This summer I was working with the US Centers for Disease Control and Prevention and a French NGO called Première Urgence – Aide Médicale Internationale in Mae La, the largest Burmese refugee camp in Thailand. Due to political hurdles, the camp does not have the same infrastructure as surrounding Thai villages. This creates unique public health concerns. For example, there have been 4 cholera outbreaks in the past 7 years. The CDC and the Thai Ministry of Public Health are currently preparing to give Shanchol, a new oral cholera vaccine to most of the ~50,000 residents in the camp and follow them for three years as part of a prospective cohort study to assess characteristics of vaccination failure (e.g. are young people less likely to respond vaccine?).
My project consisted of providing a local staff of incentive workers with personal digital assistants (PDAs) to collect demographic data and track the residents in the camp. PDAs will potentially replace the current paper based system that has been in place for years. There are pros and cons to each system, but the accuracy and efficiency required for data collection in the upcoming prospective cohort study is not met by the current system.
There are numerous technical and cultural barriers to design a program for a local staff of camp residents with little computer and English skills. I was working with American government employees, French NGO workers, Thai programmers and Karen and Burmese camp workers. Needless to say cultural and language barriers were a continual concern. Therefore, a large part of the project was recognizing political hurdles to accomplishing our goals. For example, speaking with the elected camp government about different ways to identify people in the camp. There is no identification system and residents are apprehensive about being identifiable by the Thai government due to their status in the country.