From April 25th to 29th, Juan & I went all the way to Yangon, to facilitate on the EpiHack Myanmar 2016.

EpiHack is a hack-a-thon that brings developers and health professionals together to create technology that addresses specific issues around infectious diseases. During an EpiHack, you engage full time with a group of ~50 health and technology experts for a five day collaborative workshop to find and report outbreaks faster. EpiHack Myanmar 2016 has been organised by Skoll Global Threats Fund and InSTEDD, with support from the Myanmar Ministry of Health and the Malaria Consortium.

The first day of the EpiHack was about theme introduction and discussion. There were some introductory presentations about what was expected from us during this week, and then we dived into some insights about the health work done in Myanmar and the Greater Mekong Subregion. During that afternoon, we split up in groups to discuss and come up with different topics in which to work for the rest of the week. Health workers’ training, citizens ability to contact the Ministry of Health and ways to spread health advice to the general population in case of an outbreak were some of the issues that we found.

Epihack myanmar day 1 wrap up

Post-its, or didn't happen

Day 2 was all about problem validation. We split into three different groups, each of them picking one of the topics we found the previous day, and went on different field trips to gather more info from the actual health workers. While one of the groups went to a district-level health office, mine went to a rural hospital in the Htantabin area. We got the chance to talk with the Community Health Workers there, listening to their opinions first-hand.

People tend to underestimate how difficult it is to clearly state your own problems. So, after some back and forth, we focused on the training of the health workers. The midwives told us it was hard for health volunteers to attend to the monthly trainings they offered, because of the long distances and poor road conditions.

To address that, we sketched four different proposals for them to choose from: making improved cards with health info that could be carried around, texting or calling health workers and volunteers in a regular basis with health tips or reminders, providing a hotline to which they could call to ask for health information, or building a mobile app that would give them details about symptoms, diseases and ways to treat them. The winner was clearly defined.

Nurses phones

They also described how they filled the weekly and monthly diseases reports, which the Ministry uses to gather statistics and respond to outbreaks. They’ve shown us how they were currently using their smartphones to help with that - whenever physically taking the paper-based reports to the health center would get delayed for any reason, they are sending photos of them via the Viber app to speed things up.

We started day 3 with each group presenting their findings to the others. It was great to see how we have all seen different parts of the picture in each of the field trips - but the pieces seemed to match and overlap too much for working isolated from the others. After taking some time to digest all the information, we got a great devs-only lunch in which we designed together an integral prototype system that could address every group’s topics. We split the whole system in a couple of apps & data stores, and assigned each of them to a team. We got back to our computers and quickly sketched the app that would help community health workers to report cases and provide them with the diseases information they need - on the spot.

The rest of day 3 was all about working hard - until the afternoon. We then went out for a cultural dinner, and got to visit the Shwedagon Pagoda, Yangon’s main attraction. It’s a huge, golden Buddhist pagoda built somewhere between the 6th and 10th centuries. I love how relaxing it can be to quietly walk between the people at these kind of temples, hearing people talk, seeing them pray.

But day 4 arrived, and it was an all hands-on hacking day. InSTEDD’s CEO, Eduardo Jezierski, opened the day explaining the design we came up with the previous day to everyone in the room, so we were sure to be all on the same page. We then got back to hacking - and #hackForHealth we did.

While the health experts maintained different group discussions, we worked all day to get the prototypes built. And by “all day” I mean all day… and night. It was a long day, but it was worth it - you can tell both things from our faces at 2am.

We went to bed knowing everything was on track for the last day’s final demo.

Day 5 started with the last rehearsal - a group of participants was going to play an act showing how the prototype would work on a hypothetical scenario.

Spoiler alerts given, the play was like this. There was a volunteer that had to visit someone from his village who was feeling sick. Once there, he would call the hotline we made up during the EpiHack to alert his midwife about the issue he was seeing. The midwife would then use her Community Health Worker app to receive the message and call the volunteer back. After some chatting, she’d look up the described symptoms in the app to refresh her knowledge, and go to the village to meet the patient. She would then confirm the patient was sick, alerting the central office of the event through the app.

At the central office, someone would notice the new event in a dashboard, and decide to alert all the community workers in the zone about the news, giving some extra tips to prevent more cases in the surroundings. Those messages would come to both the CHW app - and to the audience phones, live, via SMS.

The demo went great, and we were all really happy. After all that hard work, we could see the results go from ideas to implementations in only 36hs of coding. You can’t just predict how productive a hard working group can be when you give them time and space to work as they prefer.

So the morning went by, and noon found us with a great EpiHack finished. The only thing that was left was to do some facilitator retrospective to share feedback on the event, to celebrate the results, and to gather the lessons learned for the next event. It was a really great week of work, and we were all too satisfied with what we did.

The prototypes we built for the EpiHack are all open source, and published online. You can check both the health dashboard, the volunteer app and the community health workers app. Remember - they are prototypes. Expect them to fail from time to time, but also to show you what can be actually built to help health workers do their job better.

It was a great time we had in Myanmar. I really hope to be part of another one soon!

Keep on hacking for a healthy world!