FoneAstra: Enabling Remote Monitoring of Vaccine Cold-Chains Using Commodity Mobile Phones Rohit Chaudhri 1 , Eleanor O'Rourke 1,2 , Shawn McGuire 2 , Gaetano Borriello 1 , Richard Anderson 1,2 1 Department of Computer Science and Engineering University of Washington. Seattle, WA [USA] 2 PATH, Seattle, WA [USA] {rohitc, eorourke, gaetano, anderson}@cs.washington.edu, smcguire@path.org ABSTRACT We present a low-cost, energy-efficient system to remotely monitor the temperature and location of vaccines in a country- wide “cold-chain”. Our system is based on FoneAstra [11] – a low-cost, microcontroller-based, programmable device that extends capabilities of low-tier mobile phones that are commonly used in developing countries. In the system discussed in this paper, FoneAstra is enhanced with a digital temperature sensor and integrated with a vaccine cold-box used to store vaccines in a temperature controlled environment. FoneAstra continuously monitors the temperature of the cold-box, aggregating readings over a period of time. It uses the mobile phone to which it is coupled to send periodic SMS messages with routine temperature reports or immediate alerts if it detects abnormal temperature conditions. Additionally, it enables location-tracking of vaccines in transit, based on the mobile phone’s cell tower-IDs. We present results from an ongoing lab-deployment done at PATH [18], our Seattle-based partner NGO for this project. Over the next few months, we will deploy this temperature and location monitoring system for vaccine cold-chains in several countries in which PATH operates. The client in this system, which includes a temperature sensor, FoneAstra and a mobile phone, costs $50; while the server, which includes a Netbook and a GSM modem, costs $500. We discuss how our system can scale up to enable large-scale monitoring while incurring low overhead costs. Categories and Subject Descriptors J.7 [Computer Applications]: Computers in Other Systems: command and control, consumer products, process control. General Terms Measurement, Design, Experimentation. Keywords Remote Monitoring, Large-Scale Distributed Sensing, Location Tracking, Mobile Systems. 1. INTRODUCTION Effective management and delivery of vaccines is an important aspect of improving healthcare for under-served communities in developing countries. The World Health Organization (WHO) estimates that vaccines prevent over 2.5 million child deaths from fatal diseases annually [23]. Access and availability of vaccines has improved tremendously over the last 5 to 10 years with the influx of donor resources and increased supplies from several new manufacturers. However, delivery and storage of these temperature and time sensitive vaccines continues to pose challenges in many developing countries. The WHO specifies the procedures to be followed for safe storage of vaccines, which include routine monitoring and reporting of alarm conditions (e.g. storage temperatures deviating from the allowable range for a prolonged period of time) [21, 27, 28]. Vaccines typically need to be stored in a controlled +2° to +8°C environment in order to ensure their potency (e.g. Figure 1 shows a few pictures of equipment used to store vaccines at a SILIAS Health Clinic in Nicaragua). However, country cold-chains (the supply chains for goods requiring constant refrigeration) are not always reliable; as a result, vaccines may be exposed to temperatures that are either too hot or too cold, causing vaccines to be spoiled [8, 12, 13, 16]. Intermittent power outages, limited availability of skilled staff for equipment maintenance, lack of spare parts, and interruptions during transportation are common causes for these losses [4]. Figure 1: Cold-boxes for vaccine storage at a SILIAS Health Clinic in Nicaragua Commonly used procedures to monitor the temperature of vaccines stored in cold-boxes or refrigerators at storage facilities require the facility staff to manually record temperature twice daily (per WHO guidelines [21, page 40]) on paper. This method produces accurate results (depending on the accuracy of the thermometer used and compliance of the staff performing the procedure); however, manual recording on paper makes it difficult for organizations to aggregate such data especially when facilities are not geographically co-located. Figure 2 shows the paper-based method used at a SILIAS health clinic to record the temperature of equipment used for vaccine storage. There is significant potential to reduce individual instances of spoilage and help diagnose problem areas of a cold-chain by improving the monitoring of storage temperatures and locations Permission to make digital or hard copies of all or part of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. To copy otherwise, or republish, to post on servers or to redistribute to lists, requires prior specific permission and/or a fee. ACM DEV'10, December 17-18, 2010, London, United Kingdom. Copyright 2010 ACM 978-1-4503-0473-3-10/12... $10