| Communication techniques in support of GREP | Philippe Van der Stichele |
| The role of multimedia technology in EMPRES and GREP | Julian Hilton |
Philippe Van der Stichele10
Soon after PARC Phase One commenced field operations in 1987 it became apparent that the desired level of participation in the Campaign by people, ranging from cattle owners to government decision-makers, was not automatic and in some cases could be difficult to obtain. The PARC programme far exceeded the typical exercises of disease control and animal production normally carried out by national livestock services. People's cooperation is not only vital to achieve eradication of rinderpest, but also their active involvement is crucial to make livestock services sustainable, and to safeguard the environment against desertification in Africa.
Furthermore it was recognized that in order for the Campaign to achieve sufficient momentum and priority at the international level, it was highly important to deliberately increase the awareness of various organizations and the general public about PARC.
To meet these needs, PARC added ‘Development Communication’, as a key component in its overall strategy, midway through PARC Phase One.
Development Communication aims to improve project planning and implementation, people's participation and training through better communication and sharing of knowledge and information between all parties involved.
In PARC, Development Communication has focused on increasing the mutual understanding between national livestock services and rural cattle owners through improved person-to-person dialogue and information exchange. It has aimed to help livestock ministries to use communication techniques and create appropriate media materials. It has encouraged governments and organizations at the international level to discuss more openly about issues of rinderpest control and the needs for mutual action, and has begun to help them to better recognize the value of initiating PARC policy reforms. It has also helped to create and promote a Campaign identity, and instill a sense of progress and commitment towards final success, amongst members of the Campaign.
In practice, PARC's Development Communication activities have occurred on two levels: at the regional level in OAU/IBAR to provide a limited amount of technical assistance to PARC member countries and to promote international awareness of the Campaign, and at the national-level with basic funding and expertise to carry out communication components within PARC national projects.
Funding for the regional communication activities between 1987 and 1992 was provided through the FAO/TCP Programme and the Government of Belgium for a total of $ 1 million whilst specific national activities for the PARC national projects in Uganda and Sudan under the FAO/TCP programme amounted to $ 200,000. Inputs consisted of a PARC Regional Communication Adviser in both the Nairobi and Bamako OAU/IBAR offices. They helped to design a model PARC communication policy and strategy, a multi-media materials example kit, communication guides and training materials for adaptation at the national-level, and informational materials for international awareness. The projects also conducted some training at the national-level in six countries, carried out missions to formulate national-level communication components for inclusion into a number of PARC national projects as funded by the EEC, helped national authorities identify funding, initiated actual communication activities in ten PARC countries, and collected national media materials examples for future reference by other PARC countries.
As an end result, the communication inputs have greatly contributed to:
sensitize PARC member-country decision-makers on the need for a concerted PARC policy;
influence public opinion in support of vaccination and surveillance campaigns;
establish a better liaison between animal health field personnel and cattle-owners and, initiate participatory decision-making processes at community levels.
As an end-result also, OAU/IBAR has now convinced the majority of the PARC member countries that funding negotiations with the EC for their individual national PARC projects must include an average of 5–7% of their budgets to be devoted to communication activities.
1996 - ONWARDS
Based on the positive impact of Phase One, the EC has now approved a second and more comprehensive Communication Project devoted to PARC which started in January 1996. (Project GCP/RAF/290/EC, amounting to approximately $ 2.3 million over 3 years).
The new project is to play a pivotal role in the future activities of PARC. Since many of PARC's future interventions are to touch the social fabric of the livestock owners, livestock service personnel and private veterinarians, Communication will have to contribute to a change of knowledge, attitude and practice among its client groups.
Its tasks are now to assist OAU/IBAR and the PARC member countries to:
switch from a vaccination phase to a serosurveillance phase in a majority of Western and Central African countries whilst reinforcing the vaccination campaigns in others (Eastern/North Eastern);
help to reinforce transboundary collaboration and the effectiveness of sanitary cordons;
design appropriate communication strategies to reach pastoral communities;
make national livestock services more financially self-sustaining and effective in the field;
promote the privatization of animal health services (through sanitary mandates and the costrecovery system);
help safeguard against desertification and help revitalize the livestock sector.
In order to accomplish these tasks, the project has provided to each OAU/IBAR Offices of Nairobi and Bamako a team of two communication professionals with regional responsibilities.
The plan is to create within the Veterinary Services in each PARC-member country a Core National Communication Team (CCT). The CCTs will be trained in the development communication discipline and helped to design and apply their PARC national communication strategies to carry out public awareness campaigns that inform and motivate people effectively, from the grass-roots level to the decision-makers. They will also assist the OAU/IBAR Coordination Unit to promote policy reforms, international actions against animal diseases and environmental safeguards by mass-media campaigns and by creating and disseminating audio-visual materials to a variety of decision makers and the general public.
GREP AND INTERNATIONAL MOBILIZATION
The Global Rinderpest Eradication Programme is an innovative, concerted, international effort to eradicate the disease.
It requires global community participation (as was done by WHO for the eradication of smallpox).
Strategies must be designed to attract donors and decision-makers.
Donors need to appreciate the objectives and cost-effectiveness of developing early warning mechanisms and the international community must be stimulated to react to emergencies.
There is a need to have common baseline approaches/themes between all components of GREP.
The strategy of rinderpest campaigns is now changing. As there are less disease foci remaining, mass vaccination campaigns should become the exception rather than the rule.
Campaigns should be aimed more and more towards surveillance activities and improved, sustainable veterinary services.
Attention should also be given to the risks of desertification, including pasture management and the improvement of animal production and marketing.
GREP AND THE NEED FOR A COHERENT COMMUNICATION STRATEGY
A sound communication strategy must be designed to support GREP from the early planning stages of its individual national components right through to their negotiation, implementation, monitoring and evaluation stages. The GREP Communication Strategy will enable:
better planning and programme formulation through participatory approaches at all concerned levels;
to generate support from the donor community and from decision-makers through improved presentations;
to ensure people's participation and commitment through better dialogue and joint decisionmaking processes;
to raise the awareness of the communities with regards to their crucial role in epidemic early warning systems;
to spread and share knowledge and information through a better use of media, interpersonal communication and the application of modern electronic technology (connectivity through the Internet and e-mail) at different levels;
to raise the communication skills and the motivation of concerned field staff through improved training and through the provision of adequate communication tools.
GREP COMMUNICATION ESSENTIALS
Following the PARC Communication experience, recent PARC General and Regional Meetings have listed “Communication” as a primordial area of intervention for the future.
It is therefore essential that the WAREC and SAREC components of GREP make a firm commitment to incorporate a sound communication component into their programmes. This must be done within their regional coordination activities as well within individual national programmes.
The financial implications cannot be overlooked. A minimum of 5% of individual country programme budgets should be earmarked to cater for the National Communication components and negotiations should be undertaken with the donor community to establish regional communication coordination teams (for WAREC and SAREC).
Julian Hilton 11
Background: The Global Village
Predictions about the dawn of the age of the Global Village have been common since Marshall McLuhan first propounded the idea in the 1950s, but now the dawn seems finally to have arrived. Strikingly, the communications instrument that has forced the issue is not, as McLuhan predicted, the television, but rather the computer as gateway to the Internet - the name given the worldwide network of computers which constitute the Global Village communications channel. This channel, now increasingly capable of supporting multimedia (text, image, animation, sound, even video), is opening for veterinary uses, and not just the “surfing” of the college student.
The global spread of the Internet is rapid, incoherent and cross-cultural. The speed with which it is developing however, is not just a function of the remarkable developments of computing technology (which in someways is still not very efficient) but of the steadily reducing cost of access. The opportunity now exists, almost irrespective on where in the world you are, to access information of the highest quality and immediacy at the cost of a local telephone call - or even by mobile telephone operating from batteries in the field. Putting this opportunity to work in the service of GREP and EMPRES is a challenge now worth facing seriously, since at the heart if the mission of global eradication of disease is the circulation of information and data of the highest quality and credibility.
Imagine a veterinary officer could stand in a field next to an animal suspected of being sick, capture visual and diagnostic data from that animal by camera or by, for example, ELISA, transmit the images and data for further analysis to a national lab, or one in Paris, Rome, Vienna or Pirbright and receive the analysis back again into the field setting. Imagine every village had such a capability, reinforced by support materials suited to the local culture and conditions, but at a price that each village could afford without subsidy; imagine the impact that could have on the capacity to prevent and control diseases.
It is time to plan for that scenario since the technologies that enable it are now within reach, not just technologically, but perhaps more critically, economically. Economists recognise certain magic thresholds in the adoption and spread of new technologies; what we are living through is our global passage through such a threshold.
If the premise is accepted that we now all share in the concerns of a Global Village, then diseases, such as rinderpest, which have hitherto been seen as in the ownership of the countries which have them, are now problems which affect the village as a whole. We are all owners now. And the issue is not simply one of mobilising a global strategy for controlling and eradicating a key disease; the world's veterinary services are in a process of evolution and realignment to bring livestock production and national veterinary activity closer into liaison, in turn reflecting a new interest in achieving common scientific standards, for example in diagnostics and disease control, as a basis for a common trade order aimed at facilitating world trade.
11 President, The TELOS Group, Suite 38, Beaufort Court, Admiral's Way, London E14 XL9, UK.
AVIS and other Enabling Technologies
In preparation for the exploitation of the opportunities the new global communication technologies offer, a consortium was formed in 1993 to develop the APPLIED VETERINARY INFORMATION SYSTEM (AVIS). The founding consortium members are the Food and Agriculture Organisation, Rome; Institute for Animal Health, Compton and Pirbright; Office International des Epizooties, Paris; The Telos Group, London. Membership on an associate basis is open to public and private sector bodies with an interest in promoting standards in the field of veterinary services, especially in the prevention, management and eradication of diseases.
AVIS was intended to capitalise on the potential of powerful but increasingly affordable computing technology (computers have roughly doubled in power and halved in price every year for the past forty years) to build a custom made, easy to use system for veterinary medicine, integrating three key functions:
training and information
data capture and management
decision support.
This combination of purposes led to the following mission statement:
“To develop, make and distribute information technology products and services for animal healthcare, aimed at consciousness raising, human resource development, local capacity building and cost effective delivery, to prevent, alleviate or cure suffering.”
AVIS Users
AVIS recognises the needs of general veterinarians and other animal healthcare workers, in that “memory is treacherous”. Even the most thoroughly informed professionals need reminders “to make them master of the situation and enable them to prescribe exactly what their judgement tells them is needed for the occasion” (Merck Manual).
The principal users of AVIS are animal health workers, with particular attention to need in the primary sector. But systems are also envisaged in the educational setting, such as in schools, colleges or universities, and in the workplace.
Education and training improves the basic efficiency of primary care, delivering Awareness, Recognition and Treatment (ART).
Data capture, management and analysis enable correct identification of diseases, efficient case management and overview of case mix, audit tracking and outcome analysis.
Decision support tools enable overall sector management, epidemiology, cost benefit analysis and overall performance and quality control.
The AVIS Development Process
AVIS initially agreed a three year development process, which ran from February 1994 -January 1997, and which proceeded as follows:
Phase 1: Rinderpest
Phase 2: Foot-and-Mouth Disease ELISA: A Manual
Phase 3: Modular roll-out of full AVIS system.
Remarkably, AVIS has kept very much to schedule. Rinderpest is now completed, Foot and Mouth Disease well advanced, and other modules for example for Poultry Diseases and BSE are now in development. Other EMPRES diseases, CBPP, Rift Valley fever, lumpy skin disease, and priority list B diseases, such as rabies, tuberculosis and salmonellosis are in script development.
When complete, AVIS was also designed to enable two key activities: technology transfer by distance learning and real-time professional support. Technology transfer is a key to sustainable development; effective technology transfer in turn depends on human resource development and local capacity building.
AVIS is now sufficiently advanced to open up the wider objectives of the system to review and redefinition, which is where the opportunity to contribute to the strategic missions of GREP and EMPRES is both timely and fully achievable.
AVIS Goals
As early as 1993, the following goals were set for AVIS. They bear reprinting since there has been a considerable degree of success in meeting them.
to build a modular, multimedia information system providing rapid, low-cost access to standardised disease management information on a global basis
to create, by national consultation meetings, user seminars and working groups at local level, a network of key users
to agree a detailed specification for the AVIS system, software and box
to define a methodology for integration of AVIS into existing animal health information systems
to create a communications network enabling AVIS users to be in direct communications with each other, and with other on-line sources of information
to create and provide an AVIS Box, a personal computer either portable or desktop in nature, which contains all the essential tools and techniques required to support the practice and management of primary care
to derive management information from and for AVIS users sufficient to enable authorities at district and national level to manage their resources effectively.
Rinderpest
Rinderpest was chosen to initiate the AVIS project for a number of reasons, of which one in particular stands out. It is now a common, though poorly explained, experience of the application of the computer to standards (such as SOPs, diagnostic standards etc) that computerisation greatly facilitates and reinforces consensus formation, and through consensus standards emerge by practice and consent rather than by fiat. Capturing this process is intrinsic to the widespread recognition of what standardisation could ring in the way of benefits to the global process of disease eradication and/or control.
Rinderpest also acts quickly, which challenges AVIS to produce a system capable of rapid response. So the longer term vision of AVIS is real time support for the field worker. To achieve this takes time, financial resource but most importantly close attention to the user at work and the requirements that user might have as the computer plays an increasingly large part in his or her life. So a number of goals were defined for AVIS in the first stages of deployment:
introduce target users to the potential of multimedia and test assumptions about generic aspects of the system itself
deliver an information and training package on Rinderpest, containing information on: the disease, agent and clinical symptoms, pathology, control, vaccines, the ELISA system, seromonitoring, legislation and regulations
develop synergy with related EC and WHO activities, such as PARC, WAREC and SAREC.
A significant advantage of modern computing is that development can be modular in nature, enabling costs to be contained, and user evaluation to be absorbed into the development of new modules.
AVIS and Rinderpest
AVIS was born from a long and well-conceived process of consultation and testing. For example: consultation meetings were held at the Institute for Animal Health, Compton (November 10th 1992 and February 9th 1993), at IAEA Vienna (March/April 1993), at BBSRC Institute for Animal Health, Pirbright Laboratory, at OIE Paris, at FAO Rome, May 1993 and FAO Kenya, September 1993, and a further series of informal discussions throughout 1994 confirmed an interest in principle in developing AVIS.
This interest was pursued at the OIE Regional meeting, Rabat January 1995 where the project as a whole, and the first prototype system, on Rinderpest, was demonstrated to the delegates. In a feedback session the following priorities were established:
rapid access to information of the highest quality, based on agreed standards
quality control of data going into the system
capacity to access data from paper sources
timeliness of reporting
observation of national standards
cost effective training and SOP type support for field work.
These reactions and the prototype itself were presented at the General Session of OIE, May 1995 and approval was granted to pursue the project into its full development. The first results, the complete Rinderpest program and the first modules on Foot and Mouth Disease and Newcastle Disease were presented at the General Session, May 1996, when a wide range of countries initiated the process of implementing the programs at national level.
Rolling out the AVIS System (May 1996 - December 1998)
The full AVIS system will now be developed and rolled out by the end of 1998, with new diseases and support tools being added in regular succession. The centres of excellence such as Pirbright which have created the content will also oversee regular updates, based on an evaluation of standards as they evolve.
The evaluation phase has confirmed that the AVIS project will be training and information led, as the most cost effective way to build multimedia systems into the practical working situation. To reinforce this purpose, modules are now in planning explicitly to support EMPRES objectives, and these will be available either through the AVIS system or stand alone. Internet deployment is planned as part of the priority activity for 1997.
Training modules lead naturally into data management, e.g. for epidemiology and disease management, and into decision support.
The system will use standard software where possible, to enable easier technical support. Training materials will be authored in a windows based environment such as Toolbook, integrated with modules written in standard languages, such as C++, Prolog and Visual Basic. The computer platform is easy to specify - any computer that supports Windows 3.1 or higher will run AVIS programs.
Systems in Practice
While this paper has outlined a strategy under the AVIS program for deployment of multimedia computing, there is no intention to ignore the extremely valuable work being done through and with other systems. On the contrary, every opportunity is being sought to integrate with them. As computing systems advance such integration becomes progressively easier.
The issue however, is not technology but user needs. In his paper outlining the requirements he sees for the effective management of disease under the EMPRES rubric, Dr. Bill Geering has defined three powerful requirements for the information management capability of any system:
what has happened?
what does it mean?
what can we do about it?
AVIS is committed to assisting the world's veterinary authorities in being able to meet the challenges set by such questions. In practice this determines a set of actions which GREP and EMPRES will need to pursue to achieve the value from multimedia systems that can now be realised:
achieve policy consensus
signal a clear intent to deploy such systems
define and adopt strategic objectives
define the timeline
define a roll out and user support strategy
create a representative user group
mobilise resources - human and financial.
The purposeful and supportive mood of the GREP technical consultation meeting suggests that the will now exists to act, and given that will a global implementation can be underway in earnest by 1998.
