve around the land and its ability to feed its people. For this, indigenous African Knowledge and Ideas ensured access to land through its belief that land was for the ancestors, the living and the future. Social support systems, for example susu and fidodo, forms of social capital, were designed to guarantee optimum production levels for the individual household, relying on group strength. The mechanical and philosophical tools which were designed for such production systems however have not responded to meet present challenges such as rapid population growth, let alone external factors of globalization and world trade imbalances, and erratic climatic patterns. Lack of intellectualization of the indigenous production system, inappropriate government policies or low government priority towards rural agriculture, poor infrastructure, civil strife, the primitive tools, unimproved crop cultivars or animal herds, reliance on rain-fed agriculture, lack of storage facilities, inability to replenish the land, uncontrollable disease and pest outbreaks, unfair market conditions, among others, have kept agriculture in rural sub-Saharan Africa in its primordial state. Today, sub-Saharan Africa is particularly notorious for its chronic food shortages and human wasting. Africa's population growth rate, at about three percent doubles the population every 24 years and outstrips its food production level. Sub-Saharan Africa's population has doubled in just 25 years to 620 million, even after taking into account declining birthrates and rising deaths from acquired immunodeficiency syndrome (AIDS). The high population growth rate has outpaced economic gains, leaving Africans, on average, 22 percent poorer than in 1975 (PAI, 1998). Africa's proportion of food insecure people is by far the highest in the world, with one fourth of its people being underfed (GLOBAL 2000). A large number of child deaths are attributable to the potentiating effects of malnutrition in infectious disease. Per capita food production has declined by about seven percent since 1980 in sub-Saharan Africa and countries of the region dominate the list of 40 developing countries where food production decreases have been recorded consistently (Missiaen, 1997). Africa's chronically undernourished people more than doubled to 215 million between 1969-71 and 1990-92 and is projected to reach 300 million by the year 2010, including micronutrient malnutrition with a large percentage of iron deficiency, vitamin A deficiency and risks of iodine deficiency disorders. (FAO, 1996).
   • The present technological state of agriculture in rural sub-Saharan Africa is only a few stages removed from the Stone Age. About 80 per cent of the agricultural workforce in the region rely on the "hoe technology" (Hunt, 1990; Global 2000) or farm implements with little mechanical advantage hence farm holdings are small, in the age of sophisticated agriculture and precision farming elsewhere. Massive tractorization schemes have been expensive failures and farmers rely on rain-fed agriculture in an uncertain climatic era; crop varieties are genetically primitive races. Lack of sophistication at the basic level of production in sub-Saharan Africa has resulted in the over-utilization of human physical strength with untold hardships, including hernias, among rural dwellers. Development, to many in sub-Saharan Africa, is centred around gold and diamond mines or oil fields but not provision of portable water and, open sewerage systems line urban streets.
   • Global Knowledge exists, which if policy makers in sub-Saharan Africa employed as capital, would enable modelling of successful sustainable rural communities. At this stage in human civilization, it is feasible to determine the carrying capacity of rural lands. Knowledge about the demographics of a community, its human and environmental resources and types of tools and cultural production systems, would enable estimation of current production levels. This would lead to determination of optimum production levels if solutions were provided for limiting factors, through modernization of the knowledge system. Hypothetically, this could translate into designs of adequate production systems to address the chronic food shortages that have come to define Africa in global media circles.
     
   • Population Growth Rate and the Environment
   • Population growth is an important factor in food demand in sub-Saharan Africa. Attempts to raise food production broadly in line with this increase in demand would have significant agricultural, economic and environmental costs. Currently, food supplies only provide an average of 2,100 calories per person per day or about 90 percent of the minimum calorie requirement recommended by the Food and Agriculture Organization of the United Nations (FAO, 1996). Africa has a young population, most of whom are idle, disenchanted, uneducated and "vulnerable" but have great growth momentum, with serious implications for food requirements and consumption patterns unless such momentum could be channelled into productive labour if proper schemes in education, skill acquisition, and tools are designed and distributed around strategic national issues. In some rural areas, for example, Kpando District of Ghana's Volta Region, about 43% of the population is under 15 years of age. The dangers posed to Africa's environmental security with such demographics in light of food inadequacy include declaration of rage on the environment in search of livelihoods. Strong and able-bodied young African males have converted large portions of land into bare ground by extracting trees for charcoal production to feed urban consumption, as a means to earning livelihoods, destroying watersheds and arable land in the process. Combined with unimproved agricultural land, there is increasing pressure to cultivate previously uncultivated lands, thereby unmasking strange diseases, such as Buruli ulcer. Buruli ulcer has become a serious problem in Cote D'Ivoire, Ghana, Benin and Togo, and cases have also been reported from other countries in Africa and from Australia (Perera, 1998). Buruli ulcer is a mycobacterial disease related to tuberculosis (TB) and leprosy and was first identified in 1948 among farmers in Australia, where it is known as Bairnsdale ulcer. It causes severely deforming ulcers, mainly in women and children, destroys skin and underlying tissues and, if left untreated, can lead to severe complications, loss of organs such as eyes and breasts, amputations and other permanent disabilities. Information on the disease is scarce, little is known about the mode of transmission to human beings, and patients usually come to health services in the late stages of the disease. Unlike TB and leprosy, Buruli ulcer does not respond to antibiotics once entrenched although it can be fairly easily treated in the early stages. A total of 10,000 cases have been recorded in Cote d'Ivoire since 1978 and up to 16 percent of the population in some villages are affected. In Benin, 2,300 cases have been recorded since 1989 and up to 22 percent of Ghanaian villagers are affected in some areas. Most victims of Buruli ulcer live in rural areas near rivers or wetlands in tropical and sub-tropical regions of Africa, Asia, Latin America and the Western Pacific. The bacterium lives in hot and humid forest soil but seem to thrive near dams, irrigation ditches, and cleared forests. This has led some scientists to link the increase in the disease to the clearing of rain forest or disturbance of upstream regions (Perera, 1998).
   • Meanwhile, in the indigenous African Knowledge and Ideas system, a piece of the forest was set aside and mythologically assigned as the place of worship of their gods and nothing was to be extracted from that land. That idea, common among the Ewes in eastern Ghana for example, which should have formed the basis of forest conservation and reafforestation campaigns, is now under threat due to the primordial agricultural production system.
   • Rural agriculture in sub-Saharan Africa requires improvement in soil nutrition and provision of improved seeds. Much of the household garbage produced in rural Africa is organic in nature. However, little scientific methods have been designed for conversion of such waste into agricultural land replenishing nutrients. Massive irrigation and tractorization schemes have failed and only eight percent of the region's water resources are under some form of management. The Volta Lake in Ghana, for example, with a capacity of 148,000 million cubic metres, covering 8,483 square kilometres and running 402 kilometres north to south within the country (Yirenkyi, 1998), empties all its contents into the sea. Water management systems have not been able to deliver water even to farmlands which are peripheral to the body of water. Thus rural farmers are forced deeper into the forests in search of arable land, as the fallow period has shortened below the required minimum for rejuvenation.
   • Health reform in sub-Saharan Africa requires more than adequate food production locally.
     

     When it comes to ending hunger, economic growth is not enough. Africa needs growth with equity. Hunger will not be overcome just by growth in GNP or in food production; poor people and poor women in particular must have access to food. [Africa needs] to invest in [its] people - in their good nutrition, in their health, in their education - to invest in ways that improve their lives. Freer markets and a strong place for the private sector are also crucial. But they are not enough. We need to invest in farmers, not just in farming -- Catherine Bertini, 1998.

     
     
     Women and Children's Health
   • Sub-Saharan Africa's prospects for economic development largely depend on the success or failure of its governments in accelerating efforts to improve health services to women and children. A civilization's future is stored as potential energy in its children and youth. However, 53% of all deaths in sub-Saharan Africa occur between ages 0 and 4 years, compared with 11% in China. For girls, the probability of death between birth and age 14 is 22.0% in sub-Saharan Africa compared to 1.1% in established market economies. Five of the 10 leading causes of death are communicable or perinatal diseases. With the exception of tuberculosis, these major causes largely affect children younger than 5 years (Getty, 1997). Many children in Africa succumb to diarrhoeal diseases which could be minimized by access to quality-controlled bottled beverages. Lack of access to such drinks is due to the disproportionate importance which has been given to soft drinks of Western appeal. Thus Bottling Companies in Africa are not interested in developing local beverages from the tons of fruit that go waste at the markets and farms. Local drinks such as, liha, the indigenous Ewe soft drink brewed from maize and ginger, have not progressed beyond ancestral production systems.
   • The reproductive health of sub-Saharan Africa's women and other issues of perinatal health are of particular concern in producing a comprehensive healthmap. Frequent childbearing, high levels of pregnancy-related maternal mortality, and an epidemic of sexually transmitted diseases (STDs), including HIV/AIDS, all take their toll on the African woman. Although sub-Saharan Africa's women constitute only ten percent of the world's women population, the African female population accounts for 40 percent of all pregnancy and childbirth-related deaths, much of which could be prevented with affordable measures. An African woman has a one in 15 chance of dying in pregnancy or childbirth, or odds more than 200 times greater than those faced by women in the United States. Of childbirth-related maternal deaths, nearly three fourths are directly related to severe bleeding (25 per cent), infections (15 per cent), unsafe pregnancy intervention procedures (13 per cent), eclampsia (12 per cent), and obstructed labour (8 per cent). Eight per cent of deaths are due to other direct causes such as ectopic pregnancy, embolism and anaesthesia-related complications, while the remaining 20 per cent are due to indirect causes such as anaemia, malaria or heart disease (UNFPA, 1998).
   • Informed rural experts would acknowledge that African women give birth anywhere - at home, on the farms, at markets, or at commuter stations, with the bulk of childbirth assisted by traditional birth attendants (TBA) as the highest forms of obstetrics in rural Africa. TBAs deliver almost all the babies in rural Africa, including people who become policy makers, but little effort has been made to provide general training and resources to this profession of ancestral and future evolutions. AIDS is posing a new dilemma for the African woman. While breastfeeding confers enormous benefits, preventing malnutrition and illness, saving lives and money, it is also, however, one way an HIV-positive mother could transmit the virus to her infant. A child stands the greatest risk, about 20%, of vertical or mother-to-child transmission during the time of late pregnancy and childbirth, and an additional 14% risk that an infant will become infected through breastmilk (UNICEF Home Page).
   • Women are disadvantaged in access to educational and economic opportunities, and their low education and social status limit their ability to use safe pregnancy intervention procedures and health services. Teenage pregnancy is another morbidity characteristic of the rural African woman. More than one in seven African adolescents give birth each year, more than twice the average for other developing countries and two and a half times the rate in the United States. The reality is that a 35-year-old rural African woman is likely to be a grandmother. Adolescents are also at high risk of unsafe pregnancy intervention procedures and HIV infection. About 22,000 African women die each year from unsafe pregnancy intervention procedures, reflecting limited access to counselling and medical care while the traditional practice of female genital mutilation on 110 million women in the region further jeopardizes the African woman's health (PAI, 1998). A study in 10 countries revealed that health staff discuss sexually transmitted diseases with only one in 10 reproductive counselling clients, and AIDS with just one in 14. Such services are often the only contact women have with the health system and thus an important opportunity for educating women about protecting themselves from HIV/AIDS. Provision of sexual and reproductive health information and services to young people remains highly controversial (PAI, 1998)
   • However, African governments are making some progress in addressing these challenges. Reproductive health counselling has increased dramatically in some countries, to about 18 percent for the region as a whole. This dramatic change has been induced by fundamental shifts in people's attitudes towards childbearing, urbanization, rising cost of education and other basic needs, and the improved chances of child survival. However, some 22 million married women who indicated a desire to delay or avoid another pregnancy were not using preventive measures. This need gap for family planning in Africa is higher than in any other region. Most countries in the region are extremely poor and current funding falls far short of the estimated $2 billion needed in order to meet family planning and other reproductive health needs. In 1990, African governments spent only about $200 million of their own money for all preventive health services, including reproductive health counselling. The lack of resources in the region highlights the need for continued assistance from the wealthy donor nations. The Safe Motherhood Inter-Agency Group (IAG), recommended that donors increase support for reproductive health campaigns and related health care from the current $500 million to at least $1 billion by the year 2000. However, maternal and newborn health services would cost an average of $3 per person per year in developing countries with maternal health services alone costing as little as $2 per person (UNFPA, 1998). It behoves upon policy makers in Africa to institute appropriate priority areas and health policy should reflect concrete efforts towards general livelihood improvement. Moreover, infant formula manufacturers should be enticed to fund programs which aim to educate adolescents about reproductive responsibilities and to provide knowledge, resources and services to mothers regarding perinatals.
   • Making motherhood safer requires more than good quality reproductive health services; women must be empowered and their human rights guaranteed, including their rights to good quality services and information during and after pregnancy and childbirth (UNFPA 1998). Condoms alone would not prevent teenage pregnancy or frequent childbirths. People, particularly young women and men, need improved livelihoods and secured futures.
   • Traditionally, most African women space childbirth by two to three years and derogatory terms are used to describe those who might give birth too frequently, for example, kpendevi dzila, in Ewe. Following delivery of a child, specific foods are provided to the nursing mother, for example, palm nut soup in Ghana. Care is provided by female relatives to the nursing mother to minimise post-delivery complications and to enable the woman to recuperate fully before engaging in daily chores. The extent to which such indigenous practices are incorporated into modern reproductive counselling services would determine the level to which such campaigns are successful.
     
   • Indigenous Medicinal Practices
   • The initial consultation of a patient in rural Africa is often with an indigenous healer. Indigenous medicinal practices have been documented quite extensively and some countries have already begun incorporation of indigenous healing systems into mainstream medical practices. There have been improvements in the formulation, processing, packaging and labelling with regard to dosage prescription, leading to increased usage of indigenous drugs especially as cost of modern medicine has soared with decreasing accessibility (Atteh, 1992). According to Atteh (1992), Idrisu Aremu, a villager from Oga-La, near Ilorin, Nigeria, cannot be denied a place in medical history. Aremu is a bone setter, who is reputed to have reset bones too fractured for the formally-educated doctors at University of Ilorin Teaching Hospital so that when doctors decided on amputation of limbs relatives of the injured withdrew the patients and consulted Aremu who, to the admiration of the doctors, would successfully reset the bones. And there are many Aremus for other ailments.
   • However the complexity of diseases confounds diagnosis by indigenous medical practitioners due to similarity of symptoms between quite different diseases, often leading to tragic ends due to delayed treatment at hospitals. Thus incorporation of indigenous medicine into modern forms of disease treatment should go beyond a herbalist enlisted by a modern hospital and should include diagnostic tools to assist indigenous doctors. The infirm, whether physical, psychiatric, or psychological, are concentrated at several "Healing Camps"which are operated by charismatic churches, at least in Ghana. This practice extends the African psyche of associating the spirit with the physical and replaces the incantations of the indigenous rituals associated with the healing process. Such healing camps should be included in health programs in order to reach where the poor who are sick are likely to gather, and efforts should be made to characterise the populations and ailments present in such camps. Further, market days are important days culturally; many villagers come to a central town to exchange goods and services, as well as meet family members from other communities. Thus the concept of mobile clinics visiting communities on market days could assist in health screening of rural dwellers.
   • Indigenous medical knowledge in sub-Saharan Africa includes the practice of dipping specific twigs as herbs in locally distilled liquor, such as akpeteshie, for treatment of chronic backaches and some stomach ailments. However, such knowledge has not been enhanced and the practice has remained rudimentary. The limitations of such a practice include lack of appeal to those who do not indulge in alcoholic drinks, and the active ingredients, side-effects, and scientific evidence of effect on condition are all shrouded in mythical undertones.
   • An integrated telehealth system could reach the village doctors by providing internships with the formally trained medical practitioners for enhanced diagnostic methods and distinction between similar disease symptoms. However, increases in non-primary disease incidence should also be of concern to health planners in the region.
     
   • Non-Primary Diseases
   • Apart from the so-called people diseases, ironically, a male dying of heart disease is more likely to be in sub-Saharan Africa than in North America (Getty, 1997). Furthermore, of world male homicides, 40% were in sub-Saharan Africa. Thus for Africa's morbidity to be strongly tied to "people diseases" alone is a woefully inadequate model. The ratio of deaths from non-communicable diseases (e.g. heart disease, cancers) to deaths from communicable diseases (e.g. influenza, tuberculosis), has been proposed as a crude but useful indicator of epidemiological transitions. These ratios range from more than 13 in the established market economies and former Soviet economies to 0.4 in sub-Saharan Africa. However, oddly enough, the probability of death from a non-communicable disease is higher in low-income regions such as sub-Saharan Africa than in high-income regions. This finding is at odds with the popular perception that many risk factors for non-communicable diseases are more prevalent in high-income than low-income populations. The apparent paradox of higher non-communicable death rates in the adults of the developing world has been attributed to the other major determinants of non-communicable disease mortality of which leading possibilities include communicable diseases and malnutritional conditions in children as determinants of subsequent non-communicable diseases in adulthood (Getty, 1997).
   • Although infections and malnutrition still constitute the major component of the disease burden, there is accumulating and convincing evidence that chronic disorders in general and cardiovascular disorders in particular are becoming increasingly important in sub-Saharan Africa (Muna, 1997). More than 20 years ago, infections (30%), cardiovascular disorders (24%), and cancer (23%) were the leading causes of death among middle-aged men in a large urban hospital in one of the sub-Saharan African countries. Although specific data is still lacking, infections involving various cardiac structures and the pericardium, rheumatic fever and rheumatic heart disease and cardiomyopathies constitute frequent causes of cardiovascular deaths. Hypertension also is increasingly being recognized as an important health issue in Africa, where rates in rural areas range between five and 10% and may frequently be in excess of 15% in most urban areas, although the incidence levels are still much lower than rates for populations of African origin living in developed countries. Hypertension is an important factor in stroke and congestive heart failure which are responsible for most cardiovascular deaths among adult black Africans. Recent hospital and community-based studies have suggested that cardiovascular mortality may be up to 15% and often in excess of 20% of total mortality. Average total cholesterol levels and the risk for coronary heart disease also remain low for black Africans, and HDL-cholesterol levels are generally high. However, changes in cholesterol levels in some population groups (average levels in a Nigerian population rose from 140 mg/dl to 160 mg/dl between 1958 and 1980) suggest that there are also some opportunities for education and primary prevention. Similar considerations can be made for diabetes, which is less than 2%, and obesity. For example, with education on limiting salt intake, sedentary lifestyle, and obesity as attributable risks, it is feasible to reduce the incidence of hypertension. The tobacco industry and cigarette smoking as well should concern African health planners. Although smoking-related disorders are not important causes of mortality and morbidity in Africa, smoking rates may be as high as 40 % in some urban areas (Muna, 1997).
   • The current epidemiological transition to increasing cardiovascular morbidity and mortality among Africans has arrived much faster than Africans either anticipated or can cope with. A poorly executed health care agenda that consisted of the prevention and treatment of infectious diseases has thus been compounded by other emerging health issues. The transition is no longer from communicable to non-communicable diseases but rather a transition to communicable and non-communicable diseases (Muna, 1997).
   • Appropriate education within a primary health care system is needed to repel some of the looming darkness in African health issues.
   • It would be preposterous in African health discourse to minimise the impact of new plagues, such as human immunodeficiency virus (HIV) that causes AIDS. AIDS is nowhere more threatening than on the African continent (Zihindula, 1998). Twenty-two of the 33.4 million people infected with HIV/AIDS live in sub-Saharan Africa and 4 million have already died of it (PAI, 1998). Africa at the Turning Point) and UNAIDS estimated that 8 million children have been orphaned by this epidemic. The AIDS incidence in Africa is likely to diminish life expectancy by 20 years, decrease work productivity, and increase infant mortality rate. The sad point is that all the efforts by Africans to improve their economic situation would be undermined by the disease (Zihindula, 1998), if comprehensive solutions are not designed soon.
   • Several specific factors are to blame for the spread of the disease on the African continent, including poverty, lack of education, and armed conflict. Despite attempts by non-governmental organizations (NGOs) in the area of development, and other organizations to educate people about the threat of AIDS, many Africans are in denial about the existence of AIDS. According to some accounts, soldiers picking up prostitutes are said to often claim to be immune to the disease. Moreover, many African parents do not allow their children to receive information about the use of condoms as prevention against the disease, believing that it would encourage them to indulge in sexual activities (Zihindula, 1998).
     
   • Public Hygiene
   • Another factor in the African health crises concerns hygiene at public places. Food hawkers display their ware close to gutters filled with dirt, raw sewage and stench while Petrol Stations are brightly lighted, clean, and the workers neatly dressed, at least at the newer filling stations in Accra, Ghana. The cost of unsupervised urbanization and unrealistic "industrialization" in the region has worsened the health status of the African. The Korle Lagoon in Accra, Ghana, for example, is a standing syrup of raw industrial and household sewage, close to the nation's main Teaching Hospital named Korle-Bu or Korle's Well. Implications of such poor public hygiene include poor health and lack of aesthetics. Holding down dust even in non-desert areas, with proper lawncare would minimize the incidence of respiratory diseases.
   • Rapid growths in urbanization especially among the poor has intensified the sordid nature of urban squalors. Conglomeration in high numbers of poor people in city slums which are little serviced by potable water, toilets, underground sewerage systems, or proper housing has only confounded eradication of disease inoculum, thus serving as perpetual inoculum of TB (Garrett, 1994). About 80 per cent of the plagues afflicting rural Africans and the urban poor are water-borne, water-related or water-associated (Ayensu, 1997), including many of Atteh's "people-diseases - diseases such as malaria, diarrhoea, guinea worms, schistosomiasis and onchocerciasis. Therefore, provision of clean drinking water alone would help eradicate some of these health hazards. Provision of village wells is a task which African governments should be able to undertake if proper strategic choices in application of technology are made, such as to drill for water instead of in vain for fossil fuels. Bottled water is now common in the urban centres of Ghana but efforts should be made to replicate that situation in rural areas. Introduction of ventilated pit outhouses in Ghana is a positive development especially when kittens in North America have "Litter Maids." Generally, however, African governments have devoted enormous amounts of energy in drilling for oil while there is no evidence that such finds have contributed to the economic well-being of their citizens. The recent conflicts in the oil-rich delta of Nigeria in which 700 or more human lives were lost in the oil pipeline fires that ravaged rural communities are a sordid reminder that people needs have not been met with oil revenues. Thus rural people have directed their rage at technologies which they perceive as meaningless, and against the people who manage them, often at the poor's own peril. Every informed person could have guessed that the fires were imminent, yet about 5,000 children orphaned by that disaster were being driven out of schools for not having paid school fees.
   • Moreover, the reduction in the crime level of New York city has been partly ascribed to increased beautification of that city through its ability to control graffitti and provide a clean environment, apparently based on the Broken Window hypothesis. That hypothesis suggests that a beautiful environment is an indication of communal peace and demonstrates that the community cares about itself. Neglect of an area would invite vandalism and induce high crime waves. Such a model could be employed to reduce the increasing wave of violent crimes in urban sub-Saharan Africa.
     
   • Road Safety Education
   • Poor road conditions in sub-Saharan Africa is a principal component in the number of road traffic accidents. However, lack of proper knowledge about vehicles, driving conditions and respect for traffic signs, poor driver training, abuse of pedestrians, and drunk-driving have significantly increased the insecurity on African roads. Issues such as these are more likely to be addressed with Road Safety Education programs than any single factor. During 1996, about 10,000 people were killed in South Africa, and close to 50,000 seriously injured, of whom 40 percent were pedestrians. The cost to that country's economy was in the order of R11.9 billion, excluding the emotional and social impacts. The 1,306,589 notices issued between October 1997 and January 1998 country-wide in South Africa's Arrive Alive Campaign, broke down into offences related to speed (813,230), drunk-driving ( 6,455), unfastened seatbelt (142,868), overtaking dangerously (1,818), overloading passengers (3,353), crossing of barrier line (5,770), invalid driving licences (42,103), ignoring red traffic signal (84,379), reckless driving (1,302), negligent driving (1,216 ), and vehicle non-roadworthiness (69,834 ). Furthermore, most accidents occurred on Fridays, Saturdays and Sundays reflecting enthusiasm in week-end indulgence, such as, alcohol consumption and reckless driving. Similar situations exist in other African countries.
   • Vehicle ownership or its operation still represents achievement of a status which connotes possession of technological device which mystifies the ordinary person, hence over-exuberance in its use. Often operators of private commercial vehicles, the bulk of the transportation providers, are illiterates or people who seldom possess more than basic school certificates. Vehicle conditions are also woeful. Although fitter mechanics in Africa are ingenious, ensuring survival of vehicles too old to be found in most of the other regions of the world, such ingenuity has not benefited from global knowledge in machinery and tool handling and maintenance. Thus rickety vehicles ply the roads in the region, endangering the lives of all - operators, passengers, pedestrians, and victims' families. These road accidents often stretch the resources of the health system. Driver education, through local driver associations should be a possibility and efforts should be made to ban sale of alcohol within defined perimeters of commuter stations while encouraging drivers to police themselves as police services are not immune from the bribery situations in Africa. The general public should be sensitized towards road safety and be encouraged to monitor drivers' conduct.
     
   • Reflections
   • In addition to the logistics and human networks required in establishment of a viable telehealth practice in Africa, the human and physical nature of rural Africa dictate that innovative elements are applied in a holistic telehealth scheme. While global connectivity can impact the diagnosis, care and delivery of formal medical practices, majority of Africans lack access to hospitals. A large number of Africans, for lack of alternatives, rely on centuries old treatments which have remained primordial. Moreover, primary health care, of which education is an important component, if assisted by access to global knowledge capital, would unleash unlimited potentials in reversing the morbidity of Africans. The goal would be creation of a knowledge bridge between modern practices in medicine and health and the indigenous concepts of health, and finding appropriate diffusion channels to enable the synthesized knowledge to reach the majority of Africans. That would be accomplished through equal partnerships among local and external intellectuals, African and donor governments, and between technologists and traditionalists. A health model should fully define the type of knowledge capital which is required for a successful primary health care campaign, and ways to utilize a channel through which the synthesized knowledge system can flow interactively among intellectuals, target group, and sponsors.
   • A gender emphasis in such a model should not be an overstatement because of the direct implications of gender in health, such as perinatals, and indirectly due to the relationship between a mother and an infant, and woman and household. Therefore, ability to design curricula that can be delivered as adult and continuous learning programs would be critical. Inclusion of National Councils on Women and Development, and Home/Health Science Departments at African universities should be of priority although autonomous Women Studies Institutes would be more appropriate. In the long-term, programs on sustainable rural livelihoods would yield results in terms of pilot projects on a wholistic model that includes agricultural productivity for nutrition, micro-credit systems for household security and investment in rural occupations, and studies in the properties, and concentration and packaging of indigenous medicinal herbs.
   • Other elements of sustainable primary health care campaigns would include ensuring that there is connectivity between the fixed nodes at the hospitals and the rural communities. Hence an information access and delivery system which would constitute interactivity with a virtual healthmap for both ordinary people and medical personnel. This would ensure that there is contact between municipal hospitals and rural areas without the need for rural people to trek over long distances to hospitals, that is if they can afford the cost of prescription drugs. It would be important to explore possibilities of including Institutes for Medical Research, Schools of Medicine and Pharmacy, Nursing Schools and Public Health Departments in establishment of African Health Index Structures, a web browser index or program to identify all African medical practitioners and technologists in the diaspora as potential nodes in African telemedicine and telehealth practice. Interactivity with Private Road Transport Unions and Motor Traffic Units are required to effectively educate drivers, pedestrians and the general public regarding drunk-driving, traffic signs, pedestrian crossings, speed, and vehicle maintenance. Relationships should be established with national bureaucracies regarding adolescent education about reproductive responsibilities and precautions. Some form of internship programs should be designed for indigenous healers, including traditional birth attendants and faith healers, by associating them with hospital staff where they would acquire better skills in diagnosis since disease symptoms can be similar and confound conditions. The number of people who use such indigenous healers' services is higher than most people would admit.
   • Considering the above, the Indigenous African Perspective on Sustainable Livelihoods (IAPSL) contends that indigenous governance is the key to a holistic model in sustainable rural development. Indigenous Leaders in Ghana and editorial comments in the Ghanaian daily newspapers have made similar observations. For example, Nana Addo Dankwa II, Okuapemhene, at a two-day workshop organized by the National House of Chiefs and the National Commission on Civic Education, expressed "... the need for harmony between traditional values and the people's wish for good governance and democracy ... there should be a way to match the two for the benefit of society." Therefore, the IAPSL aims to build the capacity of African communities to manage their co-existence. The IAPSL focuses on the awareness, coping and adaptive strategies of rural African dwellers in order to identify the organizational patterns embedded in indigenous African Knowledge. The major activity of IAPSL is to document, in both text and audio-visuals, the way in which African groups practice their right of representation, autonomy, accountability, dissent and attainment of sustainable livelihoods. The group will devise procedures for translating indigenous African Knowledge systems into integrated policy tools, including science and technology needs of rural people. IAPSL aims to promote its vision of Africa in the 21st century by associating with many like-minded institutions and individuals world wide.
     
   • Further Readings
   • Afele, Senyo John. 1999. "Information and Communications Technologies in The New African Renaissance: Toward Innovative and Thinking Systems." In: L. Njinya-Mujinya, Senyo John Afele, Peace Haboumugisha, Sope Maithufi, & Dziedorm R. Asafo (eds.). Now and in the Next Millennium, 1990S-3000 CE: Assessing Africa's Scholarly Publishing Needs and Industry. 1999
   • Edition. Journal of African Religion and Philosophy (JARP). Contact: L. Njinya-Mujinya, C/o, Box 1604, S - 751 46 Uppsala, Sweden. Email: Leuben.Njinya-Mujinya@teol.uu.se
   • Anani, Kofi. 1999. "Reflection on Africa's Literature-Dependence." In: L. Njinya-Mujinya, Senyo John Afele, Peace Haboumugisha, Sope Maithufi, & Dziedorm R. Asafo (eds.). Now and in the Next Millennium, 1990S-3000 CE: Assessing Africa's Scholarly Publishing Needs and Industry. 1999 Edition. JARP.
   • Atteh, O.D. 1992. "Indigenous Local Knowledge as a Key to Local Level Development: Possibilities, Constraints and Planning Issues." Studies in Technology and Social Change, No. 20. CIKARD, Iowa State University, Ames, Iowa.
   • Ayensu, Edward S. 1997. "The Status of Science in the Service of Sustainable Livelihoods in Africa." Paper presented at the workshop of the UNDP International Working Group on Sustainable Livelihoods. Pearl River Hilton, New York, November 19 - 21, 1997.
   • Clinton, Hillary Rodham. 1996. It Takes a Village. Simon and Schuster.
   • Development. volume 41, number 2 (June, 1998), page 99, Section: Window on the World.
   • d'Orville, Hans. 1996. "Tackling Information Poverty." In: Hans d'Orville (ed.). Beyond Freedom: Letters to Olusegun Obasanjo. p.483-494.
   • FAO. 1996. FAO/UNFPA Expert Group Meeting on Food Production and Population. FAO/UNFPA Expert Group Meeting. Food Production and Growth. Rome, 3-5 July 1996. http://www.undp.org/popin/fao/expmtg.htm
   • Garrett, Laurie. 1994. The Coming Plague. Penguin Books, New York, N.Y., U.S.A.
   • Getty, Vicky. 1997. Electronic Food Rap EFR 7(44): Global Burden of Disease (1 of 2). http://www.cc.emory.edu/CARTER_CENTER/PUBS/G2000/g2-feedg.htm)
   • Interim Report On The Arrive Alive Campaign. South Africa. 1 October 1997 - 10 January 1998 Department Of Transport. http://www.transport.gov.za/projects/arrive/interim.html
   • Missiaen, Margaret. 1997. Developing Countries: Nutrition and Food Aid Needs http://www.brown.edu/Departments/World_Hunger_Program/hungerweb/HN/Articles/WFS/MISSIAEN.html (World Hunger Education Service)
   • Njinya-Mujinya, Leuben, and Peace Habomugisha. 1998. "The Third Millenium, Information Banks and Publishing in Africa." In: P. Habomugisha, D.R. Asafo, and L. Njinya-Mujinya (eds.) Now and in the Next Millenium 1990s-3000 CE: Assessing Africa's Scholarly Publishing Needs and Industry. JARP & RA-GLOBAL Communications. p. 146-154.
   • Odhiambo, T.R. 1997. Research and Knowledge: Natural and Physical Sciences. Paper presented at the Research and the Production of Knowledge in Africa Conference. Center for the Study of Cultures, Rice University, Texas, November 7 - 8, 1997.
   • Perera, Judith. 1998. Health - Africa. WHO Targets Untreatable ulcer. http://www.tbwt.com/articles/gin2/gin806.htm
   • PAI (Population Action International). 1998. Pres Release. Africa at the Turning Point: Development Hinges on Success in Population. Study highlights rising demand for family planning as key to progress. May 3, 1998 -- Washington, DC http://www.populationaction.org/programs/afpop/afpop_pr.htm
   • Soedjatmoko. 1989. "Education Relevant to People's Needs." Daedalus: Journal of the American Academy of Arts and Sciences. p211-219.
   • The Indigenous African Perspective on Sustainable Livelihoods http://www.globalknowledge.org/english/archives/mailarchives/gkd/index.html
   • UNFPA. 1998. UNFPA, Five Other International Agencies Seek to Slash Half Million Annual Maternal Deaths. http://www.unfpa.org/NEWS/RELEASES/SAFEMOTH.HTM
   • Muna, Walinjom F.T.. 1997. Health Priorities for Sub Saharan Africa and the Challenge of Cardiovascular Disorders. http://www.healthnet.org/programs/procor/987comm.html
   • Yirenkyi, Godwin. 1998. Ghana in Brief. Institute for Scientific & Technological Information, CSIR, Accra. Pages 14 and 15.
   • Zihindula, Mulegwa. 1998. AIDS in Africa. General Board of Global Ministries, United Methodist Church. December 14, 1998. http://gbgm-umc.org/africa/aidsafri.html
   • Prepared by: John C. Afele, Ph.D
     University of Guelph
     Guelph, Ontario

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2. PAKISTAN

   Establishment Of A Regional Center (POP) For Distance Learning/Virtual University At Karachi, Pakistan

   Prepared by: Shahab Khan
   Director
   Planwel University
   Planwel Institute of Science and Technology (PLANWEL)
   A-1, L.C.H.S
   Gulistan-e-Jauhar, Block-20
   Karachi. 75290, Pakistan
   outlinebak.htmlPhone: 011-92-21-811-5851
   011-92-21-811-5094
   Fax: 011-92-21-811-6178
   E-mail: Afroz@khi.compol.com or
   afroz@planwel.edu
   URLs: http://www.planwel.com, http://www.planwel.edu, http://www.planwel.edu/Research/tampere.html

   [[TINA: Pls take his material from his URL and insert here.]]

   Tak, please note which pieces you would like to include. Thanks.

   [[TINA: The last one in his address with tampere.]]