Fighting Ebola in Liberia with technology

Growing efforts under way in Liberia to employ mobile phone technology to bolster response to the deadly outbreak.

Proponents say simple mobile phone technology is desperately needed for the Ebola response in Liberia [AFP]

Nairobi, Kenya – Liberia’s technology hub was abuzz this past summer. A team of Liberian techies set lofty plans in motion for the next two years – promoting entrepreneurship, freedom of information, and women in technology.

But by the end of August, however, the Ebola outbreak had brought these plans to a grinding halt.

iLab, which is based in the capital Monrovia, announced it would be limiting its public events in a blog post that read, “Dear friends of the iLab, I am sure we are all aware of the emergency situation getting more and more serious – and are all gravely concerned.”

Liberia: Living with Ebola

Since then, Ebola’s confirmed death toll has climbed past 5,000 with most deaths occurring in Liberia, Sierra Leone, and Guinea.

Monrovia was no Nairobi or Cape Town – two of the continent’s technology hubs – but iLab had aspirations.

Today, these aspirations have a new mandate: how can technology help fight Ebola?

“Tech has a role solving the crisis but it will also have a big role rebuilding Liberia after the crisis,” said Teemu Ropponen, country director of iLab. 

Mapping Ebola

Among other things, iLab is using a mapping tool developed by Kenyan start-up Ushahidi. Desperate for information during Kenya’s post-election violence, Kenyan techies developed a crowd-sourced mapping tool to better understand the violence. This tool is now used to map Ebola and other crises around the world.

“Maybe it’s a little bit of an optimist view, but sometimes situations of crisis also force innovation,” said Ropponen. “If out of this crisis there were a couple of good innovations that can be used in Liberia or elsewhere then in a really, really sad and dark story, that could be an awesome outcome.”

Maybe it's a little bit of an optimist view, but sometimes situations of crisis also force innovation.

by - Teemu Ropponen, iLab

This is all part of a growing effort to use technology – particularly mobile phone technology – to bolster response to the outbreak. Two million text messages are sent out every month with information about Ebola by the International Federation of Red Cross and Red Crescent Societies (IFRC). Officials in Nigeria used phone records to trace who Ebola patients had come into contact with, eventually helping make Nigeria Ebola-free.

“One of the most basic needs in any emergency response situation is the need for information, and its incredible how little exists,” said Dana Zucker, from UNICEF’s Innovation Unit. UNICEF recently launched U-Report in Liberia, an SMS-based polling system targeting young people.

“Technology, when used effectively – and simple technology like a basic SMS phone – can support and strengthen the additional communication efforts that are already happening by connecting people to better, more accurate information faster than before.”

Limited reach

This is part of a trend that has proliferated across the continent. Propelled by the success of Kenya’s MPESA – a mobile money transfer system now used around the world – entrepreneurs developed applications for everything from Uber-style taxi services to mobile midwifery.

But unlike Kenya, the heart of mobile technology in Africa, Liberia is no Silicon Savannah. In 2013, it ranked 175th out of 187 on the United Nation’s Human Development Index. Only 4.6 percent of Liberians have  access to the Internet, and while many more have a phone, this still represents only 60 percent of the population. In Sierra Leone these numbers drop further: only 1.7 percent have access to the Internet, while 44 percent have a mobile phone subscription.

Still, many of the promises of mobile technology are desperately needed in the Ebola response. Contact tracing, faster response times for body collection, more efficient delivery of supplies, better ways to disseminate accurate information, and improved data collection and analytics could all, at least in theory, be helped by technology.

“Ebola has spread because people didn’t always have the right information and if they did, they didn’t always trust the source,” said Rukshan Ratnam from UNICEF in Monrovia. “That is where I see the potential for such technology, for providing accurate information where it’s needed right in someone’s hand.”

Already operating in several African countries, U-Report’s polls covered a variety of subjects, including education, depending on the needs and input of local youth.

‘Pen and paper’

With Ebola at the forefront on so many Monrovian minds, it was a natural subject for the application’s launch in Liberia. Responses are aggregated online and made publicly accessible in a way that gives youth a voice and will hopefully influence policy. In Uganda, U-Report has 268,903 subscribers linked directly to the government through their phones. UNICEF’s next step is to launch mHero, a tool to connect health workers operating on the front lines of the crisis to the government.

We don't want technologies to get in the way of the basic epidemiology.

by - Joel M Montgomery, Center for Disease Control

But once you get outside Monrovia, the potential of these tools gets more complicated. Barely a decade has passed since Liberia’s civil war that killed 250,000 people and destroyed the country’s entire electrical grid, as well as many roads. Even for people who have phones, much of the country is a cellular dead zone.

Mobile technology may offer new opportunities but it doesn’t subvert the same problems that have plagued the Ebola response since the beginning: lagging infrastructure.

“The fear is focusing too much on the mobile technologies,” said Joel M Montgomery from the Center for Disease Control’s (CDC) Ebola response unit in Liberia. “We don’t want technologies to get in the way of the basic epidemiology. We all recognise that’s where we need to be moving, but we don’t want it to be a distraction either and the fear, from a public health perspective, is that these flashy softwares and the bells and whistles have the potential to distract.”

When asked if any other technologies had proved more useful than mobile technology, Montgomery laughed and said, “Yeah, pen and paper.”

This is all part of a general lesson still being learned: innovation doesn’t really matter when you don’t have the basics. Without enough medical supplies, trained health-care workers, Ebola treatment units, and the infrastructure to get people and supplies to the right place at the right time, technology is impotent.

‘Africanised’ solutions

It is not that CDC and other actors on the ground don’t recognise the value of exploring technology despite the challenges. CDC is using remote-sensing technology to track the location and movement of populations in Liberia. This work is increasingly important as people move out of Monrovia and into more remote areas, perhaps bringing Ebola with them.

With an average of 28 new Ebola cases arriving daily in Liberia over the past two weeks, emergency response is already more than a full-time job. There are other partners whose domain is to focus exclusively on the deployment of technology. IBM’s Africa Research Lab developed a system that uses phones and radio for citizens in Sierra Leone and the government to communicate with each other. According to IBM, the system has already had success in aggregating data on the outbreak and identifying regions with growing numbers of cases.

“There are infrastructural challenges in Sierra Leone, there are infrastructural challenges in Liberia, but this is needed there so what is the work-around so that we can have an impact,” said Uyi Stewart, chief scientist at IBM Research-Africa. “This is the concept of Africanised solutions, the idea of localising innovation to make it relevant to the conditions of use.”

Most of these efforts are nascent and it will take time before their efficacy can be measured or concrete impacts delivered. Liberia isn’t Kenya and it isn’t Nigeria and the unprecedented nature of this epidemic means that a great deal isn’t yet known.

Source: Al Jazeera