Open-source 'ecosystem' central to fight against Ebola

A nurse checks on a patient at the Kenama Ebola treatment centre run by the Red Cross Society. (Francisco Leong, AFP)

A nurse checks on a patient at the Kenama Ebola treatment centre run by the Red Cross Society. (Francisco Leong, AFP)

Striking healthcare workers put Sierra Leone’s fight against Ebola in jeopardy. Harnessing open-source software and the voters’ roll solved the issue.

Little known to the rest of the world, a team of open-source software developers played a small but integral part in helping to stop the spread of Ebola in Sierra Leone, solving a payroll crisis that was hindering the fight against the disease.

Emerson Tan from NetHope, a consortium of nongovernmental organisations working in information technology and development, told the story at a technology conference in Hamburg, Germany.

Tan said he was dispatched to Sierra Leone in October 2014 with a vague mandate: “Go and improve things.”

He found the most urgent problem was distributing wages to healthcare workers on the frontline fighting the epidemic.

“In the old system, people didn’t get paid for months,” Tan said. Doctors and nurses were forced to take money from patients, he said, undermining confidence in the health system at a vital time.

And, when healthcare workers went on strike, Ebola patients in hospital quarantines broke out in search of food, spreading the disease.

When millions of dollars began pouring in from international sources, it was unclear how to distribute it to the 30 000 healthcare workers needed to tackle the epidemic.

Until that point, payroll was handled in cash, and Tan said he was sometimes handling “kilograms of money”. At one point, the central bank informed him it was going to run out of banknotes. Also, there were only eight ATMs in the country.

Time was a pressing concern.

“We have a couple of months or we’ll lose the region,” a United Nations official told Tan at the time.

To solve the problem, the team drew on existing open-source software solutions for payroll management, biometrics, logistics and accounting.

Tan said: “You could not possibly develop systems this quickly without the existence of this huge open-source ecosystem.”

The team cannibalised Sierra Leone’s voter registration machines to create a payroll and enrolment scheme.

As they could not use fingerprint biometrics, because it would have created a cross-contaminating risk, they used open-source facial recognition software called OpenBR to enrol healthcare workers.

From there, they developed a mobile money system that substituted cellphone-minutes for cash, and created an automated payment system.

They completed the core system in two weeks, making it possible to pay workers punctually “100% of the time”, Tan said.

A total of 3 955 people died in Sierra Leone, more than a third of the total deaths associated with the 2014-2015 West African Ebola outbreak. – © Guardian News & Media 2016

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