Humanitarian hackathon for Gaza

Batool Matter and Michelle Graham stood shoulder to shoulder in front of a panel of judges, ready to present their design for a better ambulance emergency triage system for low-resource settings. They and four other team members had spent the better part of a week working on the design, and they had carefully rehearsed their presentation.

But after a few minutes, the internet connection unexpectedly cut out, and the video feed connecting Matter and two of the judges to the rest of the group blinked into blackness. Suddenly, Graham was left to continue the presentation on her own.

Although they appeared side by side, Matter, Graham, and the judges stood a world apart—half of them located in a gold-painted shipping container on Johns Hopkins University's Homewood campus, half in a similar room in the Gaza Strip on the coast of the Mediterranean Sea.

It was the final day of the Humanitarian Design Challenge presented by the Johns Hopkins Center for Bioengineering Innovation and Design, or CBID, which is housed in the Department of Biomedical Engineering. Participants in Baltimore and Gaza had spent the final week of June designing solutions for health care problems in humanitarian crises and conflict, with a specific focus on helping first responders in Gaza—among the most densely populated places on the planet. Health and safety problems there have many sources: political turmoil, military conflict with Israel, travel and import restrictions, and poverty.

Image caption: Ashok Sivakumar (left) works with his teammates in Gaza to finalize their presentation. They've created a text messaging system to send detailed injury and incident reports over Gaza's limited 2G network.

Image credit: Will Kirk / Johns Hopkins University

The challenge includes an unusual feature: a series of audiovisual Portals from Shared Studios that allow teams separated geographically to collaborate as though they were in the same room. With floor-to-ceiling video screens, a discreet camera, and high-quality audio, the Portals create the effect of being face to face with a person far away.

"This was the first time I learned about the Portals, and it was really wonderful to be able to share and talk person to person like in the real world," said Majd AbuHamed, who was one of 45 scientists and health workers in Gaza to participate in the challenge. "My teammates in Baltimore were really enjoyable, helpful, and had a lot of information to share with us in Gaza. Our discussions were good, and it was thanks to this technology that it was easier for us [to work together]."

For the 19 participants in Baltimore, the Portals served as a reminder of technological disparities around the world and how video conferencing tools that are often taken for granted in the United States can create a new world of opportunities for those in other countries.

On the day of judging, coordinators versed in tech troubleshooting were able to re-establish the Portal connection, allowing Matter to catch up to her team's presentation.

"Sorry for the interruption!" the coordinator said as she cued up the presentation. "But, hello, this is Gaza!"

Image caption: When not using the Portals to collaborate, teams could work together through Google, email, and the encrypted messaging and phone service, WhatsApp (pictured).

Image credit: Will Kirk / Johns Hopkins University

The Humanitarian Design Challenge was funded by a grant from the Aspen Institute and supported by the U.S. State Department and the Bezos Foundation. The project honors the memory of Ambassador Christopher Stevens, who died in the U.S. diplomatic mission in Benghazi, Libya, in 2012. The program is designed to honor his passion for building understanding and cooperation between Americans and people from the Middle East.

The challenge participants were trained in a variety of tools used in design, including what's referred to as genealogy mapping, a process of tracing a problem to its root causes and identifying potential avenues to solve it. They learned that doctors and other health care workers, when asked, will often request tools that are familiar to them.

"One part of our process is to get teams to go beyond the familiar by getting to the roots of the job the provider is trying to do," said Youseph Yazdi, director of CBID and the principal investigator for the Aspen-Stevens project. "This allows the team to think of creative new solutions."

He added: "Whenever you design something, you're going on a journey. The journey these teams have started doesn't end after they've done their initial presentations—there's more beyond that. Their goal should be to learn about the process as well as design something useful."

The teams came up with a range of solution concepts, including:

• A telecom system to direct ambulance drivers to the optimal hospital and alert hospital ERs of incoming patients so they can optimize treatment
• An intuitive and durable hospital bracelet for patient identification and coding of their condition that keeps this information accessible even when computer and information systems are not available
• A mask to prevent tear gas inhalation and injury by health care first responders
• A bandage for limb wounds that is infused with a naturally derived coagulant and antibiotics to stem the flow of blood and reduce infections
• A self-stabilizing splint for limbs to prevent further injury while allowing proper blood flow
• An app and educational program that teaches the fundamentals of emergency response to untrained citizens

The winning team built a text messaging system that could send detailed health and incident reports from first responders and ambulances to emergency rooms over Gaza's 2G network, which is limited to voice and SMS. The team, made up of six members from Gaza and two from Baltimore, will continue developing their system through CBID and will be invited to apply for funding from the Stevens Initiative grant.

"It is one thing to design a solution for a wealthy health care system like at Johns Hopkins, but a much higher level of creativity is needed to make something that will work in a tough place like Gaza. This team did just that," Yazdi said.

Many of the hackathon participants said they were inspired to take up the challenge with hopes not only of designing a health care solution but also of collaborating with their peers around the world.

"I was drawn to the hackathon because of the Gaza angle," says Ashok Sivakumar, a member of the winning team and a Hopkins graduate student who works at the Applied Physics Laboratory. "I was curious about what their perspectives would be like, and about the experience of building a team from scratch. It was great to get firsthand experience of solving problems, and just putting my head down and seeing what's possible."

Added Hadil Elburai, from Gaza: "It was an amazing experience. One day I hope to visit the United States to be in touch with my team members, as well as the other teams and experts, to thank them for their efforts and for teaching me something new."