Figuring out the project

The details of my actual project are starting to nail themselves down. As I mentioned before, I've been brought in to help expand the REACH project (which mainly means the REACH database system) to a new geographic location in Rajasthan, thus proving that it can scale and be replicated throughout India. However, I've never been entirely sure what that meant, since I'm not a database programmer, and I don't have the language or cultural skills needed to go out to the villages and collect the raw health data.

The task becomes clearer once you understand how REACH works. The theory is simple: we build a giant database tracking all the women and children in our covered district, we track who's getting their shots and prenatal visits and everything else, and then we either provide the care directly (the model used here in Medchal) or we show the "failure list" to the governmental ICDS worker and try to guilt them into doing their job (the model to be used in Rajasthan, with a slight twist I'll get to in another entry). The practicality is a bit harder. How do you maintain a database covering all the births, deaths, and medical interactions of nearly 45,000 people in an area that's still working on developing what we in the West would consider basic infrastructure?

The answer, not uncommonly, is to look to the patient population. For REACH, that specifically means a corps of Community Health Volunteers (CHVs) -- women who live in our target villages and are willing to serve as our eyes and ears. (The name says "volunteer", but they're paid a small honorarium. I need to find out just how much.) However, they don't exactly have laptops handy. So, they have to write their data in a big ledger. Once a week, they come with their ledgers and present them to our supervisors, who copy down the data into their own ledgers. They also copy it onto special data entry forms. These forms are then given to a room full of data entry techs, who type them into an app that loads the data into the Oracle backend. Now, consider that in most of the steps along that chain, it's being done by someone who cares, but also has only an eighth grade education. Stuff gets lost or corrupted, and the data entry techs are neither paid nor educated enough to think about the numbers they're keying in.

That, then, is where I come in. I'm basically a rented brain being shipped out to Rajasthan to look at the work that's being done on a daily basis. Most especially, I'm to look at the data coming in and be the lone guy who actually THINKS about whether we can trust them. Likely, I'll find that we can't, which means we'll have to try to figure out what's going wrong and how to fix it. This sounds a lot like some of those consulting jobs I applied for earlier in the year.

Of course, in the meantime, I first have to become an expert in how this system is supposed to work, both logistically and technologically. In order to achieve this within the space of about a week, I've been assigned to write the 2008 REACH Annual Report. The theory goes that in order to write about it, I have to understand it and locate the holes in my understanding. I think this is a pretty solid theory, and that's what I'll be pounding on this week.