Mischief, mayhem, music – these words appeared on a Matatu in Nairobi, Kenya. Matatus are Kenya’s public transport mini buses that nearly half of Nairobi’s population rely on for their daily commute.
But while those words may pass for the usual graffiti and colour that define matatus in Kenya, they are an excellent depiction of the chaotic nature of one of the country’s most popular public transportation options. The Star Newspaper, one of Kenya’s major dailies, described matatus as a weak link in anti-corona war – owing to the crowding and poor ventilation.
It is no surprise therefore that there are already a number of initiatives towards the containment of COVID-19 that target the public transportation both by government and private sector.
Individuals and companies in the technology sector are coming up with contact tracing solutions for public transport and other sectors where crowding is common. The idea is to be able to rapidly identify and isolate individuals who may have come into contact with a COVID-19 infected person; this in turn reduces the risk of multiple infections.
One of these initiatives is the COVID-19 Contact Tracing app developed by three final year students at the Jomo Kenyatta University of Agriculture and Technology – JKUAT. “What we are doing is risk mapping. Once you have this information, you can categorize different areas as high, medium or low risk,” said Boniface Tumaini Bundi, one of the three students, adding that contact tracing enables authorities to prioritize high risk areas in their emergency response thus optimizing the few resources available. The application is already in use by over ten matatu companies that operate an average of 300 buses each.
Understanding risk
The Sendai Framework for Disaster Risk Reduction highlights the understanding of risk as a priority for effective prevention and management of disaster risks. It calls for national and local authorities to promote real-time access to reliable data, including geographic information systems, and use information and communications technology innovations to enhance measurement tools and the collection, analysis and dissemination of data.
Creating new approaches
In addition to the contact tracing application, the three students have created two other applications in collaboration with a selection of healthcare facilities in Kiambu County in Central Kenya; one that enables self-testing and clinical triaging and another that captures important data in COVID-19 patient management. Both of these integrate with the contact tracing and medical records systems already in use.
In practical terms, if a person whose details had earlier been captured in the contact tracing application tests positive for COVID-19, the healthcare facility in which such a person seeks treatment, assuming it’s one of the facilities participating in the project, has the option of adding patient management data to the application. This would include the kind of medication administered to the patient, response to treatment and the duration of care among others. Such data collected over time by different facilities, can help healthcare workers to learn with ease the most effective approaches to treatment.
Victor Muthembo, a final year student of Public Health and one of the three innovators, said, “We do not have a standard treatment for Coronavirus but we can have one if we are able to study different approaches to see what is working and what is not”
The self-testing application on the other hand can be downloaded by anyone interested in knowing their risk level. “The app will ask you a number of questions, like , do you cough; do you have a high fever; and based on your responses it will tell if you are at a high, medium or low risk and further advise you on what to do,” said Crispus Onyono, the application engineer.
At Plainsview Hospital which is less than 5 Kilometres from Jomo Kenyatta University of Agriculture and Technology, the self-testing application is integrated into their triage system. This according to the doctor in charge, Dr. Micky Macatha Ndung’u, is a way to make hospitals safer and to keep the few testing kits in the country for people who really need them by the symptoms they exhibit.
“It may appear really simple but what it does is sieve out people based on their symptoms. It means doctors prepare to handle patients based on their risk levels hence reduce the chances of being infected and passing on the infection to subsequent patients,” he said.
Depending on the risk level recorded by a patient at triage, the facility is able to serve them with appropriate care for the health workers and other patients; this means reduced risk of infection hence hospitals can remain open at a time when they are most needed.
The question that many have asked however has to do with security of personal information captured in the application. According to Crispus Onyono, one of the three students and the software engineer for the application, they have simplified the application for matatu operators to ensure it does not take much of their time while also ensuring that personal information of the commuter is protected. “They only need to key in the identity card number or name of the person. This information is encrypted for safety but even if someone managed to decrypt it, you realize you cannot do anything with it unless you have the help of the government registrar to give you other details of the commuter,” he said.
As a security measure, many commercial buildings in Kenya already require names, phone and identity card numbers of all visitors, and so requiring just one of these will be seen by many Kenyans as less intrusive.
As such applications continue to be developed across the world including by Apple and Google, privacy remains a key concern for many people and may slow down uptake globally, the experience in Kenya may present a learning opportunity for the rest of the countries.