Objective: — Introduction of free and open source SMS and voice applications. Specifically for real time data collection and team communication. — Rapid design and prototype of solutions to match the requirements of the use cases put forward by the participants Application List: — Verboice — Resource Map — GeoChat When and Where: – InSTEDD Innovation Lab SEA : Phnom Penh Center, Building B1, 4th Floor on 28th October from 8.30AM to 5.30PM.
The ICT4D Cambodia Network is a group of local and international NGOs in Cambodia working together to enhance collaborating between the Cambodia’s project partners and SPIDER to promote transparency, sharing of information and a socially accountable Cambodia through ICT to build, expand and sustain a network of actors in Cambodia. Other network aims are also included increase the level of impact and sustainability and increase the visibility of the project. The participating network members include, Innovative Support to Emergencies Disease and Disasters (InSTEDD), Association of Progressive Communications (APC), East West Management Institute (EWMI), The Swedish Program for ICT in Developing Regions (SPIDER), Open Institute (OI), and Women’s Media Center of Cambodia (WMC).
The National Center for AIDS/HIV, Dermatology and STDs (NCHADS) is a national center in Cambodia that provides public health services for the Cambodian people. The OI/ART (Opportunistic Infection / Antiretroviral Therapy) service is one of the main NCHADS services involved in the treatment of HIV patients. There are currently 53 OI/ART clinics providing treatment services for HIV patients in Cambodia. In order to provide indicator information to these clinics, NCHADS must first collect accurate data from the sites, analyse the data, and then send the analysis to the sites in order to help them improve their care. The challenge is to improve the accuracy and speed of this process. As part of collaboration, the iLab Southeast Asia has been providing NCHADS with adaptive technical assistance to support its strategies for future development of Health Information Systems (HIS). In light of this already close relationship, NCHADS utilized the services of the iLab Southeast Asia to develop the CQI Dashboard Indicator Application.
MOTIF is a project funded by the Marie Stopes International Innovation Fund, with academic support from the London School of Hygiene and Tropical Medicine. The objectives of MOTIF are to develop, implement and evaluate a mobile phone-based intervention (SMS and phone call) to support post-abortion contraception for clients at four MSIC clinics in Cambodia. Voice messages were developed with clients and technology partners at the InSTEDD iLab South East Asia in Phnom Penh (to design call flows, message content and audio quality), BBC Media Action (to share experience of using voice messages), a local women’s radio station (to record message content) and extensively tested and refined with clients during the formative research process.
The National Center for AIDS/HIV, Dermatology and STDs (NCHADS) is a national center in Cambodia that provides public health services oriented toward serving the Cambodian people. The VCCT (Voluntary Confidential Counseling and Testing), OI/ART (Opportunistic Infection / Antiretroviral Therapy) and STI (Sexually Transmitted Infection) are the main NCHADS services involved in the HIV testing, HIV treatment, STI testing and STI treatment. There are currently 61 OI/ART sites, 237 VCCT sites and 35 STI sites in Cambodia. To maximize the efficiency of improving patient care across all sites, The InSTEDD iLab Southeast Asia continues to work closely with NCHADS to develop technology tools to improve information and data. This Data Integration tool was created to develop a technology supported system which would link data between the VCCT, OI/ART and STI systems in Cambodia. By using Master Patient Index (MPI) for storing patient information across applications and a fingerprint scanner for identifying patients, patients’ records can be accessed from any clinic within the NCHADS network that they decide to receive testing and/or treatment in.
Project: PRIVATE SECTOR REFERRAL SYSTEM Date: Nov 2012 — Present Location: Cambodia Technology: Custom Tool Due to the health policy in Cambodia, private clinics do not treat Malaria patients. This means that when a person with Malaria comes to the private clinic, they must be transfered to a public health center. One obstacle in this process is keeping track of these referrals. In collaboration with The National Center for Parasitology, Entomology and Malaria Control (CNM), Clinton Health Access Initiative (CHAI), and funded by the Malaria Consortium Cambodia (MC), the Referral System began development in November 2012. The Referral System is an SMS and web-based application that will enable private providers to message information about each referred patient into an online database. The message from private providers will include the referral slip number and patient’s phone number. When the patient arrives at the public clinic their referral slip information and number will be sent to the system by the health center so that the information can be matched up with the original referral submitted by the private provider. With this information, the system at CNM is able to monitor patients so that they can see who was referred and which patients have been accounted for at public facilities and which have not.
Dr. Larry Brilliant, a well-known preventive medicine and public health physician with a strong interest in technology, conceived of the idea for InSTEDD with his “One Wish to Change The World” award at the TED Conference in 2006. During his TED Prize acceptance speech, Dr. Brilliant shared his wish to develop an early detection and early response system that would serve to warn the world of developing threats, saving more lives through earlier, more collaborative and more effective alerting and response. InSTEDD was organized in 2006–2007 to serve as a catalyst to empower individuals and organizations by using technology for more effective action in early warning, prevention and response to disasters and public health threats. The founders’ vision was to build an organization that would help make the world safer by making technological innovations accessible to humanitarian and public health organizations to help them do their work better, faster and smarter. Since 2006, we have significantly expanded this vision to incorporate a very important element of capacity building to ensure long term sustainability. We believe our value as an organization is not to just help people use technology, but rather to help them develop the skills and access the resources needed to design and evolve technologies. Local capacity building is essential for this process.
Photos activities of project Spider. The Relationship: In December 2011, Spider organized a workshop in Phnom Penh to explore the possibility of supporting ICT4D projects in Cambodia. This workshop resulted in four Spider supported projects which led to the Spider ICT4D Cambodia Network. In addition, the InSTEDD iLab Southeast Asia received a one year grant from Spider focused on creating an Interactive Voice Response Systems for Support of Women and Children. InSTEDD’s Verboice tool, which is part of our technology platform, is an open source Interactive Voice Response system that lets users create and run applications via voice, thereby overcoming literacy and geographical barriers. Our main partners in this project are the Open Institute and the Women’s Media Centre of Cambodia. The collaboration will increase support for women and children on issues related to health and safety by raising their awareness through relevant and easy information access created in their local language.
Voice is the most universal and inclusive means of communication, and it’s an ideal way to expand the reach and impact of health and humanitarian technologies. In September 2012, with funding from Spider (The Swedish Program for ICT in Developing Regions), the InSTEDD iLab Southeast Asia introduced and extended Verboice, an open-source tool which specializes in using interactive voice response (IVR) to support health, safety and sustainable development work. Verboice projects can start small and scale up, making it possible to improve lives even in communities previously closed off by literacy and technological barriers. Below are a few of the projects to come out of this grant. For more information, please continue here: instedd.org/blog/verboice-in-cambodia/
The data from all sites are collected by NCHADS and then aggregated to a central database. When data needs to be collected, the data management teams at each site make a copy of each file and then email it to the central NCHADS office so that they can copy the data into their centralized system. Once NCHADS received the file, their data management teams update their national databases. They are able to combine all the data from the sites into their centralized database allowing them to export all the information in a single Excel Spreadsheet. Simplifying data merging and allowing export to a CSV file helps NCHADS to analyze the information they receive to help their research teams improve treatment, care and processes.
Working in the world of public health exposes us to a number of potentially life threatening scenarios. InSTEDD’s tools are designed to work in high stakes environments where people need to quickly share information, coordinate resources, and align their efforts towards the common goal of ensuring the public’s health and safety. In an effort to create a fun and interactive environment for people to learn how our tools work and how significantly they can improve communications, we teamed up with UC Berkeley to create a public health simulation — using Zombies!
As a part of their participation in UC Berkeley’s new course on mHealth, sponsored by the Center for Health Leadership, five graduate students engaged in current mHealth global health research projects. Working with Caricia Catalani on InSTEDD initiatives, these students developed: policy brief on obstacles and facilitators to meHealth data sharing, impact evaluation design for a project aimed at improving maternal and child health through the establishment of a national health information system in Rwanda, critical review of the literature on alert/reminders for health, status report on telemedicine providers in India, micro-review of the scientific literature on OpenMRS, and background research on the status of maternal and child health in Rwanda. The students presented their research findings to the InSTEDD team at The Hub SoMa in downtown San Francisco.
HIPPP = HEALTH INFORMATICS PUBLIC PRIVATE PARTNERSHIP. This public-private partnership between multiple agencies of the US government and several private organizations and NGOs was created in 2010 to promote health system strengthening within multiple developing countries. The approach is focused on first building local capacity in ICT portfolio management, architecture, and integration and then funding specific changes to health systems as planned by each country using these approaches.
Social Innovation Camp started five years ago in the UK and has since then been run in 16 countries globally from which over 30 new social ventures have been created, with 12 receiving further funding, investment or significant in-kind support just in the UK alone. In November 2012, Social Innovation Camp came to Southeast Asia with an event in Kuala Lumpur, Malaysia. Two of the InSTEDD iLab Southeast Asia’s Project Managers, Sokha and Mann, traveled to KL to participate in the cross-sector collaborative event which brought together the best of SE Asia’s software developers and designers. The groups had just 48 hours to build some web/mobile-based solutions to a set of social problems – from back-of-the-envelope ideas that could change the world into social start-ups – complete with working software. To learn more about this event, go to: sicampasia.com/kl-2012–2/
Project: NATIONAL OUTBREAK RAPID RESPONSE TEAM COORDINATION Date: May 2009 — Present Location: Cambodia Technology: GeoChat We set up GeoChat for the Cambodia Communicable Disease Control (CDC) so they could improve their ability to monitor early stages of disease outbreaks throughout Cambodia. In order to help them communicate crucial information and coordinate responses faster, we developed a tool that supported them in conducting regular SMS-based disease reporting. Such early detection enables early response by health care staff, and preventions of the unnecessary spread of disease outbreaks. The CDC Deputy Director relies on GeoChat to keep disease outbreak rapid response teams (RRT) communicating in real time so that they can respond to potential outbreaks before they become national emergencies. Due to the changing nature of outbreaks, it is imperative for the RRTs to stay up to date with what is going on where and with whom, in as close to real time as possible. Since much of the RRTs time is spent in areas with little cell phone reception, riding in vehicles and conducting field based interviews, phone calls would be too unreliable and disruptive to be used as the primary way to communicate. In addition, phone calls are not an ideal way for multiple people to be informed simultaneously, which hinders important and potentially life saving communications from taking place. Using GeoChat, these RRTs are able to create response groups on the fly to involve only the members necessary for each event. By using rapid SMS communications, the response staff is able to chat on the go and stay up to date with what is going on where and with who, is as close to real time as possible. With the help of GeoChat, the RRTs were better able to prepare for and respond to outbreaks, particularly the H1N1 outbreaks of 2009.
Albert Einstein once said “Everything should be made as simple as possible, but not simpler”. At InSTEDD, we take that to heart. In order to ensure that we are creating a tool that is simple to use yet helpful and scalable, we make sure to do usability testing throughout the design and development stages of our projects. In this album, we invited users to the iLab Southeast Asia office in Phnom Penh, Cambodia to test the latest version of our Resource Map tool. Resource Map lets users record, track and analyze their resources geographically in a collaborative environment accessible from anywhere. You can learn more about Resource Map here: www.instedd.org/technologies/resource-map/ Learn more about InSTEDD’s human-centered design approach here: www.ilabsoutheastasia.org/our-work/approach/
In September 2012, Sokha Rum (Technical Project Manager at iLab SEA) and An Yon (Field Support Officer at iLab SEA) traveled to Battambang Province to meet with health workers and officials who treat HIV/AIDS patients within Cambodia. They spoke with these individuals so they could learn about what resources they had available, what their skill levels were and understand their workflow so that they could help design a solution to support their work under the Health Informatics Public Private Partnership (HIPPP) Project. You can learn more about this work here: www.ilabsoutheastasia.org/our-work/projects/ Projects: – Health Informatics Public Private Partnership – HIV Mobile Appointment Reminders – HIV Data Aggregation
The iLab Southeast Asia’s Yon An (Field Support) and Sokha Rum (Technical Project Manager) went to Cambodia’s Batdambang province to conduct a field assessment of the health clinics that work with HIV positive patients. This field assessment visit was coordinated by NCHADS staffs. To learn more about our work in this area, please follow the link: www.ilabsoutheastasia.org/our-work/projects/
In September of 2012, one of the InSTEDD iLab Southeast Asia’s Senior Software Developers, Channa Ly, taught a PHP study group. The small session was attended by a diverse group of learners from NCHADS (National Center for HIV/AIDS, Dermatology and STD), ITC (Institute Technology of Cambodia), and others universities. The iLab Southeast Asia regularly hosts these types of sessions in order to support local capacity building.
In Brazil, youth from the favelas of Rio de Janeiro used UNICEF– InSTEDD iLab Latin America’s new digital mapping technology tool to reduce disaster risks within their communities. Located just above sea level, Rio de Janeiro is vulnerable to floods, landslides and natural disasters that are expected to increase with climate change. The city’s favelas are largely situated along mountainsides, and are already prone to both disasters and socio-environmental risks, such as poor infrastructure. In recent years, heavy rains have caused hundreds of causalities and destroyed many homes. In response to these growing threats, UNICEF, with the support of the Municipality of Rio, the Municipal Secretariat of Health and Civil Defense, and Centro de Promoção da Saúde (CEDAPS), has developed a youth-led mapping project in which adolescents are engaged to identify social and environmental risks in their communities. UNICEF, with the Massachusetts Institute of Technology (MIT), the Public Laboratory for Open Technology and Science (PLOTS) and InSTEDD iLab Latin America, developed a cutting-edge mapping platform that enables real-time data collection through web and mobile applications. Learn more about the project here: instedd.org/map/favela-digital-mapping/
We set up GeoChat for the Cambodia Communicable Disease Control (CDC) so they could improve their ability to monitor early stages of disease outbreaks throughout Cambodia. In order to help them communicate crucial information and coordinate responses faster, we developed a tool that supported them in conducting regular SMS-based disease reporting. Such early detection enables early response by health care staff, and preventions of the unnecessary spread of disease outbreaks. The CDC Deputy Director relies on GeoChat to keep disease outbreak rapid response teams (RRT) communicating in real time so that they can respond to potential outbreaks before they become national emergencies. Due to the changing nature of outbreaks, it is imperative for the RRTs to stay up to date with what is going on where and with whom, in as close to real time as possible. Since much of the RRTs time is spent in areas with little cell phone reception, riding in vehicles and conducting field based interviews, phone calls would be too unreliable and disruptive to be used as the primary way to communicate. In addition, phone calls are not an ideal way for multiple people to be informed simultaneously, which hinders important and potentially life saving communications from taking place. Using GeoChat, these RRTs are able to create response groups on the fly to involve only the members necessary for each event. By using rapid SMS communications, the response staff is able to chat on the go and stay up to date with what is going on where and with who, is as close to real time as possible. With the help of GeoChat, the RRTs were better able to prepare for and respond to outbreaks, particularly the H1N1 outbreaks of 2009. This album is the GeoChat Training: Cambodia Rapid Response Team at Kandal PHD
Using a combination of GeoChat and the Reporting Wheel, 18 health centers in the Kien Svay Operational District (OD) are able to use SMS to easily and rapidly send in their weekly disease reports to their respective headquarters. These health centers are using GeoChat to facilitate public health communications about more than a dozen infectious diseases in 3 different districts of Cambodia: Kien Svay, Leuk Daek, and Lvea Aem. In addition to bottom up disease reporting described above, GeoChat is also being used for top down information sharing. The Operational District lead uses GeoChat to send information that they receive at the national level about upcoming meetings, events or critical information to the health centers, all through SMS. Before GeoChat and the Reporting Wheel were utilized to facilitate public health communications, a combination of VHF radios (walkie-talkies) and paper based reporting systems were the tools were used. This method was slower and error prone, making it a much less effective system. Now that InSTEDD’s tools are used to support public health communications, the healthcare workers are better able to see emerging outbreaks, share information about prevention and treatment as well as coordinate responses with their teams, which enhances their ability to save more lives.
Reports consist of critical malaria drug stock information, geographic locations and the number of patient cases from the villages and health centers. Date: March 2012 — Present Location: Lao PDR Technology: Resource Map With funding from The Global Fund, we began working on a project for the Center for Malaria Parasitology and Entomology of Lao PDR (CMPE) to provide technical assistance in the development of an SMS system for malaria reporting. The malaria reports consist of critical malaria drug stock information, geographic locations and the number of patient cases from the villages and health centers. The goal of using an SMS-based reporting system is to help the people at various levels within the healthcare system get critical information and alerts from the field, in real time. By having up-to-date information, they can better manage and coordinate their resources and better protect people from the potentially devastating effects of this disease.
This album captures the iLab Southeast Asia (iLab SEA) human-centered design process in action. In the following photos, team members from the iLab SEA, based in Phnom Penh, do a user evaluation to test the usability of software we are developing. This album covers 2 laboratories and 2 health centers in Kampong Cham. ***ABOUT THE PROJECT*** Tuberculosis Testing in Rural Areas of Cambodia: TB Lab Results Alert System In September of 2011, InSTEDD’s Phnom Penh based iLab Southeast Asia started collaborating with Family Health International (FHI) and the National Center for Tuberculosis and Leprosy Control (CENAT) to improve the efficiency of reporting TB lab results to patients living in rural villages of the Kampong Cham province of Cambodia. Until recently, provincial health care centers in rural villages in Cambodia have been relying primarily on a paper-based medical reports system, as well as inadequate civic infrastructure such as telephone systems and basic roads to transport TB test results between rural health centers where patients have access to TB tests and centralized laboratories with the facilities to analyze the tests and report the results. In most provincial health care systems in Cambodia, TB smears are taken from patients suspected of having contracted the TB virus in health centers. The smears must be transported, usually by motorcycle, to testing laboratories where they are analyzed. After the results are obtained in the labs, they are transported by the same means back to the health care centers where patients are informed whether their test results are positive or negative. This whole process, when reports are facilitated by means of a paper-based system, takes on average between 10 to 14 days. During this time it is possible for patients who have contracted TB to unknowingly spread the virus to new victims.
Project: MALARIA REPORTING IN LAO Date: March 2011 — Present Location: Lao PDR Technology: Custom With funding from The Global Fund, we began working on a project for the Center for Malaria Parasitology and Entomology of Lao PDR (CMPE) to provide technical assistance in the development of an SMS system for malaria reporting. The malaria reports consist of critical malaria drug stock information, geographic locations and the number of patient cases from the villages and health centers. The goal of using an SMS-based reporting system is to help the people at various levels within the healthcare system get critical information and alerts from the field, in real time. By having up-to-date information, they can better manage and coordinate their resources and better protect people from the potentially devastating effects of this disease. This set shows how we conducted user testing sessions in the Slavan province of Lao.
iLab Southeast Asia staff, Yon and Mesa, traveled to Myanmar (aka Burma) to participate in BarCamp Yangon 2012. Mesa gave a presentation on “Test Driven Development (TDD)” to about 50 people. Yon also gave a presentation on “Technology and Grassroots level users” to about 20 people. As a special treat, Nobel Peach Prize Winning activist, Aung San Suu Kyi, gave the opening speech to kickoff the event.
An important aspect of InSTEDD’s work is that we work with the people who will actually be using the tools we create every step of the way. We don’t build anything in isolation and we involve the end-users every step of the way. When we spoke to the people at these rural health centers, we encountered a number of issues that we had to find creative solutions to work around. Back in mid 2009, part of the InSTEDD team went to Southeast Asia to work with some rural community health workers in order to create a simple, fast and easy way for them to share information about disease instances at their health centers. Disease instances would include things such as the disease type, the age of the person who was sick, the date of when they fell ill and so on. The information needed to be shared in a somewhat structured way so that the health workers higher up the information hierarchy could easily be able to tell when there was a problem. We needed to help them find a way to “compare apples and apples”, not apples and mangoes… Continue to rest of blog post here: instedd.org/blog/toilet-paper-roll-reporting-wheel/
In 2011, InSTEDD designed, developed, and pilot tested a tool, called Watchfire, to help the American Red Cross(ARC) improve their community level disaster response in the San Francisco Bay Area. Working closely with the ARC on a needs assessment, we learned that their highest priority was improving the speed and coordination of ARC’s Disaster Action Teams (DATs). Using an agile development process that involved the ARC in the cycle of building better and better technical solutions, we developed Watchfire, a simple and yet powerful system that initiates and tracks the process of building a volunteer response team with people who are geographically close to each other through phone calls and text messages. For more information, please continue to: www.instedd.org/watchfire
Malaria is the 5th cause of death from infectious diseases worldwide with sub-Saharan Africa and Asia accounting for 98% of global malaria deaths. Today, nearly half of the world’s population is considered at risk of contracting the disease. In areas with high transmission, such as Cambodia, the most vulnerable groups are young children, who have not developed immunity to malaria yet, and pregnant women, whose immunity has been decreased by pregnancy. The costs of malaria – to individuals, families, communities, nations – are enormous. The Malaria Day Zero Alert System is a web based application with SMS capabilities that enables health center workers and village malaria workers to report Malaria cases by sending a simple text message to the Malaria Day Zero Alert System. The cases are then automatically sent as SMS alerts to system administrators, supervisory health centers, operational districts (OD), Provincial Health Departments (PHD), as well as The National Center for Parasitology, Entomology and Malaria Control or CNM (formerly called National Malaria Center). The online system also provides the ability to view reports, manage users and places on a map, set up and send template messages, send alerts to groups or individuals, and set thresholds for the number of malaria cases to allow before reports are sent to supervisors. Once centralized, malaria case reports can be sent to areas where outbreaks are probable, as well as elevated up to the national level where emergency action can be taken if necessary. The Malaria Day Zero Alert System connects to CamGSM’s network securely and in a scalable way through our Nuntium technology. As of August 1, 2011 there are 17 Health Centers, 4 Operational Districts and 3 Provinces using the Malaria Day Zero Alert System system.
Where: Angkor Chum Referral Hospital, Angkor Chum Operational District, Siem Reap Province What: CNM with CHAI train to selected 17th HC under Angkor Chum OD about using SMS with DyRM to update their HC malaria stock for every 2 weeks. When: 30 Aug 2011. One morning training
Project: RURAL TUBERCULOSIS TESTING & TREATMENT Date: September 2011 — Present Location: Cambodia Technology: GeoChat In September of 2011, the we began collaborating with Family Health International (FHI) and the National Center for Tuberculosis and Leprosy Control (CENAT) to improve the efficiency of reporting TB lab results to patients living in rural villages of the Kampong Cham province of Cambodia. With the help of funding from USAID, we developed a custom reporting application that builds upon the SMS-based reporting functionality of GeoChat. In the SMS-based TB Lab Results Alert System, once the TB tests are analyzed, the results can be reported immediately to the health centers in real time using text messages on mobile phones. Real-time reporting means that patients with positive TB test results can be given medical treatment right away, as well as receive important education by village volunteers with specialized training about how to prevent spreading the disease to others. Where: iLab Southeast Asia (Phnom Penh, Cambodia) When: 23rd Aug 2011 What: Train the trainer to FHI, CENAT staffs about TB Lab Result Alert System
Our Chief Technology Officer, Eduardo Jezierski was recognized this year as a Microsoft Alumni Fellow. The purpose of this award is to recognize and support a Microsoft alumnus who have made a meaningful difference in the daily lives of others by using his/her talents, time and resources to contribute to the world. This slideshow was used during the event to highlight InSTEDD’s work.
InSTEDD has provided support for health staff coordination and training using mobile phones. GeoChat is supporting information-sharing between operational districts and health centers, as well as other health focused communication needs. By keeping the district-level staff in the field but connected via their mobiles to their supervisors, they receive formal and informal alerts and information about new disease protocols or events in neighboring provinces. This prepares them to be on high alert for potential outbreaks within their districts.
These photos are from our work in rural villages, provincial health centers and governmental health offices. All of the people we work with in Southeast Asia are deeply committed to improving the health conditions of their communities in order to prevent potentially catastrophic outbreaks.
In August of 2010, InSTEDD’s Director of Communications, Brooke Estin, went to the field to photograph the people affected by InSTEDD’s work. She visited rural villages, provincial health centers and governmental health offices. All of the people she met were deeply committed to improving the health conditions of their communities in order to prevent potentially catastrophic outbreaks.
In November 2007, InSTEDD participated in a public health/humanitarian response demonstration performed with local organizations near InSTEDD’s headquarters in California called Golden Shadow. This is an event held in parallel with the larger State of California exercise called Golden Guardian.