 I would like to invite the last of our speakers, Dr Laura Loughlin, who is a fellow in the European Programme for Intervention Epidemiology Training and recently volunteered in the Ebola response. Thank you very much. I'm very excited today to discuss a project that was initiated in January of this year in Tunk-A-Lily District for the mobilisation of local people and technology in mapping for this year's Ebola epidemic response. Mae'r ffordd o'r bwysig yn Llyfrgell erbyn i'w ffyrdd i Llyfrgell sydd yng Nghymru, iawn i'n ei bod yn rhan fournod o'r 430,000. Mae'r rhan seven thousand kilometre ychydig, ac mae'n gweithio'r rhan fyrdd yna'r panlyw gyda swazeland yw'r gweith. Mae'r rhan fournod o'r dysgu yn ymgyrch sydd i 11 tiffdym a ffyrdd yn rhan 1000 bylygau. Mae'r 450 ydych chi'n bwysig yn y dyfodol yn y dyfodol yma, Yt yw deisimwyr 2014, y Ebolau Ymysgwyl Cymru wedi gilydd y Cymru yn ymweld i'r llai gynghwyl Magdorachau. Roedd hynny'n clywed â'r MSF Holland. A dyna, mae'r Ebolau Ymysgwyl Cymru wedi gafodd o gafodd yma o'r cyffredin. Yn oedd y cysyllt i'w wneud eich cyfroedd rymog a'r cyfroedd amser, mae'r cysyllt i'r cyffredin i'r cyfroedd sy'n gweld o'r gweithio a'r cyfroedd o'r cyffredin, er eich cyfnodd i'r cyd-gwyl yn lleol iawn, o gymryd y Bod prominent. Ond yna'n du'r gwarnio'n rhoi hefyd i'w cramffo'r problemo, ond rydyn ni wedi bod yn cyrraedill ar gyflodol derbyn amlwg, ond wefyn yn unwyd i weld o bwlytsio pob o bolygau ym brill. A'r bwlytsio'n gyfydlu ei rŵn, oedd yn bwlytsio iawn, oedd ei wneud ei chyfu sydd wedi gweld ei Ribs, o'r bwlytsio llyfiad o'r bwlytsio, were missing locations of recent villages and satellite villages, so there was many many gaps that were identified, Peattchodape aren't as bad as they were, but they were empty, but still there were many villages that were missing, so this led to the project in which the aim was to improve mapping within Toncl Formerly District by mobilizing local people in order to obtain reliable geographical information to tracing bullau cases under their context. So for this project, I'll discuss some other methods that were used and that's in yn mynd i boblnegirio'ch syniadol o'r cyhoeddoedd iawn i'r fawr. A'r trainiad yn dynnu'r roffinio'r pryd o'r shwt. Yn y bydd y mynd i boblnegirio'ch cyhoeddoedd, bydd y gallu'n cael ei gynnig yn amlwg ffoilio'r o'r McOchara'r cyhoeddoedd, oedden i'n gwyflandi ddiwrs motormall. Ond bydd yn y bydd'r cyhoeddoedd cyhoeddoedd Yn Ysgolrwyr yn gwefwllaeth. Felly, mae'n cyfle â ahogu gwahoddiadau a'r amser hynny, a wirioneddau o ran am arlwyng ein twofynu ar hyn. Mae'n mynd i'r gweithio i ddechrau'r technoliedig yn ymryd wedi'i zaerbyn arlawni. Rydych chi'n meddwl yng Nghymru, mae'n meddwl i'r ddysti future honi. A'r byddwch chi'n gweithio o hyfforddiad o'r warith. Mae'n meddwl sy'n ei, a'r phonesau oed Practi, ac mae'n meddwl ystafell o un i'r ddechrau ein gweithio. There is no language barrier because they speak local weirdest. There is huge advantage to mobiliatise the locals. The新 technology that is used... ...in open data kit and collect software... ...is an Open Source Tool that can be used to create and manage mobile data collection. With the open street map assignment this is a map and navigation application. To access high-quality phone street map data. There is a major advantage to using the Disc Gang collect software. It's available on the Google Play software for Android devices and you create your survey in Excel and then it can be transferred to the web platform and then you can then enter your data in the software and this is secured on a server that MSF controls. So any data collected is secure. And then in terms of advantages for using Asmund, this is again free. It's available on the Android, Google Play is for Android devices and it works both online and offline as coverage was an issue at times and also internet is an issue. So it's great to have these technologies available and all free and easy to use. So the information that was collected using this survey was very concise and precise because they wanted to collect accurate information about village names, the GPS locations, the alternate or you know, complete name of the villages as well as contact information of village chiefs or heads and also the number of households in the village to get a population estimation idea. Also another information was collected in terms of health care access. So what type of health care facilities in the village, where it was located, contact information for the health care workers and also the location of the nearest health care facility if there wasn't one present in the village itself. So to collect this information, it's very straightforward. Once you're logged on to the MSF server, then you just select a blank form, select the server that you want to carry out, fill in a blank form, begin the new survey, and then it's a very simple swipe action to go through the questionnaire to collect the information. And we kind of can give little like spelling is important, little notes to the collectors, they know to collect correct information. So it's very easy to use software and at any point you can save the questionnaire as you're collecting the data. So this is important so you don't lose any information. Then to get more accurate GPS location estimates, you can record the location coordinates that can also pinpoint favourite locations or they can track which route they had taken using the GPX recording feature with Asmont. So in terms of training and costs, 24 local workers were hired. These are just people that Ivan found around Mac Baraka. So 12 people with motorbikes, otherwise known as the cattle drivers, and 12, we call them health motors because we gave them a health motor wage, but 12 local people with Android smartphones. So the training, very short, one to two hours. It was fantastic because these people knew how to use their devices, it was a matter of explaining by the software, and also how to conduct themselves in the field and how to get informed consent, these type of things and of course their safety. So that was how long the training was, so it was very short, and the daily costs were also low. Motorbike drivers, they got 25 euro per day on average and the local people who got a health motors wage of 10 euro per day and that covered the rate and also the cost of phone use. So the village, 950 villages were surveyed in two weeks, which is a huge accomplishment for such a small team, and the villages that were surveyed were within the cashment area of the EMC in Mac Baraka. So each team surveyed around 80-10 villages per day, and they collected information not only about the GPS location and the names of villages, but also contact information, population data estimates and access to healthcare information. And the fact that they were able to collect this much information in such a short period of time and for only 3 euro 50 per village is a modest cost for such a huge investment in their time. So here is just some of the how, this is a very simple map, not quite as elaborate as the other two speakers presented, but this information is vital, it shows you, the red dots represent the number of cases that occurred in a village. So we can see that the distribution throughout the Tungalley district, this allows for lots of action. You can respond quickly when you know exact location of where cases are for distribution of hygiene kits. Also large turnover of expat staff in the time that EMC is open. So this also allows them to see the distribution of cases in the district and also to see, you know, also for survivor follow-up. As I said, there were over 450 cases in Tungalley during the Ebola outbreak and some of them have gone to different districts to receive treatment so we can map where all these cases are for survivor follow-up. So this just gives an illustration of exactly how many of the villages were mapped or surveyed by the team. So it's quite an extensive number of villages that were visited and surveyed. And then when we combine this, it's a very busy map, when we combine this with the data that was ready available, so in green we see this is the data that was collected by our team and then the red, this is kind of the pre-existing data. We can see that there was a lot of information missing in Tungalley district and this information collected really added to that. So there were many, many advantages to mobilising local people and one was that it would allow rapid implementation of a survey with lower source needs. It also gave the ability to train local people with technology on their own devices, so it instilled them with a lot of confidence they were able to partake in this Ebola response by collecting information on their own phones. So this gave great local and community involvement. So in conclusion, this is for an experimental project, it gave them the modest investment to gather large-scale geographic and population data rapidly. It also gave the ability to use locally appropriate technology in genuine partnership with local people. And this could most definitely be used for future emergencies to improve response and is actually being used in the Central African Republic at the moment for large malaria projects. So this is very accessible information and it's very easy to use. So I would like to thank the project team to Ivan Gaten who actually designed this project. I was very intrigued and fascinated when I heard about it, so big thank you to him. And to George Stanley Grotze and the local workers in my baraca who worked collecting this data. And also all the MSF staff in my baraca and to Jane Gragan Cos has done this for their help with this presentation. Thank you. Thank you very much Laura, an excellent example of the application of technology in the field. Does anybody have any, yes, questions straight in the front, in front of me? Thank you very much for your presentation. My question is, did you have any challenge during the heights of the Ebola outbreak when the government imposed restrictions and mobilities in terms of having your mappers go from villages to villages and perhaps even going into health centres when the government have recommended no movement between villages. Thank you. So at the time if you're working with MSF you're able to get a pass, so you're able to pass through the boundaries. So that was one major advantage and then you try to ensure that you're going to health facilities, that they make sure they didn't go inside. There was also protection measures but at the time if you worked with MSF you're able to get a pass to pass the police controls. At any time did you think that maybe perhaps the mappers were at a bit of an increased risk when they go from villages to villages? In general when, even in my bracket it's a case investigator team, so you always make sure that they don't go inside health cities, the nobody contact rule applies. So that's one of the main things with MSF is you know you don't touch somebody then you know you're safe. So you would not put someone in a risk if you knew but they were given advice and training during the time that they had the very short training to ensure that they didn't touch anybody and going to health facilities always kind of keep your distance. That's the general rule when you're in the field for us and for also for them. Thank you very much. Can we have the online? We've got a question from our online audience. So I have a question from the online audience about mapping for drug resistant TB in areas of high prevalence and how that could potentially help save lives and potential costs. That would be hugely beneficial. You know I think it's a low cost project, the software is available, everything is a matter of training. So I think in general that would be very beneficial for health facilities or for organisations if they kind of would be able to track where these, where high water prevalence and water resistance is. So I think it's a very low cost project that would be able to implement, it's accessible. These people had, you know, these were not highly skilled. You know, they had smartphones, they were in the training and off they went and they enjoyed the experience. So I think it can be done, it's very adaptable to any environment. Thank you. A gentleman in the check shirt. Yes, excellent presentation. I wonder, you didn't present it but did you use the track feature to trace out trails and roads to the villages so that that might serve provision of care later on? Yeah, that was also carried out. So yeah, they were able to track the trail the way the team operated that they would select a region where they would investigate and they would kind of branch out. So we kind of had an idea of the trails that they took and in general the roading because there's some mining that goes on in Sierra Leone. So some of the roads are quite well mapped but it's kind of added to that what was available. Great. One last question from the gentleman in the middle. Thanks Laura, great presentation. So you said it's a pilot and you learnt a lot from it. I'm wondering what you would think would be the next step if you could add one thing to this system to improve it next time. What would you do? Good question. Yeah, I mean every project has limitations but I think for this experiment we have a low number of workers and I think for the future maybe you can gather so much more information. So we gathered healthcare access, it can be used to try and gather as much more information as possible about socioeconomic status and also for advocacy as showed by Sylvie that was done in its free time which is very useful especially if you want to try and follow up on cases that were in quarantine. That type of information could have been collected also just in terms of trying to identify if villages, what the socioeconomic status was, if they were more at risk of being a party, a lack of food and all these type of things would have been very useful. Great. Thank you very much Laura. Would you like to join me here and I'd invite the other two speakers back up onto the panel here. We have 15 to 20 minutes now of open discussion.