Subject: West African Ebola Treatment Unit Communications Capabilities
From: "Steve Birnbaum" <[email-masked]>
To: "Hunter Biden" <[email-masked]>
Date: Fri, 7 Nov 2014 18:27:57 -0600

Hi Hunter,

I hope that all is well.

I thought it might be helpful to bring you into the loop on something.  First, I briefed a colleague of mine who was part of the team invited to the White House by May Chu last month to brainstorm PPE solutions, and he forwarded it onward.  The email exchange is below.

Many believe that the dip in Ebola numbers last week stems not from our getting a handle on infections, but from a lack of information coming out of the affected region.  If we don't get data, we don't know what the status is, and it limits our ability to track new cases to get ahead of the outbreak.  Unlike some other humanitarian responses, the ability to move data here is absolutely critical to effectively respond.

My information comes from conversations I've had with MSF, OFDA, OSD and the AFRICOM J6 Branch Chief for Plans & Future Operations.  As of yesterday, there is no change in the status.

OFDA asked MSF for a spec for the Ebola Treatment Unit (ETU) that the military would build.  The spec provided was the one used in the Congo, where no computers are present.  Therefore, the spec does not include anything related to communications technology.  That spec was passed on to DoD as the build-plan for the current ETUs.

The fact that there is no communications capability being built for the ETUs is not being communicated to  MSF and other groups.

Once the ETU receives the first patient, it becomes a hot zone.  At that point, IT personnel will not be able to get close.  Since the priority is to receive patients as soon as the ETU is ready, we have a limited window of opportunity to get equipment installed.

The lack of planning for ICT concerns me.

In my opinion, an affirmative decision not to build ICT capabilities that is then communicated effectively to stakeholders such as MSF is a legitimate plan.  At least in that case, they would know to begin their own planning in advance as opposed to arriving on-site and discovering that they may not be able to communicate from the location.

Ideally, I'd like to see us leverage the lift capacity and manpower of the military mission to transport and construct communications antennas and other related equipment.

I briefed the WFP Emergency Telecom Cluster lead in Liberia, and he's checking to see if WFP has budget to provide comms to the ETUs that the USG is building.  It seems to me that if USG helped make this happen, it would save WFP funds for other areas.

I've also spoken with some of the mobile phone operators in the countries, and they are open to a public/private partnership whereby "we" help them expand their cellular networks, and they continue to operate the new nodes.  That way, we can have cellular coverage rather than just WiFi.  That is important for use in contact tracing since we can then track people's mobile phones.

In addition to my usual roles, NetHope have brought me on board during this response to help them with the getting communications capabilities set up for the Ebola response.

Regards,

Steve

Begin forwarded message:

From: "Chu, May" <[email-masked]<mailto:[email-masked]>>
Date: November 6, 2014 at 7:58:42 AM PST
To: Eric Rasmussen <[email-masked]<mailto:[email-masked]>>
Cc: Dave Ferguson <[email-masked]<mailto:[email-masked]>>, "Smith, Megan" <[email-masked]<mailto:[email-masked]>>, "Panchadsaram, Ryan" <[email-masked]<mailto:[email-masked]>>, "Steven VanRoekel ([email-masked]<mailto:[email-masked]>)" <[email-masked]<mailto:[email-masked]>>, "Hercik, Christine (Intern)" <[email-masked]<mailto:[email-masked]>>
Subject: RE: Communications capabilities in the Liberian ETUs

Eric,
Appreciate the input and pointing out how we can facilitate the connectivity issues.  We couldn’t agree more that there must be connection.  Have copied a number of our colleagues here because they are working on the very communications and data connectivity challenges with hopes of getting some of that infrastructure stood up soon.

May

From: Eric Rasmussen [mailto:[email-masked]]
Sent: Wednesday, November 05, 2014 3:07 PM
To: Chu, May
Cc: Dave Ferguson
Subject: Communications capabilities in the Liberian ETUs

Dear May,
(cc Dave)

We met briefly in the PPE workshop last month and I hope you’re doing very well. I’ll put a small photograph below to help recognition.

I’ve learned this morning that we may have a medium-sized issue worth addressing in the design of the Ebola Treatment Units (ETUs).

If my information is correct, the model for the ETUs came from a previous Congo outbreak and does not involve any provisioning for communications. The earlier model design was provided to OFDA who sent them to DoD without further specifications. Those original Congo ETUs had no technology whatever and so neither do these. When the communications gap was pointed out to DoD there was reportedly significant pushback that no modifications can be made on the accepted model.

Perhaps I am mis-informed (and that would not be surprising...) but the communications people who are working with NGOs in West Africa are looking at the ETU specs and see nothing for communications. No wireless, VSat, cell, radio, or antenna - no ICT at all. Apparently whoever is expected to take over management of the completed facilities is also expected to provide their own ad hoc communications.

That may be a little shortsighted, and would later be, at the very least, not standardized. The ETUs, therefore, might not be able to talk to each other, to larger medical centers, to testing laboratories, to transport systems, to smaller referring clinics, to logistics hubs, or to local media. If we were to let this happen, we might not look very smart.

Would you be willing to have someone check? I’m happy to be nudged aside with a little snort of derision as you tell me all is well, but otherwise this might be a significant gap that can be easily filled.

Good fortune in your work,
Eric
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Eric Rasmussen, MD, MDM, FACP
CEO
Infinitum Humanitarian Systems
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