Day by Day

What happens when an environmental disaster takes out the infrastructure we rely on for digital health to support our survival efforts and support continuity of health care? It’s Tuesday and we’ve endured Cyclone Gabrielle’s high winds and heavy rains since Saturday, here in New Zealand. And the storm continues to rage as it passes through the rest of our island nation. On the other end of the planet, Turkey and Syria are dealing with the most devastating earthquake in living memory. It feels like the Earth is raging at us.

I’ve been reflecting on the value that digital health might bring in these circumstances but my mind is turned by the radio stories telling me about power outages and road closures. The Coromandel has both. The cell towers are no longer operating and cell phones are powerless. In places, there is no infrastructure for digital health to do its job of connecting people, providing services at a distance, and feeding people with information. Clinical services might be flooded and computers damaged. Cloud services are useless if there is no power to enable access to them once the backup power has run out.

Digital health is about purpose, people, processes and product, in that order. If we focus on the product, we lose sight of the purpose and the people who make the processes work. If the product isn’t working, e.g., due to the damage of a cyclone or earthquake, we lose data and some processes embedded in the product. In a disaster when the product isn’t working, we still have purpose, people and processes. I’m reminded of this whakatauki:

He aha te mea nui o te ao
What is the most important thing in the world?
He tangata, he tangata, he tangata
It is the people, it is the people, it is the people

While digital health technologies and associated skills remain mission critical for delivering the best health care available, it is the people who are the most important thing in these circumstances. It is the spirit that rises up during and after a disaster and continues to rise that transforms a response. Even if we temporarily can’t use digital technologies, we can still use the skills and insights of digital health to rise up.

This morning I took a photo of the tidal damage to the beach wall at Browns Bay. The damaged reveals a wall built in 1982 and hidden by decades of overhanging grass. Some of the wall, that was built later, did collapse further down, but what I take from this is the value of strong foundations and the strength of planning, solid design, and hard work.

Kia kaha digital health workers. This disaster will uncover weaknesses and strengths in digital health foundations. We have much work ahead of us.