Category Archives: Humanitarian Efforts

Trustworthiness in response

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Originally posted on the Aspiration blog

When I came on with Aspiration in January, it was clear in my soul why the joining up made sense. But not many folk in the disaster and humanitarian response circles I run in pay much attention to the overlap of activism and response. It took some time to make it clear and explicit. Back in May Anne from Hirondelle asked for a vizthink for a talk she was going to give, and for the staff working on the project to have a common view of all the moving parts of the program. Anne works in the overlap of response and journalistic integrity1, and has far more experience in both DOING and in EXPLAINING this overlap. I hope that by showing you our drawing and by talking about her case study this overlap can become more clear to even more people.

Getting the Word Out

Hirondelle works in radio programming in austere areas. Radio programming can be for music. It can also be to get information out – information about health, politics, and community action. Radio can be used to propagate messages inspiring violence through rumors or outright instigation. Messages can also be used to disseminate messages of truth, care, and empowerment. Radio broadcasts were used to coordinate after the Haitian earthquake. It’s a consistent medium used in a lot of places to a lot of different purposes.

Communication gets more expensive the further away from a radio tower you are, as outreach has to happen about the radio programs even existing and/or install additional towers. Anne also pointed out that “it’s not just a question of expense. If you’re out of range, you’re out of range. Radio silence.”

Enter Bluetooth. The consistently increasing number of people with phones, including the Nokia 1100 and other ‘dumb’ phones have started exchanging media files via Bluetooth. Even when there isn’t any internet, it’s still possible to transfer files directly from one device to another2. But people can only transfer what they’ve already got. And so Hirondelle works with a local women-run NGO Media Matters for Women to set up places called Listening Centers, where media programming is delivered by bicycle. People socialize, listen to a program together, and take the audio files with them to share with others3. 

Messaging and Trust

Mostly, these Bluetooth ‘podcasts’ are about maternal health, domestic violence, and education4. Hirondelle’s ongoing dedication to development and humanitarian response (“slow” disasters) means they’re trusted in most of the communities they’re in. Which means when conflict hits, they often continue to be trusted. Trust is more complicated for other groups, as organizations like the UN might also set up a radio tower and offer programming during extreme times, but their transient nature, close alignment with ‘official’ voices, and not being in the local language inhibit the deep bonds associated with trust from forming. Local radio stations which are in the local language often end up aligned with (or coerced by) those instigating violence. Hirondelle being independent while still close to the communities they serve, with newsrooms that reflect the diversity on the other side of the microphone, means the trust in groups like Hirondelle is deeper. That’s vital for effective response5.

This long term investment in community also means that when something as terrifying as Ebola breaks out, there are infrastructural ways6 to distribute trusted messages. The female journalists in their network used the same capacities built up for their physical and digital safety when speaking truth to power for making informed choices during the Ebola outbreak. The skills to think critically about messaging, how to check in with community members, and how to disseminate trusted knowledge outward to others also applied in both contexts. Even the messaging and response to Ebola is politicized, with who people go to for help depending on networks of trust. And in places like Guinea, Liberia and Sierra Leone with long histories of civil war and authoritarian governments, official messages about how to deal with the spread of the disease weren’t trusted – even if the information they contained was right. Our means must match our purposes, and vice versa, and the capacities we build in calmer times bolster our resilience when the world gets complex and dangerous. By taking care of our present selves, our future selves are better off.

Footnotes

  1. Which has become activist, strangely/sadly, as truth-telling becomes a radical act.
  2. The ability to transfer files to each other directly – something inhibited on many devices through firmware.
  3. Copyright (or Copyleft) activism is vital to our ability to create media which is our own / held in common, so we might share it outwards. Can you imagine “oh, this program might help you teach your abusive partner that what they’re doing isn’t ok, but you can’t share it to your sister who might be experiencing the same thing because DRM.” Yuck.
  4. They also work with locals to create the programming, and have all sorts of amazing stories about how their programming has changed relationships and cultures, but sadly that isn’t the point of this blog post.6
  5. Being trusted by those wishing to disentangle or opt out of conflict has to do with also having a history of truth telling, especially to power. Activists do this. So do efforts like Hirondelle. Ergo, Hirondelle is activist in a very subtle way.
  6. Mesh networks can’t be disaster-only, because people won’t trust them and won’t know how to use them.
  7. Means of production. People are not just consumers of media or of technology… to co-create is an act of empowerment which more closely strikes at the root of societal issues.

What’s the Catch?

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Chaos Communications Camp is something that happens once every four years, and it is My Favorite. It’s a few thousand hackers etc camping together in Germany. There’s brightly colored hair everywhere, and a slowly improving gender ratio, and stickers on laptops, and a gigabit to the tent. There are disco balls in trees, and competing soundscapes of German techno and old rock and roll or hiphop, and a giant sparkley rocket ship called Fairy Dust. I’m camping with Norton’s Obscure Phoggy Embassy (the manifestation of a few Bay Area hackerspaces), which is successfully trolling much of the rest of Camp through their assumption we’re being colonial (because Emperors), as well as having an inflated shark Rubin‘s been shouting at people to jump over. Also, NOPE attire are booty shorts.

I was invited to sit on a panel called “What’s the Catch?” put together by nat from Open Technology Institute. Josh (also from OTI), Kate (from tor), and myself were the three panelists. We each attempted to speak for about five minutes, and then we focused on questions from the audience. Our topic was an ongoing debate in infosec (and other) circles : is it possible to take money from governments and corporations while maintaining a project’s integrity? I vote yes, if you work really hard at it. The talk will eventually be up on the CCC wiki (and I’ll likely post it here once it’s up) but for now, this is the rant I put together when I was considering how to concisely state why I think this is the case.

In relation to this, and the other existential questions which I continually struggle with, I refer often to a quote from the Zapatistas, one of the few groups to maintain a governance structure after their revolution: “Caminando preguntamos,” which roughly translates to “we walk while asking questions.” To me, it means that we should move, but let’s analyze as we do. Let’s be in both critique and solidarity with each other.

I’m going to attempt to touch on three points, alliterated for your memory: perfection, pluralism, paternalism.
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Accountability in Response

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I’ve started writing about response over on the Aspiration blog, but this one still has cursewords in it, and is very much in my own language, so I figured I’d post it here first.

The problems our planet is facing are becoming more extreme. People and politics mean there are larger populations more densely packed in cities. Nomadic populations traveling along their historical routes are now often crossing over arbitrary (have you *seen* some of the country lines people in Western countries have drawn in places they might never have even been!?) political boundaries, making them refugees or illegal immigrants. Climate change means more and more extreme events are impacting those populations. We have *got* to get our shit together.

In all this, the people who have been historically marginalized often become even more so as those in power see scarcity encroaching on their livelihoods. But the ability to hold people accountable in new ways (through things like social media), as well as (I hope) a real awareness and effort in the long arc towards equality, means there are groups of people seeking new ways to better allocate resources to those most affected by these events. Often, these groups are also in a post-scarcity mentality — that, when we work together, wisely, we can do a whole lot more with a whole lot less. These are folk who think we *can* reach zero poverty and zero emissions (within a generation). These are the folk who see joy in the world, and possibility.

The resource allocation and accountability necessary for these transitory steps towards a world that can survive and even thrive won’t happen in a vacuum. In the organizations, governments, and grassroots efforts there are entire supply chains, and ways of listening (and to whom), and self-reflexive mechanisms to consider. In these are embedded corruption, and paternalism, and colonialism. In these, too, are embedded individuals who have been Fighting The Good Fight for decades. Who have added useful checks and amplifiers and questions. It’s into this environment we step. It is, at its core, like any other environment. It has History.

It’s in this context that I’m so excited about Dialling Up Resilience. It taps into questions of efficacy in programming by using and contributing to metrics for success in building resilience. It assumes good faith in policy makers and implementers by offering up data for them to do their jobs better. It protects against bad actors by providing granular, speedy data aggregated enough to protect data providers but transparent enough to be clear when a program is working (or not, if those we’re assuming good faith in don’t actually deserve that). And, my favorite part — instead of contorting and posturing about what makes people able to bounce back faster after a climate-related shock… we just ask them. Of course, it’s a bit more complicated than that. But the core is there.

We’ll be working with a few different groups in Kenya, including the National Drought Management Authority (and their Ending Drought Emergencies program) and UNDP on their existing surveying initiatives, as well as groups like GeoPoll (SMS), Twaweza (call center), and Kobo (household) on stand-alone surveys about how communities estabilish and track their own resilience. If we get the grant extension, we’ll work more directly with communities using tools like Promise Tracker and Landscape (a digitized version of Dividers & Connectors) to be closer to their own data, and to subsequently be able to have more agency over their own improvement as well as accountability.

What’s also exciting is that our means and our ends match. I was recently in Nairobi for a stakeholder workshop with not only the project partners, but also with the organizations which would eventually make use of the data. We’ve been conducting community workshops to test our basic assumptions and methods against reality, as well as to be sure community voice is at the core of each component we consider. We’ve thrown a lot out… and added some amazing new things in. We’re hoping to break down the gatekeeper dynamic of accessing communities in the Horn of Africa, and we want to be coextensive with existing programs (rather than supplanting them). It’s feminist and it’s development and I’m kind of fucking thrilled.

How can humanitarian response be decentralized?

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Originally posted on the Aspiration blog

For a long time, it wasn’t possible to include everyone’s voice in planning or decision-making without impossibly large amounts of time. There was no way to listen, at scale. So aggregation and centralization became common, especially in times of urgency, even with the troubles these tend to cause.

But now, with the technologies we have, we can *listen*, in high resolution and in high fidelity. But technology isn’t a silver bullet. We also need the political will and the personal values to make that happen. With Aspiration’s new Digital Humanitarian Response program, we get to support some of the rad people willing and able to make these movements happen. In May, we hosted the Humanitarian Technology Festival at MIT. The Digital Response Wiki provides resources and notes, and here are some top-level highlights from the event:

Disaster and humanitarian issues don’t happen in a vacuum

Notes from the Humanitarian Technology Festival

Groups like Public Lab help lay the groundwork (both socially and technically) for fast-cycle disasters, via their ongoing interaction with communities around environmental justice. This also provides scaffolding for handing off responsibilities after an extreme event. Kathmandu Living Labs, a group committed to mapping the infrastructure of their geography, is an excellent case study in this. When the Nepal earthquake hit, they were able to jump into action quickly due to pre-existing Open Street Map communities, workflows, data infrastructure, and (most importantly) social ties. Kathmandu was then capable of making use of (and maintaining) the updated data after the fact. Simply by being (and being allowed to be) active in affected communities on a day-to-day basis, organizations can support communities in becoming more resilient to disasters.

That said, preparing for extreme events before they happen can help mitigate the severity of impact on people lives. We explored the idea of games to make what might be considered dull more fun. No need to start from scratch (though that can be stimulating as well!). Climate Centre makes such games, and publishes them openly over on their website.

We already have much of what we need

One of our spectrogram statements was, “We already have all of the technology we need.” While we were divided in our responses, we acknowledged that the ability of groups of people to make do with what they have in disaster is astounding. And our preferences apply here technically as well as ethically. Distributed, federated systems both for technology and for communities/governance are more resilient than centralized systems (as well as addressing human rights in general). There are a few of these rad systems being built, NYC Prepared being one of my favorites.

Data and consent are deeply linked

Data use with populations that are vulnerable (based on their history, their current circumstances, or both) is still a big question, but not one we need to face on our own. OpenGov, Missing Persons, and other transparency-related initiatives have figured an awful lot of that out, and we should take note. Additionally, while consent is different in high-stress situations than in long-term advocacy campaigns, it should still be a strong consideration in any plan or intervention.

We looked at the Framework for Consent Policies which came out of a Responsible Data Forum in Budapest, and suggested advocating for a “notify this set of people in case of emergency” embedded into social platforms, similar to Networked Mortality or ICE contacts in some phones. This way, people would be consenting and determining who would be their contacting associates in case of disaster (unlike what Facebook recently did). Consent is a component of accountability, both of which highlight how frontline communities might be the architects of their own rescue.

Accountability is just as important in precarious situations as it is in everyday life, if not more so

Accountability is sorely lacking in humanitarian aid and disaster response. Fantastic organizations exist to track where spending is going, but money is often considered misspent. Frameworks exist for deploying aid in ways which alleviate, rather than exacerbate, conflict and tensions. However, these frameworks and mechanisms are still sometimes insufficient, as even well intended groups remain in regions for decades while populations become reliant on them, rather than becoming self sufficient.

Rather than come up with an external group to hold response groups accountable, we figured the frontline community could state whether or not initiatives are working, and those reports could be sent directly to the response organizations, their donors, and relevant constituents. This factors in strongly to the Dialling Up Resilience initiative grant of which Aspiration is a part (Yes, it’s spelled with 2 L’s. They’re Brits). More on that soon.

You can find more thorough notes from Humanitarian Technology Festival on (you guessed it) our wiki. Reach out to us if you have any questions about this ongoing work. Contact us here: humtechfest@aspirationtech.org / @willlowbl00

Digital humanitarian response: Meanwhile, in Nairobi…

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Originally posted on the Aspiration blog

I was in Nairobi, Kenya, at the end of April participating in various happenings across humanitarian response spaces. From interactive gameplay to resiliency indicators, here’s how we focused attention on frontline communities through digital means.

Facilitating gameplay to model for resource allocation

Game materials to indicate water points

I attended the 9th International Conference on Community-Based Adaptation (CBA9) with the Red Cross/Red Crescent Climate Centre in Nairobi on April 24-30. I was there to facilitate a game which simulated the citizen reporting of water resource status and distribution in an area to better inform allocation.

The game stems from Taarifa, a free software project that has been widely deployed to collect, visualize, and map infrastructure information. The Climate Centre is well known (and appreciated) for their distillations of complex climate, environmental, and social systems into fun-to-play games, which are available on their website.

Often, these games start simply, and then complexity is layered on as each set of rules is understood by the participants. There are additional challenges when designing a “pervasive game” like this one, which is a game that extends play out into the wider physical world. All the details needed to be written on one piece of paper and accessible across languages, and players need to be able to join at any point, and without a facilitation start-session. Phew. We did our best, and you can view our materials here.

Day one was focused on re-creating the system as it is now – everyone had to find the rest of their community, their malfunctioning water points, and engineers. Some would know the problems in space and time, but others had the tools to solve them when and where needed. How to link problem and solution? Communication was intermittent, if it happened at all. Information sharing was consistently one step behind of the facts.

On day two, we introduced the ability to SMS update and query, thus enabling a faster and more efficient match between broken pumps and the engineers who could bring tools and parts to help communities have safe water. People now only needed to find each other to make exchanges, and they were able to document and share in real time where water points were and what the status was.

How’d it go? It was confusing… just like life. There was slow uptake… just like life. Only one group used the technical assist (i.e., SMS)… just like life.

This game showed what we think we already know— that having a solid technical tool doesn’t mean anyone is going to use it. But as community-based adaptation practitioners, we often need to (re)learn what we kind-of know, and ask some tough questions, such as ‘why are available solutions not being fully embraced by those who can allegedly benefit from them?’

In Tanzania, the Taarifa team had a chance to both chat with end users about what their hopes and concerns were, as well as work with local software developers to localize the interface. That activity alone increases buy-in, as well as increasing appropriateness.

This game created a space for conference participants to see the same lack of uptake in their own behavior that pervades climate and development work, rather than it being an externalized problem space to grapple with during program design and implementation. It highlighted our collective need to better tap into the social systems around digital solutions, and rethink how to enable genuine embracing by those who can benefit from them. The Climate Centre will be taking the game forward into Zambia, where climate change and infrastructure are already under intense scrutiny.

Supporting community-driven indicators of resiliency

We are taking part in an initiative to build locally-driven strategies for resilience to extreme events such as drought. Our focus within the “Global Resilience Challenge” is on local indicators, or measurements, of resilience.

“You get what you measure,” as systems thinker Donella Meadows once said. When we talk about indicators of resilience, things like gross domestic products, income, and education come to mind. But that doesn’t work for everyone in all places. Actually, we often find that “more” (higher GDP, more trade, etc) is a dangerous synonym to describe “better” when we are trying to evaluate resiliencey.

In response, a few groups have worked on measuring other things, such as the happiness index. Similarly, what matters in resilience is that frontline communities are the ones describing what their own environments look like, what is important to pay attention to, and laying boundaries in how to interact. If communities have the ability to determine their own indicators and carry out subjective measurements within open data frameworks, large-scale understanding can also happen across communities.

What do we even mean by subjective? My favorite “subjectivity” delineation occurs around “framed” and “open-ended.” For example, we could set out a frame of the top five things we think are related to resilience, and then ask community members en masse how they rate their own standing on those things. Or we can ask people what they think is important to their own resilience. Both are subjective indicators.

To make this project happen, we are collaborating with the Overseas Development Institute, National Drought Management Agency (Kenya), GeoPoll, DataPop (Harvard Humanitarian Initiative and MIT Media Lab), CGIAR Research Program on Climate Change, Agriculture and Food Security, and the Center for Civic Media. We’re reading a lot, talking to community partners, and beginning to ramp up various ways of both examining what questions we should be asking as well as how we’ll ask (SMS surveys, household surveys, call centers, other). We’ll try some of these things out and meet again in June or July.

Humanitarian Technology Festival

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I came on with Aspiration back in January as the Community Leadership Strategist, to merge the work I’ve been doing in the humanitarian and disaster response space with Aspiration’s practices and team. It’s been a *blast* so far, and continues to be.

Most of the work I’ve done in the last 5 years has been about what social justice looks like when we’re doing response, with a focus on technology (as that opens up paths to conversations we otherwise quit having). With Geeks Without Bounds, we did hackathons all over the world, including Random Hacks of Kindness and SpaceApps Challenge. I’ve been a coordinator for the Digital Humanitarian Network, keynoted the IEEE Global Humanitarian Technology Conference, was invited to the White House to talk about Sandy response, facilitated the first hackathon IN (not just for) Haiti, etc etc etc. I’ve also had a huge organizational crush on Aspiration since my first DevSummit in 2013, attending as many Aspiration-connected events as possible. When I was able to join Team Aspiration, I was overjoyed — even while much of the work I’ve continued to do on response had already existed, it’s been a slow shift to get those previously-defined objects to be a bit more Aspiraiton-shaped.

The Humanitarian Technology Festival in Cambridge May 9+10 is the first event that is both committed to response and framed on Aspiration ethos. I am SO EXCITED about this it hurts. Let me explain why.

The very way we deliver aid perpetuates the need for more aid, both for fast- and slow-onset disasters (or “extreme events” or “humanitarian issues” or “earthquake” or “famines” or whatever you’d like to say). When people need lodging after a hurricane, they’re either told to evacuate and/or they’re put into temporary homes, away from neighbors and family. There is little impetus to return and rebuild both social and tangible structures. People are uprooted, and must start from scratch. When, instead, we see that people don’t just need lodging but in fact need social fabric, responders (and the technologies used for response) can focus on how to maintain family and neighborhood ties. People are then less stressed as well as being more likely to take their own actions to return and rebuild.

For humanitarian aid, this is even more paternalistic and stratifying… while not actually “fixing” any of the things it aims to. Aid is primarily about making the giver feel better. But like Tom’s Shoes picking up on the “buy one, give one” idea that OLPC actually handled with cultural grace and systems thinking, instead Tom’s put some people out of work while trying to provide something THEY thought others needed. Even if it had been delivered in a less-jerky way, aid often ends up with locations dependant on that aid, rather than internally strengthened. This is one way we keep extracting resources out of other places without actually contributing to those locations. See also this bit of the paper I’m still working on. This allows the worst parts of globalization (erasure of cultures, consolodation of wealth, etc) to continue.

Some might say “fine, let them fend for themselves,” but that’s not ok either. When we don’t have to look at our neighbors (when we build walled housing complexes, or segregated schools), we can ignore how bad things are for them. And that’s also not an acceptable answer.

What we need are ways to listen to what people can offer, and what they need, under the assumptions that we are equals. This is why I’m so excited to see how the participatory methods I associate so strongly with Aspiration come to bear on this space. Just do a search-and-replace for “Nonprofits” to “Affected Communities” on our Manifesto and Participant Guidelines. People in these fragile situations are NOT a population to playtest new tools. Not only do failures have a larger impact in these spaces, but to think of another location and its people as “demo” space is undignified and unjust. We need better ways (not just better tools) for life EVERYWHERE, and to assume that we WEIRD (Western Educated Industrialized Rich Democratic)-o’s have all the answers is downright arrogant. By instead, as we do at Aspiration events, speaking to each other in easy-to-understand language, under the assumption that everyone is bringing something meaningful to the table, and that together we’ll figure it out; we can shift not only how we do response, but the after-effects of that response.

I’m especially excited to speak to people about distributed response, and how the tools we build for ourselves can be welcoming to others using as well. Check out NYCprepared and Taarifa to see what this can look like.

Distributed and Digital Disaster Response

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Been working the new job with Aspiration in SF (while I still live in Providence and Cambridge), which is outstanding. Also been working on a paper about the topic I’m focused on with Aspiration, of how we perform mutual aid, at scale, specifically in disaster response and humanitarian aid. It calls for what we’d call a “mixed-mode system” in Complexity Science. I gave a talk at Berkman Center yesterday on the topic, and they’ve already got the video live. I had a great time! Thanks to everyone for coming out and sharing your brains with me.

Closing out at Geeks Without Bounds

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One of my favorite parts of being a part of an organization has come again: the off boarding. Many might be anxious about such a time, but I see it as the glorious moment of truth where you trust that what you have helped to nurture and build is bigger than you are.

Geeks Without Bounds has always striven to be an organization where Lindsay, Lisha, and myself came together as equals to perform the visioning, pragmatism, and yes – adminis-trivia of creating and maintaining a non profit. I’m thrilled to trust the organization to grow and change in their capable hands in ways I would never have thought. This is a good thing – if I had been able to predict where they go, the results would be flat, and without scaling ability. Together, they’ll focus on building GWOB into a 501(c)(3) focused on education and hackathons, with a continuing commitment to seeing projects through the first phases of creation and launch, from good idea to actual deployment.

I’m headed off to two new hats: community leadership strategist with Aspiration, whom I’ve had a huge organizational crush on for a couple years now. There, I’ll be seeing what of Aspiration’s highly interactive event stylings transfer into the digital disaster and humanitarian response space, continuing to explore the effects of social justice on networks via events like Weaponized Social, and documenting methodologies for use across languages and cultures. The other hat is as a professor of practice at Brown, teaching a class on digital communities.

I look forward to working with you in the future, either as partners or allies!

-Willow Bl00

NECSI Salon: Ethnic Violence

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On January 28th, the monthly salon gathered at NECSI to discuss ethnic violence from the lens of complex science. Yaneer Bar-Yam, president of NECSI, gave a brief talk about NECSI’s paper about modeling violence. Marshall Wallace, past director of the Listening Project, also gave a quick talk about his field experience with communities who opt out of violence. Again on Feb 4th, NECSI hosted an informal discussion around the case study of Libya. What follows are my big take aways and Sam’s asides, embedded into the fairly rough live notes from the salon. I call out these take aways and asides specifically because note takers often are lost in the notes, just as a photographer is never in the picture.
We hope you’ll join us on Wednesdays of this month to begin exploring medical systems, on ensuing fourth Wednesdays for structured discussion, or on other Wednesdays for more informal times.
wednesdays
Register for this fourth Wednesday here.

I am primarily left with a sense of purpose towards fostering collective intent towards alleviating suffering. In this entry, you’ll see a few ways large-scale violence is posited to be avoided. It is my personal opinion (of which I will opine at the end) that diversity is the key to equality as well as dignity, based on both the complex systems modeling and field experience framing these discussions.

But first, what do we even mean by “violence”? We’re referring to violent events occurring at level of massacres or bombing. These levels do seem to be slightly contextual based upon general violence levels in the area. Continue reading →

Complexity Salon : Ebola

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These notes were taken at the 2014.Dec.18 New England Complex Systems Institute Salon focused on Ebola. Sam, Willow, Yaneer contributed to this write-up, and 20 people were in attendance. We hope you’ll join us in future. We’ll have unstructured meetings each Wednesday from 18:00 to 20:00 (6p-8p) starting Jan 21st, with the fourth Wednesday of each month structured towards contribution towards a global challenge. The next such structured event will be on January 28th, on the subject of ethnic violence. You can see notes on this and potential future subjects here, and can register here.

About Ebola at NECSI [briefing by Yaneer]

NECSI has a history of studying Ebola models, and has predicted something similar to what is currently going on in West Africa for some time now. NECSI started with a model of pathogen evolution in which the most aggressive stable state has virus constantly passing slowly through populations, creating islands, dying out as people expand into areas with no disease.

Aggressive diseases plus long-range transport

Then if you add long-range transport, you get more and more aggressive strains. The more long-range transport you have the more aggressive the strain can be without dying out; and eventually could kill an entire global population. Paper published in 2006, mentions risk of Ebola.

As transportation becomes more pervasive, vulnerability increases.

Early warning and preparedness

Presented to the WHO in Jan ‘14. They were respectful and excited by the work. Discussed other public health issues faced by WHO, however didn’t return to pandemic models.

Since then: outbreak happened. Lots of discussion. Why don’t we engage in risks in a more serious way? Everyone thinks their prior experience indicates what will happen in the future.

  • Look at past Ebola! It died down before going far, surely it won’t be bad in the future.
  • Models of outbreaks look at existing conditions, which prove to be too limited here.

Example: with flu, people take exactly that disease and known circumstances, and simulate an outbreak, ignoring changes in the disease or in the conditions (and: nothing has to change in order to have huge risk). the same properties could remain, but a low-probability event could unfold, “fat tail distribution” – past experience isn’t necessarily a predictor of what will happen in the future.

Individual and community

Contract tracing, the standard public health method, doesn’t work well when there are more than just a few cases. Stop thinking about the contacts of the person, think about the community. Travel restrictions so new communities aren’t infected. Now that people go door to door for symptom screening, the cases have decreased dramatically in Liberia.

People were saying: “The beds are empty!” Authorities responded: “We can’t figure out why. We think people are still sick!” Why are the hospitals and authorities waiting for the sick to show up? Going door-to-door in the neighborhoods shows what’s going on, and is what is effective.

Once you know the right question, the answer is clear.

Interests

We then stated our interests – each person said one thing about the topic or intro talk they’d be interested in diving into more during breakout groups Continue reading →