Public Health Spending vs. Infectious Disease Rates

Some food for thought, from a really interesting piece on the World Mapper website.

This is a map comparing public health spending around the world. Countries that spend more money are exaggerated to show their spending size compared to their neighboring countries and other continents.

World Map by Public Health Spending

Nothing too surprising here, I think. We see that the United States and Europe spend the most, relative to their size. Look at Germany up there! And France! Kind of nuts.

Compare this public health spending map to the map of infectious Disease Outbreaks.

World Map by Infectious Disease Outbreaks

Nearly the opposite map in terms of perspective/size of countries, no? The Western Hemisphere is tiny tiny in this case, and India and Nigeria are MASSIVE.

Again, nothing here is too surprising. But it is really striking to see and compare these contracts in a similar format of distortion.

Based on this information, consider where we find ourselves in the Ebola crisis. We have a highly infectious disease that travels through social networks, tearing apart families and communities while also presenting truly horrifying symptoms. The disease also presents itself in some of the hardest to reach communities on the planet. I have learned, throughout our efforts to improve tech opportunities for doctors and field workers in Liberia and Sierra Leone, that there really isn’t a one-size-fits-all solution to public health data collection and/or patient follow up. What worked for the US to run in its contact tracing programs are not necessarily a good fit for the communities that we work with in West Africa or the West African Diaspora Community.

This version of public health, especially in the face of a disease as challenging as Ebola, requires a mix of practical applications and rethinking models to fit limited infrastructure, and compassion for the communities that we are trying to reach. The tools we provide, on their own, are worthless if we cannot convince our communities to adopt and engage with them. This seems to be the missing piece in a number of the programs and efforts we see on the ground. But, I am hopeful that we will continue learning from our mistakes and improving our methods and outreach.

What You Should Remember About The Ebola Crisis

This week we’re working through a lot of narrative, start-up pitch-like documents for our work on the Ebola crisis. My colleague revisited a series of stories and well documented aspects of the crisis this morning. We found that this particular description from the New York Times piece titled “For A Liberian Family, EBola Turns Loving Care Into Deadly Risk” powerful:

“Ebola is a family disease, Liberians are reminded continually in Sunday sermons. The more families pull together to fight the virus, the more they seem to fall apart.”

Even the spaces where people used to go to seek comfort or reconnect are off limits. The fabric of society is twisted to meet public health requirements. It is necessary, but also very very sad.

“This destruction of families is the central tragedy of the epidemic. On a continent with many weak states, the extended family is Africa’s most important institution by far. That is especially true in the nations ravaged by the disease — Liberia, Sierra Leone and Guinea — three of Africa’s poorest and most fragile countries. Ebola’s effects on the region, in undermining the very institution that has kept its societies together, could be long-term and far-reaching.”

You can read more of the article here.

Assisted Contact Tracing — in Brief

I want to explain in a little more detail what I am working on now — I think the following, which I was working on for a press release, will help explain the project.

First off, ACT is a software used by healthcare workers, contact tracers, field organizers, and physicians working on the ground to track and predict the spread of the Ebola virus.

There are two components to Assisted Contact Tracing (ACT).

First, ACT collects and organizes data about the ebola outbreak through contact tracers. This data is available for us by organizations like the CDC and the WHO. Beyond that the identities of contacts and ebola patients is protected, allowing other organizations to look through the data for trends but not identify specific contacts.

Second, ACT helps contact tracers, health care workers and physicians prioritize cases that come up in the field. Rather than rifling through a gigantic list of contacts generated by an Ebola patient, the ACT system helps healthcare workers prioritize cases. The data provided by ACT provides contact tracers with context before they make visits: they will know before they walk into a community whether or not their contact is showing symptoms so that they can better prepare and protect themselves from infection.

ACT uses contact information collected by the initial contact tracers to generate automated calls in specific dialects back the contacts every day for the 21 day quarantine period to monitor for health/symptom changes. Once a contact reports that they are sick and their symptoms, ACT generates an SMS to local health care workers and physicians to report the case, contact information and location of the patient.

This measure cuts down on time for data collection and accuracy, and allows field workers and healthcare workers to build better strategies for patient outreach.

ACT is a critical tool for a few reasons.

First, it would limit the level of exposure to Ebola for healthcare workers, who are currently some of the people most at risk of being infected by the virus.

Second, the automated check-ups allow a suspected patient to remain isolated at home, rather than having to stay in an isolation ward. “ACT is important for the system to allow people to pursue their own healthcare, so [potential patients] don’t have to go into isolation. It also provides information on how to care for a family member in their home with limited resources,” say Camilla Hermann, Founder and Director for Odisi | ACT. ACT does not make cold calls. These automated calls are opt-in and only start after a doctor or contact tracer has first met and spoken with an Ebola patient or contact.

While ACT is currently geared towards the Ebola crisis, we think this program will have broader implications and potential applications in public health infrastructure around the world. I will continue to update based on our progress as we start getting into better field testing and data collection work.