By: Carolyn Moore and Lesley-Anne Long
Photo credit: Moses Khanu

Since the launch of the first free Training Health Workers for Ebola webinar series in October 2014, we have seen hundreds of members of the global health community come together to share vital, timely information to save lives and prevent the spread of the disease. This real-time and archived delivery of information has been critical to the continued response. We are excited to be working with partners, IntraHealth International, Ebola Alert, and TechChange, to continue growing this community as the response continues and countries begin to rebuild from the outbreak.

A team of organizations, led by mPowering Frontline Health Workers and IntraHealth International, are coming together to share tools and information on how to support health workers responding to and rebuilding from the Ebola crisis.

Please join us in a three-part webinar series beginning April 1.

Health workers in West Africa have been responding to Ebola since 2013, and, according to the latest WHO situation report, the pace of the outbreak is beginning to decline. This calls for relief and celebration. However, this is far from final for those who have been affected by Ebola.

The virus has left indelible marks on their lives, and their stories are many and severe:

The Ebola situation is once more improving in terms of infection rate, but the socio-economic needs are enormous.” (Moses Khanu, Pastor, Sierra Leone)

What comes next for Guinea, Liberia and Sierra Leone, the three most affected countries? And how can countries nearby and in the region plan for future potentially deadly outbreaks?

Health workers remain at the center of community response and support. At the same time, the governments and international organizations that support health workers are seeking answers for how they can restore health services in West Africa, strengthen health systems, and prepare for future health emergencies.

What’s next for Ebola affected countries?
Many organizations are working closely with all actors across the health sector. In our second series of Training Health Workers for Ebola webinars in April, we will have a group of colleagues who have been working in the affected countries talking about lessons learned and planning for rebuilding and strengthening health systems.

We invite you to join the discussion in the webinars.

Reviewing lessons learned, and looking ahead
These webinars will focus on tools and strategies that health workers, as well as the governments and organizations that support them, can use to continue the response, protect their communities and help rebuild health systems. Free training and information resources are concurrently being posted in the Ebola Resource Center http://www.hrhebolaresources.org/

Please join us in the webinars! Here are the details:

Webinar Schedule:
April 1: Working with Youth, Volunteers, and Vulnerable Populations
April 8: Community Mobilization and Preparedness Planning
April 15: Effective Use of Data

All live sessions will be held from 10.00 – 11.00am EDT.

These webinars will bring together more than 15 international health organizations, led by mPowering Frontline Health Workers and IntraHealth International.

Registration and more information are available here. The webinars are open to all, and will build upon the presentations and discussion in the first Training Health Workers for Ebola series.

All of the webinars will be available for viewing at www.techchange.org after the air dates.

The webinar series has been made possible by the generous support of the USAID-supported Health Communication Capacity Collaborative.

By Timo Luege, TC103: Tech Tools and Skills for Emergency Management facilitator

As technology for disaster response evolves, digital mapping is playing an increasingly important role in helping emergency managers in humanitarian emergency response operations. When considering the best tools and skills to respond to the Ebola crisis in West Africa, earlier this year, Doctors without Borders/Médecins Sans Frontières (MSF) sent a dedicated Geographic Information Systems (GIS) officer to Guinea, to support the local and international medical teams who are fighting the Ebola-outbreak. To find out whether that was a good investment, the MSF GIS Unit asked TC103 facilitator Timo Luege to write a case study showing the impact of this field-based GIS officer.

Some of the key observations are:

  • Most of the the areas close to the border of Guinea, Liberia and Sierra Leone had not been mapped previously. This meant that it was very easy to see the changes.

  • Despite being in a very remote area, the GIS officer had decent internet connection which allowed him to reach out for remote support. Among other things this made it possible for the volunteers of the OpenStreetMap community to contribute directly to supporting the response. So this is also a case that shows what crowdsourcing can contribute to humanitarian emergency response.

  • Since the GIS Officer was in the field, he and his local staff were able to provide context to the basemaps that were produced remotely. Both components were important: without the remote support, the GIS wouldn’t have been able to create all basemaps at the granularity that is available now. But without the GIS in the field, a lot of the traced outlines would not have been meaningful, because you need local knowledge to know whether a building is a school, a hospital, a police station etc. Also: assigning the correct names to villages is at least as important as mapping roads. Again, you need people in the field to do this.

  • Because MSF chose to use formats and tools that encourage or even require sharing, many maps created for MSF will add value to local communities, local government and help other humanitarian and development organizations working in the area. This means that the outputs will continue to be beneficial and can be built upon.

You can download the complete case study here:

GIS Support for the MSF Ebola response in Guinea in 2014

GIS Support for the MSF Ebola response in Guinea in 2014

This post originally appeared in Social Media for Good

Interested in learning more on how to use digital crisis mapping tools for humanitarian emergencies and natural disasters? Enroll now in this online course on Mapping for International Development and Tech Tools & Skills for Emergency Management.

About the TC 103 facilitator: Timo Luege

Timo Luege

After nearly ten years of working as a journalist (online, print and radio), Timo worked four years as a Senior Communications Officer for the International Federation of Red Cross and Red Crescent Societies (IFRC) in Geneva and Haiti. During this time he also launched the IFRC’s social media activities and wrote the IFRC social media staff guidelines. He then worked as Protection Delegate for International Committee of the Red Cross (ICRC) in Liberia before starting to work as a consultant. His clients include UN agencies and NGOs. Among other things, he wrote the UNICEF “Social Media in Emergency Guidelines” and contributed to UNOCHA’s “Humanitarianism in the Network Age”. Over the last year, Timo advised UNHCR- and IFRC-led Shelter Clusters in Myanmar, Mali and most recently the Philippines on Communication and Advocacy. He blogs at Social Media for Good and is the facilitator for the TechChange online course, “Tech Tools & Skills for Emergency Management“.

TechChange recently broadcasted the Training Health Workers for Ebola webinar series, with the sponsorship and webinar content of mPowering Frontline Health Workers and IntraHealth International. Over 550 participants from more than 70 countries have joined this webinar series so far, and more health workers around the world continue to sign up to view these recorded sessions for free.

The 4-part webinar series brought together voices from all over the world, both in terms of expert contributors and online viewers. We are inspired not only by the amount of people who participated online, but also by their contributions to the discussion on the information and tools necessary to support frontline health workers. Many commenters interacted with guest experts by asking important, timely questions, as well as by sharing information and resources on the work that they or their organizations are doing on the ground in Liberia, Guinea, and Sierra Leone to respond to the outbreak.

In case you missed the series, here’s a brief recap of each webinar:

In the first webinar, “Learning and Information Needs for Frontline Health Workers”, Dykki Settle (IntraHealth) and Sean Blaschke (UNICEF) discussed their work with the free SMS mobile communication system, mHero. Informed by the challenges faced by communities in Liberia, mHero was developed with the aim of investing in and strengthening tools that have already been implemented in Liberia to support the development and accessibility of health workforce information.

In the second webinar, “Health System Support for Frontline Health Workers”, Dr. Chandrakant Ruparelia (Jhpiego) shared key considerations for designing training programs for healthcare workers in areas affected by the Ebola outbreak. Additionally, Marion McNabb (Pathfinder International) pointed to the importance of leveraging existing training programs and mechanisms effectively in the Ebola response. Panelists from Digital Campus and Medical Aid Films also shared their experiences with using video for behavior change communications and health messaging.

In the third webinar, “Community Mobilization and Interactions with Clients”, Gillian McKay (GOAL) presented information about the social mobilization campaign that GOAL is implementing in Sierra Leone through two key innovations: uniformed services training emphasizing protection for officers involved in the Ebola response, and an Ebola survivor and champions media campaign to build trust and support within communities affected by Ebola. Additionally, Reverend Moses Khanu shared information on frontline efforts and the resources and support necessary in Sierra Leone.

In the fourth webinar, “Data to Support Effective Response and Case Management”, Jonathan Jackson (Dimagi) provided information on his organization’s effort to build a mobile tool for frontline health workers that can aid in contact tracing while collecting information for real-time data visualization and analysis. Additionally, Garrett Mehl (WHO) and Matt Berg (Ona) discussed their collaboration on the WHO data coordination platform to promote a harmonized Ebola response.

If your interest is piqued by any of these four webinars, you can watch each all recorded sessions in their entirety for free when you register using this link.

With each webinar, you will also find the discussion among online participants in the comments section. You will see that many participants shared details about their work and experiences, as well as initiatives that are emerging or already in place in the Ebola response. Where possible, we have also included the presentation slides and resources shared by presenters during each webinar.

As mentioned during each webinar, you can find additional resources and interact with experts on the Ebola Resources for Health Workers site.

If you’re interested in learning more on the role of technology in the Ebola response, join our online courses in mHealth and Tech Tools & Skills for Emergency Management.

 

Before the recent Ebola outbreak, the terms “contact tracing” and “Ebola” were spoken by only a small community of public health specialists consisting of infectious disease physicians and epidemiologists. As total cases of Ebola Virus Disease reported by the Centers for Disease Control and Prevention (CDC) exceed 10,000 across Guinea, Liberia, and Sierra Leone – almost 5000 of those fatal – these terms are increasingly entering general conversation.

What is Ebola contact tracing?

Rapid contact tracing is essential to the identification and isolation of symptomatic cases of Ebola disease, interrupting secondary transmission, and slowing exponential spread of the virus. It involves identification, documentation, and monitoring of all individuals who have come in contact with a single symptomatic case. In many cases, this is an analogue process of recording data on paper case notification, contact follow-up and field report forms, transporting those to a data entry center, and entering them into an electronic database. In other cases, mobile device can be used in the field for direct data entry into an electronic database.

Contacts have been exposed and are at risk for developing Ebola disease, but have yet to show symptoms. This is where understanding a few basics about Ebola virus and disease is helpful.

  • Transmission: direct contact with the body fluids of someone, ill or deceased, with symptoms of Ebola disease; or contact with objects contaminated by their body fluids

  • Symptoms: fever, headache, diarrhea, vomiting, stomach pain, unexplained bleeding or bruising, and muscle pain developing up to 21 days after exposure to the virus

If a contact develops symptoms within the 21 days of monitoring, they are immediately isolated and contact tracing begins for this new symptomatic case.

Ebola and Contact Tracing 

Contact tracing can get complicated, so much so that the CDC has a dedicated program, the Epidemic Intelligence Service, to build US health professional capacity and expertise to do so. A single Ebola case can result in the need to trace numerous contacts. In the early outbreak stages, rapid response is most critical as contact tracing efforts are somewhat manageable. If not contained, exponential transmission can make contact tracing efforts unwieldy, as is the case in the current West Africa Ebola outbreak.

Why is it so difficult to integrate mobile phones for contact tracing?

Several challenges in contact tracing could potentially be addressed with mobile solutions. Given wide geographic spread, remote locations and limited resources, real-time data collection and monitoring with mobile phones could facilitate rapid alert of new cases and contact follow-up. These tools could reduce time lag between data collected in the field and response, and serve as a more relevant basis for assessment and prioritization of control interventions. Given that solutions are developed with the Principles for Digital Development in mind, particularly open standards, open data, and open source software, the use of mobiles could address asynchronous data collection and reporting while lowering barriers to stakeholder collaboration.

Irrespective of the integration of mobile devices, contact tracing in Guinea, Sierra Leone and Liberia presents challenges unique from those in which the methods were developed. How do you identify and quarantine an affected patient effectively in a culture where many objects – from mattresses, toilets and food, to the burden of caring for the ill– are shared? How can reliable data be collected if interviewees intentionally misdirect or misinform surveillance officers in fear of response efforts? Social behavioral change communication could address these challenges, with mobiles playing a role.

Several groups are currently working to address data related issues in the West Africa Ebola outbreak. Notably, the World Health Organization’s Harmonized Ebola Response built on the Ona platform, the Ebola Open Data Jam, and mHero, a collaborative effort partnering IntraHealth International’s iHRIS software and UNICEF’s mobile messaging platform RapidPro. Three initiatives running in parallel leave one questioning if any single effort is actually impacting harmonization?

The challenges hindering rapid integration of mobile solutions are not necessarily unique from larger challenges in implementing mobile solutions, nor aid for that matter. Do you understand the user and ecosystem, did you design for sustainability and scale, and did you leverage opportunities for collaboration? There are suggestions that the WHO and mechanisms for responding to global health challenges are outdated, positioning the West Africa Ebola outbreak as a defining moment in their reevaluation. Perhaps it will also bring new perspective to effective leverage of mobile solutions.

Are you a “healthie”, “techie” or someone in-between interested in the use of technology in global health? Then don’t miss your chance to join course facilitator Kendra Keith and the next cohort of TC309: Mobiles for Public Health starting November 17th, 2014!

Frontline health workers in Guinea, Sierra Leone, and Liberia are responding to the largest Ebola outbreak in history. To protect themselves and their communities, health workers responding to Ebola need clear, reliable, and timely information on how to detect the disease, prevent its spread, and care for patients.

To respond to this crisis, mPowering Frontline Health Workers and IntraHealth International approached TechChange to deliver a free online webinar series on “Training Health Workers for Ebola—Protection, Detection, and Response”. In these webinars, more than 15 international and in-country health organizations will share information with participants on how to support health workers responding to Ebola. The four one-hour webinars will air on October 21, 23, 28, and 30, each starting at 10:00 am EDT.

The webinars are open to all, and we welcome participation from as diverse an audience as possible. This includes Ministries of Health, health workers, community leaders, program implementers (in-country and international), policy makers, and others. Health professionals from over 15 countries have already signed up, and participants represent government, health care facilities, international NGOs, and civil society, and other sectors.

The presentations and discussions in the webinars will (1) describe how to leverage available resources to train, support, and communicate with frontline health workers and others involved in the direct Ebola response through mobile technology; (2) consider ways to connect implementers to resources, collaborators, and sources of information; and (3) explore how to improve opportunities to enable implementers and programmers to share efforts, collaborate, and avoid duplication.

Webinar schedule:
October 21: Learning and information needs for frontline health workers
October 23: Health system support for frontline health workers
October 28: Community mobilization and interactions with clients
October 30: Data to support effective response and case management

All live sessions will be held from 10.00-11.00am EDT. For those who cannot attend the webinar sessions live, all webinars will be recorded and available here after the air dates.

These webinars are being supported by a 4-week discussion in the Health Information for All (HIFA) forums and we invite you to join and add your views. In addition, IntraHealth and mPowering are launching an online Ebola Resource Center for participants and others to share messages, training content, guidance documents, and other information. This site will also be a place for programs to share information about their work and to connect to others for support, ideas and collaboration. The Ebola Resource Center will launch on October 21.

If you and/or your organization have content on Ebola that you would like to share in the Resource Center, please email Dave Potenziani at Intrahealth at dpotenziani [at] intrahealth [dot] org.

We look forward to meeting you in the webinars & invite you to participate in the conversations in the HIFA forum.

You can find the webinar page and registration information at https://www.techchange.org/live-events/training-health-workers-for-ebola/.

Please share this information on this webinar series information with anyone interested in responding to the Ebola outbreak.

Photo credit: BBC

By Timo Luege, TC103: Tech Tools and Skills for Emergency Management facilitator

As Ebola continues to ravage Sierra Leone, Guinea and Liberia, people from all around the world are working together to stop the disease. In addition to the life saving work of medical staff, logisticians and community organizers, information and communication technology (ICT) is also playing a vital part in supporting their work.

After consulting the TechChange Alumni community and other experts in international development and humanitarian assistance, I pulled together a list of different technologies being applied to manage Ebola. Below are six examples showing how ICT is already making a difference in the current crisis.

1. Tracing outbreaks with mapping and geolocation
Aside from isolating patients in a safe environment, one of the biggest challenges in the Ebola response is tracing all contacts that an infected person has been in touch with. While that is difficult enough in developed countries, imagine how much more difficult it is in countries where you don’t know the names of many of the villages. It’s not very helpful if someone tells you “I come from Bendou” if you don’t know how many villages with that name exist nor where they are. The Humanitarian OpenStreetMap Team has helped this process through creating maps since the beginning of the response.

See: West Africa Ebola Outbreak – Six months of sustained efforts by the OpenStreetMap community.

Monrovia OSM pre-Ebola
Map of Monrovia in OpenStreetMap before and after volunteers mapped the city in response to the Ebola crisis. (Humanitarian OpenStreetMap)

In addition, the Standby Task Force is supporting the response by helping to collect, clean and verify data about health facilities in the affected countries. The information will then be published on UN OCHA’s new platform for sharing of humanitarian data.

2. Gathering Ebola information with digital data collection forms
Contact tracing involves interviewing a lot of people and in most cases that means writing information down on paper which then has to be entered into a computer. That process is both slow and prone to errors. According to this Forbes article, US based Magpi, who just won a Kopernik award, is helping organizations working in the Ebola response to replace their paper forms with digital forms that enumerators can fill out using their phones.

Digital forms not only save time and prevent errors when transcribing information, well designed digital forms also contain simple error checking routines such as “you can’t be older than 100 years”.

If you are interested in digital forms, check out the free and open source Kobo Toolbox.

3. Connecting the sick with their relatives using local Wi-Fi networks
Elaine Burroughs, a Save the Children staff member who is also TechChange alumna of Mobiles for International Development, shared that they are using their local Wi-Fi network to connect patients in the isolation ward with the relatives through video calls. Both computers have to be within the same network because local internet connections are too slow. In situations where video calls are not possible, they provide patients with cheap mobile phones so that they can talk with their relatives that way. Elaine added: “Several survivors have told us that what kept them going was being able to speak with their family and not feel so isolated when surrounded by people in hazmat suits.”

4. Sharing and receiving Ebola information via SMS text messages
I have heard about a number of different SMS systems that are currently being set up. Some are mainly to share information, others also to receive information.

mHero is an SMS system specifically designed to share information with health workers. It works with UNICEF’s RapidPro system, a white label version of Kigali-based TextIt which is one of the best SMS communication systems I know. RapidPro is also at the heart of a two-way communication system that is currently being set up by UNICEF, Plan International, and the Scouts.

The IFRC is of course using TERA to share SMS, a system that was developed in Haiti after the 2010 earthquake and already used in Sierra Leone during a recent cholera outbreak.

5. Mythbusting for diaspora communities via social media
Social media also has a place, though not as much as some people think. With internet penetration at less than 5 per cent in Liberia and less than 2 per cent in Sierra Leone and Guinea, it is simply not relevant for most people – unlike radio for example. However, all of these countries have huge diasporas. The Liberian diaspora in the US alone is thought to be as many as 450,000 people strong – and they all have access to social media. Experiences from Haiti and the Philippines show that the diaspora is an important information channel for the people living in affected countries. Very often they assume that their relatives in the US or Europe will know more, not least because many don’t trust their own governments to tell the truth.
Social media can play an important role in correcting misinformation and indeed, both the WHO and the CDC are using their social media channels in this way.

6. Supporting translations of Ebola information remotely online
Last but not least, Translators Without Borders is helping NGOs remotely from all over the world to translate posters into local languages.

Low tech does it
As a final word, I’d like to add that while technology can make a real difference we must not forget that very often low tech solutions will be more efficient than high tech solutions – it depends on what is more appropriate for the context. So don’t start an SMS campaign or launch a drone just because you can. It’s not about what you want to do. It’s not about technology. It’s about what’s best for the people we are there to help.

A Summary Infographic

TechChange Ebola Infographic

We will be discussing these technology tools, Ebola, and many similar issues in TC103: Tech Tools and Skills for Emergency Management and TC103: mHealth – Mobiles for Public Health. Register by October 31 and save $50 off each of these courses.

Do you have additional examples of how ICT is helping in the Ebola response? Please share them in the comments!

This post originally appeared in Social Media for Good.

About the TC103 facilitator: Timo Luege

Timo Luege

After nearly ten years of working as a journalist (online, print and radio), Timo worked four years as a Senior Communications Officer for the International Federation of Red Cross and Red Crescent Societies (IFRC) in Geneva and Haiti. During this time he also launched the IFRC’s social media activities and wrote the IFRC social media staff guidelines. He then worked as Protection Delegate for International Committee of the Red Cross (ICRC) in Liberia before starting to work as a consultant. His clients include UN agencies and NGOs. Among other things, he wrote the UNICEF “Social Media in Emergency Guidelines” and contributed to UNOCHA’s “Humanitarianism in the Network Age”. Over the last year, Timo advised UNHCR- and IFRC-led Shelter Clusters in Myanmar, Mali and most recently the Philippines on Communication and Advocacy. He blogs at Social Media for Good and is the facilitator for the TechChange online course, “Tech Tools & Skills for Emergency Management“.