Shipping Containers Become Tiny Clinics to Aid in Disaster

Tiny clinics made from shipping containers first saved lives in Haiti. With solar power, they’re an en vogue mobile medicine option for disaster response.

MARIETTA, GA. — Marietta High School students have been working with solar panels, waste recycling systems and furniture design to turn 8-foot by 40-foot shipping containers into off-grid models similar to two tiny clinics recently delivered to Haiti’s Les Cayes General Hospital — an area still recovering from Hurricane Matthew in 2016 and this year’s hurricane flooding.

Clinic in A Can, a maker of the tiny clinics, provided grant funding for Marietta’s credit-earning high school design project, which began in 2014. The pre-engineering students that participated two afternoons each week built out their designs with engineering, architecture and other professional mentors, like Marcellus Pitts, chief executive officer of Atlanta-based Pitts-Fowler Enterprises. He told Youth Today that the idea that helping people would motivate students proved sound.

The student prototypes will remain at the Georgia highschool’s Engineering and Architecture Research Laboratory for Sustainability (EARLS) Lab, but the results of the students’ work will address a stated educational need by the community of Plaine de L’Arbre, in the northern part of Haiti. They want a community and training center where visiting teachers can hold classes.

The reality is that disaster survivors have a wide variety of special needs, such as refrigeration for insulin and electricity to keep oxygen machines and surgical equipment going. Disaster response often requires the aid of mobile medicine, a need tiny clinics serve during the transitional phase of disaster recovery.

What are Tiny Clinics?

Hospitals of Hope, the non-profit organization that owns the Kansas-based Clinic in A Can, has deployed tiny clinics for disaster response needs for emergency medicine, primary care and infectious diseases in many places throughout the world.

The first tiny clinic took two years to design and one to construct, and was set up in Les Cayes and after the 2010 earthquake. It costed $12,000 to build, equip and ship, according to Michael Wawrzewski, founder and CEO of Hospitals of Hope. Many more have since been built and deployed in Haiti, and are still in active use, according to non-profit organization.

According to Clinic in A Can’s Facebook account, GE Foundation supported the two new mother and natal care tiny clinic units that were sent to Haiti this month. They’ll provide flexible space for medical treatment and examinations while repairs continue at Les Cayes’ General Hospital.

Though customizable, the self-contained tiny clinics by Clinic in a Can consist of two exam rooms, a laboratory and a mechanical room with a generator and water system. They can be modified to contain a dental room, a radiology suite or a surgical suite, according to the company.

Solar-Powered Tiny Clinics

Like the new units sent to Las Cruces, they can be delployed to areas that get knocked off the grid. According to the company, solar-powered tiny clinics are designed to support life-saving medical needs in remote locations, regardless of surrounding infrastructure:

  • 6 mt units with six solar panels and eight lead acid batteries run 24 hours/7 days per weeks
  • A nine solar panel and eight lead acid battery option will run two 6 mt tiny clinics 8 hours/7 days per week
  • The average power consumption for an air conditioner, shallow well water pump, LED lighting and all medical equipment in a 6 mt unit is less than 500 watts
  • In overcast conditions, the solar powered tiny clinics provide power through a back-up battery system for up to 18 hours, with all equipment running normally

The units are built in the U.S. and shipped ready for use.

Memphis Mulls Over IBM’s Initial 911 Overuse Data Findings

In the city of Memphis, Tenn., 911 has been used as primary basic healthcare and transportation, but thanks to an IBM Smarter Cities Challenge grant, several data-backed solutions could help the city reduce millions in EMS shortfalls while improving healthcare for residents.

MEMPHIS, TENN. — Overreliance on 911 has led to an annual $20 million shortfall in the Memphis Fire Department’s EMS budget, according to Fire Dept. Division Chief Andrew Hart.

It’s an issue that’s being faced nationwide,” says Doug McGowan, chief operating officer for the city of Memphis.

Hart says the number of ambulance rides increased 24 percent to more than 124,000 trips each year from where it was five years ago. Also, while the city’s population has stayed at 650,000 people since the 1970s, the distance EMS travels has vastly increased. The city has doubled in size from 170 to 350 square miles. There are times when ambulances are not available for service calls.

The high 911 call volume in Memphis is very complex, says Masharn Austin, a workforce strategist on the city’s IBM team. A lack of readily accessible transportation is one reason why, he says.

“Calling 911 is purely a function of not being able to get to basic care,” says Austin.

For others, it’s upfront cost. By 2014, the poverty rate in Memphis was 30%1.

“We recognize our answer for the past 50 years is if you call 911, we will give you a ride to the hospital,” says Hart, adding that in Memphis, there are two options—call 911 and pay nothing up front, or find a ride and pay to see a doctor.

“It almost leads people to call 911,” says Hart.

Data-Driven Change

Memphis was one of 600 cities worldwide to apply, and one of 16 selected, for the 2015 IBM grant because of the opportunity to align on a major problem with data-driven solutions.

“Our goal is being brilliant at the basics,” says McGowan, part of Mayor Jim Strickland’s Innovation Delivery Team, which is charged with helping to make Memphis as effective and efficient as it can be.

The city had already put some thinking in how to reduce calls by establishing programs that put healthcare navigators in the community and nurse dispatchers on the telephone to find other solutions for frequent 911 callers.

IBM’s data crunching, which included using its Watson Analytics predictive analytics and data visualization tool, validated the programs. City officials say the results are giving them the confidence to keep moving forward with paramedicine and telemedicine programs they started last year.

An overview of the analysis, which the city and the company shared with EfficientGov, revealed some 2,000 frequent 911 callers for the navigators to work with.

It’s something that we struggled with. Having outside experts was huge,” says Hart. “Working with IBM is very beneficial in showing insurance companies that the cost savings [of the paramedicine program] is beneficial,” he adds.

Other IBM findings can help focus the city on solutions for the Memphians that use the 911 system. For example, a heat map reveals the zipcodes with the highest volumes of calls. New healthcare opportunities based in those areas or transportation vouchers to travel to points of healthcare could start reducing the number of 911 calls from those areas.

“We have to think differently. We have to think about the customer journey…We’re thinking from the point of service backwards,” says McGowan.

Surfacing Smarter Solutions

The IBM team arrived in Memphis in late February and spent about 10 days conducting more than 80 stakeholder interviews and gathering all relevant data from various city departments.

Key findings focused on the 911 process, collaboration among city departments, gaps in service, transportation issues, incentives and dis-incentives, educating the community and funding.

“This is not something one group could do on their own,” says Hart.

A lot of the things Memphis was doing, they were doing a good job at, they were just doing it in silos,” says Austin.

While IBM is still working on the final report, expected in May, the team’s recommendations are focused on collaboration among healthcare stakeholders, innovating Memphis’s 911 process, providing healthcare service alternatives, creating incentives and impactful corrective actions and launching a citywide education campaign.

On a micro level, some recommendations like consolidating systems data or establishing mobile health units are going to take time, money or collaboration from the city’s partners.

However, Austin points out that while the costs for some recommendations might be high, such as $500,000 per year just to operate a mobile health unit, the return on the investment is justified—one long-operating mobile healthcare unit in Boston shows a 36:1 return.

“It’s unbelievable the impact you can have in the community by providing immediate care,” says Austin.

IBM summarized recommendations based on the magnitude of the impact and how hard or easy each solution would be to implement.

Other recommendations, like empowering EMS to treat on-scene and EMS initiated refusal, will be hard to implement but would have high impact in addressing the problem. Memphis is debating the possibilities now. McGowan thinks that there are opportunities for paramedics to treat on scene and get ambulances back out for service faster. “We have faith and confidence in our front lines to make decisions,” McGowan says.

However, Hart cautions on legal concerns. The city has engaged its risk management team to look into what would be required to give EMS the authority, qualifications, compliance, etc…

A major piece is educating citizens on when to call 911, and when they really shouldn’t. IBM recommends campaign messaging based on what are the consequences of calling 911 just to get a ride. “It’s educating people through shaming,” says Austin.

While 911 shaming might not be the specific focus of a public outreach campaign, Memphis began talking this week with film production crews about the success of negative ad campaigns, such as the National Council Against Smoking’s campaign. Memphians could possibly save some lives by not tying up an ambulance to go and fill a prescription.

Why Cities Should Invest in Festivals

From their potential to promote branding to the partnerships they create, festivals further both cultural and economic development in numerous cities.

Summer weekends around the U.S. are replete with music festivals. But dig a little deeper and you’ll find plenty more unique events to attend – including festivals that celebrate Shakespeare, kites, film and art, Halloween, food trucks, agriculture, beer and more.

Cities are investing in festivals, for good reason.

When done right, festivals promote a city’s brand, increase tourism, foster the arts and community involvement and increase revenues for the municipality and local businesses. They can even revitalize a city and spur sponsorships.

Branding and Tourism

According to the National Research Center, Loveland, Colo., uses its annual Fire and Ice Festival to grow the brand of “America’s Sweetheart City.” The event, featuring a downtown snow sculpture and fireworks, coincides with Valentine’s Day and attracted 24,000 people in 2016, making it one of the largest events on its kind in the nation.

Each September, Loveland also puts on “Pastels on 5th,” a sidewalk chalk-art festival that highlights Loveland’s internationally renowned arts community.

Both events raise Loveland’s profile “in the most beneficial ways possible,” City Manager Bill Cahill said in an interview with the National Research Council, Inc.

Community Involvement

Chandler, Ariz., hosts a variety of events: There’s an Ostrich Festival, a Cinco de Mayo Celebration with Chihuahua races, a Tumbleweed Festival, jazz and Greek festivals and more.

These events, according to Chandler’s website, “showcase our people, our heritage, and our values … and strengthen community bonds.”

Even the small town of Forest City, Iowa, is getting into the festivals game.

The inaugural Tree Town Music Festival took place Memorial Day Weekend in 2014 after six years of planning by a private group. This festival bills itself as the “Midwest’s premiere country music destination festival,” and offers camping and glamping.

Profits, Revitalization & Sponsorships

While some festivals provide a financial bump for local businesses, others help to drive the economies of the region in which they are located.

The Sundance Film Festival generated almost $63 million in 2015, according to a study from the University of Utah. An estimated 46,100 filmgoers spent on car rental, lodging, dining, transportation and retail, according to the study.

In Providence, R.I., WaterFire is the big fish.

The unique festival features around a hundred metal, flaming braziers set into the middle of a downtown river that fire tenders, dressed in black, fill with wood and keep alight from small boats. Attendees stroll, take gondola rides or dine al fresco at restaurants that border the river while listening to instrumental music coming from speakers hidden along the tributary.

The non-profit WaterFire is credited with helping to pull Providence out of its economic decline, which began in the 1930s.

The immensely popular festival, founded in 1994, has been called the “crown jewel of the Providence renaissance.” Hotels and high-end condos, which have since been built around the rerouted river, use WaterFire images for promotion. Rooms and tables with a view are reserved months in advance.

WaterFire attracts 1.1 million people to downtown Providence each season, has an annual impact of $114.3 million from visitor spending and creates 1,294 jobs, according to the organization.

There are 13 Waterfire events scheduled for 2016, each with a different national sponsor, such as Bank of America, National Grid, Waste Management and CVS.

In fact, sponsorship of festivals is up around the country.

According to a recent study from IEG Sponsorship Report, sponsorship spending on fairs, festivals and annual events is expected to total $878 million in 2016, a 2.1 percent increase from 2015.

Public Private Partnerships

Many festivals employ the use of existing public space and don’t require new construction to run. This makes them nimble and able to “switch venues and change up programming if necessary,” according to Jonathan Wynn, associate professor of sociology at the University of Massachusetts Amherst, author of Music/City: American Festivals and Placemaking in Austin, Nashville and Newport.

There is a cheaper, more equitable path toward creating culturally vibrant cities, one that requires less public funding and much less steel and glass,” Wynn wrote in a recent opinion piece promoting investments in festivals over museums in the Des Moines Register.

In his research, Wynn found that the most successful U.S. festivals are created organically through public-private partnerships.

“Festivals are really successful when they are generated by a subcultural infrastructure of alt-weekly magazines and music venues, then winning support of [convention and visitors bureaus], chambers and city halls,” he said.

Creating Electricity From Water & Sewer Pipes

Technology enables Portland, Oregon, to create electricity from the water flowing within its city’s pipes. Find out how the system works.

What Happened?
The city of Portland’s Water Bureau is teaming up with Lucid Energy to implement its first in-pipe hydroelectric system as a source of renewable energy. The underground, gravity-fed water pipeline will use an in-conduit turbine to spin from passing water to produce electricity at a lower price while reducing the environmental impact of the city. The hydroelectric system is one component of Portland’s Climate Action Plan that calls for increased use of clean, low-cost energy sources and the installation of 10 megawatts of on-site renewable energy.

So What?
The hydroelectric system developed by Lucid Energy is designed to take on the electrical needs of densely populated regions with significant water usage. The system works within pipelines and is based on the flow of water naturally occurring throughout the municipality, making it a predictable, clean source of renewable energy not affected by weather conditions or other external factors. The electricity produced by the first installation of the hydroelectric system is expected to power 150 homes throughout Portland. As the system expands, more homes will be serviced by renewable energy.

Why hydroelectric power?
According to the Energy Efficiency and Renewable Energy Clearinghouse, hydroelectric power installations provide municipalities and city infrastructure with emissions-free power solutions that uses flowing water to produce energy. A turbine is moved by running water, which in turn powers an alternator or generator to generate electricity.

Hydroelectric power sources are not only environmentally-friendly but cost effective. The latest hydro turbines are able to convert 90 percent of available energy into electricity, compared to just 50 percent created through the use of fossil fuels. In the United States, hydropower costs 0.7 cents per kilowatt-hour, one third the cost of fossil fuels or nuclear power and one-sixth the cost of natural gas.

What to consider
Before installing a hydroelectric system, municipalities must ensure there is a flowing water sourceavailable to keep the technology operating efficiently.

Lucid Energy outlined a checklist of conditions needed prior to a hydroelectric system installationincluding proper:

  • Pipe diameter of at least 24 inches
  • Pipe material- such as steel, ductile iron or concrete
  • Operating pressure – typically above 20 PSI
  • Minimum downstream pressure to determine how many turbines are needed to operate the system
  • Volumetric flow – varies based on pipe diameter
  • Pipeline above or below ground
  • Vault
  • Electrical load
  • Electric grid
  • Planned pipeline construction
  • Performance contract in place

As to where the hydroelectric system installation should be placed, Lucid suggests municipal water or waste water systems, industrial water systems or irrigation systems where water flow is strong and consistent. Leaders can also have hydroelectric power sources installed where pipeline construction or maintenance is in progress for cost savings, as well as retrofit sites with vault access.

Comprehensive U.S. Map of Drug Deaths by County

The opioid crisis is a modern American epidemic punctuated by skyrocketing deaths. Our interactive map shows which counties are hardest hit.

Drug overdose deaths and opioid-involved deaths continue to increase in the United States. States like Maryland have passed bills to address the statewide crisis and increase access to naloxone, while Connecticut has coordinated efforts across municipalities and jurisdictions to address a dramatic rise in opioid abuse through training, referral and medication-assisted treatment.

According to the Centers for Disease Control and Prevention, the majority of drug overdose deaths (more than six out of ten) involve an opioid. Since 1999, the number of overdose deaths involving opioids (including prescription opioids and heroin) has quadrupled. From 2000 to 2015 more than half a million people died from drug overdoses.

The counties with the highest mortality rate and the highest number of overdose deaths from 2016. We have also created an interactive map that allows you to see how your state has been affected by the opioid epidemic.


    • Data for this article was found at County Health Rankings as an aggregate of Centers for Disease Control and Prevention data.
    • Age-adjusted death rates were calculated as deaths per 100,000 population, using the direct method and the 2000 standard population.
    • To find 2017 data, the CDC calculated a summary of changes in the 2017 measures from those used in 2016 and a summary of all changes since the first release in 2010.

Bike Sharrows Found to Implicate Cyclist Injuries

They might be the cheapest bike infrastructure, but evidence is mounting that bike sharrows do not make cycling in cities any safer.

Bike Sharrows, made official by the Federal Highway Administration (FHA) in 2009, are symbols painted in a lane of traffic meant to be shared by cars and bicycles. They’re the cheapest way for cities to increase road safety by directing bicycle traffic, mostly so that cyclists can stay out of the “door zone” and avoid getting clipped by people exiting parked cars. They also indicate to automobile and bus drivers that cyclists have a right to the traffic lane, and to watch out for them, which perhaps cues drivers to give cyclists they pass wider berth.

In a previous EfficientGov story, Data Solutions for Reducing Bicycle Crashes, 2015 bicycle injury research showed that in the vast majority of bicycle crashes, the motorists involved did not see the cyclists before impact. That’s regardless of whether traffic lanes are unmarked or contain bike sharrows, painted bike lanes or cycle tracks.

Even with a super sharrow–white bike sharrows painted on a wide, colored line in the center of a traffic lane–safety results are mixed. A 2013 study by Oakland, Calif., found that the super sharrow:

  • Led cyclists to ride farther from the door zone than they did with standard bike sharrows
  • Had no negative effect on auto operations or transit speed
  • Did not significantly change the average passing distance for motorists who overtook cyclists
  • Decreased the percentage of motorists that leave three feet or more when passing cyclists

That study also found that all sharrows led motorists to switch to the left travel lane than they did with no bicycle markings.

More recently, University of Colorado Denver analyzed bike infrastructure from 2000 to 2010 at thousands of blocks in Chicago. The researchers analyzed several factors, such as where bike sharrows and bike lanes were installed and where there was no bike infrastructure, bike commuting rates and street collision data. What they found is that bike lanes encouraged more bike riders and that the rate of injuries declined the least with sharrows:

  • Cyclist injuries on roads with bike lanes decreased 42 percent
  • Cyclist injuries on roads with sharrows decreased 20 percent
  • Cyclist injuries on roads lacking bike infrastructure decreased 37 percent

In addition to possibly decreasing the likelihood that drivers will give cyclists wider berth when passing them, bike sharrows might be “more dangerous than doing nothing,” according to these university researchers. They presented their findings to the Transportation Review Board, according to CityLab, calling on the Federal government to expose sharrows as the “cheap alternative that not only fails to solve a pressing safety issue, but actually makes the issue worse through a sense of false security.”

StreetsblogUSA considers sharrows the “dregs” of bike infrastructure, and its coverage of the research not only questioned the ethics of continued use of sharrows, but said it calls for more appropriate bike infrastructure. The blog has been covering transit trends that relate in part to improving conditions for pedestrians, cyclists and transit riders.

According to the National Association of City Transportation Officials, more than 26 states were already using sharrows by the time it was approved by FHA.

How Blockchain Could Make Driverless Vehicles a Reality

Blockchain technology is not just for cryptocurrency–governments can use it for many services–and it will play a role in securing the Internet of Things.


By Stephen Armstrong

Blockchain could be used to implement driverless transportation–cars, shuttles, buses and more–pivotal pieces of a smart future powered by the Internet of Things. Blockchain technology has the inherent potential to make autonomous transportation systems secure from cyber attacks.

It’s all in how it works. Blockchain is the decentralized electronic ledger technology behind cryptocurrencies like Bitcoin. The ledger of encrypted transactions is open, so it is distributed all over the world.

A cyber attack would require tampering of all ledger instances simultaneously, according to Sir Mark Walport, the United Kingdom’s chief scientific adviser, who wrote a Distributed Ledger Technology report featuring global case studies on using blockchain for trust and interoperability.

Government Uses of Blockchain

While blockchain may have been born into currency, it can be used for many types of transactions from real estate to government records. It can be used to collect taxes, record land and property registries and more, wrote Walport in his report.

It’s beauty is in having copies of the ledger on computers all over the world–this is what actually allows for cryptocurrency assets to be transferred and recorded without external verification.

In fact, while Bitcoin itself may seem like a cash-grab game of sorts, the largest banks are actually collaborating to explore blockchain and how it can improve auditing of transactions to improve efficiency and reduce costs.

LHV Pank, the largest independent bank in Estonia, has already issued cryptocurrency securities, according to Walport’s report.

Blockchain for the Internet of Things

If each driverless vehicle is an autonomous device–and a part of a whole system–centralized failure is by nature eliminated. Blockchain can then increase the security of implementing individual autonomous, enabled devices.

Autonomous vehicles are becoming a reality – cars are increasingly part of the Internet of Things…You don’t want your connected vehicle to be tampered with. So, blockchain’s distributed ledger has the potential to monitor car operating systems, sensors, doors. You can baseline the known state of the device’s configuration and then check for tampering,” said Walport.

While blockchain may not currently be feasible for ride-hailing companies that must screen drivers and perform other tasks guided by human judgement, it’s already being tested for other transportation uses.

Plex.AI, a 2015 Canadian car-insurance tech startup located at an Ontario incubator, has developed an automotive telematics platform. The broker can reportedly give its insurance carriers real-time, remote diagnostics on cars. The technology uses Ethereum blockchain, machine learning and artificial intelligence to produce information about its customers that get quotes and sign up through its Rover app.

It’s not just a new way of thinking about money – it’s a new way of thinking about trust,” said Amos Meiri, co-founder of Israel-based Colu, a blockchain technology company.

Read the original story on Wired’s website.