InSTEDD update: Building the technologies of outbreak containment and humanitarian action

(Running notes from the InSTEDD update breakfast at TED2008) (UPDATED 10 March 08)

InSTEDD was imagined as his "wish" by TED Prize 2006 winner Larry Brilliant (speech summary and video), when he said that he wanted to "build a powerful early-warning system" which would make use of the Internet and other technologies to detect disease outbreaks, early signs of famine, environmental degradation, water poisoning, bioterror, etc. His goal was to "have the earliest possible warning of all bad things" so that they could be "contained with early response". He called it INSTEDD, for International System for Total Early Disease Detection.

Quite a challenge -- both technologically and socio-politically. Two years have past, and many things have happened in the meantime (including dropping the example that Brilliant had mentioned in his original speech, a Canadian system called GPHIN, and starting tech developments from scratch). Last week, Brilliant and the InSTEDD team hosted a breakfast at TED to update on the idea's progress. The lower-case "n" is not a typo: the project has been renamed Innovative Support to Emergencies Diseases and Disasters, becoming a tech lab for technologies in this field -- and they're working on several of them -- and since January it has been run by Eric Rasmussen, a former US Navy physician and commander with significant disaster-relief experience. (Larry Brilliant is the CEO of Google.org, which is backing InSTEDD).

Running notes on Rasmussen's presentation (thanx PM):
The recent US National Intelligence Council's "Mapping the Global Future" report identified HSN1 -- avian flu -- as a major global risk.
After we assembled the team we talked to a lot of people about their problems/challenges and we found common threads including: geo-referenced imaging, language and translation, unreliable communications, cultural acceptance, lacking essential data. I am going to focus on work around emergent strategic collaboration. To figure out the collaboration, we decided you have to get out on the ground with the people you are working for so you can see what they are dealing with -- if you don't go, you don't know. Collaboration in outbreak containment and humanitarian action is the critical task. You can abbreviate an absolute disaster. People in the field know exactly what they need to do. They don't have the technical wherewithal to do it or the money to hire people who can do it for them. People cannot talk from the places where bad things are happening, because of language and technology issues.

The response/relief agencies can collaborate, if you can give them a way to communicate. (He shows a photo of massive rubble in Banda Aceh.) There are 30,000 bodies in this photo. The only communication we had was SMS, there was only one cell phone tower standing and it took days to get more.

InSTEDD is in the field testing new technologies. Working with the Rockefeller Foundation on the Mekong Basin Disease Surveillance Program, assisting efforts in SE Asia (Cambodia, Laos, Myanmar, Thailand, Vietnam, and the Yunan Province of China)  to prevent, predict and respond to emergent infectious diseases through improved  information flows. Working in Mekong Basin in Northern Cambodia. Steung Treng Province. It takes 4 hours by dirt road, impossible in monsoon season. Their only ways to communicate: Bikes, on foot, by boat. These people are just as intelligent as anyone in this room, but have no access to communication.
(He mentions last fall's Golden Shadow field simulation in the Bay Area that tested several tools InSTEDD is developing).

Rasmussen goes on to describe several of the technologies being developed/tested:
1. SMS from the field displayed on Google Earth with sender's GPS coordinates; it shows up as a dot on map with a mail icon. Click on that and you can see the full message and/or respond.
2. We put people on rooftops where there isn't cell service with equipment to communicate online via satellite. Use a Ricoh camera with built-in GPS and wireless. The images go straight into the laptop and up on the map.
3. We are working with WHO's Early Warning and Response Network (EWARN), testing synchronizing information for the EWARN database via SMS (using a tool Microsoft has developed that allows cellphone-laptop, laptop-cellphone communication). In many regions with no Internet access, SMS is the fastest channel to get the data out.

4. (He shows a photo of  GATR, an inflatable satellite communications device - photo above) It looks like a beach ball, goes in a backpack and is inflated with a small pump. When I first saw it, I thought there's no way that will stand up in rough conditions. But it does. (Popular Science wrote about his use of it last year). It is not something for long term use, but it's great for short-term emergency outbreaks. We will be taking it soon to Laos. When we went to Banda Aceh, our satellite communications were delayed a few days because we couldn't get the rigid antenna on the (little) plane.
5. Simultaneous IM translation. Works now in 17 languages. Accuracy "not terrible" but improving: around 65-68 percent. But it is IM, so if it is garble, you just message back send again. It is now in use in Iraq and Afghanistan for military and civilian purposes.
6. Spot tracker (bright orange satellite personal tracker, see picture below). Uses GPS. Once activated, it sends a ping every 10 minutes, mapping your movements on Google Maps. Each is numbered. It tells who, what, where and when and it has an emergency"help" button. It can work in a backpack, so you can hide the bright orange color if you need to. The technology costs $150; the subscription, $150 a year. That's nothing.

What we need to do: Solid science is developing around indicators. We need to evaluate these very large data sets we're beginning to assemble.

Rasmussen wraps up with a pitch for a sponsor for a vehicle they want to launch to get this info out, which will be called the Humanitarian Technology Review and will be an electronic newsletter. He says people are willing to help produce it, but they need a sponsor to publish and distribute.

UPDATE 10 March - Mary Jane Marcus, program manager at InSTEDD, gave a speech on "Technologies for Early Disease Detection and Rapid Disaster Response" at the Texting4Health conference at Stanford University on February 29. Her slides, which cover much of the above in details, are now available (PDF 4.3 MB).

Comments

[Lauren Miehe]

The SPOT Tracker is a really useful piece of equipment that has come to market. Satellite phones are still pricey but needed if you in a part of the world without cell coverage (85% of the earth). It is nice to be able to offer satellite technology at a much more affordable price and give people a better sense of security.