Installing Ruby’s hardware: from one mother to countless others
A blog by Lil Patuck, a member of the Frontier Tech Hub featuring photography by Greg McKinney
After two years of research, planning, and testing, a health worker in Harar, Ethiopia, picked up a heavy box and walked through a warehouse doorway. The edge of the doorway held a freshly installed ‘geoseal hub’, drilled into the concrete just minutes before, and inside the hub wires connected a chipboard and a sensor to a local SIM card. It had been built by hand by Ruby Hill, a design engineer 6,000 miles away on the Isle of Wight in the UK.
Inside the Geoseals ‘hub’, which tracks RFID tags passing by. Image credit: Greg McKinney
On the other side of the doorway, the man set the box down and turned to a confused group of people crowded around a laptop, who had fallen silent.
“We didn’t expect him to hold the box like that,” said one person eventually, while another laughed and shook their head, scrolling through the code on the screen, where nothing had changed.
The hub on the doorway was designed to pick up a signal from a sticker on the box as it passed into the warehouse, triggering a report to be sent to the computer via lines of code. These lines of code would signal to a central platform that the box containing life-saving malnutrition supplements had arrived at this location: a rural health center hundreds of km from its starting point in Addis Ababa. It’s a journey where aid such as this can be easily lost, stolen or delayed, especially in times of conflict.
Alasdair, Maraf and Bilisu watch the screen for new code, along with UNICEF’s nutrition officer Mekit. Image credit: Greg McKinney
Before this moment, back on the Isle of Wight, Ruby had spent time painstakingly testing these sensors on her own doorways, over and over again, after studying the dimensions they were to fit later on. She varied the box contents, the height of the sensors, the antenna placement and the shape of the doorway, and after packing up 13 ‘hubs’ to install on the doorways she had meticulously examined, her colleague Alasdair had flown them to Ethiopia. There he tested them one final time on a hotel doorway in Addis Ababa.
But in all their tests, one thing they hadn’t accounted for was the box being held differently by the human carrying it. In their previous tests they had picked up the boxes with two hands, the box carried in front, but in this case, the box was hoisted onto the man’s shoulder and carried through on its side, hiding it from full view of the installed hub on the doorframe.
Storeroom worker picks up malnutrition supplies to store away. Image credit: Greg McKinney
Test, fail and learn
This is the kind of story which demonstrates why the Frontier Tech Hub exists: to test, fail and learn early on, when the stakes are lower, and potential impact is still in reach.
The word ‘failure’ has negative connotations, but Ruby, who selected the components and designed the hardware, was eager to discover unanticipated bugs, barriers and hurdles to enable her to iterate the solution and ensure its strength in the long term.
“The technology is something we can test here in the UK, and we can run it as many times as we like here, but we're not actually in that environment… The most important insight is that it's okay to be wrong and make your experiments challenging.”
She’s passionate about human-centered design, and creating solutions defined by deep understanding of the end-user’s needs, in the knowledge that “the person who is using the technology is the best person to design that technology.”
“I'm not a stock checker,” she says. “I don't work in aid or humanitarian work and I have very little knowledge of that. I'm an engineer. I work from my office in my garden and my visibility of that world is very small.”
As with any pilot project, this isn’t the first time the team have found their assumptions to be false, and over the course of the journey their focus has shifted to a more specific solution. The idea for this solution was originally submitted by Pioneer Philip Cockerill 3 years ago, who wanted to test using IoT and sensors to track supply chains from end to end. In other words, you would know where any shipment was, at any time, and know when it was opened. But since then, Philip, Alasdair and Ruby uncovered a different need together: to know the stock levels at existing recipient locations. Rather than tracking shipments on their journeys, the solution they have developed provides data insights by placing sensors at destination health points to track aid arrivals via the RFID labels on each box.
Ruby shows FCDO Pioneer Phillip the updated hardware. Image credit: Dave Thomas
“Every step of the way we have changed because we've received new data and information. And that's the beauty of the design: it kind of converges and diverges and changes as we go along.”
Their ability to be open to changing their idea has led them to developing an evolved solution that resonates with the stakeholders they’ve been working with, such as WFP, UNICEF and the Ethiopian Ministry of Health. They also shifted from costlier tracking methods like breakable seals and GPS, to working first with simpler, more cost-effective RFID technology (even the labels themselves can cost anything from a penny to £30).
“What's really nice about the Frontier Tech Hub is that we actually get to experiment and find out in a risk-free way whether or not this is going to work. When you're developing stuff, it's normally tied to a price and a time, and to have space to get it wrong is really important.”
Same needs, different places
When the project started, Ruby’s sense of purpose lay in her passion to understand a problem and create a potential solution which wouldn’t add additional complexity to the lives of the people using it. In this case, the problem is ensuring that rural health centers have the right stock levels of malnutriton supplements, which saves the lives of babies and children suffering from undernutrition, stunting and wasting. According to the WHO, nearly half of deaths among children under 5 years of age are linked to undernutrition, affecting hundreds of millions of children globally. Working with long lead times for resupplies when needed, having weekly prescriptions for patients available is vital.
“At the moment it’s done on paper, but you can't make very quick inferences on data because it's just a tally. It's not enough. The information [the central warehouse] has is: ‘we have sent some boxes, but no one knows if they've arrived’. The only person who knows it's arrived is the person who's using it.”
“And that person,” Ruby explains knowingly, “is focussed on a completely different job. They're focussed on treating the patient, not the stock level in the cupboard. They are when it's empty, but they've got other things that they need to do: they're saving lives, not worrying about whether or not there's enough of the malnutritional supplement in the cupboard.”
As the project progressed and the geoseals product evolved, Ruby became a mother herself, giving birth to a daughter who had nutritional needs not dissimilar to those faced by the weekly beneficiaries in Harar. It spurred her on to help ensure others had the same access, creating a deeper drive to develop and de-risk the technology.
“There were [photos of] a stock out and I found it so emotional. I was imagining these women trekking to these remote points with their child who they can't feed to find that there is no aid in that cupboard.”
A mother and her baby visiting her local health center. Image credit: Greg McKinney
Through her regular appointments she also recognized the mental load placed on the health workers in Harar, who were responsible for making decisions based on rough, paper-based data when they needed to focus on the mothers traveling up to 2 hours each way to be prescribed aid. “They just want to know that it's there and they can use it.”
“Going through having a baby in the middle of all of this has been quite a big impact: seeing how children are affected by malnutrition and my own struggles getting the food for my daughter, which were bureaucratic. I didn't have to trek for miles. And when I actually got there, they had the food I needed.”
Scaling to meet the need
The technologies used are not new, but using them in this environment is, and the data generated by these hubs could help people to make really important decisions about stock management throughout the supply chain.
“The impact is just helping one person at this point. We're only trialing in four remote clinics, but there are so many across Ethiopia, something like 200. So if we could scale up country by country and be able to track hundreds of thousands of shipments, then we would be able to help so many people.”
Mothers wait with their children to see the clinician. Image credit: Greg McKinney
The high water content of malnutrition supplements makes it one of the hardest types of stock for these hubs to sense and track, which makes this pilot’s learning even more valuable, because this solution could theoretically be applied to the majority of other humanitarian aid, providing better data on stock levels when it’s needed.
“So it's not just malnutrition or supplements that we can track with this technology. It's an RFID label. So it just has to be anything you can put a label on. A lot of the aid that we saw at the warehouse were things that were transported in boxes. It's very easy to take those things like water purifiers, shelter kits, health kits and label them.”
Maraf and Bilisu install a Hub above the doorway of a stockroom. Image credit: Greg McKinney
The team in the UK are in the midst of gathering the data from Ruby’s first batch of geoseal hubs, installed in a central UNICEF warehouse in Addis Ababa where RFID labels are being stuck onto boxes, and at remote health points in Harar, where the sensors are awaiting the arrival of stock.
Back in Harar are the two newest members of the team: Maraf and Billisu, computer scientists from Haramaya University who are able to fix bugs and problems as they appear, both on the software and hardware, checking, listening and watching for the next “failure” to appear.
In July this team will be screening a short film (alongside a report) online about their project, and the potential impact geoseals holds for humanitarian supply chains in the future.
If you would like to be invited to the event, email lil@hellobrink.co to be added to the guest list.
