Voiceless faces and missed Cases – Operation ASHA bridges TB and technology

The road to recovery for a Tuberculosis (TB) patient in Cambodia can be long and arduous. For three months, 65-year old Mr. Nou Pov suffered from coughs, fatigue and night sweats, all of which are symptoms of TB, without being able to obtain an accurate diagnosis. “I became weak. I could not work, so I just sat at home,” recalled Nou. Only when an Operation ASHA staff stopped by his home while screening for TB door-to-door and recognized his symptoms was Nou brought to a local health center for testing. Upon being diagnosed with TB, he finally began his 6-month long treatment course.

Nou was lucky to ultimately obtain a diagnosis, but an estimated 36% of TB cases, or 21,060 individuals, remain undetected in Cambodia, according to the Cambodia Ministry of Health. A socioeconomically disadvantaged patient in Cambodia, like Nou, faces many barriers when it comes to TB detection, such as a lack of awareness about TB and healthcare resources, a lack of access to knowledgeable and trained staff, and a lack of means to travel to health centers.

Operation ASHA seeks to minimize the barriers that TB patients face in seeking timely TB care. In 2014, we implemented a new technological solution called eDetection, an app which would strengthen TB case finding and contact tracing. eDetection uses GPS-mapping to help Operation ASHA field staff locate areas with potential TB suspects. Operation ASHA field staff then travel door-to-door through these regions, prompting individuals to answer TB screening questionnaires that have been programmed into the app in accordance to WHO guidelines. By bringing TB care directly to the doorsteps of the underserved, Operation ASHA hoped to minimize the challenges that keep disadvantaged patients from receiving care. Based on an in-built algorithm, the app prompts the field staff to follow up on certain individuals whose responses suggest that they may have TB. Paper-based monitoring methods, the standard method of keeping track of patient screening, is often compromised by human error, thus resulting in patients being lost to follow up. With our app, when a patient is not followed up with, the system generates an alert to the field team, ensuring that each patient gets the right care at the right time.

 

With backing from ISIF Asia, Operation ASHA launched a small-scale eDetection pilot in Prey Kabas Operational District, Takeo Province, in 2014 (download report here). Although our concept was simple, bringing the app technology into rural Cambodia proved to be very difficult. “Most field staff do not begin with any previous experience with using tablet technology and require much training,” said Ms. Sinoth Lay, a Team Supervisor responsible for overseeing the activities of Operation ASHA’s field staff. “None of them had even used smartphones before”. Many rural areas also lacked reliable 3G access, resulting in inconsistent connections with the central server system that sometimes hindered the field team’s work efficiency. Additionally, the vast majority of patients lacked prior exposure to technology and many were initially hesitant to share personal health information with the field staff until they became more familiar with OpASHA’s work.

Despite the initial challenges of implementation, eDetection proved to be a valuable asset for TB screening and detection based on early pilot results. In one year, Operation ASHA managed to screen over 17,000 individuals for TB in Prey Kabas OD, of which 406 people tested positive for TB and were enrolled for treatment. Areas in which the technology was used resulted in 10% more patients being screened and 16% more patients being sent to health centers for diagnosis over areas in which paper-based monitoring systems were used. Most of the field staff also viewed the app positively, praising it for increasing data authenticity in the field. Although still in its early stages, eDetection shows great potential in being both easily scalable and financially feasible. Combined with Operation ASHA’s door-to-door TB care delivery model, it holds much promise for providing high-quality, low-cost care to TB patients across Cambodia.

Hear from Nancy, a woman entrepreneur transforming traditional art through technology

By Nancy Margried, Batik Fractal

Nancy working with a traditional artisan

Nancy working with a traditional artisan

As a woman entrepreneur in technology, I have a unique perspective on running the company. I believe in nurturing  and rely on my own organization’s strength on sustaining the business.

Commonly nowadays, as a startup, it is easy to be carried away on the trend where startups rely on investments to create traction or to scale-up and grow. I started my company with my two co-founders from scratch and decided to sustain the company on its own. Since the first time, rather than using investment money to gain traction, we rely on the trait of our product (jBatik Software) and our paying customers to grow our business. We realized that only if our customers happy with our service, will then our company be successful. In other words, our success is integrated with the success of our software users.

jBatik is a pattern generator software that we use to empower the traditional textile business in Indonesia. Our main customers are batik artisans where they use the software to create endless of new batik patterns to increase their productivity and of course, their profit. To date, there are more than 2,000 artisans who have been using our software which we reached out through direct training to the rural areas of the Indonesia, the places where they live. All of them are paying customers, and we are very happy to see that their income has increased 20-25% through the utilization of jBatik Software.

ISIF Asia Award has leveraged our business in term of visibility and credibility. The opportunity to network with the fellow ISIF winners has given me a better perspective and an improved point of view on addressing the pain points and needs of our beneficiaries, which are the traditional artisans. All of these are very important to continue and grow our social business. After winning the award, we have been able to improve our software training, reaching to more organizations to collaborate to acquiring new users within new strategies and we have successfully secured funding from Indonesia government to build new software to serve more traditional artisans.

Our work is far from perfect. With the focus on progress, we believe that collaboration is the key to our innovation. Only by collaborating with each stakeholder, then we can create a breakthrough to solve our problems.

Why you should apply for the ISIF Asia Awards: advice from past award winner

By Robert Mitchell, APNIC

With nominations for the ISIF Asia Awards 2016 now open, we thought we’d check back with some of our previous award winners to understand how the award benefitted their projects and get some advice on what to include in your nominations.

Khairil Yusof is the cofounder and coordinator of the Sinar Project, which received an ISIF Asia Grant in 2013 in recognition of their work using open source technology and applications to systematically make important information public and more accessible to the Malaysian people.

Established in 2011, the Sinar Project aims to improve governance and encourage greater citizen involvement in the public affairs of the nation by making the Malaysian government more open, transparent and accountable.

Sinar project in action

Sinar project in action

What are the benefits of these kinds of Grants/Awards?

Here’s what Khairil had to say about ISIF Asia’s Grants and Awards:

These awards and grants recognize the difficult and highly technical work that a few civil society organizations do, which is often not understood or appreciated by other traditional awards or grants (for Rights) programs.

Also, being invited to an award ceremony at large event such as the Internet Governance Forum (IGF), provides you with lots of exposure in an environment where you can meet potential partners and donors that understand your work.

 

What were three key outcomes that the ISIF Asia Grant allowed you to achieve?

  1. The money from the Grant helped our part-time/volunteer effort to register as a proper organization.
  2. It also helped one of our founding members to work full time on funding applications.
  3. Attending the IGF in Turkey provided us with the opportunity to speak with potential donors, which eventually led to initial funding for the establishment of Malaysia’s first fledgling civic tech NGO, and allowed us to continue our work full time.

How has your project progressed after receiving the Grant?

The opportunity to showcase our work to donors led to further funding, which helped with consolidating open standards government data. In turn, this provided open data via REST APIs.

Other achievement include:

  • Powering Malaysia’s Open Parliament efforts [1,2] and the same in Myanmar [1, 2, 3]
  • Uncovering corruption and promoting transparency [1, 2, 3, 4, 5]
  • A civil society led open data approach, combining civic tech and open data with traditional social audits
  • Starting a Digital Rights initiative backed by a team with technical capacity, and funded by Access. We are now building partnerships with the TOR Project to collect and report on network interference data and build Computer Emergency Response Team (CERT) like alerts for digital rights incidents. We are also providing policy input on Internet and digital rights issues such as trade agreements

What should nominees include in their applications?

  1. Don’t be shy with sharing your methodology and the insights you’ve learned along the way, even if you might think it is trivial. If you’re a very technical team, run your methodology by non-technical friends or family members to get their insights. What you think is mundane, might be inspiring to others.
  2. Review all the outputs you have done; blogs, reports, software, photos, etc. If you’ve been passionately working on your ideas and project, you will be surprised at how much you have achieved. List the highlights in your proposal and reference the other outputs in an appendix or link.
  3. Do Google alerts for mentions and links to your project. It might feel a bit narcissistic, but again you might be surprised at who is referencing or mentioning your project internationally or is inspired by your project work.