SIDSnet: Nauru

SIDSNET INTERNET TRAINING WORKSHOP
Nauru
29 September - 01 October, 1999
Jan Pryor, D.O., M.P.H

Introduction
The United Nations Development Program (UNDP) and the Small Island Developing States Network (SIDSnet) have targeted 15 Pacific island nations for training activities directed at the use of Internet-related applications and technologies as tools for appropriate development. Among these Pacific island nations is the Republic of Nauru.

Telehealth can be defined as the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health, and health administration. Given the relative isolation of Pacific island nations, telehealth has been one of the Internet-related applications that has been of most interest to the region.

Over the past year Dr. Jan Pryor, Research and Telehealth Coordinator at the Fiji School of Medicine, has been working with individuals from UNDP and SIDSnet on the development of appropriate telehealth activities in the region. Subsequently, Dr. Pryor became involved in the planning for the UNDP/SIDSnet project to provide Internet-related training in the Pacific.

In preliminary consultations with representatives from the Republic of Nauru it was suggested to the UNDP staff in Fiji that Nauru was interested in Internet-related training in the areas of distance education and telehealth. Consequently, Dr. Pryor was asked to participate in the UNDP/SIDSnet Internet training activity for Nauru. It was planned that Dr. Pryor would arrive in Nauru on Tuesday, 28 September 1999 to prepare for a three-day workshop that would take place over the following three days from Wednesday, 29 September through Friday, 01 October.

Preparation for the Training Activity
During preparatory discussions between Dr. Pryor and UNDP staff the necessity of having the local representatives in Nauru fully informed and prepared for the training activity was emphasized. Specifically, it was suggested:

that the relevant government officials (e.g. the Secretaries and Directors of the Health and Education
Departments) needed to be in support of the activity and needed to identify appropriate participants for the
workshop,
that an appropriate venue for the training with multiple Internet-connected computers needed to be identified and
arranged for in advance, and
that the local participants in the training activity needed to have access to relevant technologies (e.g. computers
and the Internet) after the workshop in order to take full advantage of the training.

To arrange for and confirm the above, UNDP staff repeatedly communicated with their local contact for this activity, Mr. Criden Appi, Director of Nauru Telecommunications. To assist in this process Dr. Pryor forwarded to Mr. Appi a draft agenda for the training workshop and discussed via email messages the ability to modify the training activity as deemed appropriate by the skill level and training needs of the participants.

Before arriving in Nauru, Dr. Pryor prepared and copied multiple handouts for the workshop covering a variety of relevant topics. These handouts included a questionnaire, a checklist of the basic skills needed to fully take advantage of the distance education opportunities available through the Internet, an overview of general computer use and word processing, an outline for the use of electronic mail and worldwide web browsers, and exercises on the use of spreadsheets and statistical software.

Dr. Pryor arrived as scheduled early in the morning on Tuesday, 28 September, and after a short rest met the local contact for the training activity, Mr. Appi. It became clear after a brief discussion with Mr. Appi that much of the anticipated local preparation for the training workshop had not taken place as evidenced by the fact that:

none of the relevant leadership in the Departments of Health, Education or Telecommunications had been
consulted and approval for the workshop had not been obtained,
the only participants identified to take part in the workshop were a few personnel from within Nauru Telecommunications,
the training venue for the workshop had not been clearly identified or arranged for, and
computers, modems and phone lines with Internet connections had not been made ready.

Hence, Dr. Pryor was immediately challenged with the need to get all of these details worked out or the workshop would not be able to take place as scheduled. Dr. Pryor worked closely with Mr. Appi to work out these numerous details, and to a large extent, oversaw the necessary negotiations and arrangements.

Dr. Pryor and Mr. Appi first met with Dr. Mark D. Kun, the Secretary of Health and Medical Services, and Mr. Bruno Waqa, the Acting Secretary of Education to obtain permission to conduct the workshop, and to inform them as to the workshop’s schedule and agenda so that they might assist in identifying appropriate participants for this activity. Permission was also obtained from Mr. Waqa to approach Ms. Camilla Itsimaera, the Principal of the Nauru Secondary School (NSS), to negotiate the use of the NSS computer lab
and the assistance of the NSS computer instructor, Mr. Steve White.

Subsequently, Dr. Pryor was driven to the other side of the island by one of the Nauru Telecommunication workman to track down Mr. White at his house and enlist his assistance. Fortunately, the NSS students were on a break between terms, and in spite of his also being on break, Mr. White graciously agreed to assist in the preparation for the workshop and to be present throughout the workshop so that we could use the NSS computer lab.

Dr. Pryor then traveled back to NSS and met with Ms. Itsimaera to get final permission to use the NSS computer lab. Although the NSS computer lab had 10 computers, only one of them had a modem and there were no telephone lines in the room. Hence, it became necessary to arrange for 6 phone lines to be placed in the computer lab and to find and install additional modems and/or computers with modems. Mr. Appi had his technicians work on the installation of the necessary phone lines and this was completed by the end of Tuesday afternoon. Mr. Appi was also able to track down two modems and one computer with a modem that could be brought to the computer lab for installation on Wednesday morning. Dr. Pryor also made available his laptop computer that had a built-in modem. In all, a total of five computers with modems and Internet connections were eventually made operational for use during the workshop.

Dr. Pryor and Mr. Appi went to Nauru Hospital later on Tuesday afternoon to meet with the Director of Health and Medical Services, Dr. Godfrey Waidubu, who had not been available for an earlier appointment. After explaining to Dr. Waidubu the intent and agenda of the workshop, he expressed his frustration over the fact that the phone lines on the hospital’s side of the island were too unreliable to maintain an Internet connection and that he and his staff had given up on this until a more dependable system was in place. Mr. Appi confirmed that the phone lines to the hospital were indeed unreliable and that the situation could not be rectified until an upgrade of the phone lines was completed within the next year. Although Dr. Waidubu does have plans to ultimately make computers and relevant training available to his staff, until the problem with the phone lines was dealt with, Dr. Waidubu thought that spending time on the development of computer and Internet skills among his staff would be fruitless.

Dr. Waidubu further explained the current off-island referral situation in Nauru wherein there was a very high demand for off-island referral with resulting costs far exceeding the annual referral budget of Aust$2.5 million. Dr. Waidubu could see only minimal benefits of distance consultation in the future as the political system seemed to drive the off-island referral process perhaps more than did medical need. He also noted that all of his doctors were ex-patriots, were all fully trained, and hence had a minimal need, if any, for distance education. Although Dr. Kun expressed a differing and more optimistic opinion in regards to these issues during a further discussion the following morning, the obvious lack of interest by Dr. Waidubu in the planned training activity resulted in there being no workshop participants from the Department of Health and Medical Services.

Following the final installation of necessary computers, modems, and phone connections on Wednesday morning by Dr. Pryor, Mr. White and the Nauru Telecommunications technicians, the workshop started, albeit behind schedule, on Wednesday afternoon.

The Training Workshop
From Wednesday afternoon, 29 September, through Friday afternoon, 01 October, Dr. Pryor conducted workshop activities at the NSS computer lab. There was total of fourteen participants representing Nauru Telecommunications, the Nauru Department of Education, and the Nauru Airport Authority.

All participants were given an initial overview of SIDSnet including its purpose and collaborating partners. The SIDSnet homepage was also used as an example for a source of pertinent information about the Pacific islands.

Most of the workshop participants already had basic computer skills. However, there were three participants who did not have these basic skills and who required individual work as appropriate. The basic skills covered were:

basic components of the computer system and what they do,
basic concepts of how the computer organizes information (e.g. drive, folders/directories, programs),
concepts and use of the “Windows” operating environment,
use of the mouse and its buttons (click, double-click, click and drag),
use of the “Windows Explorer” application to copy, move and organize files, and
use of the “Word” application to create, modify and save word processing documents.

All participants received specific instruction, and extensive hands-on exercises and practice on Internet-related applications with an emphasis on the use of electronic mail (email) and the worldwide web. Relevant concepts and skills that were covered include:

basic concepts related to networks in general including intranets and the Internet,
functions of an Internet Service Provider and how to enlist their services,
access and use of common email applications including:
- how to compose, send, receive, print and save messages,
- how to use file attachments and potential problems with them (e.g. viruses),
- how to use the address book, and
- how to organize folders and messages within an email application,
access and use of Internet-based email services (e.g. Hotmail, Yahoo, etc.),
use of relevant listservers, (e.g. PACNET, those available through Egroups),
how to create a listserver,
basic concepts related to the world-wide web, webpages, hypertext links and uniform resource locators (URLs),
access and use of common web browser applications (e.g. Internet Explorer and Netscape Navigator) including:
- how to access a known URL,
- how to use a search engine (keywords, search strategies, etc.) to find information relevant to any given enquiry,
- navigation between webpages using hypertext links, the back and forward buttons, the history list, etc.,
- how to create and edit bookmarks,
- how to print and/or save webpages,
- how to download and save files,
- how to print and/or save graphic images, and
- how to install and use common plug-ins (e.g. Acrobat)
identification and use of relevant distance learning resources on the Internet including those that are freely accessible and those that require enrollment and a fee,
consideration of how to gain support from supervisors for participation in relevant distance learning activities, and capture, manipulation and use of digital images.

In addition to the above areas, Dr. Pryor was also able to provide an overview of current telehealth processes and resources available in the Pacific. This included a practical demonstration of the Tripler distance consultation website, the use of common Internet-based resources for health-related information (e.g. Medline), and strategies to find relevant health information for lay persons.

Internet access was available throughout the workshop through 5 computers. Hence, the workshop participants were given numerous hands-on exercises to test their knowledge and practice their on-line skills in the above areas. The activities practiced were made relevant to the participants’ individual needs as related to their employment and personal interests.

In all, the participants were quite enthusiastic and worked diligently. Knowledge and skills among the participants were obviously increased over the course of the workshop.

Conclusion
As planned, a UNDP/SIDSnet-sponsored three-day workshop was conducted in Nauru covering the use of relevant Internet-based technologies and applications. Fourteen individuals from Nauru Telecommunications, the Nauru Department of Education and the Nauru Airport Authority participated in the workshop. Contrary to expectations from the workshop organizers, there were no participants from the Nauru Department of Health and Medical Services.

Various areas of knowledge and skills were covered in the workshop with a focus on the practical use of Internet-based applications, especially those involving email and the worldwide web. A special emphasis was also placed on practical opportunities in distance education. The workshop participants were enthusiastic and attentive. Relevant knowledge and skills were clearly gained.

While there were specific and repeated efforts to plan and organize the workshop ahead of time, there was little preparation made on the part of the local contact persons prior to the arrival of the Consultant. In spite of this, patience and persistence on the part of the Consultant and cooperation from relevant individuals allowed the workshop to successfully proceed.

However, future workshops in similar small island jurisdictions should be preceded with greater planning efforts in recognition of the tendency for relevant details to be left to the last minute. This additional effort will hopefully allow for increased participation and a more productive training activity.

CONTACT:
Jan Pryor, D.O., M.P.H.
Fiji School of Medicine
Private Mail Bag
Suva, Fiji Islands

Office Phone: (679) 311 700 ext.1202
Home Phone: (679) 320 790
Pager: (679) 290 095
FAX: (679) 305 781
Email: pryor@fsm.ac.fj

www.sidsnet.org