CBS is a system and methodology for detecting and reporting events of public health significance within a community by community members. The Red Cross Community Based Surveillance (CBS) platform gives a mechanism for local communities to report on health risks in real-time using SMS. By monitoring real-time data, we can respond to an outbreak before it spins out of control, thereby saving lives. This new technology could be a valuable contribution to outbreak prevention and response, as it provides a means to report and monitor health risks in real-time and in a simple manner. By closing the surveillance gap and enabling communities off the grid to alert of potential outbreaks, CBS can provide the means for early detection and early response.
From local to global
Connectivity infrastructure can hinder communities in communicating risks of public health significance. For instance, during the 2012 cholera outbreak in Sierra Leone, information sharing was a challenge. The Sierra Leone Red Cross established 400 Oral Rehydration Points (ORP) in the affected communities, where health risk data was collected. However, there was no means to receive and share this valuable health data as it had to be manually collected at all ORPs. For the hardest to reach communities, there was an information delay up the several weeks.
From this case grew the idea of the CBS platform. How could we collect and analyse critical health data, in real time?
Today we have developed the methodology and digital tool together with our partner national societies in Sierra Leone Red Cross, Haiti Red Cross, Madagascar Red Crescent and the Somali Red Crescent. While Norwegian volunteer tech developers programme the platform, the platform is simultaneously tested by our partner national societies on the ground who feed valuable user experience information back to the volunteer developers. The two-fold volunteer model with simultaneous implementation and software creation provides an opportunity to ensure that the CBS platform is built and adapted for scale-up and with the ability to provide a simple and reliable means for early detection, warning and response to outbreaks. By connecting local community volunteers with global volunteers we are building new forms of volunteering.
Solving and building with the community
While looking at different available digital tools we were not able to find a tool that fit all the needs we had identified on the communities where we work. We sought advice from different technical companies and in the process learned that there were technical volunteers who wanted to contribute to the Red Cross, but who were struggling to find a way to contribute. They are not the typical “first aiders” volunteers, but they had something that we didn't have; competencies in tech development.
Petri Wilhelmsen, Graphics and Simulators developer: “I write a lot of software. But this is an opportunity to use my skills to help something bigger. The tech we are working is something that both new and experienced devs can learn and participate.”
The 4th Red Cross Codeathon was a 48-hour coding marathon, where 68 people met to improve on the CBS platform (12 domain experts, 56 volunteer developers). During the two-day codeathon, we worked on improving the CBS platform MVP (Most viable product), which is currently used live in Somaliland. The CBS platform follows the domain-driven design pattern where each “bounded context” acts as a microservice. The communication between the bounded contexts is event-driven, and within each microservice the front-end is based on React (some parts are still being rewritten from Angular), with a .NET Core backend and MongoDb for storage. They are dockerized and deployed to a Kubernetes cluster, with Kafka as the event hub. The analytics bounded context is built with R and D3js. (CBS Github)
Each Codeathon participant joined a team consisting of health experts, CBS platform experts, developers, designers, project managers, and data analysts. Each team focused on one part of the plattform (bounded ccontext) with predefined challenges.Two of our most important tasks were to build an automatic alert system, as well as automatic visualization of data. These two functionalities will make it easier for our field colleagues to detect and respond to disease outbreaks earlier. Both of these features were drastically improved during codeathon: we now have a test-ready notification system and completed map analysis functions (with false data) which is to be linked to real platform data. In addition, we completed the front-end migration to React and made other parts of the platform more stable.
Reimagining volunteering at RCRC and digital transformation are big themes at the Red Cross Red Crescent. By connecting and co-creating with community health volunteers in local communities and digital/technology volunteers, we aim to respond to the changing nature of humanitarian response. Thanks to all the community volunteers (local and global), donors, and all the supporters of the CBS project. The next steps of the CBS team is to plan out the next stages of the software and community. There will be another codeathon in the coming months. Details can be found via the CBS Mailing list and blog.
[Editor note: This blog post was co-written by Rebecca Bushby, Tonje Tingberg, Anine Kongelf, Samson Gejibo, Roxanne Moore, and Heather Leson.]
[Credits: Truls Brekke, NorCross (Quiet moment at codeathon) ; All other photos: Heather Leson CCBY_30; CBS image: NorCross/IFRC.]