Following the recent Ebola outbreak, there have been a number of investigations to ensure that we learn the lessons from this epidemic and use them to prepare for the next. This has included noted philanthropists such as Bill Gates and Paul Allen calling for governments and NGOs to use the epidemic as a wake-up call, as the next outbreak may be even more widespread.
One sector that is likely to provide a significant impact in future outbreaks is technology. With recent innovation in converging technologies such as mobile computing, mobile communications and broadband internet, it has been possible to trial a number of innovative approaches to epidemic response. Although technology has been used to assist in the fight against epidemics in the past, the recent Ebola outbreak has led to a step change in the level of focus from the technology sector.
Many are now suggesting we need to prepare for the next epidemic through the use of germ war games. A number of technical trials are already underway that could form part of this early response. By building on these technologies as suggested and initiating appropriate war games, we can validate our readiness for the next epidemic.
Technology cannot stop the spread of the epidemic but it can educate, warn and empower those on the ground and those that need to be aware of the situation to significantly reduce the impact.
There are four areas where technology has been used in trials during the Ebola outbreak that can be accelerated.
During an outbreak, clear messaging to the local population is vital to ensure they are informed and reminded to use appropriate precautions, getting clear information to the point most required. Thanks to Africa’s technological push for mobile phones, several NGOs have been able to spread the message highlighting the hazards of Ebola and how to avoid contracting the virus.
In a recent project, Text To Change was able to work in conjunction with Airtel, sending more than 1 million text messages to inform the Sierra Leonean population of ways to prevent the spread of Ebola. Programmes such as this are able to utilize the available technology to quickly reach the population with up-to-date information and, more importantly, quickly update it as the hazards change. It is through the use of these tools that we are able to reach a disparate population to make them aware of the issues and treatments for some of these diseases. It is important to note that, although technology and mobile phones are becoming more prevalent in Africa, the widespread use of smartphones is limited. The TTC and other programmes focus on using SMS texts to spread the message.
Technological advances in mobile computing are used to train health workers in the field. Tools such as the Oppia browser and e-buddi from the MMEI have been able to provide training directly to health workers on the ground. The benefit of tools such as this is that they can quickly deliver standardized learning, with the ability to be updated in the field as new procedures are validated. This replaces potentially conflicting training that is not widely disseminated or tested. Additionally, by using established communications links, training material can be tailored and tested with the health workers on site.
By using these tools, we are able to focus efforts on training the existing staff, health workers and local population to treat themselves long after the emergency support has ended. This will also have an appropriate knock-on effect on the general medical infrastructure in the region. At present, the penetration rate for mobile devices is much lower in the rural areas most in need of such advice and treatment, but this will change.
Much has been written about the growing connectivity capabilities within Africa and the developing world. Improved connectivity facilitates a number of technological advances and is a key enabler of the technical capabilities discussed in this article. There have been significant advances in this area, but access in rural locations is still limited. From our work in the region, this is the key tool that can bring both economic and health benefits.
During an epidemic, communication is a critical tool to ensure we can both spot the virus spreading early and make attempts to contain it by educating the local population. From an NGO perspective, it also provides a means of maintaining medical services through the use of telemedicine. In the recent outbreak, a number of facilities were effectively shut down as staff were evacuated, creating a secondary and potentially more damaging issue, as basic healthcare was no longer available.
Anything we can do now to ensure a stable communications network in region will have a significant impact in a future epidemic. The legacy these solutions provide to the beneficiary hospitals is also significant. As evidence that such capabilities can be provided in harsh environments, recently VSEE provided telemedicine access to refugees in Syrian refugee camps. By utilizing this technology in situ, remote areas will have the capability to continue providing health services following an outbreak.
Traditional means of providing bandwidth to remote areas using satellite technology are being augmented by Wi-Fi and 3G or 2.5G technologies. This is not the traditional solution in the Western world but, due to the expense of satellite-based solutions, these technologies are economically viable. Hardware solutions such as the BRCK have been developed and deployed in Africa specifically to provide mobile internet capabilities in situations with limited power supplies. This device provides internet access when the power is out, utilizing any remaining 3G communications links.
Real time monitoring
Several innovative solutions such as Epi-info VHF and EVDNet have been trialled to assist in the monitoring of any new virus outbreak. This is an area that has seen real innovation in using the available mobile capabilities in the region. The viability of these approaches will only grow with the increase in mobile penetration.
Innovations that are being trialled include examining data from mobile phone towers to track users who have been close to a known case of the virus. Other initiatives are being trialled that allow staff to electronically enter patients’ details as they are received at a medical facility, thus helping to provide a clear picture of the outbreak itself. These technologies leverage the communication capabilities others are trialling to allow clinics to be linked together and tracked centrally. Data from these tools are now being analysed with at least one hackathon being aimed at using the data.
These trials highlight the potential usage of technology, and the results are starting to show promise. With the next epidemic potentially just around the corner, it is imperative to continue pursuing these technical evaluations to ascertain which tools can be effectively used in the next outbreak. Technology will not stop the outbreak alone but, as has been shown, it can be an effective force multiplier that can be leveraged to aid in the detection and treatment of the next epidemic. We must continue pushing ahead with these evaluations, holding war games to validate which approaches are the most successful if we are to avert widespread casualties in the future.
The report, Managing the Risk and Impact of Future Epidemics: Options for Public-Private Cooperation, is available here.
The World Economic Forum on Africa 2015 takes place in Cape Town, South Africa from 3-5 June.
Authors: Jonathan Meadows, Chief Technologist and trustee for Masanga UK, and Hajo van Beijma, Founder and Partnerships Director, TTC Mobile
Image: Health workers rest outside a quarantine zone at a Red Cross facility in the town of Koidu, Kono district in Eastern Sierra Leone December 19, 2014. REUTERS/Baz Ratner