Wednesday, December 23, 2009

Camera Choices

I received a pre-Christmas note from a friend on which camera to buy and I thought about it and wrote back. FWIW, I'm sharing my thoughts ...



On cameras, the brand I've worked with is Canon. It's been good. I went there because I thought the digital color was strong and pro usage is pretty extensive ... though of course there are flame wars between Nikon and Canon. Both brands offer exceptional options. Here's what I've looked at and work with --

Point and Shoot -- the top rated two options are the Canon G10 (now the G11) or the Leica D-Lux 4. I bought the Canon G10 for about $500 and subsequently lusted after the Leica for about $700. (The Leica has some awesome image quality for a small camera and a certain elite appeal.) However, as I got used to the Canon, my lust faded. Leica, while nice, is too "precious" ... not as sturdy as the Canon, no auto lens cover, a little harder to set. The Canon G10 or G11 gives you a lot: Great image quality, the ability to shoot in RAW format (and, subsequently, edit/post-process native image files without loss of quality ... this is really important to me). Plus it has a pretty bomb-proof metal case and feels okay in the hands.

On the digital SLR, there are a lot of options. I started with Canon's Rebel for about $500, and moved up to the 5D (which cost new about $3,000). But, really, many Canon SLR bodies will be just fine, particularly as you get started. The key thing that makes the difference is the quality of the lens. The kit lens I got with the Rebel was pretty weak, about a $100 thing ... the images were never very sharp. My first higher end lens was the Canon 70-200 F4L, about a $600 deal (non-I/S). The damn thing delivers great results, all my shots at bike races (including candids) are from that lens, both on the Rebel and the 5D. Subsequently, I added the 24-70 F2.8L (the wedding "brick") and I'm probably going to get the 135 F2L before my next overseas trip. So, I'd recommend a reasonably inexpensive digital SLR like the Rebel or a used 20D or 30D, and spend more money on good glass -- which you'll keep using if you move the camera body up the food chain.

One advantage of the point and shoot is that it is portable and mostly self-contained -- e.g., it has its own flash, no need (or ability) to change the lens. The SLR is more complicated (and more capable, as you grow ... some pros, though, like Chase Jarvis think the iPhone is the best thing since sliced bread (mostly because it's easily ubiquitous ... if there's good light).)

There are lots of review sites out there. I think Fred Miranda is among the best -- http://www.fredmiranda.com.

So, these are my starting thoughts. Get something you like, that feels right, and shoot a lot. Henri Cartier-Bresson, my favorite photographer, said something like "Your first 50,000 shots will be bad, so get them over with." It's a great art form, and way to remember things you like, your family, the mountains.

The other piece of the equation is what you do after you take the pictures. I discussed this here.

Anyway ... I hope you have a great holiday and that photography brings you as much satisfaction as it does me.

Friday, December 18, 2009

Favorite 2009 Pictures

I probably took fewer bike race pictures this year than in past years, but I took more nature pictures. I think my quality settled down a bit. I had more fun. Here are a few favorites with comments. Originals are posted at http://images.jamesrwilson.com. You can click through pix to download high resolution or order prints.

Nathan at Fitchburg



This is my personal favorite. I like the black and white, the contrast of youth and harsh context. My son Nathan following a national-level road race where he fought to win second, solo, against the powerful Hot Tubes squad. A couple months past his 18th birthday. Nathan is an exhausted but matured warrior here, something I mark as a turning point. Nate continued the 2009 season to set ever higher marks, achieving Category 1, winning big races, besting pros, and riding to a silver at the USA Junior championships.

Chris Kelley at Kelley Acres Cross



I've known Chris over the years and been fortunate to grab some nice images. I like the ethereal lighting and how Chris's beauty and wisdom penetrate. Outdoors on her farm.

Andy Wulfkuhle at Capital Classic Cyclocross



This is "Bad Andy" Wulfkuhle, 2009 Pennsylvania Cyclocross Champion. (Apology -- I had mislabeled him as Wes Schempf in an earlier post.) I like this gritty image.

Joellen and Pam Mauch at Reston Town Center



Mother and daughter in the rain. I like this pairing, generational beauty with a sense of both je ne sais quoi and knowing.

Bobby Phillips at Turkey Day



The Baltimore Bullet is one of the winningest cyclists to grace our region. A friend, one who has given much. This shot is of Bobby as he memorializes his mother and father at the start of the annual race he hosts in Maryland.

Middle Child at Wilmington



This reminds me of a Sally Mann picture. The girl looks defiant and perhaps angry, her brothers watching the bike race, her mother laden with her next sibling.

Young Racer at Tour de FCCC



I like the lighting and color balance with his one, the strand of hair (click through to zoom). I recall that she won her class. Beautiful.

West Side Road, Mount Rainier, Nisqually Bridge







This was an important part of a journey for me, some time off in raw nature. I wrote a blog post on this.

Deschutes River, Mount Bachelor (USAC Nationals)



This was one of those virgin nature shots, refreshing. I grabbed it after an 80 mile loop riding around Mount Bachelor in Oregon. Makes me want to drink the cool water, put on my backpack and head out.

Ethiopia Healthcare Network

My next big round of photography comes in January 2010 when I travel to Ethiopia. I'll be working (volunteering) for the Ethiopia Healthcare Network charity and related programs in Addis Ababa. Below is a favorite shot from my Ethiopia work in 2007. These children in Dukem are yearning for (and need) healthcare.



Have a wonderful New Year! -- Jim

Questions for LeAlem

I'm conducting a site visit to LeAlem Higher Clinic in Addis Ababa, Ethiopia, on January 17-31, 2010. This is a scratchpad of thoughts for that trip, with background and draft vision and questions. Comments or suggestions on this blog, at Facebook, or email to me are welcome.

Background

We founded Ethiopia Healthcare Network (EHN), a 501(c)3 non-profit, in December 2008 and started the LeAlem project in October 2009.

About two years ago, in November 2007, John Wimberly and I visited LeAlem and met its medical director, Dr. Alemayehu (Dinku) Gebrehiwot. When a clinic construction project we were working on -- the "Clinic at Dukem," south of Addis -- became ensnared by local politics early in 2008, we turned to Dr. A. to consider a different approach. We shifted from infrastructure development to healthcare delivery, in order to more immediately provide benefit to needful patients.



Dinku (pictured above) is an amazing individual. He regularly works 12-14 hour days, seeing many tens of patients. He is noble, dedicated, smart and humble. With EHN support, LeAlem serves 100 additional patients each month, patients who cannot afford and would not otherwise receive professional care. EHN's October 2009 grant enabled LeAlem to hire an additional doctor, social worker and nurse.

Our focus is mothers and children who do not have access to professional medical care. We do this because it concentrates resources and will help us achieve excellence, and because we believe children and their mothers are the seed corn and binding force of a community. As EHN grows, we'll likely have projects that support more broadly-based community healthcare, particularly in rural areas.

This is a long-term effort, and we are only at the beginning of the beginning, a couple months into our first project.

Vision

EHN is fortunate to be headquartered in Foggy Bottom, Washington, DC, near the White House and blocks from the State Department, international development organizations, and a major university and medical school. EHN's Board is an exceptional team of experts, individuals who were born in Ethiopia, generous patrons, and well-connected professionals.

We envision the EHN "network" drawing upon resources in the Washington area and helping them to deliver value -- charity, healthcare -- a continent away, in a place orders of magnitude less fortunate. Beyond leveraging DC resources, in the long term we envision EHN clinics and projects across Ethiopia networking, working together and with regional resources, NGOs, government and other organizations to provide care, alleviate suffering and improve outcomes.

So what's next? We have started a project that is delivering meaningful results (see link), at low cost. My focus and line of inquiry for the LeAlem visit will be on how we can help, how we can enable. How can we better serve the great mission of delivering medical care, relieving suffering, and improving outcomes -- while responsibly stewarding EHN resources and talents? What shared vision can we develop and support?

While in Addis, I will meet with Dinku at length and meet with all the staff supported by EHN. I will shadow Dinku and his clinic, open to close, observing activity and interventions, and develop anecdotal case studies describing EHN-supported work and challenges.

In addition, I'm scheduled to meet with NGO and government officials, and tour a few other medical and social work centers, including Biruh Tesfah (Bright Future), which cares for displaced girls and women, many from rural Ethiopia, and helps them develop skills and gain traction in the urban economy.

Questions

Here are draft questions to explore at LeAlem. These will likely change based on research, feedback from partners, and cogitation.
  1. What is Dinku's vision for program expansion? How could we help with next steps? What are the limits of LeAlem's current capacity?

  2. Could Dinku envision working as a center of the EHN network, with additional clinics in Ethiopia, locations in Addis as well as rural areas? What scenarios are plausible? Would others be willing to take on roles in this area? What resources would be required?

  3. How would we identify new projects? Do any new projects come to mind?

  4. Considering different time frames -- one year, three years, five years -- how might the LeAlem program evolve? What additional resources make sense? Could a telemedicine program, with specialists from GWU online, be feasible? Would it make sense to rotate med students in with LeAlem, perhaps in combination with the large Black Lion hospital in Addis?

  5. Who are we serving? Where do the EHN LeAlem patients come from? Where do they go? Do LeAlem patients need and receive follow-up? What are post-treatment outcomes? What degree of the EHN work is preventative?

  6. Are there meaningful, additional community needs to be addressed -- sanitation, hygiene, education, housing, clean water -- needs that severely impact the outcome of LeAlem patient care? Can we make a difference here? How? What partners or coalition?

  7. Who are our partners? Are we collaborating with local government agencies, NGOs, family care providers, other health care providers? Should we work to strengthen relationships like these? What are the risks and benefits?

  8. Given our focus on women and children, is there more we can do? Gynecological/urological expertise? Neonatal? What are the most significant problems for this population? Can we do better?

  9. What vaccine programs are available for children? Pneumococcal vaccine? Could we partner with or help form an immunization program for client children?

  10. How does LeAlem handle HIV cases? Is there a referral structure (e.g., PEPFAR) that works? Are we connected to a program to prevent mother-to-child transmission (PMTCT) of HIV?

  11. Are there elements that EHN's current LeAlem project is missing? Equipment, medicines, infrastructure, staffing, management? How could we be better? Are there parts that are inefficient?

  12. Are we measuring the right things? How is the patient case tracking data valuable? Research, trend analysis, publication, quality assurance, follow-up, grants, government reports, support for fundraising?

  13. How can EHN volunteers help? Money, politics, collaboration, clinical or technological expertise, NGO contacts?

  14. Does it make senses for Dinku and/or LeAlem staff to come to the US, for advocacy, training or other reasons?
These are a few topical areas, probably all weighty, we look forward to examining. Other logistical matters are well in play -- from lodging to setting up meetings in Addis with NGOs, diplomats and the like. Ideally, I'd like to return to DC with at least one or two pieces for publication, to help grow the charity.

The end goal, the site visit purpose, is to help EHN learn how it can do more to deliver care to underserved patients, efficiently and effectively, and to gain assurance that our resources and talents are being well-applied.

Wednesday, December 9, 2009

LeAlem Progress Report, November 2009

This is an extract of LeAlem Higher Clinic's November 2009 progress report, furnished under terms of an Ethiopia Healthcare Network (EHN) maternal and child care program grant. Located Addis Ababa, LeAlem is headed by Dr. Alemayehu (Dinku) Gebrehiwot, a specialist in pediatrics, obstetrics and emergency medicine

In summary, during the second month of operation, LeAlem exceeded numerical benchmarks set by the grant, caring for 103 patients. Ninety-two percent (92%) of the patients had annual income below $100 US per year; the balance of patients had annual income of $100-200 per year. Ninety-seven percent (97%) of post-school age patients were female.

Without EHN support, all patients would not have had access to professional healthcare. Patient outcomes were largely positive, alleviating suffering, treating disease, and supporting improved pre-natal and infant health.

Patients were treated for a diverse range of diagnoses, including pneumonia, head injury, reproductive complications, pregnancy, diarrhea/intestinal disorder, gangrene, hemiparesis, urinary tract infection, seizure, candidiasis, asthma, metastatic cancer, adverse reaction to anti-retroviral therapy (ART), and Parkinson's disease.



Ethiopia Healthcare Network (EHN) appears to have effected a highly successful launch of the LeAlem program. A more extensive quarterly report will be provided in January 2010. Additional assessment and case study data will be developed during an upcoming site visit.

Based in Washington, DC, EHN seeks further support and volunteers to enable measured growth in healthcare programs. Volunteer needs include fundraising, administrative, multimedia development and research support. For information, please see the EHN
web site or email info@ethiopiahealth.org.

Secure, online donations may be made at
this link. EHN is a 501(c)3 charitable organization; donations are tax deductible. Thank you.