Alex Watt

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Hello Africa!

In January 2020, I spent a week in Ethiopia with a team of medical professionals from my church and a sister church in Boston. It was an amazing week, and the environment was quite different from my “normal” in the States. On the return trip, as the plane was descending into Pittsburgh, I was shocked to see residential neighborhoods with large, beautiful houses, after a week of houses being very small and made of corrugated metal.

Anyway, our team was there to run a clinic. I had been told I might be able to work on a tech project, but had pretty low expectations. This post is about how that did, in fact, materialize.


Ethiopia ACT logo

Ethiopia ACT serves the sick and poor in Addis Ababa. It was started in 2002, at the height of the HIV crisis. Today their ministry still helps with HIV/AIDS, but has expanded to include other social care as well: For instance, they have met the financial needs of hundreds of families and have helped hundreds of families become self-sufficient. When I met the founder, Andy Warren, I was impressed by the data-driven decision-making approach he champions. He told me that measurable impact is one of their ministry values.

Because data is so important to their ministry, Ethiopia ACT runs a database server in their main office with records for families. One of their staff members, Danny, does most of the database administration, and he had asked our team to work with him to enable social workers to collect data in the field with donated Android phones and sync that data to the database. Previously the social workers were using paper forms. So Bill, a Pittsburgh colleague, and I got to work thinking about how to make this possible.

The initial vision was simple enough: Capture the patient ID, a couple metrics related to HIV/AIDS, and the date. As I understood the problem domain better and sketched a solution, I suggested other changes to their data model to get more value from the work we were doing. I convinced Danny that in addition to tracking HIV metrics over time, we could get even more value by having a table of visits. Working together, we came up with the following additional fields:

Since then, the project has expanded to capture additional data, but this illustrates some of the work in improving the data model.

One key detail I didn’t realize on my first day, that became apparent throughout the week: Supporting offline use would be critical. The electric and Internet infrastructure in Ethiopia is extremely unreliable, so a good solution would need to not only allow data to be collected offline, but also support the database server being offline frequently.

About the Tech

Ethiopia ACT uses FileMaker to run its database. Bill and I were unfamiliar with it, and briefly considered other options, as I wondered if we could find something open source that would be more robust and easier to integrate, but the ease of maintaining FileMaker by their staff and of creating UI’s to manipulate the data would be hard to replicate. We decided to leave it.

Ethiopia ACT also uses Fulcrum to gather data from the field. With Fulcrum, anyone can make a survey form, and push it to mobile devices. The app works great offline and can sync data to Fulcrum’s servers when it comes back online. This worked great for some projects, but for the data they track in FileMaker, there was no obvious way to connect the two systems.

Exploring the “How”

After a couple days of investigating, we not only decided to stick with FileMaker, but also decided that Fulcrum was probably the best option (or a good-enough option) for the mobile data collection. I did spend a hot minute tinkering with Expo, but that wouldn’t have supported easy maintenance. (Frontend friends: If you think running npm install is awful over high-speed Internet, you should really try it in Africa sometime. 😃)

Thus the high-level plan became:

With that plan, we decided to try integrating with FileMaker first: There were more moving pieces with that – authentication, pushing to multiple tables, figuring out how to even enable the API (we had to upgrade FileMaker to get support for it), etc.

For the FileMaker integration, I looked at two libraries primarily: fmrest (Python) and fms-api-client (JavaScript). Although I’m better at Python, the JavaScript package was much better documented, so I decided to go with it. It took a few tries to understand the API, but overall a proof-of-concept of pushing dummy data into the server was pretty simple.

Final Architecture

Here’s the data flow we landed on:

Tech Stack Summary:

Battle Scars

Every tech project has at least a few foibles. Some of the ones we encountered:

Some Wins


What I thought would be a small project actually became a pretty mature software project. I needed some additional time after getting back to polish it, and since then Danny has also wanted to extend it to handle more fields. I’ve been mostly hands-off for this – I review his code, and we’ve had lots of conversations about programming, version control, testing, etc., but he has been the one making the changes.

As I think about the impact, I am really excited that Ethiopia ACT can use this project to better serve hundreds of families in Addis Ababa. It’s also been very exciting to see the skills Danny has developed from continuing on this project (e.g., Git, VS Code, Node.js, etc.) and to get to continue to work with him, including our occasional early morning calls over the past year (early morning in Pittsburgh is afternoon in Africa).

Danny also told me that this project has made the field workers more connected with the administrators and managers, which was encouraging to hear. I look forward to seeing how the Lord uses this in 2021 and beyond!

In the long tradition of writing a “Hello World!” program to learn a new language, I decided to title this post about writing a program in (and for) Africa, “Hello Africa!”

  1. This helps the project track the movement of families over time – as areas grow up, the poor are often forced to find other housing 

Posted on 23 Dec 2020.

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