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Texting help and health in disaster response

Nonilan Sulibat, a rice farmer in Laguna Province, will soon receive expert advice on how to increase his field's productivity on his mobile phone. Rice is a staple part of the Filipino diet David Swanson/IRIN
The Philippines looks set to expand its rapid monitoring system, based on mobile phone text messaging, to lessen the number of deaths and improve emergency response times. With over 7,000 islands and more than 100 million people, the archipelago experiences an average of 20 typhoons a year, with stronger storms in recent years.   
 
Surveillance in Post Extreme Emergencies and Disaster (SPEED), a project supported by the World Health Organization (WHO), uses SMS / text messages on mobile phones or the internet to alert emergency health officials to dangerous situations and send them health information, and receive data on health conditions in communities and reports of disaster damage. 
 
The system was set up in 2009 on a trial basis after the Philippines, one of the world’s most disaster-prone countries, was battered by back- to-back typhoons. Ketsana dumped enough rain to flood more than 80 percent of the capital, Manila, when major rivers and waterways burst their banks, swallowing entire urban communities in the worst flooding in recent history. 
 
Exactly a week later, Parma ravaged the northern Philippines, triggering landslides and floods. More than 1,000 people were killed, 600,000 were displaced, and up to 10 million were affected by the storms, which caused an estimated US$43 billion in economic damage, according to the World Bank. 
 
As emergency workers struggled to help people in desperate conditions, an outbreak of deadly waterborne diseases, including Leptospirosis began ravaging survivors, infecting more than 3,380 people and killing 20.
 
"It was a wakeup call for us. It caught many health workers off-guard, because they too were victims of the flood," said Carmencita Banatin, head of the Emergency Management section of the Health Department. "So we decided to do something and improve monitoring in post-disaster [circumstances] and asked the WHO to help us put in place a surveillance system through text messaging."

WHO sent its Global Outbreak and Alert Response Network to Manila, which worked with local officials to establish the initial phase of SPEED, covering flood-affected areas. "We realized that in the aftermath [of a disaster]… health managers needed to make quick decisions based on verifiable data on the ground to prevent more death from disease outbreaks," Banatin said. 
 
Manila - Police evacuate an elderly couple from a flooded section of suburban Pasig city east of Manila on 28 September 2009
Photo: Jason Gutierrez/IRIN
The country averages 20 typhoons a year
SPEED can be activated within 24 hours of any disaster, including displacement caused by conflict, and works by tapping into the vast mobile phone network in the Philippines - official statistics say almost everyone has a handset. Where mobile phone systems are down, field reporters can use radios to send in statistics for their area, she said. 
 
Health and emergency “reporters”, usually disaster response or health officers at the barangay (the smallest administrative area) or municipal level, fan out to community health facilities, hospitals and evacuation centres to check on reported cases of the most common post-disaster diseases. 
 
This data and other information is then sent via mobile phone - using codes and formats specially designed for the system - to the central SPEED server based in Manila, where it is collated and analyzed before making the information accessible to emergency officials at all levels of government. 
 
The system also sends immediate "notification alerts" to the mobile phones of designated recipients when the number and distribution of specified health conditions go over a specified threshold, "signifying the potential development of a possible outbreak or epidemic, thereby allowing officials to respond quickly," Banatin noted.
 
WHO country representative in the Philippines, Soe Nyunt-U, said access to the SPEED website would be restricted to emergency officials who could make vital decisions, including mayors, governors, members of the executive department and emergency relief agencies. They would be able to pull up tables, graphs and maps to help them analyze trends and deploy help where it was most needed. 
 
"The principle is to prevent more deaths and diseases. Disasters do happen, and deaths and injuries at the time of the incident, but through this system we would be able to prevent outbreaks that could lead to more fatalities," Soe Nyunt-U told IRIN. 
 
He said the nationwide SMS-based surveillance system was unique to the Philippines, but other countries in the region were beginning to study the module. Localized surveillance systems had been put in place after major disasters, such as the 2004 tsunami that struck Aceh in Indonesia, but they were abandoned when the situation normalized.  
 
"This is a very good example of harnessing technology for a noble cause," said Soe Nyunt-U. "With this tool, we can prevent outbreaks, prioritize movements, and health and emergency officials can pinpoint where to deploy help with immediacy.” 
 
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This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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