Tech for Change

By Adele Waugaman

This week has seen a devastating series of events in the Pacific.

Over the weekend a deadly tropical storm slammed into the Philippines, causing severe flooding in urban areas and affecting tens of thousands.

Tuesday, a powerful underwater earthquake triggered a tsunami with waves 15 to 20 feet high that crashed into the Samoa islands, destroying homes and taking lives.

Then yesterday and today two successive and devastating earthquakes struck the Indonesian island of Sumatra, leaving thousands buried in rubble and in desperate need of aid.  

Groups funded by the UN Foundation and Vodafone Foundation Technology Partnership are deployed in all three Pacific Ocean emergencies to provide vital communications services that enable relief workers to deliver food aid and emergency supplies. As we reported yesterday, both the World Food Program (WFP) and the non-profit Télécoms Sans Frontières (TSF) are in the Philippines ensuring that relief workers are connected and, on WFP’s part, have access to radio communications to ensure workers’ security.

Tropical storm Ketsana dumped the heaviest rains in more than 40 years, and has affected 2.5 million people, according to government estimates. The WFP has boosted its food aid relief program there and now aims to feed 1 million people in October.

TSF also deployed to Samoa, where after Tuesday’s tsunami entire towns have been wiped out, over one hundred are dead and many thousands more are now homeless.

TSF added to its roster of simultaneous deployments today when it announced it would also deploy to the Indonesian island of Sumatra to provide communications for aid workers and to conduct a “humanitarian calling operation,” providing free three-minute phone calls so that those affected can give news to their family and ask for personalized assistance.

In situations of crisis such as these, a phone line can be a lifeline essential to delivering relief or reconnecting a family. Our thoughts are with all those whose lives have been affected by this deadly string of disasters, and with the relief workers working in difficult conditions to help save lives.

* UN Dispatch is supported by the UN Foundation. You can view a list of disaster deployments supported by the UN Foundation and Vodafone Foundation Technology Partnership here.

[Photo  Credit: Télécoms Sans Frontières]

by Adele Waugaman

Could a mobile phone be a key tool in the prevention of disease outbreaks and epidemics? Judges on the Wall Street Journal’s Technology Innovation Awards panel believe so.

DataDyne.org, a core partner in the United Nations Foundation and Vodafone Foundation’s mHealth (mobile health) program, has just won the prestigious award in the Healthcare IT category. An article in this week explains:

In developing countries, gathering and analyzing time-sensitive health-care information can be a challenge. Rural health clinics typically compile data only in paper records, making it difficult to spot and to respond quickly to emerging trends.

"With EpiSurveyor, developed with support from the United Nations Foundation and the Vodafone Foundation, health officials can create health-survey forms that can be downloaded to commonly used mobile phones. Health workers carrying the phones can then collect information—about immunization rates, vaccine supplies or possible disease outbreaks—when they visit local clinics. The information can then be quickly analyzed to determine, say, whether medical supplies need to be restocked or to track the spread of a disease."

A key advantage of EpiSurveyor is its sustainability: the software is free and open source, meaning that country health officials can download health surveys and modify them to meet local needs. For example, last month Kenyan health officials adapted EpiSurveyor to help track and contain a polio outbreak in the northern Turkana district.

Although large-scale immunization efforts eliminated the last indigenous cases of polio in Kenya in 1984, recent inflows of refugees fleeing violence in neighbouring Sudan renewed the threat of a polio epidemic. Health workers in Kenya used a web-enabled version of EpiSurveyor to help track and contain these outbreaks. On the DataDyne blog, health worker Yusuf Ajack Ibrahim noted how immediate access to health data enabled health workers to refine their emergency vaccination campaign:

"Weakness noted were acted upon immediately. Some of the actions taken were redistribution of the vaccines, on the job training for our health workers, staff redeployment, immediate case investigation of suspected AFP cases, and change of [the] social mobilization strategy."

The Foundations invested $2 million to support the development, piloting and subsequent expansion of DataDyne’s EpiSurveyor health data-gathering software for mobile devices. In partnership with the World Health Organization and national ministries of health, the Foundations are helping to bring to scale the EpiSurveyor mHealth program in over 20 countries in sub-Saharan Africa.

The new mHealth Alliance, announced earlier this year by the UN Foundation, Vodafone Foundation and Rockefeller Foundation, will build on this effort by promoting thought leadership, global advocacy and public-private sector collaboration to help bring the smartest ideas in mHealth to scale around the globe.

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Adele Waugaman is communications director for the United Nations Foundation and Vodafone Foundation Technology Partnership, which provides strategic and financial support to the use of mobile technology to improve health data collection and healthcare delivery in the developing world.

This blog is cross-posted on UN Dispatch.

'Country looking and moving forward, not back'
by Claire Thwaites

Kigali, Rwanda -- With limited knowledge of the country aside from TV images from the horrific 1994 genocide, I was immediately struck by Rwanda's incredible atmosphere of progress and the resilience of its people. This is a country looking and moving forward, not back. It's a country that now strives to be the tech hub for Africa, an "African Singapore," as its President Paul Kagame likes to say.

Plans to deploy fiber optic cables to encircle the landlocked country in 2010 will help make this idea a reality. The country also has been especially successful in using mobile phones to improve public health and healthcare delivery. I was lucky enough to be able to witness one of the key mobile health (mHealth) programs-or healthcare programs being delivered with mobile technology-underway.

After a 30-minute drive through the rolling hills outside of Kigali, we arrived in Masaka, a community of about 25,000 people but only one health clinic. At this clinic, doctors and health workers are using TRACnet to monitor and manage 1,332 patients with HIV/AIDS.

Supported by the Rwandan Ministry of Health, Voxiva, and the Treatment Research and AIDS Centre (TRAC), TRACnet is an electronic records system that can be uploaded to mobile phones. In Masaka it is being used to track and record the distribution of anti-retroviral medications, ensure drug adherence, electronically create and submit patient reports, and access the most up-to-date information about HIV/AIDS care and treatment.

A growing number of countries in Africa and other developing communities are adopting this type of mHealth technology as a way to increase efficiency, decrease costs and greatly improve healthcare delivery. For example, the United Nations Foundation and Vodafone Foundation Partnership, where I work, has partnered with the UN World Health Organization, the non-profit DataDyne.org and local ministries of health to develop mHealth initiatives in 22 countries in sub-Saharan Africa - where mobile phones far outnumber health clinics or hospital beds. A recent publication we commissioned outlines over 50 examples of mHealth projects in nearly 30 countries. Together with the Rockefeller Foundation, we recently announced the formation of an mHealth Alliance to promote best practices in the field of mHealth and to help broaden the reach of modern healthcare technology to those that need it most.

In Masaka, I was guided through the health clinic by the local program manager, Hareuhana Diaedonne. During the tour, Hareuhana spoke at length about the simple but significant benefits that have been brought about by the introduction of mobile phones to the local healthcare system. Using TRACnet, he reported, data entry that used to take months to record and aggregate now can be collected in just 5 minutes.

Walking around the health centre, I was struck by how while the health facility itself is still rudimentary, the work of Hareuhana and others using mobile technology to promote healthcare is helping to land Masaka at the leading edge of the mHealth frontier.

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Claire Thwaites is the Head of the United Nations Foundation and Vodafone Foundation Technology Partnership, which provides strategic and financial support to the use of mobile technology to improve health data collection and healthcare delivery in the developing world.

Dr. Daniel J. Carucci

April 7, 2009

In places where there are few cars, where roads remain unpaved, where basic infrastructure services such as clean water and electricity are scant, mobile phone technology has become an enabling power for millions of people. As many readers of UN Dispatch already know, this is particularly the case in the field of global health, where mobile technology is revolutionizing healthcare delivery in the developing world (see some examples here).

Today is World Health Day, a day set aside to highlight a priority area of concern for the World Health Organization. This year’s focus is on the safety of health facilities, and the readiness of health workers who treat those affected by emergencies – a challenge, particularly in remote and resource-poor environments where health workers may have infrequent contact with home offices.

To put the opportunity of mobile technology for healthcare (or “mHealth”) in context, consider these figures. Today, there are 2.2 billion mobile phones in the developing world, compared to 305 million computers and only 11 million hospital beds. Mobile technology is not a panacea for the significant global health challenges we face today. But it is a powerful new tool that has the potential to extend the reach of health care to the “last mile” and may play a powerful role in meeting the Millennium Development Goals by 2015.

There's much work to be done. Each year, millions of children die from diseases that could be prevented through broad-based and routine immunization programs, education programs and health campaigns. Hundreds of thousands of women die as a result of complications during childbirth. Millions still succumb to HIV/AIDS, malaria and tuberculosis. And much of the health care system in the developing world is faced with insufficient resources, lack of adequately trained staff, and frequent shortages of critical vaccines and medicines. The global economic crisis we all face will impose a disproportional share of the burden on the poor, resulting in even greater strains on overly burdened health care systems.

It is a daunting challenge but over the past decade, the world community has rallied to tackle some of these most vexing problems. Increasingly mHealth technology is being used to help meet the global health challenges of today. Electronic survey forms running on mobile devices can bolster a struggling health care system and help ensure timely data transfer on the vaccine stock levels in rural health clinics. SMS text messaging and other mobile-enabled programs can keep remote health workers up-to-date through distance learning programs, and health alerts and can provide patients with the information they need to live healthier lives.

Ongoing mHealth projects are already in motion throughout the world as detailed in our recent mHealth for Development report and involve education and awareness, remote data collection and monitoring, communications and training for health care workers, disease and epidemic outbreak tracking, and diagnostic and treatment support.

The mHealth Alliance, a new umbrella organization announced by the UN Foundation, Vodafone Foundation and the Rockefeller Foundation, will bring together key stakeholders from the public and private sectors, from government and civil society organizations, and from health and mobile technology industries. This collaboration will bolster the ability of sustainable and scalable mobile technologies to address healthcare challenges throughout the developing world, helping us reach the Millennium Development Goals.

Back in 2000, only the optimistic and determined few believed that measles deaths in Africa could be reduced by nearly 75% in less than a decade. But the success of the Measles Initiative showed that broad-based, multi-sector partnerships can enable us to accomplish together what no single actor could alone.

So while we continue to face substantial new global challenges, there is reason for optimism and determination. With the support of technological and scientific innovation, partnerships with developing world governments, the technical expertise and talent of UN agencies, resources from bilateral and multilateral donors and philanthropic organizations, and the generosity and good will of the grassroots public, together the global community will be able to reach those who need help most – especially those on the last mile.

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Dr. Daniel J. Carucci is Vice President for Global Health at the United Nations Foundation, which operates a $30 million Technology Partnership with The Vodafone Foundation.

By Oisin Walton

I am among the two teams of Telecoms Sans Frontieres (TSF) emergency telecommunications specialists who deployed to Haiti as it was hit by four cyclones--Fay, Gustav, Hanna, and Ike--all in less than a month. TSF's teams deployed from bases in Nicaragua and in France to support communications both among humanitarian relief workers, and for Haitians who had been driven from their homes by flood waters.

The hub of humanitarian relief efforts in Haiti is in Gonaives, a northern city that has been mostly destroyed by the hurricanes. Local authorities estimate that as many nearly 56,000 families have been affected by the cyclones, and living conditions here are extremely difficult.

Although water levels in Gonaives' streets have lowered, mud has taken over. Gonaives is surrounded by hills devastated by deforestation, triggering mudslides that pour into the city. Daily storms make removing mud from homes and roads impossible, and aid agencies fear the stagnating water will spread diseases if it is not removed quickly.

Haitians forced from their homes by the storms are now crowded into schools, churches or hospitals that have been converted into temporary shelters, even while these buildings also have been affected by the storms. In other instances those left homeless are staying with family or friends. Our driver, for example, has been sheltering 20 people in his house for more than 2 weeks.

I am on the TSF team that is running a 'humanitarian calling operation' that provides affected populations with free, 3-minute phone calls to reconnect with loved ones. Since we launched our operation two days ago, it has been a tremendous success. Already more than 500 families were able to contact a loved one to ask for money or just give news to their family for the first time since the cyclones.

Each day, the TSF team providing calls for the local population travels from shelter to shelter, reaching on average 2 shelters per day. We use both satellite and mobile phones--satellite phones for international calls, and mobile for domestic ones. Access to satellite phones is very important since 80% of calls being placed go abroad--of those calls, 90% are to the United States, mainly to Florida but also to New York, Boston, Washington or Kansas.

Today, a 53-year old woman was able to call her father in Miami for the first time since the disaster. She thanked us because even if her father wasn't able to send any money they were both very happy to give news. "It was so good to hear his voice. You gave me 3 minutes of happiness," she said before leaving. Later, a man cried after calling his wife in Boston.

The Western Union office here has now reopened, making TSF's calls even more important as people will now be able to arrange money transfers. The Haitian Diaspora is indeed a huge source of revenue for many families living in Gonaives.

Normally, a 3-minute call from Haiti would cost around 135 gourdes. To put that in context, a cup of rice here (people don't count in kilos or in pounds but in "cups") costs 35 gourdes. For a population devastated by the food crisis and then these storms, access to TSF's phone lines may mean not only moments of comfort connecting with loved ones, but possibly also a lifeline to friends or family who could send money.

TSF's calling operations should last another 10 days depending on the needs. Our deployment to Haiti--which also includes telecommunications support for United Nations Disaster Assessment and Coordination (UNDAC) teams, as well as for relief workers with UNICEF and NGOs such as Médecins Sans Frontières and the Spanish Red Cross--is supported by partners including the European Commission Humanitarian Office (ECHO), and the UN Foundation and Vodafone Foundation Technology Partnership, which supports the use of emergency communications for disaster relief.

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Oisin Walton is head of communications and international relations for Télécoms Sans Frontières. For more information about TSF visit www.tsfi.org. For more information about the UN Foundation-Vodafone Foundation Technology Partnership, visit www.unfoundation.org/vodafone.