I dagens Göteborgs-Posten svarar jag på fem snabba frågor om den nyligen genomförda studien av den svenska insatsen mot Ebola i Liberia.

Då de kompletta svaren på frågorna av utrymmesskäl inte får plats i den korta spalten så tänker jag mig att det kan vara värdefullt att läsa mina fullständiga svar på frågorna.

5 frågor till Jonas Landgren

Forskare i interaktionsdesign vid Chalmers tekniska högskola, och nyligen hemkommen från Liberia där han studerat hur Myndigheten för Samhällsskydd och Beredskap (MSB) arbetat på plats i huvudstaden Monrovia samt i orten Greenville i södra Liberia, i samband med Ebolautbrottet.

Vad kan en forskare i interaktionsdesign studera i samband med Ebola-arbetet i Liberia?
Min forskning fokuserar på organisering av insatser vid krissituationer, och den här typen av arbete är beroende av olika typer av teknikstöd. Jag ville se vilken teknik som används och hur tekniken kan utvecklas för att stödja personalens arbete i fält.

Hur kan det hjälpa de som är smittade av Ebola?
Arbetet i fält är väldigt informations- och kommunikationsintensivt, då förutsättningarna ändras hela tiden. I slutändan handlar det om att höja effektiviteten i stödet som ges och se till så att resurser i form av vård, material och kunskap når fram till de som mest behöver det, inte minst ute på landsbygden. Jag hoppas att mitt arbete kan öka kunskapen om dynamisk organisering så att rätt insatser sker vid rätt tillfälle då uppdrag och hjälpbehov ofta behöver omformuleras beroende på händelseutvecklingen. Till exempel så ändrades MSB:s uppdrag på ett ganska betydande när det första teamet av vårdpersonal precis kommit ner, en förändring som inte alls fanns med i den planering som skedde i Sverige innan man åkte ner. Sådana plötsliga förändringar innebär naturligtvis utmaningar för teamet. Många i teamet har ju erfarenhet från andra insatser, så det har ju en god vana att ställa om.

Hur kom det sig att du reste till Liberia med MSB?
Jag har tidigare gjort liknande fältstudier vid pågående krissituationer och arbetat med MSB i andra projekt som handlar om krishantering. I höstas fick jag veta att de på regeringens uppdrag och förberedde en snabb insats och då blev jag nyfiken på hur det arbetet skulle se ut på plats och gavs möjligheten att åka med.

Vilka var de viktigaste lärdomarna du tog med dig hem?
Att det är svårt att planera och förutse vad som kommer att hända i den här typen av dynamiska händelser där så många individer och organisationer är involverade. Alla vill väl, men arbetet på plats kan uppfattas som rörigt. Sen blev det väldigt uppenbart att den Ebolaskräck som i perioder synts i svensk media inte motsvarade de upplevda riskerna på plats. Det har funnits mycket okunskap och florerat många fördomar här hemma om sjukdomen som inte alls stämde in i den bilden jag fick i Liberia. Starkaste intrycken kom från möten med familjer som hade anhöriga som hade tillfrisknat från Ebola, deras tacksamhet för de internationella insatserna var väldigt stor.

Hur kan din forskning komma till gagn för liknande framtida kriser?
Mina slutsatser kommer att ingå i MSB:s kurser för framtida utresande personal i form av utbildning, metodik- och systemstöd. Detta var första gången MSB skickade med en inbäddad forskare i fält, så jag hoppas även att fler myndigheter och organisationer gör detta i framtiden.

//

 

Today is the last day in Liberia and it is with pleasure that I am looking back at a very exciting and insightful field study. The amount and level of challenges faced and overcome by clever and insightful actions by the Swedish response personnel is astonishing. The fight against Ebola is far from over even if this health disaster now seems to shift into another phase here in Liberia, there is still a lot of difficult issues that the Liberian government must address.

I am back in Monrovia after a fantastic time with the MSB-personnel in Greenville. Yesterday, I contacted Hans Rosling that is working as an advisor for the Ministry of Health (MoH) here in Liberia. He invited me to come over to the team at MoH to learn about their work on ebola epidemiological surveillance . MoH is just 500 meters from the hotel were the MSB Liberia HQ is located, so it is just a short hop by car or a nice walk.

During the visit to Hans, I was introduced to Knut Staring (University of Oslo) that has arrived from Oslo to Monrovia as an expert of the health management information system (DIHS2) that is in use to monitor and analyze the ebola outbreak. DIHS has a long history and Knut and his colleagues at Oslo University have worked on various versions of this system for many years. When following Hans and Knut in their work at MoH, it was evident how many young, smart and ambitious people that work in the team. The atmosphere was similar to a start-up company with a high tempo, serious conversations in a positive attitude with lots of smiles and laughs. The picture shows Hans next to his visualization of the process for case management and contact tracing.

The visit to the team at MoH gave additional insights about the possibilities created when you combine ambitious people, organizing skills, domain expertise and technology use. I would argue that these aspects are important in all types of response work, since without them it will be very difficult to be able to adapt to changing conditions or having flexibility to make use of sudden opportunities. A designerly attitude is also very important, and I have often seen this attitude among the international response personnel and the Liberian personnel in both small scale situations as well as in larger and more complex situations.

Sadly, I will leave the MSB Ebola response team and Liberia on friday.

I have for the past few days been in Greenville in the south of Liberia. This small town  has experienced several Ebola-cases. MSB has set up a rapid response ETU that has taken care of Ebola patients. The medical care of the patients has been done by local medical personnel and the MSB-personnel has been in a support and coaching-role. At the moment there are no patients at the ETU. When talking with the local medical staff, the challenges becomes evident, that these fantastic people are facing when working in PPEs taking care of the Ebola-patients, having in mind the temperature and risks in relation to the wage.

The other day, we visited a small village that has had several Ebola-cases. Together with health and psycho-social personnel for the Greenville hospital, we participated in a meeting with the people in the village to inform and discuss about the intervention. The intervention has been successful and the village does not have any more Ebola-cases. There is still monitoring activities in place to follow up on individuals that have had contact with those that were sick. The visit gave important insights into the amazing work done by the health teams and the work by the local community in their fight against Ebola.

It seems as there are challenges for the international community in channeling the material and personnel capacity that exists in the Monrovia area to ensure and build up capacity on a district-level and community-level where the frontline battle against Ebola is taking place. This is not a surprising observation since in all natural- or health-disasters, the coordination of resources is complex. But when observing the small means that these local health teams are working with, one also realizes that coordination in general should perhaps be given an even stronger attention as well as support.

// Greenville, 4th of January

During the intense autumn with interesting field studies at MSBs national situation room, I got in contact with the team that were intensely engaged in the planning of the Swedish response operation against Ebola in West-Africa. This resulted in an opportunity to conduct field studies on location in Liberia. The studies on location i Liberia will be done in collaboration with DRL (The Disaster Resilience Lab) at Tilburg University and Agder University that already has been to Accra in Ghana and studied the UNMEER-operations. So my studies will together with the work by Tina Comes and Bartel van de Walle hopefully result in important insights regarding how to further advance technology use and management of international response efforts in times when agility, flexibility and a designerly attitude is more important than ever in the fighting of a continuously shifting health-disaster. My focus in Liberia will be on the Swedish operations and the challenges they face and learn from the experiences they make. The field studies starts today and will end on the 10th of january.

My field study has become possible due to MSBs openness to and interest in research combined with support by URBSEC at Chalmers and Gothenburg University. I will whenever possible, provide updates from the field here on the blog.