Cholera, a water born intestinal infection caused by exposure to contaminated food and water, has been largely eradicated from developed countries which have adequate water and sanitation facilities. However, in many parts of the developing world, where access to clean, safe drinking water and proper latrines is limited (particularly in rural and slum areas) the disease is a growing reality, especially during times of environmental crises and natural disasters. Zimbabwe is currently experiencing a cholera outbreak which coincides with the country’s rainy season. The disease has infected over 100,000 people since 2009 and has contributed to an estimated 20% increase in under-5 mortality since 1990, stagnating the country’s ability to achieve the MDGs and improvement of population health more broadly. Similarly, Haiti has been described as being in the midst of one of the most devastating cholera outbreaks in modern history, with over half a million people infected, and 7,000 deaths since October, 2010. Displacement, compounding by crowded camps, disrupted water and sanitation services and population migration as a result of the 2010 earthquake, have caused rapid spread of the disease amongst the population.
Despite the challenges that the disease presents, there are a number of interesting mobile health solutions being developed and deployed to tackle this and other similarly infectious illnesses. Mobile health applications and services are being utilised across cholera disease surveillance, education and information campaigns by local and international aid agencies and Government bodies. Particularly effective in predicting areas likely to experience cholera outbreaks and transmission trends is a new innovation developed by the Flowminder team at Karolinska Institutet, which extracts location based information about population movements from mobile phones following natural disasters. . In Haiti, Flowminder was able to use position data information collected from Digicel’s SIM cards to estimate magnitude, and movements of populations exposed to cholera, which enabled better humanitarian response to direct aid. According to the authors, the results of this study “suggest that estimates of population movements during disasters and outbreaks can be delivered rapidly and with potentially high validity in areas with high mobile phone use.”
This study and similar interventions demonstrate the significant potential of the location based information from the mobile network in disease outbreak surveillance and across the humanitarian and disaster response environment. However, obtaining this kind of information from operators can be difficult as it may be perceived as being commercially sensitive, or in violation of customer confidentiality agreements.
How can mobile operators, the global health and aid communities best work together to ensure that mobile innovations like Flowminder can be more widely adopted?