Feature Story

How open source helped beat Ebola

by Jason Deign

open-source Ebola

The power of open source helped save lives during the Ebola epidemic.

More than 10,000 dead, hundreds of thousands affected, and a world paralyzed with fear at the prospect of contagion. It is hard to fully grasp the impact of the 2014-2015 Ebola outbreak in West Africa, and the valor of those who put their own lives on the line to save the lives of others.

But among the countless stories of human tragedy and heroism, it's now known what a vital role open-source software played in supporting doctors during critical times.

When doctors first started treating patients, the lack of electronic medical records made patient care even more difficult.

That's because written records could not be taken outside treatment centers for fear of spreading infection and at the time, so little was known about the disease.

To come up with a solution, Save the Children International and Doctors Without Borders worked independently to adapt an open-source platform called OpenMRS for use in West Africa.

Doctors in ‘red zones', where infected people were being treated, were given waterproof tablets that could be sterilized after use. They accessed the OpenMRS platform via a specially adapted user interface designed for use with the heavy, gloved suits worn by medical staff.

Workers on the outside then transferred the data wirelessly for analysis. Not only did the open-source system help improve treatment and understanding of the disease while it raged across Sierra Leone, Guinea and Liberia, but it now remains in place to deal with future outbreaks and other medical threats.

See also: Open Source is at the core of your digital transformation

Open source also helped to set up a system, to ensure medical staff got paid.

NetHope, an innovation-focused non-profit working on behalf of agencies such as Relief International and the Red Cross, went out to Sierra Leone in October 2014 to install network and communications gear, but found it was money, not data, that was failing to get through.

According to press reports, thousands of medical workers resorted to begging for handouts from patients since Sierra Leone's public sector payroll system was so antiquated. NetHope emergency response coordinator Emerson Tan said the situation worsened when healthcare workers went on strike and patients had to break out of quarantine to find food, putting other civilians at risk of infection.

In response, a NetHope team patched together a payroll and human resources enterprise resource planning (HR ERP) system based on off-the-shelf open-source components.

The system, which featured biometric enrollment based on Sierra Leone's voter registration machines and OpenBR facial recognition software, was assembled within two and a half weeks from first prototype to national rollout.

"This was the fastest large-scale HR ERP implementation and rollout in health care management history," notes Tan on his LinkedIn profile.

Then, because the nation only had eight teller machines and was running out of cash, NetHope also collaborated in the creation of an automated mobile payments system from scratch. That project took less than five weeks.

The technology made sure medical staff could be paid on time, all of the time, for the first time in the country's history, restoring confidence in the healthcare system at a critical point in the Ebola epidemic.

Open-source expert Stefano Luperto, of the systems integration consultancy Sourcesense, says it is no wonder that open source played such a prominent role within the innovation that helped beat Ebola.

"Being able to set up a system quickly and cost effectively is common to every project in open source," he says. "If budgeting is a problem, using open-source products can save a lot of money, so it can be very important to organizations such as charities."

At the same time, today's open-source platforms have largely overcome previous handicaps relating to complexity and stability.

"In the past, open source was difficult to adopt," says Luperto. "Now there are a lot of companies that support open source because they do business on it. It's also much more reliable than in the past."

The bottom line is that if open source was able to help in the fight against one of the most lethal epidemics of recent times, it can likely come in handy in a host of other situations. "There's a lesson that every company can learn from what happened in West Africa," Luperto says.

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