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Doctors Without Borders Fights Outbreaks With New Tech And Old-Fashioned Paper

The outcome of a study is usually reduced to one number. But behind that number is a lot of people.”

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Niger, one of the world’s poorest countries, is also one of the most vulnerable to disease. And responding to disease outbreaks is anything but simple for organizations that do so, such as Doctors Without Borders (aka Médecins Sans Frontières, or MSF). When MSF epidemiologists arrive in Niger to address the spread of rotavirus, for example, they are faced with a host of challenges that compound one another. And MSF doesn’t have the luxury of responding in a sequenced, structured way: spending six months assessing the scope of the disease, providing education and awareness of its dangers, setting up clinics to provide vaccinations and then assessing the results. MSF has to act, immediately.

In Niger, in coordination with its Paris headquarters, MSF tackles these complex problems with a blend of advanced technology and simpler tools. While epidemiological research employs modeling and statistical analysis, in the end much of the effort comes down to basic paperwork — on actual paper forms filled out in rural homes and hospitals throughout the country.

On this week’s episode of our podcast What’s The Point, Rebecca Grais of MSF’s Epicentre discusses how data is used on the front lines and how it can help areas facing disease- and poverty-related challenges.

Also this week, a Significant Digit on the growing rate of people who are coming out of the closet on Facebook each day.

Stream or download the full episode above, and find a partial transcript below.


Lots of paperwork. On paper.

Rebecca Grais: The other thing we want to do is make sure that the standards and the implementation of a project like this meets the standards that one would meet anywhere else in the world. And you need a lot of paper.

Jody Avirgan: You mean physical paper?

Grais: Yeah! You need a lot of physical paper! And you also need a lot of paperwork. There’s a great rule in the conduct of clinical trials that is if it’s not written, it doesn’t exist.

Avirgan: I’m hung up on this paper thing. Is there not mobile technology or some other way to gather data in a more efficient, connected way … [that] might actually be more efficient or cheaper than paper?

Grais: That’s all true if you have access to the Internet. It requires network coverage; it requires stable electricity; it requires things which you don’t have in a context like this. Mobile devices and all those things are super, but it’s gotta work.

The second [factor] is, is [the technology] sustainable, or are you bringing in something only for a brief period which is then going to disappear? So you’ve taught a whole bunch of people how to use a fancy tablet that you’re going to take away again, and it’s not going to be something which is then something that can be incorporated into the environment.

Avirgan: This is like that — and I know that this is an apocryphal story — but it’s like how NASA spent billions of dollars trying to develop a space pen, and the Russians just used a pencil. Sometimes the simplest technology …

Grais: Sometimes the simplest technology works better.

Avirgan: That story, by the way, not true. But, nevertheless, a good metaphor.


If you’re a fan of What’s The Point, subscribe on iTunes, and please leave a rating/review — that helps spread the word to other listeners. And be sure to check out our sports show Hot Takedown as well. Have something to say about this episode, or have an idea for a future show? Get in touch by email, on Twitter, or in the comments.

What’s The Point’s music was composed by Hrishikesh Hirway, host of the “Song Exploder” podcast. Download our theme music.

Jody Avirgan hosts and produces podcasts for FiveThirtyEight.

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