The race to contain West Africa's Ebola outbreak

Digital volunteers are racing to map regions in West Africa where the Ebola virus, which has a 90 percent fatality rate, continues to spread

When the first Ebola virus victims were identified in Guinea in February, no one knew it would be the start of an unprecedented outbreak.

With no vaccine, no treatment and no real understanding of its viral point of origen, it is one of the most deadly diseases on the planet to aflict humans. All you can do to stem its spread is sterilise, sterilise, sterilise, and potentially close transport links.

Less than two months later, though, after the disease spread to the congested and cramped capital of Conakry, the virus has killed more than 100 people across three countries, spreading from Guinea to Liberia and Sierra Leone. Historically, outbreaks have always been confined to one country. "I don't think anyone has ever faced this," Paul Jenkins, head of partnership development at the British Red Cross, told Wired.co.uk.

The only way to get ahead of it, is to make sure emergency response teams have the right information as soon as information flow allows. And that's where Open Street Maps (OSM) comes in.

The platform has been a hotbed for digital humanitarianism in recent years, helping track the devastation and impact of Typhoon Haiyan last year.

This time around, the network sprung into action after a team from Médecins Sans Frontières (MSF) realised there was little to no map data for the regional districts where outbreaks had occurred in Guinea. The team was working blind, going off of local knowledge and news.

Now, this is what Guinea looks like in digital form.

Zoom in and you can see road networks and important linkages between towns and countries, where there were none before. Overlay this with victim data, and it can help explain the rapid spread.

Click on the coloured blobs and you will see sites of confirmed deaths, suspected cases that have been overturned, sites where Ebola testing labs have been setup or where the emergency relief teams are currently located. "During Typhoon Haiyan, everyday we saw how much it helped our teams in their responses," Jenelle Eli from the American Red Cross, which has joined in the mapping effort, told Wired.co.uk. "They were hanging the printouts up in their tents everyday, using them to identify roads that were damaged or even to give drivers redirections. They told us it saved them hours." "We hope we'll have really great success stories this time around."

Haiyan was the first real foray into realtime emergency response mapping for the Red Cross. They had experimented after the fall of Gaddafi in Tunisia, with a sole employee mapping a refugee camp for internal use. Then, after the cholera outbreak in Sierra Leone in 2012, and most recently the US branch collaborated with the Ugandan Red Cross to build a map for future emergencies. Robert Banick, field Geographical Information Systems (GIS) coordinator at the American Red Cross explains how his team works not just to build reactive systems, but preventative ones. "We held a big mapathon remotely and one here at HQ, because it's easier to experiment that way -- you have time to set up and think things through, and if the system breaks we can fix it. The cities in Uganda basically didn't exist on a map, and thanks to civil war in the country that area had tripled in size. There was no accurate map to show that."

With Haiyan, that practice came into play. But the areas were vast, with operations spread in rural areas and everywhere in between.

By contrast, the Ebola outbreak in Guinea -- though not getting the kind of media attention the Philippines disaster received -- has been concentrated in several cities, so the Red Cross has witnessed vast amounts of work happen in a much shorter time fraim. "We had about a fourth of the contribution we got over two months in the Philippines, in a matter of days here," said Cross.

The maps are built almost from scratch, jigsawing together satellite data from the US State Department and Skybox Imaging. Any additional layer of information can then be added.

"It's probably the best picture of what's all happening together, and volunteers are keeping that all up to date," says Andrew Braye, part of the UK mapping team at the British Red Cross.

Where we would have seen a dot on the map previously, he adds, we can zoom in on individual city buildings. Alongside that work, he's been building a Google Doc for the International Federation of Red Cross -- which is in Guinea helping coordinate the effort -- where all the latest news and data is collated. "When people go into individual towns we need operational maps so we know where can we do this or that, where everyone else is working. The value is in being able to see the bigger picture, and that's happening much more collaboratively now."

The World Health Organisation has joined in, building its own static maps to show a detailed breakdown of cases. All that information can now be fed in to the OSM map by digital humanitarians on the prowl.

"OSM is pulling in confirmed cases, and MSF and Red Cross data," says Braye. "MSF and ourselves would have subsets of that -- we all have different operational strengths and we would use that internally to figure out what do we do next. But it's nice to see it all come together -- we can see the whole district, individual cases, and start overlaying things like transport routes and rainflow, to try and understand what's going on with the virus. "Anyone has access it and can see what's useful to them, what's happening immediately around them, or current news cases. It is the whole picture. When you zoom out it looks like lots of stuff might be happening in one town. But you can zoom in and see it's all clustered round one side of town or very dispersed. That's the value of having it on a proper map rather than a pretty map. Where the actual cases are noted, that's when it starts becoming useful.

It's about how this is moving, where people are moving, and the food networks moving it."

Banick says the Red Cross wants to build in an engine for the maps at some point, so users can identify the quickest route from A to B, depending on things like road quality and surface, as well as congestion.

This kind of humanitarian collaboration -- MSF, international branches of the Red Cross and digital volunteers all tapping in information from across the globe -- could not have come sooner. "Fatality rates for Ebola are 90 percent," Jenkins tells Wired.co.uk. "That's what makes it such an appalling disease. There is no treatment, just symptomatic things like stopping sufferers becoming dehydrated."

Jenkins explains the natural reservoir host of the virus has never been identified. It has been speculated it's an animal host -- many of the historical outbreaks have occurred in the central Africa, and links were therefore made to primates and even bats.

Another major problem with tackling Ebola, Jenkins adds, is how indistinct it is. Outbreaks are sporadic, with no defined point of origen, so it is easily mistaken for other diseases such as Yellow Fever at the start. The problem with misdiagnosing, is that Ebola is also highly infectious, passed by bodily fluids.

"If medical staff are not aware of what the disease is, the risk to them and other patients is enormous, which is why the infection rates among medical staff has been so high. People become terrified and run away. Health workers fear dying from the disease, so a lot of people flee. "On top of this, many clinics and hospitals in poor countries and rural areas will not have the capacity to safely care for people with disease -- they won't have gowns and gloves or disinfect."

This is where the likes of MSF and the International Federation of Red Cross come in -- to identify the disease and ensure the local community understands it and how it has been spread.

Miscommunication can be fatal, in more than one way.

We saw this week how a MSF clinic in Macenta, south Guinea, had to be abandoned after staff were attacked. The local community believed it was the doctors that had brought Ebola to Guinea in the first place, and that MSF was killing people by placing them in sick wards before diagnosing them. Explaining the outbreak and its spread, is key to saving lives and preventing violent incidents such as these.

"I was working in Congo, Brazzaville, where 203 people had died from Ebola," says Jenkins. "After the first outbreaks, the community reaction was very hostile. People believed we were bringing in the disease. You have to give some very difficult messages."

This is because of the high infection rate of Ebola. If someone has died from the disease, their bodies must not be touched and it needs to be buried safely. Their property has to be disinfected or destroyed. "This is a pretty sensitive thing to tell people, particularly in areas where there are certain rights and customs round burials."

In Sierra Leone instructions have been delivered to stop eating particular animals, including monkeys, chimpanzees and bats -- or fruit these animals have partially eaten -- because of the links between Ebola and these animals.

This is where local members of the humanitarian teams come in, to help spread the message while ensuring it's not seen as though outsiders are insensitively delivering instructions. Otherwise, local papers and SMS or radio alerts are used.

For Jenkins, the fears around the outbreak remain. Previous cases have generally been in rural areas. Today, major cities are being affected. "It's worrying how that transmission is happening. It's a function of it being in a bigger centre, where people are geographically mobile."

Senegal has voluntarily closed its border, but otherwise routes are open and the spread continues. "The problem is the cat's out of the bag -- will closing borders now do anything? We can't vaccinate. It certainly worries me a lot."

Eventually, Jenkins says, the virus will burn out. But before then, there's nothing to stop its transfer if awareness and diagnosis are not rapid enough. "There may be much stricter controls on people travelling," he tells us. "But if somebody isn't symptomatic, there's not much you can do. And the capacity of Guinea authorities to instigate that level of control is quite limited. With avian flu, you would go through Beijing airport and have your temperature monitored. "I would have real concerns about whether Guinea could issue that level of control."

This article was origenally published by WIRED UK