USA-Cuba InfoMed has been very active in 2000, and 2001 will mark the beginning of a change in our emphasis. This report is intended to describe what we've been up to, and where we need to take it from here.

But let's start off by saying, hey, we had an asskicking year. The major points to bear in mind are that we shipped not one but two full size containers between mid-September and the end of October (yes, that's right, 80 feet of container loading in six weeks!), that we now have a workshop in Oakland as well as in Santa Clara, that we've really come to the end of the line as far as trying to ship 486 hardware in all but a very few exceptional cases, and that we need to try to be technically smarter about targeting our shipments. If you'll read the "Future Plans for Infomed" section below, we think you'll agree that we need to start working more effectively to raise funds. Oh, yes, we have our own domain name now, too!

Update contents:

Computer Repair and September loadout

Donation of Network Equipment

October Shipment

Oakland Workshop

InfoMed Group Tour

Second World Friendship and Solidarity Conference Report

Future Plans for InfoMed

On September 16, we shipped out a 40-foot cargo container which had most of the machines we'd worked on in the Bay Area during the year inside it. These machines reflect the beginning of our shift in emphasis toward better computers, and we've begun working toward more rigorous quality control on what we're shipping. In particular, we're running detailed diagnostics on every harddrive we send, since we've been told that many of the drives fail in transit. By sending out known error-free harddrives, we hope to get a handle on when the problems with the drives arise.

The container loaded on September 16 included:

Over the next year, as this year's crop of computers are distributed throughout the network, we'll be working closely with Infomed to set our targets for priority equipment, but initially it appears we need to focus on two areas:

  1. well-tested pentium class machines
  2. networking hardware, from ethernet cards and modems up through an ambitious radio modem plan, which will allow us to connect computers in rural clinics to the central network, bypassing the telephone network entirely. We're very excited about working on this.

One "bonus item," of far greater use to Infomed than we'd anticipated, were older VGA-to-television adapters. While no longer popular for presentation work in the US, these are fantastic for Infomed, especially since one of their foci is training. It's very handy to be able to display work to a large group of students in an auditorium on television monitors, and as many of the auditoria already have TVs for lectures, these adapters turned out to be a wonderful thing.

The moral here is that we're interested in peripheral devices as well as computers - and it's especially helpful if some group is planning on upgrading a lot of them at once, as then the Infomed staff can more quickly deploy them.

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In July 2000 a major manufacturer of network equipment contacted us for the purpose of donating laboratory equipment they had been using to model their customers' installations for diagnosing and solving problems. The company was changing its product line and therefore donated a very large quantity (325 pieces) of routers, switches and hubs mounted on 41 wheeled racks. David Wald and Tom Seccombe picked up the equipment in the South Bay with the assistance of the donor and Dave, Tom, and Ed Biow heroically unloaded it, got it - in racks and in record time - up a flight of steps to store at the Oakland facility. (Yes, racks up steps - look, ma, no ramp!)

Near the end of October we loaded and shipped our second container. It carried primarily the network equipment (routers, switches, hubs) and many spare parts for this equipment. Prior to shipping, Dave Wald, Ed Biow and Peter Bell spent many days working through the racks in which the equipment was donated, being sure that the delicate gear was as securely fastened in place as possible. This material will allow a major expansion of the InfoMed network to cover many more hospitals and medical schools. A total of 325 major pieces were sent - a very valuable shipment.

The container also carried 97 Pentium and 486 computers in various states of repair. We would have liked to have had the time to thoroughly vet these machines but together with our colleagues at Infomed decided that its value as sources for spare parts was higher than waiting on shipping it until we'd gone through it, since the networking gear didn't fill the container. Additionally, the container had direct medical aid aboard as well as scientific journals. This shipment arrived in Havana via Montreal on November 30.

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In the spring of 2000 the Alameda County Computer Recycling Center (ACCRC) and their landlord invited us to occupy a space in a large commercial building in Oakland (5725 International Boulevard.) We set up a worksite in a single large room, with Peter Bell in charge. Other volunteers include Ed Biow, Lindsey Frank, Toby Phillippe, Rita Barouch and Carolyn Doherty.

This has been useful for all our volunteers who live in the Oakland-Berkeley area. It has also been invaluable as a temporary storage space for larger items; since the part of the building we are in is currently under renovation, the owner was kind enough to let us store the network hardware there.

Our relationship with the ACCRC has been a highlight of the past year. The CRC has donated approximately 150 computers to Infomed, and the ACCRC staff have been incredibly nice about helping us suss out problems with the space, with recalcitrant computers, and pitched in to help us load the router container. We greatly appreciate all of their help.

Recently, the owner sold the building. The new owner, with a large debt, is hoping we can pay for the space. We may receive a 30-day eviction notice in the next half-year, but we're hoping that we can work out an arrangement between our group, the ACCRC and the new owner which will let us stay. Ultimately, we hope to be able to relocate to a site in Hayward which is being developed by the current building's original owner and will have the ACCRC as its primary tenant.

During the weeks leading up to the shipping of the network equipment, a total of approximately 150 hours of time was donated by three volunteers in the course of two weeks or so. The amount of work that got done in that time was great, but it presents a problem to our organization: if we're to be able to take advantage of large donations in the future, we need to be able to get people to come in and donate a lot of time on very short notice. We think Project Infomed needs to have some grant money at its disposal which would let us compensate people for being able to set aside their ordinary work like that. But we would like to avoid being placed into the role of "employers" as the paperwork would be unmanageable. We will be exploring grant funding for some aspects of our work (being able to bring people in, as well as getting our feet wet in radio networking in Cuba) in the coming year, and recognize that we may be hovering on the brink of moving from a purely volunteer organization to one which is primarily a volunteer organization. We would acknowledge any organization with an interest in funding technical work. If you are interested in either sponsoring technical time or in helping us locate granting agencies, please get in touch with Peter Bell, webhead@cubasolidarity.net.

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On November 5 our InfoMed Group Tour of Cuba began with the arrival of our delegation of 35 infomedistas, 21 from the Bay Area and the rest from other parts of the US.

The proceedings officially began on the Nov. 9 when our US delegation hosted a dinner party for the entire InfoMed staff of 120 people and their spouses or guests, in addition to our 35. The dinner was held at the Colibri restaurant, a property of CIREN, Cuba's neurological institute. It was a memorable occasion, attended by the Ministry's new Vice Minister, Yamila de Armas. She is an avid supporter of InfoMed and is working to make the InfoMed network a valuable and recognized institution within the Ministry of Public Health.

In the days following the dinner party our delegation was led on a tour of the InfoMed building on 27th Street and was shown the command center and how it functions. Some of our personnel held strategy sessions with the leaders of the National Center for Medical Sciences Information and the InfoMed Project where current status and future plans were discussed in detail.

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Our group tour to Cuba was timed to include attendance at the Second World Friendship and Solidarity Conference, November 10- 14. The first one was held in 1996 for the purpose of enhancing and solidifying world support for Cuba in its hour of need. This Second conference brought together 4,200 people from 1 14 nations, a truly impressive sight.

The conference was organized to include three plenary sessions in Havana's Karl Marx Theater and two days of Committee sessions at the Theater and the International Convention Center in western Havana. In addition there were three Optional Visits organized to bring the world delegates to visit three institutions that have special significance for the Cuban people and its internationalism.

V.P. Carlos Lage
The opening plenary session (Friday, Nov. 10) featured a speech by Carlos Lage, Vice President of the Council of State. Dr. Lage, a physician by training, is charged with directing economic policy of Cuba. He delivered a thoroughgoing explanation of Cuba's economic policy, its background, its current status and its future. He explained how Cuba had inflicted a strategic defeat of the blockade by surviving and by then turning the economy around with an average growth rate of 3.2% over the last 5 years (7.2% in the most recent year.) Most importantly, he asserted that Cuba will never abandon its socialist agenda of never leaving any Cuban behind, as is unfortunately the case with almost all developing countries. Even if the growth of the economy could be accelerated by opportunistic foreign direct investment, Cuba would reject that path.

National Assembly President Ricardo Alarcon
Following Dr. Lage, the delegates heard a speech by Dr. Ricardo Alarcon, President of Cuba's National Assembly. Alarcon, who had been deeply involved with negotiations in New York over Cuba-US immigration policy, the Elian Gonzalez affair and other delicate matters, described the history of diplomacy of Cuba vis-a-vis the United States. His presentation was the epitome of lucidity and illustrated Cuba's high morality in international negotiations while demonstrating the convoluted and hypocritical stances taken by the US State Department in many of these encounters.

Minister of Foreign Affairs Felipe Perez Roque
The following day, November 11, Cuba's Minister of Foreign Affairs, the youthful (age 35) Felipe P6rez Roque, informed the audience of recent diplomatic initiatives by Cuba. In particular he described the very recent ballot in the United Nations General Assembly where, for the ninth straight year, that body voted in favor of the Cuban resolution (first introduced in 1992) to condemn the US blockade of Cuba. This year the vote was 167 to 3, with only 4 abstentions. (The U.S. and Israel were joined this year by the Marshall Islands, a wholly-owned US subsidiary in the South Pacific with a total population of 68,000.) P6rez Roque described his work as Cuba's top diplomat in successfully reaching agreements with many additional nations of the world, enlarging the list of Cuba's friends on the globe.

Committee Sessions
Following these major presentations the Committee Sessions were held: Comm. #I "The Blockade", Comm.#2 "Information" and Comm. #3 "Sharing Experiences." These sessions were held simultaneously and each was charged with the delegates discussing these issues, relating their experiences and outlooks and recommending future actions. Each session was chaired by a rapporteur who gathered up the gist of the delegates' inputs and prepared a report for the Final Declaration of the meeting.

At the "Sharing Experiences" Commission (#3), Juan Reardon spoke in the name of USA-Cuba InfoMed. After describing briefly the work of our group, he presented some ideas prepared in collaboration with Dave Wald. The central concept of the speech was: The US-based Cuba solidarity movement must do something it has not yet done: It has to bring the issue of the blockade of Cuba to the mass movement that emerged since Seattle 99 against corporate imperial globalization. The political and practical movements against the blockade must, in turn, contribute to the overall war against neoliberal globalization. It's a symbiotic relationship between the two movements. We have to contribute to the movement against globalization and educate it so it incorporates the issue of Cuba into its demands. This will multiply the effectiveness of both efforts. The points were well received by many participants.

At the Closing Session, the curtain was raised to the sight of President Fidel Castro on the platform. He addressed the delegates in a marathon speech that ran from about 7pm to 12:30am. He ranged over many topics, including a detailed explanation of how speculative finance capital had brought about the impoverishment and collapse of many Third World economies. He declared that Cuba's economy, while not booming, was stable and growing because the nation chose to stay out of the quagmire of neoliberal globalization. Cuba is not subject to the IMF's Structural Adjustment Programs of imposing austerity on already poor population. He promised, as did Lage, that Cuba would continue on the path of slow but steady growth of its economy but focused on the difficult task of ameliorating the inequalities brought about by the dual currency economy, dollars and pesos. He said that the convertible peso would gradually succeed in removing the disparity between Cubans with access to dollars (remissions from abroad and earnings from tourism.) and those having only pesos.

Perhaps his most significant addition to the proceedings was his announced plan to significantly raise the cultural level of the entire Cuban population, beginning with a campaign to teach Cubans two foreign languages, English and one other. As part of this, Cuba is already implementing a plan to use instructional TV to telecast English lessons by foreign language teaching experts, complete with a detailed syllabus widely available for the cost of a newspaper copy. These telecasts now take place at 7am and 11 pm, not an optimum schedule but designed to fit in with regular scheduled telecasts. Some opine that, ultimately, a third TV channel will be required to adequately carry out this agenda.

With that as a basis, the president declared that his objective was to create a population who had genuine understanding and appreciation for the arts, literature and the sciences as well as an understanding of the reality that distinguishes a civilized people from those suffering from cultural underdevelopment.

The sight of incipient traffic jams in Havana alone give evidence that the Cuban economy has turned the comer and is on its way up. People seemed better fed, more relaxed and happier than at any time in the last 5 years. Tourism was in high gear with 2 million expected in 200 1. The two tier currency system is still a thorn in Cuba's society. The government does not sweep this problem under the rug, but takes necessary steps to ease it.

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Several meeting were held in which USA-Cuba InfoMed visitors exchanged ideas with the Cuba InfoMed folks. Dr. Ojito and InfoMed Director Pedro Urra expressed great appreciation for our efforts to support the network. Because of genuine progress in network technology in Cuba, the standards for InfoMed were being raised. Better computers for terminals were one of the changes proposed:

  1. We need to phase out our shipments of 486's (except for high quality computers in groups - that is, ten or more identical 486's.)


  2. Generally, only Pentium computers are useful to Infomed. Shipping costs on containers are high, and Infomed can obtain machines in small numbers through commercial vendors, so our donated machines have to be solid and new enough that it's worth everyone's effort to ship them. Our current export license covers machines up to, and including, 166MHz, but our application for license to cover 20OMHz is currently pending in the Dept. of Commerce.


  3. We were encouraged to send more computers from the medical institution in Jacksonville, FL since the first 70 Pentiums from that source were highly satisfactory. We are expecting more from that source but have not been assured of that yet. Dr. Anthony Kirkpatrick of Tampa, FL has made his first flight by private aircraft, delivering medical supplies plus some portion of the 14 Pentiums which we have supplied to him. We regard these flights (19 more have been approved) as an instrument in struggling against the blockade of Cuba.


  4. Urra described InfoMed's most pressing problem at the moment as one of greatly increasing bandwidth into the country as well as within Cuba. The demand for online service has outstripped the available bandwidth and we are examing means of alleviating it without incurring exorbitant fees for the Ministry of Public Health. Among these is the use of satellite technology. For this, there are problems of possible restrictions by the US government in the delivery of the service by US companies as well as in the shipment of the necessary receiving equipment.

  5. InfoMed demonstrated radio modems while we were visiting. Deploying radio modems is part of a long delayed plan to bring network access to those remotely located doctors who are without telephone access. Using a radio link, a doctor can receive text data and can communicate via e-mail with her medical colleagues. The packet radio technology and the satellite technology can be combined. To get started on this project, we'd like to try to obtain up to 70 radio modems. Currently, these seem to be expensive items - approximately $250 apiece.


  6. With such an increase in traffic and subscribers it is more important than ever to have a secure backup power supply for the network. The present uninterruptible power supplies only allow for 15 minutes of network operation. We have purchased a surplus diesel generator set and are getting ready to ship it as soon as we can.


  7. Advanced modem cards are desired to replace the present rack mounted modems. This will add much needed capacity intemally. Unfortunately, these are expensive. We hope that the hardware which was delivered at the end of November will address this need.


  8. Conventional computer modems are needed for many of the machines donated and already in place. 14.4 and above hardware modems - not winmodems, which require higher performance CPUs - are needed for any machines we donate this year and to replace older modems already in place. We'd like to have 250 or more by the end of the year above and beyond what we install in computers we ship.

  9. Hard disk drives are needed in fairly large quantities - several hundred are needed in the short term. We are looking around to see if we can find a relatively inexpensive supply of working hard drives with capacities in the 1-2 gigabyte range.


  10. A supply of 72-pin RAM is needed to improve performance of all InfoMed computers. Most of the 486s and pentiums we've sent can use one or another form of 72 pin RAM; unfortunately, since many machines in the US also still use (or can use) 72 pin RAM it is another item which may be hard to find in quantity as donated hardware.


  11. Director Urra raised the issue of increased collaboration between medical informatics centers in the U.S. and Cuba's InfoMed. The upcoming CRICS V conference of medical information specialists in Havana (April 25-27, 2001) is an ideal opportunity to foster such a relationship. Stanford University has a well-established medical information unit which we've worked with before. We expect one or more of their staff will likely attend CRICS V, as well as at least one of our Infomed volunteers. Urra is scheduled to visit us in the Bay Area some time in January, an opportune time for him to visit with the Stanford people.


  12. In discussing the condition of the computer equipment which we have been shipping to InfoMed we learned that a disturbingly large percentage (up to 25%) of computers and monitors were non-functional upon arrival. Particularly vulnerable have been the hard disk drives. We think that the extended periods in which the equipment was confined to the cargo containers, under conditions of high temperature and humidity, are the cause of most of the failures. During this past year, we've begun more rigorously testing harddrives prior to installing them. We hope to learn soon whether the machines in the most recent shipment of tested computers have better hard drive survival rates. If drives we knew were in good shape before shipping are continuing to fail, several ways to address the shiping and storage problems might be tried:

We shall be acting on these options in our next shipment.

With this array of needs for the InfoMed network, our future plans go well beyond gathering and shipping PC donations. The agenda outlined above will require some significant funding - beyond our present capacity. Any ideas, suggestions, offers to write grants, offers to solicit funds from the more affluent members of our society or offers to donate funds made by those of you who can afford it will be vital in our achievement of our goals.

We hope that our infomedistas and supporters will take the time to make a conscious effort to think creatively about how they can help us with this. We are talking about at the very least $15,000 to $20,000 above and beyond our normal operating expenses. We're hoping to begin a grantwriting phase in 2001 which will secure us a more permanent operating budget, since to fully implement our goals for the year would likely involve something on the order of $50,000 above our regular budget in hardware costs. However, such grants may not come online until 2002 - we're somewhat spavined by our own success at having helped Infomed install such a large group of computers - the Infomed network is now well over 2000 computers!

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