In June 2013, we began joint field-testing of our SMS-based emergency dispathcing software, Beacon, with our Haitian counterparts in the Aquin community emergency response team (ÉCRU, in French) in the southern village of Aquin, Haiti. The Beacon dispatching software is designed to make dispatching services available in communities that can’t afford “9-1-1” communications systems similar to those used throughout North America and Europe.
RUNNING OUT OF MINUTES
Similar to most developing countries, southern Haiti lacks an efficient way for the public to alert emergency medical personnel in the event of an emergency. According to local responders with the ÉCRU response team, when emergency assistance is requested, community members call ÉCRU responders directly, activating an in formal phone tree. Once word has reached a responder, they then make phone calls to other ÉCRU responders in order to pull together enough trained people to help – a time-consuming process which can lead to a lot of wasted, precious time for critical patients with acute conditions.
During the testing, which took place over several days and was supported by local partners with the Haitian Resource Development Foundation (HRDF), we were also interested to learn of other communications issues that make coordination difficult: if any one of the responders in the phone tree runs out of minutes, the ad hoc response efforts can be partially or completely shut down, depending on how quickly and efficiently word of the emergency event has spread to responders. Often, this communications breakdown has grave implications: the more complex an emergency event is, the more important sustained coordination becomes, thus more time is spent on the phone making it far more likely that a responder will run out of minutes mid-call.
BOOMERANGS AND BEACONS
As these stories illustrate, effective communications are essential in emergency response, and the hardware and infrastructure exists – i.e., mobile phones and cell towers – significant improvements are urgently needed to coordinate the patchwork, informal systems currently used. Recognizing this opportunity, we’ve developed Beacon to fill these coordination gaps, ensuring that first responders are notified as soon as a medical emergency occurs, and where it has occurred. One of the central problems from the outset has been a general lack of GPS-enabled phones being used in low-income communities – a problem Beacon has been designed to work around by working with existing systems. To illustrate how Beacon differs from conventional emergency dispatching, the following analogies may be helpful:
Boomerang Response Systems: In North America, Europe, and many other affluent countries, ambulance dispatching works like a boomerang: Ambulances are sent out to retrieve patients and return to the hospital with them. These systems are expensive – extraordinarily expensive. The $150,000 needed to buy a single, new ambulance – let alone the countless other investments in essential equipment and technology – would take a significant chunk out of the annual operating budget for many hospitals in the developing world.
Beacon Response Systems: In countries without comprehensive ambulance services, news of emergency events typically spread rapidly by word-of-mouth from the event: bystanders seek help, (either from other bystanders or by calling someone they know when needed), and whoever is available will do what they can – whether they know how to help properly or not. This is the default emergency response system in many parts of the world, and it can work effectively with surprising efficiency when properly planned and coordinated. Beacon enhances these systems by creating a “digital beacon” that originates from witnesses at the scene of an emergency and subsequently alerts all trained responders throughout a given catchment area as to where the emergency event has occurred.
Though its core application is focused on the beacon-type system, Beacon has also been developed to work with conventional dispatching systems that do not offer comprehensive coverage. As a result, Beacon can operate as both a stand-alone dispatching system where none previously existed, or as an extension to existing communications systems to expand coverage into marginalized and isolated communities. In early June we tested the software as a stand-alone system for the first time outside the U.S., and we were very pleased to see the results of all our volunteers’ work pay off.
WORKSHOP TRAINING IN CREOLE
Despite more than a year of extensive testing of the Beacon software within the U.S., our software development – including Dr. William Prescott, Mike Samuels and Michael Ryave – and our Haiti country team – Michael McGee and James Pierre – were always aware that the true utility of the software would be dependent on how well our target beneficiaries were able to interact with it. Training, therefore, was just as much a part of our trip as testing. In order to incorporate the two objectives, we designed a three-tiered training workshop with original materials in Haitian Creole:
Table-Top Simulations – With only a few toy cars, action figures, and a large map of the village, the workshop begins by walking through the six-step response cycle, first using fill-in-the-blank handouts, and then incorporating actual mobile phones
Controlled Simulations – After successfully completing the table-top exercise, the responders spread out across a small geographic area – e.g., a school, soccer field, or neighborhood – and simulate further incidents in a more realistic way, though staying within walking distance
Community Simulations – Finally, the responders mount vehicles and scatter across the community – kilometers apart – while other responders re-create single- and multi-casualty incidents in different locations, allowing the responders to simulate a variety of incidents while covering actual distances, and thus providing the most realistic testing environment
After nearly a week in Haiti, we were excited to see the ECRU response team successfully operating the dispatching system; for our first testing outside the U.S., it was a greater success than we had expected, and the insights we gained from ECRU members’ feedback was invaluable. It was also very satisfying to listen to the responders excitement, describing how it could improve their own efforts – not least of all by saving money on SMS. Yet perhaps the most gratifying moment came on the second day: When the second group of ECRU responders came, we asked the first group if they could summarize what we had been working on the previous day. Without having to say another word, the “veterans” pulled the village map off the wall, paired up into two groups, and proceeded to walk the newcomers through the entire process. In less than two hours, the new group was using the software on their own! Needless to say, our software development team found the whole experience very gratifying and exhilarating – the invaluable insights the ECRU team offered us, and the generous hospitality provided by HRDF and the staff at the Aldy Hotel, were more than we could have ever asked for. And, as a small token of our appreciation, we were able to present the ECRU responders with high-quality EMS uniforms that were donated by Calgary paramedic Geoff McEwen and the Alberta Health Services EMS agency – an exchange that put lasting smiles on everyone’s faces.
While the first testing in Haiti was a definite success, we’re under no false assurances that the work is done. To offer a community reliable dispatching will take far more than a simple workshop, so our efforts are now focused on using the lessons learned in Haiti to make the software more robust in order to ensure consistent responsiveness to an extraordinary number of possible scenarios
To learn out more about how you can support the continued development of the Beacon dispatching system please let us know! We are in need of both cash contributions and skilled communications experts in order to bring the world’s first dispatching software for the neediest of communities!