• OCHO

A DIGITAL BRIDGE

By Dan Medani


Deep in the mountains of northwest Honduras is the small but lively town of Atima. Home to a few thousand farmers, coffee growers, teachers, and students, Atima has been hosting OCHO’s annual medical mission to Honduras since 1999. In the central square of the town is a small school for children with special needs, a one-story adobe house with two rooms and a garden out back.  Four unpaid staff members work at the special-needs school in their free time, when they’re not at their day jobs, teaching at the local elementary school down the road.  Together, they provide rehabilitation services to special-needs students to help them and their families cope with the physical and mental challenges of living with a disability, and to make their lives as comfortable as possible.  It is a labor of love for these four caring and energetic teachers – astonishing people who are totally dedicated to their students, and make creative use of the scant resources available for their work.


Over the last six years, since OCHO began working directly with the special-needs school, the number of students identified in the community has grown to 201. The word is out: Atima has become known in the region as a place of healing for disabled children.  Many of the kids are now filtering in from nearby towns, some over an hour’s walk away.  With the school rapidly outgrowing its humble setting, last year OCHO signed an agreement with the local government to share the cost of building a new special-needs school, one that could handle a larger volume of patients.


OCHO’s occupational therapy (OT) team, led by Kristin Stubbs-Brockmeyer and Myrna Pittaway, helps the special-needs school in several important ways:

  • distributing donated wheelchairs, walkers, crutches, and other physical therapy devices to patients;

  • providing consultations and medication to patients in the school; and – perhaps most importantly –

  • training the special-needs staff with all the professional knowledge that comes from working full time in special-needs therapy in the United States.


During our one-week stay in Atima, the OT team will see a large number of patients, but the real help comes from the training sessions, which help the staff to be more effective for the remaining 51 weeks of each year.  While the OCHO team is in town, the teachers work long hours alongside the visiting U.S. clinicians, observing their sessions with young patients.  For the teachers, it’s a chance to sharpen their diagnostic skills and learn new therapeutic techniques.



It’s very important that the staff at the school have a way to communicate with OCHO’s occupational therapy staff after the Americans have left town – this is the key to making OCHO’s support effective year round.


In recent years, the OCHO team has continued to consult with the teachers and share expertise via email – but internet access remains expensive in Atima, and public access is both limited and extremely slow, making it hard to keep these lines of communication open.  Real-time video conferencing, for example, remains out of reach for the moment, but the current level of connectivity even makes it difficult to share photos and video effectively.


These internet connectivity issues are a subset of a larger problem – the lack of a well-developed digital infrastructure in Atima. The town of Atima has had the internet for only 5 years, and even a moderately fast internet connection is hard to come by.  Although Atima’s teachers have only recently had access to internet-connected devices, they only have access to relatively old and slow computers – some working better than others.


What’s most conspicuously lacking is the crucial knowledge that’s often taken for granted: basic computer literacy.  For the average American who has grown up in the digital age, interacting with a computer is second nature.  We’ve internalized a set of actions that we don’t even have to think about any more, like:


  • Single- vs. double-clicking; When do you single click vs. when do you double click?  Is there an easy answer for this across all applications?

  • Right click vs. left click vs. middle click.

  • Dragging and dropping (Imagine writing the instructions for dragging and dropping: Click the left mouse button down on the item you wish to drag (but only some items are draggable), and then, while keeping the left button down, move the mouse slowly towards the area you want to drop it (but only some areas are “droppable”), and if you reach the end of the mousepad then you’ll need to lift up the mouse while still keeping the left button clicked and move the mouse in the air over to the over side and then put it back down, again still keeping the mouse button down, and then try moving it again towards what you hope is a droppable area.

  • Using the mouse and/or the arrow keys to navigate through “active” text, so that you don’t have to erase an entire sentence just because of a typo in the first word.

  • Using Shift, Ctrl, Alt, Caps Lock.

  • Typing with all ten fingers efficiently.

  • Not putting spaces in usernames or passwords.

  • Opening an internet browser and typing in a URL.


These are just a few of the skills that we need to share with our partners in Atima, to facilitate better communication.  These, and probably a whole bunch of others that I can’t conjure up right now because they are too deeply engrained in muscle memory.  A modern web application like Google Drive seems to be self-explanatory, and for us it mostly is.  But it is far from a trivial task for the untrained computer user – there are hundreds of small algorithms and rules of thumb to keep in mind when using an application. So we started from the ground up, from opening the browser to naming a new document, always being careful to consider the volume and straightforwardness of the information we were teaching.



In sum: even though there were limitations with computing power and internet bandwidth in Atima, the most pressing difficulty – and the most solvable – was the lack of computer training.  Hook a remote village up to the internet, and change doesn’t just happen over night – it takes time and explicit training.


This year, during our stay in Atima, OCHO’s technology department held a series of bilingual lectures / laboratory sessions with the four special-needs teachers to train them in basic data sharing to and from the U.S.  The training sessions were led by Aidan Kirchgraber, a high school student at Friends School of Baltimore, and the writer of this article, a software developer who works at Yelp/Eat24 in San Francisco.  Each morning of training, we gathered in the computer lab of Atima’s elementary school, an air-conditioned paradise in the hot Central American sun, and presented some practical basics on how to use Google Drive. After a short break, we held a laboratory session where we put the teachers’ skills to the test.


Specially, we gave lessons on:

  • Accessing Google Drive

  • Creating and editing documents

  • Creating and editing spreadsheets

  • Uploading files

  • Uploading pictures from an iPad


The presentations and the lab sessions were given bilingually, with Aidan serving in the key role of English-to-Spanish translator.  The lab sessions typically involved a list of tasks to complete – login to Drive, navigate to a sub-directory, create a document, etc. –  and it was fun to see the teachers work together to accomplish these tasks. One moment in the lab that particularly stood out was when all four teachers were editing the same spreadsheet on google drive – their faces lit up when they realized that they were all overwriting each others notes, and a small argument broke out.  It was a powerful demonstration of the internet in action.


By the end of the week we had held four training sessions, which were hard work but a lot of fun. Keeping a strong line of communication between the CRIC school in Atima and our OT staff in the United States is key to unleashing the full power of our service, and with this training, the distance between Atima and the U.S. just got a little shorter. We are all looking forward to a year of fruitful collaboration across borders.


p.s. Be sure to check out Café Ocho’s fresh new digs at www.cafeocho.org.

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