Youth citizen science and digital twin tech for outbreak prevention

Developing a technology-driven youth citizen science sensing network to health-proof the future of African cities.

Tolu Oni

Founder of UrbanBetter

Public health physician and urban epidemiologist at the University of Cambridge

Honorary Associate Professor at the University of Cape Town

Despite >80% of South African households having access to water and sanitation, only few households have access to acceptable water (43%) and sanitation (25%) services that perform satisfactorily [1]. Consequently, national seasonal diarrhoeal outbreaks are common and disproportionately borne by poor communities, which further drives inequality and distrust in public services.

 These urban conditions are representative of continental concerns and are useful for exploring urban resilience or mitigating shocks due to health emergencies. COVID-19 highlighted the importance of early action and the interdependence of public health and economies, especially in vulnerable urban environments. It triggered unprecedented provision of water and sanitation services and economic relief for un(der)served communities [2]. Such deployment will now need sustained action to prevent anticipatable outbreaks and to mitigate downstream impacts. In Africa, the continent with the youngest demographic, >60% of urban residents reside in informal settlements that disrupt ecology further increasing outbreak risk, jeopardising human and economic development. There is therefore an urgency to deliver more inclusive data generation and application solutions that are transferable, scalable, and hyper-localised. This approach can harness the continent’s demographic dividend to prevent preventable health emergencies and save lives if data are timely, accessible and integrated.

[1]https://www.dailymaverick.co.z...

[2] https://www.internationalbudge...

Urban populations in African countries have frequent and high levels of inter-urban migration patterns and South Africa is no exception. Therefore, individuals may often learn skills in more stable urban settings, which are instantly transferable to communities in more environmentally vulnerable urban settings. 

We propose to deploy in two distinct typologies, both of which include low-income communities:

Case 1: Stable Urban Context (Hatfield region, City of Tshwane)

Case 2: Vulnerable Urban Context (Mamelodi, Hammanskraal, City of Tshwane)

From two diverse contexts, we can learn and test variance in

• community compositions and need assessment (population size, demographics, socio-economics, health and environmental variance);

• impact and response measures between contexts;

• appropriate approaches to risk, prevention and mitigation;

• trust and information relationships (local government, inter-community, and health services).

This solution adopts a transdisciplinary approach engaging communities at every step from co-design to data collection and implementation. Of note, we will leverage the demographic dividend of youth as interloculators for their communities, building the agency for data-driven advocacy (to prevent outbreaks) and responses (in the event of outbreaks).

Anticipated public goods include:

• Open access dashboards (see supplementary material): we will build out the prototype currently under development as part of InnovationAfrica@UP integrating community sensing data to both identify outbreak risk and evaluate the impact of interventions to prevent and mitigate outbreaks;

• A user augmented reality visualisation interface: an innovative aspect of our citizen scientist approach is placing data generated by community members back into their hands to inform advocacy efforts to address anticipatable environmental risks to health and to build the intellectual antibodies necessary to address misinformation and mistrust during outbreaks;

• Peer-reviewed publications: process and outcome data from this project will be disseminated in open-access peer-reviewed publications;

• Non-academic dissemination: Beyond the 3 years, we aim to pilot this solution in South Africa and other African urban settings. We will therefore leverage the Urban Better learning collaborative (https://urbanbetter.science/) to share progress and outcomes with young change agents communities across Africa working across public, private and civil society sectors to make the urban better.  

Africa is the fastest urbanising region. With >60% of urban residents residing in informal settlements, cities pose health threats through human settlements that:

• increase exposure to, and transmission of infectious diseases due to overcrowding, insufficient water and sanitation infrastructure;

• disrupt ecology with increasing proximity to agricultural industry increasing outbreak risk through exposure to animals and environmental antimicrobial resistance; 

• are associated with precarious livelihoods that reduce social and health resilience. 

Our solution is primarily premised on building predictive capability to prevent the preventable, addressing the disconnect between surveillance of (environmental and socio-economic) determinants of health and disease data systems in rapidly growing cities. By adopting participatory approaches to environment sensing and real-time feedback between environment and health data, this solution further aims to develop an early listening system as part of emergency response. Embedding community capacity strengthening achieves the secondary outcome of anticipating the social, economic and health needs of vulnerable populations to inform efforts to mitigate negative impacts of outbreaks. Our proposed youth-privileged, integrated early warning and early listening system aims to future-proof health (given realities of climate change that increase environmental risk associated with increased frequency of outbreaks) and to health-proof the future of cities in the long term.

The first year will be focused on broad spectrum detection, establishing baseline data and building a youth citizen scientist network (Table 1, supplementary material). To this end, we will:

• Build upon existing internal projects, datasets, software and technologies that are commercially available;

• Develop baselines and standardisations for comparison in subsequent years;

• Expand and mature these systems towards open access or open source interfaces relative to our proposal.

The ultimate goal is to develop a Proof of Concept solution that identifies ways to pre-empt and mitigate public health emergencies through community participation. In years 2 and 3 we aim to shift agency to the community (Table 1 in uploaded supplementary material) to:

• improve detection, prevention & response in African settings; 

• make sensors cheaper for African market;

• make sensors “community friendly” to deploy at scale;

• ensure increasing “open data” and “open access” approaches to improve inclusivity and understanding;

• improve “tech maturity” across various sectors;

• provide guidance (policy, guidelines, community development / action support);

• enable “feedback loops” between “responders” and “beneficiaries”.

Indicators against which we will measure progress and impact are as follows:

Year 1:

• Commercial sensors acquired and placed in situ;

• Data accessed and collated on digital twin platform from commercial water sensors, health data from health service, household data from household surveys, National Treasury department and South African meteorology office;

• Establish youth citizen scientist network in partnership with community youth organisations;

• Co-design outbreak mitigation citizen science instrument with youth.

Year 2:

• Develop cheaper, faster, community centric point-of-need water sensors;

• Deploy in communities and activate youth citizen scientist network to capture data;

• Install LoRaWAN and 5G networks to cover the focus areas;

• Integrate data from sensors into the digital twin platform.

Year 3:

• Integrate data from sensors into the digital twin platform;

• Explore association between data captured in communities and observed epidemiology of diarrhoeal outbreaks;

• Complete groundwork in preparation to run an outbreak simulation to assess the potential of youth citizen science sensing network and digital twin technology to identify vulnerability and tailor interventions to mitigate the social, economic and health impacts of an outbreak.

Based on our experience of developing the prototype initiatives to date, barriers experienced and strategies taken to overcome these are as follows:

• Establishing cooperation agreements for data sharing and collaboration:

  • To overcome these barriers, we have engaged in extensive discussions, stakeholder workshops and cross-community education to advance cooperation agreements with local and national governments. These engagements over the last few years are paying off and software agreements required for this solution are already in place. Furthermore, we have received expressions of interest and buy-in to this proof of concept solution from a wide range of stakeholders including the public (National Treasury, City of Tshwane) and private (Siemens, Huawei) sectors.

• Capacity barrier: on the ground skills is an essential part of ensuring the sustainability of the project. 

  • To date, we have focused on aligning and unlocking capacity across the university and the university-wide networks including embedding prototype initiatives in activities of the student body across disciplines including engineering, architecture and chemistry;

  • In addition, we will leverage Urban Better's experience of engaging youth focused community organisations in cities across Africa to the development of the youth citizen scientist network, which will also include university students living in the communities of interest. 

UrbanBetter

University of Cambridge

University of Pretoria

Future Africa

Innovation Africa @ University of Pretoria (under which the Engineering 4.0 platform falls)

The two key barriers identified relate to data access and the necessary cooperation agreements, as well as on-the-ground capacity. 

While our solutions team have begun to engage with different stakeholders as part of the prototyping of the technology and processes that will be deployed, the Trinity Challenge provides an opportunity to leverage support from challenge members, particularly in the private sector, to facilitate access to the environmental, health and socio-economic data, and to learn from members’ experience of data visualisation.  

We also anticipate that the Challenge will provide invaluable capacity and advice in support of the integrating socio-economic and environmental determinants of health.

Beyond the 3-year period of funding, we aim to expand this prototyping to other African urban contexts to ensure it is fit for purpose across different African contexts where we have other ongoing projects including Nigeria and Kenya. To this end, partnerships from the Challenge that open doors to other settings would also be invaluable.

Potential partners and how they might help advance our solution are as follows: 

• Google: support and advice on data infrastructure, management tools, GIS data on water bodies, infrastructure and services;

• Discovery Health: access to anonymised, aggregate community data on health and health behaviours;

• South African government departments: National Treasury and City of Tshwane: access to data on livelihoods, employment, water infrastructure; 

• Technology and software providers such as Siemens and Huawei (who have previously engaged with the University of Pretoria) and Autodesk: support with sensors, wireless networks and 3D design;

• Esri: support for GIS and spatial modelling;

• Gauteng City Region Observatory: advice and support for data access and visualisation;

• NASA EarthData Worldview: support with access to satellite imagery.