Aid workers in Liberia tried out a new tool this week to contain the world’s worst Ebola outbreak: the text message.
Using technology that can target mobile phones in a specific area, workers with the United Nations Children’s Fund sent texts to a group of Monrovia teenagers telling them how to sign up for Ebola alerts. The teens texted back questions, such as how can they avoid getting sick?
The back-and-forth is part of an urgent effort to use technology to help combat the virus. Aid workers say while the technology is promising, limited Internet and data connectivity in the rural areas of West Africa has become a significant obstacle.
“The system is frankly breaking,” said Lauren Woodman, chief executive officer of NetHope Inc., a nonprofit that is coordinating technology for aid groups in the region. “Our member organizations are telling us they may try and make a single phone call for hours. Text messages are being delivered two or three days later. Mobile payments for health workers are sometimes taking a week to process.”
Government agencies, international organizations and nonprofits are expanding the use of technology to help stop an epidemic that has infected almost 10,000 people, killing about half. Aid workers are using phones with Google Inc. (GOOG)’s Android to track victims, software to monitor Twitter and other social media to find outbreaks and satellite-based systems to connect rural makeshift hospitals to the Internet.
“Everybody’s trying to leverage technology in one way or another,” said Gisli Olafsson, emergency response director for NetHope, a Fairfax, Virginia-based coalition of 41 international organizations providing $40 billion in humanitarian assistance.
The text testing this week, for example, is part of an education campaign that will start in the coming days, Christopher Fabian, a senior technology adviser with UNICEF, said in a phone interview from Monrovia.
Organizations are working to overcome limited connectivity. Health workers in the three most-affected countries, Liberia, Sierra Leone and Guinea, are starting to receive mobile phones with an Android app. It allows them to log data about victims, such as their symptoms and locations, so virtual case files can be created.
“The apps allow for case investigations to be entered and saved on the phone,” Adam Thompson, chief executive officer of eHealth & Information Systems Nigeria, a Santa Ana, California-based nonprofit operating in Nigeria, said in an e-mail.
The app can be used without an Internet connection and then data will be uploaded when service becomes available, said Thompson, whose organizations provided similar phones to aid workers in Nigeria in a $14 million effort. In Nigeria, the phone app reduced reporting times for new Ebola cases by half initially, and then by 75 percent before becoming almost real-time, said Daniel Tom-Aba, senior data manager at the Ebola Emergency Operation Centre in Lagos.
For the other countries “we’ve not reached the scale where we can show or measure the impact,” Thompson said.
The Liberian government is using a system that captures the time and location of mobile phone calls made to emergency services, said Carl Kinkade, an information technology coordinator with the U.S. Centers for Disease Control and Prevention, which works with the government.
The system enables workers to analyze areas where assistance may be needed, said Estella Geraghty, chief medical officer for the Environmental Systems Research Institute Inc., which developed the software that runs it.
The company also offers mapping services and technical support, as well as software that can monitor and analyze Twitter (TWTR) and other social media sites for key words, Geraghty said.
“This is team science at work,” Geraghty said. “There is no one entity that can solve this alone. We need to gather expertise from many different areas and put these brilliant minds and technology to work.”
The Liberian government is testing a system that will allow clinics in remote areas to immediately receive lab results by text messaging so they know if a patient is positive for Ebola or not, said Kinkade, with the CDC. It can now take up to three days for lab results to be delivered to a clinic by car.
“It’s imperative that results get back as soon as possible,” Kinkade said in a phone interview. “If they know a case is negative, that person can be released. By releasing them you open up a bed and that allows somebody else waiting outside to come in.”
The International Federation of Red Cross and Red Crescent Societies is using software to send out about 2 million text messages a month in Sierra Leone about Ebola, said Robin Burton, a consultant for the organization.
The software notifies workers how many mobile phones are connecting to communications towers. Aid workers can draw a map on a wireless device of an area they want to send messages to and the software delivers the messages to phones in the defined location.
“The good thing about SMS text is that they can be targeted to specific areas and they’re retained on the phone,” Burton said in a phone interview. “People can also run and tell other people and they can take the messages and show other people who don’t have a phone.”
The system, known as the Trilogy Emergency Relief Application, was originally developed in response to the 2010 earthquake in Haiti and costs about $50,000 to operate in Sierra Leone, Burton said.
“It’s a relatively new idea around the world to do something like this,” he said.
One of the most urgent needs for aid organizations is satellite-based systems to connect to the Internet, said Woodman, with NetHope. Her group is working with the United Nations to send dozens of satellite systems known as VSATs to Sierra Leone, Liberia and Guinea.
NetHope has identified other equipment and devices it soon hopes to send to the region, including 1,000 Android smartphones or tablets for digital data collection and contract tracing, 300 laptops for rural health facilities, 200 satellite phones and more than 500 solar panels for charging laptops and phones.
NetHope also is doing an assessment of the communications infrastructure in Liberia and Sierra Leone to help develop longer-term solutions.
There are many conversations going on between non-governmental organizations, governments, and the private sector about what resources can be sent to help in West Africa, Woodman said.
“What could we effectively mobilize and in what time period and for what purposes are the questions we have to ask,” she said.
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