Emergency Response to Global Health Crisis

Story line:
The breaking dawn can be seen as the Chinook helicopter lifts off the pad, loaded with personnel and precious stores of advanced computer networking and communications equipment. On board is a team of uniquely trained specialists from the U.S. Centers for Disease Control and Prevention (CDC) known as public health informaticians (PHI).

The helicopter is headed towards a location 10,000 feet above sea level, where an explosion has isolated a remote and mountainous, yet well-populated town. The informaticians’ task is to set up an onsite information network to support the relief effort. They must have the network operational within one hour of helicopter drop off.

Although our story line is just a story, it illustrates the exciting work done by PHIs. If we define “infonomics” as the intelligent management of information, perhaps no professionals are more steeped in infonomics than these specialists, who work at the nexus of public health and information technology to enhance preparedness and response to health crises. Public health informatics emerged as a new profession in 1995, and now the CDC offers a two-year informatics fellowship.

“Networking in a Minute” workshop features opensource Sahana
The authors, all graduates of that program, recently conducted a workshop entitled “Networking In A Minute” at the CDC’s Public Health Information Network Conference in Atlanta, Ga. We began with the basics of networking, diving into ”switches,” “routers,” “CAT5E,” “Ethernet,” “RJ45,” “firewall,” and much more. We brought all network components to the classroom and coached participants as they actually assembled them into a network, though it took a bit longer than “a minute.”

But soon they configured TCP/ IP on their computers and were communicating with one another and surfing the Web. For the demonstration, we landed upon a Web-based, open-source software application called Sahana (www.sahana.lk). With a central database and a Web browser interface, Sahana is a collaboration tool that is intended to address common needs at a disaster, such as tracking the status of missing persons, conducting a relief-camp census, coordinating aid, and managing volunteers.

Once up and running, participants next pointed their Web browsers to the Sahana Web server and soon realized the power of an accurate, collaborative data network at their fingertips. The network worked wonderfully, as planned!

The network was not the end game, however, but merely a tool. Our goal was to demonstrate how a “just-in-time” communications and content network, created ad hoc, could contribute important data to decision makers.

CDC informaticians, LANs employed in Hurricane Katrina response
Our fictitious helicopter actually is grounded in the real experience of CDC public health informaticians who responded to hurricane Katrina—which devastated New Orleans and so much of the surrounding region—and is one of the reasons we offered the workshop. Public health informaticians who traveled to Baton Rouge, La., in the aftermath of that disaster quickly set up a local area network (LAN), enabling responders to enter, edit, and view data simultaneously from multiple workstations stored in a central database.

Prior to the advent of such LANs, it was not uncommon for lines to form around standalone computers at emergency sites, and data could be aggregated and shared only by physically transporting files from one computer to another, with no one really sure which data set was the most current. Because of this bottleneck, increasingly the prevailing method of data exchange became “analog mode”—verbal and paper communications— which was not a format wellsuited for optimal coordination.

As we draw our story to a close, we can tell you that our workshop informaticians met their deployment target of a fully operational network within one hour of “helicopter drop off,” but the real message is the value of preparation by a uniquely situated profession: public health informatics.

John Araujo, PhD, MHSA, is a graduate of the CDC Public Health Informatics Fellowship Program and now is a Public Health Informatician in the Office of the Chief Science Officer at the CDC.

Catherine Pepper, MLIS, MPH, is also a graduate of the CDC Public Health Informatics Fellowship Program and currently serves as coordinator of Library Field Services at Texas A&M University. She is pursuing a PhD in Health Informatics at the University of Texas Health Science Center at Houston.

Gonza Namulanda, MS, is also a graduate of the CDC Public Health Informatics Fellowship Program and currently works as a public health informatician with the Environmental Public Health Tracking Program at the National Center for Environmental Health.