Life and Death Knowledge Management: Addresses and Ebola

I just read an article about why Ebola containment has been so difficult. It’s a complex problem, certainly. There is misinformation to be overcome. There are funeral practices to be accounted for. There is equipment and training to be deployed, community health workers to teach, public health measures to be taken, an already-fragile health system to be shored up. And there is fear. But there is also something so fundamental to my professional life that it makes me weep.

In 1997, I was working at a small law firm. The three partners had a thriving practice in telecommunications law. They also had a labyrinth of a contact management system. If a client with multiple broadcast licenses (e.g., an AM license, an FM license, and a low-power FM license) moved or changed telephone numbers, we beleaguered paralegals had to update that address in at least eight and as many as eleven different places—client lists, licensee lists, accounting lists, partners’ Rolodexes.

Eleven different places. Guess what? Mistakes were made. I made one. Someone didn’t get a letter they should have. I got yelled at. I yelled back, “You know what would help? Being able to update an address once, and then be able to find it no matter what list we were looking at, the AM licensee list or the accounts receivable list or the holiday party list. It’s crazy that we have to update these things in so many places. We need a database.”

Building that contacts database was one of my formative knowledge management experiences. It turned some three-day tasks into three-hour tasks. It made our work faster and better and easier. It was life-changing, in some ways, but it was never a matter of life and death.

Almost fifteen years later I came to work on the Knowledge for Health (K4Health) Project at the Johns Hopkins Center for Communication Programs. Splashed across the program’s website, its brochures, its presentation slides, were the words “Knowledge Saves Lives.” I believe that. I took on the project’s mission as my own, and I have served it to the best of my ability.

Today those words mean something different. “Knowledge Saves Lives.” According to the article, a major reason Ebola has been so hard to contain in West Africa is this: The contacts databases are not reliable.

The process that’s helped stop diseases like SARS and smallpox seems simple: Find everyone who had close contact with infected individuals and track them for 21 days. If any of these contacts comes down with the disease, isolate them from the community and repeat the process by tracking the contacts’ contacts. But tracing works only if you have a list of the contacts and their addresses…Many contacts’ addresses were missing or were vague like ‘down by the farm road.’ In all, only 20% to 30% of the contacts in the database had a usable address.

I have a new way to explain how knowledge management can, in and of itself, be a public health intervention. But I am filled with sorrow that the most basic information and communication technologies—not even high-speed Internet, not even touch-screen miracles, just “how to have an address”—have not gone far enough, fast enough to stop this monster.

For want of a nail.