In the fall of 2006, I found myself in unfamiliar territory: on the “other” side of the byline. I was officially part of the team for “Strong Angel III” (SA3), a large civilian / military disaster preparedness exercise designed to test technologies for humanitarian crises and health emergencies. 

Set in the only “anti-scenic” spot in all of San Diego – a collection of crumbling buildings so derelict, firefighters routinely torch them for training – the deafening roar of airplanes taking off from the airport next door added a certain theatricality to the under-siege atmosphere.To this desolate corner came half of Silicon Valley – including large delegations from Microsoft and Google – along with a collection of DARPA contractors, a few out-of-uniform Joint Chiefs of Staff, several scientists from nearby universities, someone whose day job was rumored to be driving the Mars rover, and a small group of frontline NGO aid workers whose approval would be the gathering’s brass ring.

No matter how clever or technically brilliant a technology, if it wasn’t practical, it didn’t fly. (“Yes, it’s a gorgeous map. But I have a old black & white printer, so the graphics have to work in black & white…”) 

The premise for this week-long disaster techfest was suitably dire: In the midst of a spreading global pandemic, with health services stretched to the limit, terrorists launch a series of cyber attacks on an unnamed city, knocking out power and cutting internet and cell phone access. What do you do?

At SA3, you started with a jolt from a hybrid car battery to get things off to a good, green, off-the-grid start. As generators cranked up to power a fleet of satellite dishes lined up on a crumbling concrete courtyard, squads of techies raced to makeshift workstations to set up gear and get to work. My job was to wander the sprawling site and talk to everyone I could. I tagged along on field tests and tried to figure out what worked and, just as important, what didn’t and why. In short, my contribution was being a journalist, although my “articles” – rough and raw email missives written at the fringes of each day – had a circulation of exactly four: SA3’s core organizers, led by Eric Rasmussen, a Navy doctor with a taste for tech and a career spent at the frontlines of tragedy: Haiti. Bosnia. Sudan. New Orleans (after Katrina).Thailand (after the tsunami). Afghanistan. Iraq.

Refugee Charette

I had met Rasmussen a few years earlier at a “Refugee Charette” organized by Amory Lovins, the founder of the Rocky Mountain Institute and a true-believer in the power of good design to make almost anything better.

Lovins had heard him speak about a Sudanese refugee camp where aid trucks dispensed water from spigots three times the diameter of the spouts on people’s jugs, which not only wasted water but created puddles that attracted mosquitoes, triggering a malaria outbreak. Horrified, Lovins gathered 300 experts on refugee issues, energy generation, water systems, education, design, telemedicine (and one journalist) for a 3-day brainstorming session to tackle the larger of issue of how to improve the daily lives of millions of people “caught in the middle.” 

Technology for the Greater Good is an idea easy to embrace. It offers the promise of a better life for those in need, and a way for those with know-how to contribute something of themselves. From Medicines sans Frontieres, founded in 1971 by a group of French doctors and journalists in response to the famine in Biafra, Nigeria, to its counterparts, Engineers Without Borders and Architects Without Boarders, there has been a movement to provide on-the-ground professional expertise. “Design for the Other 90%,” a recent exhibition at New York’s Cooper-Hewitt Museum, focused on this kind of work, highlighting everything from MIT’s D Lab’s efforts to develop a cheaper, “greener” charcoal from sugarcane, to the Lifestraw personal portable water filtration system, and the One Laptop Per Child (OLPC) project to provide students in poor countries with the tools for a high tech 21st century education. 

Not too surprisingly, many of these design ideas have applications in the developed world. They use less energy, are generally better for the environment and often better altogether (e.g., OLPC computer screens are engineered to be used under full sun, something my MacBook Pro, for all its tricks, still can’t manage).

The problems of poverty, disaster and disease, of course, transcend geographic and political boundaries. Rich countries have no shortage of people in need. More than two years after Hurricane Katrina, New Orleans is still recovering. For tens of millions in the U.S., no health insurance means no basic health care. Although emerging infectious diseases are emerging at the greatest rate in Asia and Africa, they can spread globally as fast as a plane can fly (SARS). And outbreaks of frightening new diseases can happen anywhere (AD-14, Sin Nombre virus).

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The technologies and ideas shared at the charette ran the gamut. A DARPA researcher spoke enthusiastically about micro fuel cells that one day (soon?) would be used to power laptops, cell phones, pda’s and other small appliances for dozens of hours at a time. The military is interested in reducing the weight and number of batteries soldiers carry for their electronic gear. In a humanitarian crisis, micro fuel cells are distributed power at its most granular and portable – which can make all the difference when the power grid fails, or when there isn’t any grid at all. 

Janine Benyus, meanwhile, sparked everyone’s imagination with examples of better living through biomimicry: adapting nature’s always elegant answers to an array of design problems.

It was an inspiring few days, but how any of it would translate into making a significant difference out in the bruised and battered “real” world was less than clear.

Can Tech Make a Difference?

The issues are staggering in complexity and enormity: tens of millions of people stuck in refugee “camps” (despite the implied transience of the word, camps can last for years or even decades) or classified as IDP’s (“internally displaced people”). Billions more trapped in poverty.

Add natural disasters to the mix and the unimaginably bad quickly becomes unimaginably worse. According to a recent Oxfam report, there has been a four-fold increase in the annual number of natural disasters over the last 20 years.

At the same time, increased trade and travel, high-volume livestock and poultry operations, wars, a shifting climate, drug-resistant pathogens and a burgeoning human population have led to a significant increase in outbreaks and emerging diseases.

These intersecting crises are becoming more frequent, dangerous and severe. In an ever-flattening world, regional disasters can quickly go global, while global events often have devastating local consequences.

The need for more and better answers is beyond urgent.

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Can tech provide some of those answers? My job at SA3 was to try to see the forest and the trees. I was the only one of the nearly 800 participants able to step back from the clocking-ticking immediacy of a specific project to see the exercise as a whole.

Winning and losing ideas quickly sorted themselves out: small, adaptable, sturdy, and platform neutral routinely trumped big, specific, fragile, pricey, and platform-limited.

1. ★ Sahana’s disaster management system was lauded for its egalitarian open-source roots, while Microsoft was rapped on the knuckles for software that barely played with Linux and was oblivious to Apple.
   

1. ★ A computer-filled minivan for medical surveillance, outfitted with a small satellite dish strapped with a bicycle rack to its roof drove literal rings around a gas guzzling two-gallons-per-mile RV decked out with tons of medical gear.
   

1. ★ A parking lot full of satellite dishes, each with its own truck and crew, was bested by a “beach ball”: a lightweight cloth satellite dish set inside a 8’ cloth globe that cost a fraction of a traditional dish, used a fraction of the power and packed up into a couple of boxes that could be shipped anywhere overnight by FedEx.  
   

Technologies ranged from the simple genius of a wind up flashlight with a port for recharging a cell phone, to the breathtaking potential of software able to transliterate spoken Arabic broadcast on Al Jazeera into print, then translate that into English.

With my particular interests in biology and biosurveillance, I began to imagine all sorts of

mash-ups:

   a cheap portable satellite dish

+ a solar refrigerator

+ rapid diagnostic tests

+ cell phones and computers (powered by micro fuel cells)

+ a digital camera set up (Gigapan?)

+ transportation (of any kind, including hooved)  

= one superior field lab.

Researchers would be able to collect and store samples, do on-the-spot tests, gather information, take highly detailed panoramic photographs and send data back to a central lab. Wow.

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It was impossible not to get caught up in the esprit de corps that built over the course of the week. People blossomed at the chance to be part of something bigger than any one individual, to be part of something good. Arch competitors became supportive, enthusiastic, almost giddy collaborators.

I watched as programmers from a half dozen GIS companies worked with Google Earth staffers to develop new ways to layer real time disease surveillance and emergency data onto interactive maps. A little more than a year later, I saw the telltale fingerprints of SA3 on just such maps posted online by news organizations to chart the progress of wildfires threatening Los Angeles and San Diego.

To Keep a Good Thing Going

Given the heady sense of collective mission in the immediate aftermath of SA3, it was disappointing to see how fragile many of the newly formed and promising bonds proved to be. Although some had deep history working together after Katrina, or in the wake of the Indonesian tsunami or in various war zones, most people were swept back into their daily lives, stretched by the immediacy of work-related deadlines or constrained by corporate loyalties.

I began talking with Rasmussen – Eric – about the need for an web journal that would make it easier for people in health and humanitarian fields to learn of each other’s work and to connect with one another. Twice now, first at the Refugee Charette and then at SA3, I had seen the sparks of sustained meaningful collaboration almost catch fire. But a few days of intense conversation and idea-sharing, no matter how inspiring, can only accomplish so much. There needed to be a way to support and encourage the conversations to continue.

Ironically, although specialization has led to a greater aggregate knowledge, growing gaps between fields have led to missed opportunities and missed clues – sometimes with tragic consequences.

Months before the CDC reported cases of paralysis in West Nile patients, veterinarians documented cases in large mammals. Humans, too, are large mammals, but doctors don't have time to read vet journals and vice-versa. There are similar examples in every field.

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In October 2007, Eric took over as CEO of InSTEDD* an independent non-profit that had been spun-off by Google.org to work on “Innovative Support To Emergences, Diseases and Disasters.” 

What began glimmer of an idea in casual conversation became an assignment: What would an online journal covering health and humanitarian tech look like and what would it take to happen?

Over the last few months I have worked on the answers, profoundly aware of what an unusual opportunity this is.

The need for concrete aid – more anti-malarial bed nets, more vaccines and drugs, clean water, food, shelter, digital networks, money – is both pressing and obvious. But to say, "We need to invest in more information and better ways to connect across disciplines!" addresses a somewhat less tangible, though no less urgent, need. This truly is “innovative support,” designed to link those with needs to those with ideas, products and funding. It is a medium to make it easier to discover and implement much-needed better answers.

The Humanitarian Technology Review (working title) is an idea-in-progress. Please send any thoughts, ideas or questions to: htr@instedd.org or jaginsburg@gmail.com.

1. *“Innovative Support To Emergencies, Diseases and Disasters” is a retrofit for an acronym introduced in a speech at a TED conference by epidemiologist-turned-Google.org director Larry Brilliant. It was originally a double pun on TED and EDD – Early Disease Detection.

by Janet A. Ginsburg