Team Rubicon Leverages Fulcrum in Cyclone Idai Response

Team Rubicon Leverages Fulcrum in Cyclone Idai Response

It was extremely hot and dusty as the caravan of humanitarian aid workers from Team Rubicon pulled up to a farmhouse in Matarara, Mozambique - 40 miles west as the crow flies from Beira, but a nearly 8-hour journey overland due to road washouts and poor conditions. Team Rubicon had arrived to help those affected after Cyclone Idai ripped through Mozambique and caused monumental flooding throughout the country.

Team Rubicon was three days into a medical deployment and the arrival at the farmhouse was the first opportunity to showcase our skill set: remote-area medical. The farmhouse was truly remote; not even local cellular phone carriers received signal. The only way to contact the outside world was via satellite phone, which explained the delayed reporting that nearly 9,000 survivors were in need of food, clean drinking water, and medical treatment, with some of the survivors cut off from traditional aid services as a bridge over the neighboring river was destroyed in the floods. The only way to reach these survivors would be by helicopter. Team Rubicon is uniquely suited for these missions.

Team Rubicon deploys in Mozambique

Photo courtesy of Team Rubicon

In July 2018, Team Rubicon was the first North American non-governmental organization (NGO) to receive verification as a World Health Organization (WHO) Type 1 Mobile Emergency Medical Team (EMT), which proved Team Rubicon could deploy in remote, resource-constrained locations, completely self-sustained for 14 days without resupply, and treat 100 patients per day. This was our first deployment as a WHO EMT Type 1 Mobile, despite deploying internationally as a medical team to major disasters around the world since 2010. Team Rubicon’s start of deployment was servicing an internally displaced persons (IDP) camp about two hours outside of Beira, but there were more remote areas affected by Cyclone Idai that other medical teams were incapable (or unwilling) to travel to. The area around Matarara, with its trapped survivors, was an opportunity Team Rubicon had seen - and excelled at solving - before.

As Team Rubicon’s medical team began unloading their gear from the convoy vehicles to break camp for the night, team leader Dan checked in with Team Rubicon’s National Operations Center in Dallas, TX by satellite phone. Dan was told there were new reporting requirements from the Health Cluster’s Emergency Medical Team Coordination Cell (EMT/CC) that were imperative to transmit due to the growing concern of a Cholera outbreak. Cholera is an infectious and often fatal bacterial disease of the small intestine, typically contracted from infected water supplies, that causes severe vomiting and diarrhea. When the floods from Cyclone Idai swept through, it destroyed or contaminated the village wells. With no way to source clean drinking water, village survivors were forced to drink the contaminated water and reports of Cholera were on the rise. Given the monumental amount of flooding, Malaria was also rising.

After Cyclone Idai, cases of Cholera and Malaria were on the rise.

Photo courtesy of Team Rubicon

Team Rubicon was required to demonstrate our ability to collect and analyze patient data for the WHO EMT verification. Knowing that the team works in a mobile setting, in remote, austere locations, a paper patient record and distribution process was created. This generally worked if you could transfer the paper records to the appropriate authority each day, but the EMT/CC required all patient data to be entered into a Microsoft Excel spreadsheet that was extremely large and wasn’t able to be transmitted via email when using internet access via satellite hotspots. Since Team Rubicon was unable to transmit daily reports to its National Operations Center or the EMT/CC, the Team Rubicon medical team was operating in a complete vacuum. They needed to find another way to collect, analyze, and transmit information to the WHO and prevent an epidemic that could take even more lives.

Earlier in 2019, Team Rubicon deployed with NetHope to install wireless access points on the Colombia/Venezuela border to provide Venezuelan refugees with access to news information and offers of assistance. NetHope utilized Fulcrum to track access-point install requests as well as record successful installs. Team Rubicon received training on Fulcrum during the deployment and grew to like the offline form entry capability, ability to change forms on the fly, and manipulate and analyze the collected information via the console. When faced with the need to collect medical information in an internet-disconnected environment and transmit reports later when within range of internet, Team Rubicon reached out to Fulcrum for support. Fulcrum provided a community disaster grant to facilitate Team Rubicon’s Cyclone Idai response, including developer assistance to rapidly publish medical forms.

Team Rubicon deploys in Mozambique

Photo courtesy of Team Rubicon

A typical operation each day saw Team Rubicon load into a helicopter at the farmhouse in Matarara, take a 15-minute helicopter ride to the other side of the river, then hike 5-10 miles with all of their gear to a village because the helicopter was unable to land closer to the area. Team Rubicon would see patients needing medical assistance while concurrently conducting multi-sector rapid needs assessments in the village to identify available food stores, access to clean drinking water, and identify other unmet needs. This information needed to be transmitted back to the EMT/CC and the United Nations Cluster Coordination System to provide early warning of the Cholera outbreak as well as identify locations that needed humanitarian aid distributions. The information was extremely time-critical.

Fulcrum allowed Team Rubicon to quickly enter patient data as well as the multi-sector needs assessment data in a completely disconnected environment. And since the Fulcrum app works on a cellular phone, there was no longer a need to pack bulky and heavy paper forms. Once back at base camp, and with access to internet, Team Rubicon could transmit the daily collected information to its National Operations Center so they could generate the EMT/CC daily reports in the format the EMT/CC preferred.

Team Rubicon deploys in Mozambique

Photo courtesy of Team Rubicon

Team Rubicon was one of the only WHO EMTs that provided timely reports to the EMT/CC. The information that Team Rubicon collected via Fulcrum directly led to numerous medical evacuations that saved lives after Cyclone Idai and also facilitated and expedited deliveries of food, water, and non-food items (NFI) by other international non-governmental organizations, which also saved lives and helped stop the spread of diseases within the affected villages. Team Rubicon utilized Fulcrum for the duration of its Cyclone Idai response and was lauded by the EMT/CC for the amount of data transmitted and the timeliness of the data, neither of which would have been possible without Fulcrum.

As Team Rubicon was demobilizing from Cyclone Idai, Cyclone Kenneth struck Northern Mozambique, so the team immediately pivoted and redeployed to Northern Mozambique. Team Rubicon was the only WHO EMT that responded to the area and continued the use of Fulcrum during the team’s response to Cyclone Kenneth.

Team Rubicon Mozambique response

Team Rubicon serves communities by mobilizing veterans to continue their service, leveraging their skills and experience to help people prepare, respond, and recover from disasters and humanitarian crises. Team Rubicon’s mission is providing disaster relief to those affected by natural disasters, be they domestic or international. By pairing the skills and experiences of military veterans with first responders, medical professionals, and technology solutions, Team Rubicon aims to provide the greatest service and impact possible. Learn more at teamrubiconusa.org.

About the author

William Porter is Senior Manager for Operations Support at Team Rubicon's National Operations Center.

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