M'aidez a companion to Global Health First Responder

Natural disasters caused by climate change, extreme weather, and aging infrastructure, among other risks, represents a significant danger to human life and communities on a global scale. Epecare’s Global Health First Responder program trains individuals in disaster preparedness techniques and helps dismantle fears of helplessness by empowering community members towards 

action. 

Our proposed solution, M’aidez is an application used in addition to our Global Health First Responder course. M’aidez will provide Geospatial Artificial mapping supporting a network of trained disaster responders willing to help with recovery efforts that can be activated in a moment’s notice. Our trainings are adaptable to many settings and this application can be adopted easily through the Haitian phone company, Krik Krak. There is feasibility to expand in any international setting due to the low resource nature of our lessons.

The consequences of climate change will increasingly translate into a growing need for public disaster preparedness training and response efforts. Haiti suffered the largest number of people killed, estimated at 50,000-87,000 by Doocy et al., both in absolute terms and relative to the size of its population, due to the terrible toll of the 2010 earthquake as reported by the International Disasters Database. Response efforts by world relief agencies lead to a cholera epidemic causing at least 9,200 deaths reported by the Haitian government. This only empowered distrust of aid organizations.  

Currently, there is no succinct emergency response activation system in Haiti along with many other developing countries. This gap in prehospital care during an emergency means preventable lives are lost. This is a fact in many countries around the world. Epecare currently has 70 Global Health First Responders in Haiti without a system to connect these volunteers in an organized effort. Gaps in response can be met by community organization reducing the burden disasters have on human lives.

Led by Haitians Harold Roy and Ernst Montobon, Epecare works directly with Haitian community members to establish a network of responders who understand the cultural intricacies and needs of their community. M’aidez would function as a platform to connect resources, volunteers, and meet arising needs.

In August 2018, our Global Health First Responder training was piloted in two cities. This provided an opportunity for Epecare members to consider feedback and adapt the current trainings towards community needs, such as the inclusion of basic human physiology. 

Our support of community uptake is twofold: locals may access trainings free of cost at community centers and trainings are taught in Haitian Kreyol via our partner organizations, OISUH and Partners in Health. These individuals, now trained in disaster management techniques, are part of our responder base. This base will react in an emergency reducing the impact disasters have on the population measured through improved health outcomes. This system will ultimately allow a community to serve its own needs during a disaster. 

The M'aidez application, via Krik Krak, aids in consolidating disaster response efforts by activating those who have completed Epecare’s Global Health First Responder course and learning from responder-gathered field data. An SMS/radio based reporting and activation system, M'aidez uses GIS mapping of the situation from a central command post along with live AI-driven projections and updates from the field. Updates consist of changes in situation and needs identified during a disaster. Responders will gain access to the application via completion of Epecare’s Global Health First Responder course. New responders can also recruit other community members they have trained. This cohort of response volunteers could then be sent disaster alerts along with a notice of summons when a disaster strikes. M’aidez would facilitate the establishment of a meeting/staging area for relief efforts. Humanitarian organizations can now direct these volunteers to respond in the best possible way within the disaster zone. 

Our solution aims to fill the gap in prehospital care along with enriching an existing training program in Haiti by providing a communication network to connect trained first responders to each other, central relief efforts, and those in need. Our Global Health First Responder program introduces basic life support skills and first aid training to community members in Haiti through a “Train the Trainer” model. Members of the community who are trained by licensed health care professionals and experienced global first responders, then take their training into their community where they now have the skills to either train additional community first responders or respond to an emergency themselves. 

We plan to use community partners including OISUH, a Haitian-based organization improving community resilience, and Partners in Health, with whom our In-Country Director currently manages security. These organizations could use our solution to mobilize community responders when the next disaster inevitably strikes. This would allow communities to respond to their own emergencies in an organized and efficient manner, instead of waiting for outside relief organizations.  

M’aidez will set the new standard of disaster preparedness by enabling communities to direct relief based on their immediate needs, ultimately allowing for better allocation of resources and transparency. M’aidez will be adaptable to all resource settings, yet centered within our Global Health First Responder (GHFR) training that uniquely targets low-resource settings and aligns with our goal of establishing community driven disaster preparedness and response. Other countries use data collected from social media yet, M’aidez will quickly process this data into interactive visuals like maps, needs lists, and active alerts.  

Our proposed activation and notification system will facilitate a response network in a country which lacks a robust one. While there are disaster reporting applications on the market, this would be an Epecare-specific product that simultaneously functions as a disaster alert system. Aggregated data will steer our volunteers and facilitate live situational updates. Starting from humble beginnings, we would like this application to expand along with our service offerings. Data will be mined with Natural Language PRocessing and AI will inform future deployment efforts.   

The activation system would allow trained responders to react in an appropriate fashion. Already helping their neighbors, these community responders could be coordinated by local response organizations such as OISUH, Partners in Health, and the Haitian Government when the next disaster strikes. This allows citizens to quickly react to disasters instead of awaiting relief from elsewhere. 

M’aidez will utilize technologies including Artificial Intelligence, Natural Language Processing, Geographic Information Systems, and alert notifications. OnSolve is an emergency event notification system used for reliable rapid dissemination of communications to students and faculty at Boston University through BU Alerts. The system works by sending messages to all channels given to the university, text, email, and phone. The service provides details pertaining to the specific situation and any dangers associated, while also disseminating updates until the situation has been resolved. The system can also be used to receive updates from message recipients along with geotagging using the Haiti GSM (Global System for Mobile communication) network adapting this technology to Haiti. 

This style of communication will aggregate data including where events occur, field updates, and needs that may arise. With this data aggregation, the M’aidez platform will mine the keywords using NLP. This can than be used to adapt real-time GIS mapping of the disaster. Data can also be used to train AI algorithms to better forecast needs in the communities informing smart deployment of our responders.  

Our solution will reduce the impact disasters have on low resource communities and enable communities to take control of disaster planning. In combination with our Global Health First Responder (GHFR) Program, M’aidez, will bridge the gap in gaining access to emergency care during a disaster. Most Haitians have smartphones, as observed during our previous deployment. With this in mind, we want to introduce an activation and alert system to our program to increase the efficiency of our care. By creating a more advanced alert system, similar to the SMS based response systems used by universities around the U.S, we will be able to alert individuals of emergency situations and save lives. 

In 1985 the Los Angeles Fire Department created the Community Emergency Responder (CERT) program and this model has been replicated multiple times across the country. Our GHFR program, that is similar to the CERT structure, successfully equipped 70 community members in Haiti with skills and knowledge that will allow them to react more effectively during a disaster. Our solution would also tie directly into monitoring and evaluation within the GHFR program.

Epecare will set up a network through M’aidez to mobilize community responders while understanding the utility of our training. Output would be the number of individuals reacting in the event of an emergency, while the ultimate outcome is to build agency in community members. These steps will cause Haitians to take charge of their own community response, identify strategies for improvement, and develop resilience.

Currently, 70 Haitians have been trained as of last year. They were tasked with the mission of training their friends and family. We expect each individual to train three fellows resulting in 210 people with first aid skills. We do not currently have a communication method to monitor the utilization of our training. M’aidez fills this need.

Our annual projections are two four-day training trips allowing us to reach about 140 people directly each year and 420 indirectly. These individuals will be able to utilize the M’aidez application once trained. These projections are estimated to increase in the coming years as we expand to new settings within Haiti and the Caribbean.      

In the next five years, Epecare endeavors to ramp up training to reach our goal of 200 trained each year, so each community has a responder endemic. By the end of five years, we predict 4000 people utilizing the M’aidez application from a community responder perspective; comprised of 1000 direct trainees and 3000 indirectly trained responders. This does not include other formal responders including WHO and the Haitian Government.

Within the next year Epecare endeavors to run two training programs in new Haitian communities. Previously, we trained individuals in Jacmel and Leogane, but would like to democratize these first aid skills to as many geographies as possible. Our president, Harold Roy also performed some training in Costa Rica, a potential new location for partnerships. Finally, we expect the M’aidez application to take about a year to build.  After setting up the backend of the app it will take some time to roll out the interface and run an emergency simulation. 

In five years, Epecare’s goal is to expand our services to a new country with a focus on low resource settings. This expansion of our Global Health First Responder program would broaden our response network; we hope to train about 200 community members directly each year. With partnerships to other relief organizations we would like to quantify those saved by our trainings in order to support monitoring and evaluation. Finally, we would like to deploy the M’aidez application in a crisis when one occurs.

Some issues and barriers that Epecare anticipates is civil unrest within Haiti and language barriers. Our application relies on partnerships with the Haitian government and relief organizations, there is concern in making these relationships due to historic corruption and mistrust of government and international relief actors. M’aidez will need buy in from local and international acting partners while we move forward with our programming. 

While we have a team of dedicated Haitian Kreyol translators through our sister organization, OISUH, another issue we have run into is the translation of medical terminology from English or French to Haitian Kreyol. Kreyol is the main spoken language of the island while French is the language of the elite - leading to translation barriers when teaching skills such as basic life support. 

When considering the collection of data, it is also imperative to consider the ethical issues surrounding the use of that data and any associated privacy complications. Finally, there is the issue of cellular networks breaking down during a severe natural event like a hurricane or earthquake.

Epecare has faced and expects to witness civil unrest within Haiti in the future. As our trainers’ safety is paramount, in-country partners monitor these situations. Our in-country director, Ernst Montobon, is the head of security for Partners in Health and leads Epecare security during deployment. To facilitate GHFR security, we want to incorporate a live warning system into M’aidez which can both alert and collect security updates. 

Language poses another barrier; French and Haitian Kreyol are the predominant languages. M’aidez will be trilingual to facilitate communication between responders and community members. With incorporated AI technology, M’aidez can learn new medical terminology that may be colloquial terms used by community members. This technology can also be adapted to other languages as Spanish when launching in Costa Rica. 

Political instability is another concern. M’aidez is efficacious with considerable buy-in from the Haitian government. Epecare has established in-country partnerships such as Zanmi Lasante, the mayor of Jacmel, and Leogane’s Residence Filariose Centre de Fromation Des Maladies Tropicales Negligees. Through our established presence in Haiti and support from MIT, Epecare hopes to demonstrate the government the utility of M’aidez. 

To ensure the privacy of M’aidez users, we will de-identify any data and host our central processing system on secure servers with the help of MIT Solve. 

Because there is a chance cellular network disruption may occur, we plan to diversify communication modalities by utilizing radio. Communication is key during any disaster response. Radio allows field teams to update GIS by reporting to central command.

Epecare does not employ paid staff members; all work is voluntary. Epecare has two founders who lead this organization. We have three program managers who facilitate the day to day needs of the organization. We have six trainers and subject matter experts who lead our Haitian deployments along with Haitian translators. Epecare has three interns from Boston University School of Public Health completing their practicum experience. A board of directors and advisors are consulted on overarching goals, while titled staff address day to day operations.

Epecare is at a unique position with 70 trained individuals willing to create a communication network for community disaster response in Haiti - a country with no supported first response infrastructure. With already established connections in Haiti, dedicated staff members in Boston, and subject matter experts skilled in international humanitarian response, Epecare is poised to incorporate new technology into traditional disaster response models. Epecare’s staff members harbor a variety of skills and backgrounds, from epidemiology to medical personnel to policy experts. These staff members have far-reaching disaster response experience, both globally and locally within the continental United States. Epecare has grown substantially since its establishment in 2012, growing from a small partnership to an established team with interns, program managers, and board members. We have received multiple public health innovation grants and have preliminary data from piloting our successful launch of the Global Health First Responder program last year. We are also lucky to have a robust presence within Boston University School of Public Health, Massachusetts General Hospital, and Partners Health Care. Our staff and board are passionate about the ethical issues surrounding humanitarian response and actively participate in trainings and simulations to advance our repertoire of response skills. Alongside this passion, our staff actively keep up to date on current humanitarian response events and techniques, allowing us to stay at the forefront of innovation in disaster response education.

Boston University School of Public Health: We are fortunate to have two BUSPH alumni as Board Members as well as three current students serving as Interns for their Practicum experience. 

OISUH: OISUH is our sister organization located in Haiti. Led by a team of brother and sister, they aim to provide useful life support skills to their fellow Haitians. In the past, they helped EPECARE by recruiting local community members in Jacmel and Leogane for our pilot last August. They also found local sites for us to host our training. They serve as translators for our Global Health First Responder program. 

New England Grassroots Fund: New England Grassroots Fund is an organization which has granted us with the funds to conduct our Junior Responder program in the Greater Boston area. We support them by providing publicity and partnership. 

BAHEC: Epecare runs a Junior Responder training in Boston. The Boston Area Health Education Center has graced us with majority non-white high school students to train in similar techniques as the global programs.  

Zanmi Lasante: During our pilot, we spent time using Zanmi Lasante’s facilities and travel resources to branch out from our Port-Au-Prince base. 

Epecare provides training and education on emergency preparedness, public health and basic first aid which are sustained through a mixture of training fees, foundation grants, workshop fess, and annual gala events. Any net income is reinvested into training deployments to Haiti along building a clinic in Aquin in the near future.    

Multiple projects including Boston based Community Emergency Responder Teams (CERT) and high school based Junior Responder trainings are revenue sources for Epecare. We also partner with ACW tactical first aid kits helping them market and distribute their products. These Boston based trainings open us up to foundational grants in this area. The Epecare team is also applying to grants for our global health work. Finally, we host fundraisers throughout the year including a gala with Partners Healthcare allowing us to keep impacting these communities while updating stakeholders on the years work.   

Epecare is applying to MIT Solve 2019 to build an application that will integrate with our Global Health First Responder program. M’aidez will leverage multiple technologies to develop a coherent user interface that will reduce the impact of emergency events within austere environments. 

MIT-Solve is world-renowned, with innovations in Artificial Intelligence, global technology solutions, and climate change. Epecare would like to utilize MIT Solve resources to create a team to assist with the technical aspects of M’aidez. We believe it is imperative in an increasingly globalized world, to close the gap between new advancements in technology and humanitarian response. Partnering with MIT Solve would allow Epecare to spread technological advancements to the most under-served area in the Western hemisphere through natural language processing and adaptive technology while empowering a nation towards self-reliance. 

As we said previously, all work in Epecare is voluntary. The financial awards from the MIT-Solve challenge would allow Epecare to fund a full-time worker to steer both this project along with the others Epecare currently has in the pipeline.       

Epecare would like to partner with the new MIT College of Artificial Intelligence, and believe AI tools like M’aidez can be used in a world that is becoming more interconnected. Relief organizations like the World Health Organization, USAID, International Medical Corps, and Massachusetts General Hospital Center for Disaster Medicine would be excellent partners and testing groups for an application such as M’aidez. Deployment data can also be used to train AI algorithms predicting the field situation along with deployment locations. 

Cellular network company, Natcom, would be an excellent partner to better understand the state of the network, streamlining our communications. 

M’aidez utilizes AI in the data it collects and to advise disaster relief efforts. Our solution will be based mostly in Haitian Creole providing a rich unstructured data pool for the AI system to learn words related to disasters and medicine. This is unique in terms of using artificial intelligence training with languages less ubiquitous. We also expect definitions of medical interventions to differ from person to person. Understanding these patterns through a trained algorithm can be utilized by other Haitian-based institutions. 

In terms of global health and disaster relief, there is less data on other countries like Haiti. M’aidez will collect data on the Haitian population at their most vulnerable. This data will drive decision making when building future resiliency in low resource communities. The Global Health First Responder program is based on medicine and human biology, both fields based in STEM. Exposing individuals to these fields may peak interest propelling expansive learning and careers in the future.