1. Introduction
GoK (National Kenya government) has contracted various companies including Huawei for provision of National fiber infrastructure; Phase 1 was done by 3 companies while phase 2 is mainly being done by Huawei under ICT ministry

Small part of phase I infrastructure was destroyed under road expansion projects as a part was washed away by heavy rains.

In phase 2 fiber connection to all sub -county Headquarters is under way .; Each sub county HQ has equipment capable of providing data services to health centers, schools and other county facilities. This implies that any hospital can easily and reliably connect to and other hospital worldwide / GoK medical cloud service. The provided bandwidth is able to deliver high quality voice, data and video services like video conferencing and training.

County HQs have a metro fiber ring connecting county service offices .This is for example; Hospital, works department, agriculture, colleges among others. Inter- county and HQ connection via DWDM ring plus mesh protection from Safaricom and Telkom Kenya
The project ensures there is a provision for connecting county health, education and administrative facilities along the fiber infrastructure route and not just in the towns. This is inform of a manhole and even does road crossings to the facility.

2. Projects value to E-Health
Barriers to the implementation of e-health or Tele-health are; lack of funding to develop and support tele-health programmes, a lack of infrastructure (equipment and/or connectivity), competing health system priorities and a lack of legislation or regulations covering tele-health programmes. This project addresses the infrastructure concern.

For the counties/country to fully tap into the national optic fiber infrastructure (NOFBI) there’s needs to utilize health funds more efficiently by following engineering methods in medical systems supply. Surveys, user and technical specifications, detailed technical evaluation of bids, warranty and training is key. New equipment need to be ICT ready as per current trend .Remote medical equipment diagnosis and maintenance is possible and issues of dead equipment should never arise.

The many jobless Kenyan Engineers need be assimilated in the medical industry for design efficient utilization and maintenance of medical equipment. E-health is able to assist in below items;

1. The remote diagnosis and treatment of patients by means of telecommunications technology is part of Telemedicine. This implies a specialist In Kenyatta or Eldoret referral hospitals can assist and general doctor country wide in emergency cases using this GoK fibre infrastructure.

2. EHR system (Electronics health records) is able electronically collect and store data about patients, supply that information to providers on request and permits physicians to enter patient care orders on the computer,

3. A medical data base with much ICT incorporation will assist in:
Monitoring of hospital drugs; A county will be able to monitor when drugs are required for top-up are even likely to expire and ensure dynamic drug re- distribution within county/inter-county.
Equipment utilization can be optimized through a booking system with efficient maintenance programs of county/national/inter-county equipment.
Open system for suppliers with transparent tagged products and minimum stock holding risk for counties.

4.Smart phone/ smart watches based M-health apps are now available , The fiber infrastructure will go a long way in improving health care in rural areas ; With influx of IoT (internet of things) many health equipment sensors will be connected to the internet enabling doctor/hospital ICT systems to monitor patients remotely.

3. Network availability
Back to the infrastructure; E-health infrastructure may risk life of a citizen. If a disconnection occurs as a remote doctor is doing assistance it may lead to a patient death. Network quality standards dictate 5 nines network availability i.e.
99.999 % network availability i.e downtime is less than 6 minutes per year. GoK has strived to attain high network availability via:
Fiber infrastructure improved availability via ring or mesh protection; for example if fiber connection to Mombasa via Mombasa road gets cut; the network has alternative route via Thika –Garissa-Hola-Mombasa just as an example. Gok has approached TKL and SFC to fill in gap and provide alternative network links as a form of protection.

All core equipment rooms have been provided with stand by batteries and equipment well protected via sound grounding systems. If KPLC power is down standby batteries will take over.

Safaricom and Telkom Kenya are praying a key role in ensuring the investment is efficient through full utilization of the infrastructure and to avoid much investment duplication; http://www.ict.go.ke/fibre-optic-cable/.

Areas without high bandwidth have experienced better wireless data speeds after the operator utilized this government infrastructure.

Road markers and other fiber route protection methods
Even with alternative network routes more than one cut can happen at one go. In addition fiber repair introduces network losses which may kick link out Optical Power Budget .Site access often t take long if service teams are far away. Therefore it’s important to avoid any cuts at all costs. Along county roads one will notice road markers which indicate the fiber route /path. Road markers assist in avoidance of cable cuts from other road side utility users like water pipes and electricity ducts plus, road expansion contractors

Following experience from phase 1 GoK is closely monitoring slope protection to ensure fiber is not washed away by floods

Warning tapes.
To minimize cable destruction GoK has run a warning tape say at a depth of 0.3-

0.6 m. Bury Detectable Warning Tape is laid over underground utility lines, gas pipes, and communication cables and more to warn excavators and to prevent damage, service interruption or personal injury. The fiber cable will be a depth of
1.2 meters. GoK and Huawei runs quality checks to ensure the cable is not buried shallow but as per GoK requirements.
For previous projects GoK and network operators has undergone some losses after road contractors destroyed kilometers of fiber.

County Governments support.
All sub counties like Kathonzweni have provided very clean equipment rooms. Good operating environment is key for equipment reliability. For example a dusty room will affect equipment boards in terms of changes in capacitors, temperature and eventually cause board failures

4. Conclusion
Our Engineering graduates in Electronics, Computer science, Electrical, Telecommunications and data analysis need a chance to contribute to improvement of the health sectors through ICT. Currently medical equipment are procured without and consideration of ICT medical trends, standby power, maintenance, life cycle or any technical evaluation. In the media we have had cases where untrained personnel have caused deaths of infants following misuse of some equipment.

E-Health will assist in efficient utilization of scarce medical expertise and we shall see less of discarded medical equipment in hospitals some of which may have only minor faults. We discard equipment worth millions just because we don’t want to utilize a qualified graduate and pay him some thousands- https://www.standardmedia.co.ke/health/article/2001283816/leased-medical- equipment-lying-idle-in-public-hospitals – Our computer science graduates can assist hospitals in avoidance of expiry of drugs via production of tailored computer programs and provide mobile apps to assist remote patients health monitoring and prescriptions .There is need for more cooperation between various GoK bodies to minimize fiber cuts. Coordination in projects can enable commutation ducts and other utilities be incorporated in road or railway designs. This will save the country lots of infrastructure budget.

Appendix; Dense wavelength division multiplexing (DWDM) is a technology that puts together — multiplexes — data signals from different sources so they can share a single optical fiber pair while maintaining complete separation of the data streams. To achieve high capacity.

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