Ebola, Pop-Up Infrastructure and role of Tech in Crisis & Rebuild

The Ebola epidemic shook several countries in 2014, with international coverage being spotty early on, then escalating quickly as the disease spread. As of writing this post, the Ebola epidemic is still a major international issue. Anthony Banbury, head of UN Mission for Ebola Emergency Response said recently that its going to be a difficult road ahead, but that the Ebola epidemic can be stopped in 2015. In a chat with a UN staff member who is deployed in the Ebola affected countries to help with the response to the epidemic, several things became clearer about the role of crowdsourcing technology, mobiles and humanitarian tech organizations. To understand the role for technology, lets first start with a couple of problems. First, the countries affected by Ebola spend a very small percentage of their budgets on health care systems. This was pointed out by Dr. Chikwe Ihekweazu in conversation with Chris Anderson of TED. He shared two maps that bear reiterating. This map shows public health spending in the world: Public spending worldwide illustratedThis map illustrates the global deaths from infectious diseases, Africa and India are severely bloated, while the Americas appear as just a sliver:

Clearly this is a very big problem that requires another look at how domestic policies in African countries are formulated and percentage of spending in health care. Ken Opalo, a leading commentator and thinker on African issues looks at the question of whether IMF policies may have had a bearing in the inability of Liberia, Sierra Leone and Guinea to contain the outbreak. In a word, not really, but he makes a point that bears highlighting.

International intervention should always, to the extent that is reasonably possible, be embedded in domestic political economies. We (the royal we in development research & practice) like talking about self-enforcing this and that, but then prefer to play “neutral” and “apolitical” interveners all the time. Because we do not live in a world of benevolent social planners, there is seldom anything like a disinterested, value-neutral, and victimless intervention.

Second, Dr. Ihekweazu dropped the shocking fact that there is one doctor to every 100,000 people in Liberia. “For Ebola to cause an outbreak, it probably picked the best two or three countries to happen in,” Countries hardest hit by Ebola are places where health care systems are in utter shambles or barely exist in the first place. With the above statistics and views, the question becomes... Ideally, if interventions can be aligned with domestic political economies, what sort of socio-technological systems could help support this? What sort of partnerships and interventions could be put in place in areas with barely any health care systems to speak of, and more importantly how is that system supported once the crisis period is over? What role can tech play if at all? 1. Support mobile engagement systems like RapidSMS/RapidPro by UNDP which is currently being used to engage and educate the public in Liberia about Ebola. Tying SMS systems like RapidSMS and SMSSync by Ushahidi to online platforms and dashboard can help make sure that the flow of information about health care is not just something that is put in place during a crisis, but that its a continuing way of engaging with the public about health care in general. Mobile and Online systems coupled can form the basis for pop-up, resilient infrastructure that can help in areas with no system at all. Crowdsourcing and mobile technology can help with monitoring the state of public health post crisis. An example is checking for medicine stock outs  Examples of this exist. Just recently, Ushahidi was used to track medicine availability in Mozambique. In 2012, Crowdmap was used to track the Ebola outbreak in Uganda, and you can read more here about LERN in Liberia and how Ushahidi technology has been used to track Ebola in 2014. As we deploy tech for monitoring health issues, it is important to have better connections between the crowdmap participants and the traditional responders (including National Government and International communities).  We need to know who needs the information to do what. We have made huge advances since Haiti. It was hard to get information collected to decision makers. It is not as bad now, but a gap does exist. 2. Build transnational ecosytems: It is important to respect the volunteering spirit. It means that usually in crowdsourced initiatives we can find hundreds of volunteers that want to help, and is important that in the big crisis they help in the best way possible, but that help must have some rules. We see a lot of volunteers helping a lot for hours and hours. In some point and for long therm it will become a problem for the volunteer and for the organization. When the Chile earthquake happened all the volunteers where so exhausted because the Haiti earthquake deployment some weeks before. If we want a more systematic use of this mechanism, the national authorities and international organizations must  include in their budget the resources to hire some long term positions who can be handing over and working with volunteers to create a longer term system for early warning and response. Essentially we are talking about building ecosystems with networks of developers, entrepreneurs and development agencies so that the resilient pop-up systems mentioned above can progress to firmer health care systems which are localized and appropriate. Incubate the tech with the social. A future state of a self maintaining system/new emergent better systems can come up. This cannot happen without investing in the people to do so. In some cases there may not be a strong enough local developer community. This is where implementation teams consisted of UN staff, Ushahidi tech experts and strategists can come in, provide training, support and most of all... inspire the local community to co-create and own the solutions to local problems. Strengthen local communities like iLab Liberia to continue their work. Here is an example: In Philippines the UN had an Officer to do then liaison with volunteer tech communities and the result was great, but is important to have a stronger links. Now the traditional responders are more open to this proposal. (Note that UNOCHA Colombia was the first UN agency to do this, and today crowdsourcing and working with volunteer tech humanitarians is a standardized strategy for humanitarian monitoring). As of today there are a paid positions with Digital Humanitarian Network for Ebola Response needs. The UN should be commended for this, and supported to do more. The need to invest in knowledge is important, it means investing in organizations like Ushahidi, people and training. The tools are very important, but is more important to have well trained people. The use of GPL or open  licensed tools makes a big difference, and the philosophy behind it encourages localization and building upon (rather than starting from scratch everytime). But is important to have a more systematic knowledge management and learned lessons mechanism to avoid reinventing the wheel. Example of this: Libya crisis map, driven by UN HQ coordinated by Stand By Task Force,  but also supported by UNOCHA Colombia office. 3. Support governments and multilateral institutions by providing as best an assessment of real time data available, create systems for collection of data and advise on citizen engagement and participation. Why? Dr. Ihekweazu put it best when he said "Infectious diseases do not respect national boundaries" Ushahidi has the tools to do this, with its crowdsourcing platform, messaging apps (PING, SMSSync) and CrisisNET platforms for dashboarding and on the physical end - The BRCK. We are working hard to create applications that can sit on the BRCK and be deployed for crises. We are calling this the CrisisStack. Key is having the technology for field agents like those who are working on UN Ebola response, refugee situations/peace keeping to not only have the software, but also the hardware to resiliently do their work and engage with the public at the same time. The gentleman I spoke with about Ebola response is returning to Ghana with a BRCK, next time, it would be great for him to return with a Blue BRCK that has the necessary applications to add to his arsenal of response gear. They may start with pop-up-infrastructure, but leave behind a framework that can be built upon for resilience in the face of other problems that invariably come. I truly hope that the Ebola crisis is handled as soon as possible, but more importantly that we use this crisis as an opportunity to put systems where none exist, create ecosystems where none exist, and to make sure that information flows to warn us of the next crisis before it spirals out of control. Most importantly that there is effective response in the face of crisis.