It was a wonderful little bubble while it lasted. Getting up before dawn. Dressing in easy-to-peel layers for whatever the day might bring. Walking over to Boynton-McKay, a diner of rare perfection, where the wi-fi was as reliably good as the pancakes (a boon in connectivity-challenged Camden…) Ascending the stairs and more stairs of the town’s famous 19th century Opera House. A few minutes to mingle-navigate among tables of nibble-food before settling down for a morning of things worth thinking about.

But first, a little music. Logan Richardson’s soulful, playful, questioning sax riffs on “America the Beautiful” one day. Zoe Keating’s clear, deeply layered, architecturally precise, transcending cello pieces another. How lovely to start each day by not thinking. Just being. In the moment. Together. Brilliant.

And then it was off and running, from economics to education, urban decay to urban agriculture, environmental catastrophe to conservation hope, design theory to food design, cardboard robots to paper diagnostics, communications to comics, art to dance to music. To, to, to…

But as the last note of the Mark O’Connor-anchored jam session finale faded into festive applause and we trundled off in buses through the rainy dark to a cavernous transportation museum for one last party, the bubble had begun to weaken and thin. Faces, now familiar, circled by against an improbable backdrop of vintage automobiles, sci-fi bicycles and disconcertingly disembodied airplane parts.  A few final conversations and business cards. Some hugs and toasts. Promises to keep in touch, follow up, finish that thought. We stayed up until we couldn’t. By morning, the bubble was lost in the dazzling clarity of a New England fall day. One by one we left the the small town – Maine’s answer to Brigadoon – journeying back to the chaotic urgency of our daily lives. With each mile down the highway to Boston, and each minute in the sky back to Chicago, I could feel experiences recasting into memories, ready for sorting and analysis.

TAKE-AWAYS

Throughout the conference, Michelle Riggen-Ransom, Rachel Barenblat, and Ethan Zuckerman were absolutely brilliant live-blogging the talks and I recommend reading their posts, along with Kristen Taylor’s, on the PopTech blog to get a more detailed view of goings on.

Among the overarching themes: the serendipity of the amateur and the common sense of a cross-disciplinary approach. In short, the easiest way to see outside the box is to be outside the box.

Take, for example, the tale of the $12 computer (can be haggled down to $10). PopTech 2009 fellow Derek Lomas, who was working in India on”ethnographic design research on uses of mobile phones in urban and rural contexts,” found just such a miracle browsing a crowded electronics marketplace. It’s bare bones – hooks up to a television for a screen and runs on the 8-bit chip that powered 1980s-era Apple II computers and Nintendo game systems. So “vintage” is the tech, patents have run out, making it, for all intents and purpose, open source. Funded by a $180,000 MacArthur grant, Lomas and his collaborators the Playpower Foundation are developing software that combines educational aims with game-playing appeal. “It occurred to me that if this platform had just a few decent games, and one good typing game, it could be economically transformative,” notes Lomas, “because touch-typing can make a difference between earning a dollar a day or a dollar an hour.” Why invent an answer from scratch when you can assemble one cheaper? Innovation through shopping…

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Another theme: The most effective way to to trigger change is to provide a better alternative to the status quo.

For preventive medicine pioneer Dean Ornish, the shift from the “fear of dying to the joy of living is the key to the healthier future. For materials scientist Neri Oxman, it is moving from a Miesian reality where each building material has a specific function (steel for support, glass for light) to one inspired by Nature, where a single material yields a range of benefits (e.g., the structure of an egg shell evolved to provide strength as well as gas permeability). For clinical psychologist, Naif  Al-Mutawa, it is tackling Muslim stereotypes through the compelling comic book stories of Muslim superhero kids (“The 99″). Better is better.

MIT architect Sheila Kennedy, who has helped spearhead PopTech’s portable lighting project, points out the importance of opening up a space to new ways of thinking.  FLAP – Flexible Light & Power – is a Timbuk2 messenger bag outfitted with small solar array, battery and LED. A removable panel lined with reflective material amplifies the light from a tiny bulb cleverly tucked into a strap. AfriGadget’s Erik Hersman recently took some prototypes to Africa for field testing. But no matter whether a bag design turns out to be a viable answer or not, the thinking has shifted: Solar is not just for roofs and calculators any more. Now you can literally wear power on your sleeve.

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photo: Growing Power

Which segues into a third theme: Just add sunshine. Three ideas presented at the conference that are either dependent upon or inspired by photosynthesis have the potential to help significantly move the dial on climate change.

• Will Allen is a teacher and an inspiration for the potential of urban agriculture. His suite of Growing Power farms in Milwaukee and Chicago are designed as a series of nested ecosystems. Vermicomposting – turning garbage into wildly fertile worm castings – is the lynchpin. You start by creating soil so rich, it doesn’t require petro-based chemical additives.  From aquaponics set ups to raise fish by the thousands to a biodigester for converting food waste into energy, everything that can be harvested or recycled is. It is cleaner, healthier, oil-independent food system, with local “farm to fork” distribution networks designed to turn urban “food deserts” green.

• Willie Smits has plans for a similar polyculture fix, only rainforest-size. Trained in forestry, Smits career took a turn when he came across a sick orangutan in a Borneo market. Saving orangutans meant saving habitat, an increasingly difficult task when easy profits for palm oil led to wholesale conversion of ancient forests into modern superficially-efficient monocultures. Beyond the staggering loss of biodiversity, forest clearing fires, especially in peat-land forests, have led to “CO2 volcanoes,” spewing vast amounts of sequestered greenhouse gases skyward. Smits’ fix centers around the sugar palm, a short tree common in second-growth forest, which thrives only when grown as part of a polyculture and has a talent both for sequestering carbon (deep roots) and gushing a liquid that can be turned into sugar or ethanol. Smits has come up with a way to process the quick-to-ferment “juice” efficiently off-site. With the “juice” as the economic anchor, a suite of other forest products can also be sustainably harvested. Recently Smits set up a company, Tapergy, to implement his ideas. Notably, both Smits and Allen focus on jobs. Commodity monocultures destroy jobs and communities. Urban agriculture and tropical agroforestry create them.

• Chemist Daniel Nocera, by contrast, doesn’t want to raise plants but mimic them to generate vast amounts of energy. His epiphany: Plants routinely rebuild the mechanisms for splitting water in their leafy “fuel cells.” Scientists’ decades-long quest to find stable catalysts was not only futile but utterly misguided. Instead, his lab developed a resilient catalyst that could rebuild itself, making it possible to create both a better, cheaper fuel cell and process dirty water into drinkable water.

NEXT…

Perhaps the most exciting announcement at the conference was about a new fellows program for scientists, which takes us back to cross-disciplinary common sense. As the speaker list already demonstrates, science is an essential part of creating change for the greater good.

The further promote and support collaborations, some suggestions:

1) Develop a session or a workshop focused on tech transfer, focusing on both the legal and marketing angles.

2) Add data visualizations to the program and on the website showing connections between speakers. With such a multi-disciplinary list, connections transcend program groupings.  For example, Smits could just as logically been grouped with Michael Pollan and Will Allen.

3) Open the PopTech Creative Reuse Workshop at 8 a.m., one hour before the conference. Put out coffee as bait for early risers. I completely missed the workshop. The daily speaker sessions tended to go long, so there wasn’t much time to scoot over afterward. During breaks, the tendency was to mingle, network and nosh on site. Restaurants chosen for lunches were all located in the opposite direction.

4) Develop an online book store search-able by title, author and subject.

Now to wait for the videos to post, just in time for the long winter cozy season…

Those words were ringing in my ears when the first reports of the Mexican swine flu outbreak began trickling in few days ago. Dozens of young, otherwise healthy men were dying. Was this an encore of the infamous 1918 pandemic? Another SARS? Patients killed by their own overzealous immune systems (“cytokine storms”)? Or poor patients who came to the hospital too late to be saved?  Then came lab reports of an unusually cosmopolitan swine/avian/human virus, with genetic links to two continents. This sort of thing doesn’t just happen. An awful lot of things have to happen first to make it possible.

The only certainty: a pig link.  This wasn’t a wildlife disease that jumped species when man, beast & germ met up in crowded marketplace (civets & SARS). There was no bushmeat involved (Ebola, HIV/AIDS). This was a swine flu, with some deadly dashes of avian and human strains.

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SICK PIGS

Since TrackerNews is both an aggregator and a resource (searchable dabase of vetted links), I looked for research that might provide some clues. Fairly quickly, I found two:

• A 2004 article from Pork magazine: SIV Gets More Complicated (Herd Health), which noted a spike in the number of swine flu strains. There are now so many that a single herd can harbor more than one strain. Instead of a seasonal problem, swine flu has morphed into a year-round plague. Even more vexing, there are too many strains for a single vaccine to cover. “Since 1998, SIV has moved from a single, stable virus to a virus with the ability to reconfigure itself to the point where it may avoid control by existing vaccines.”

• A 2008 article from National Hog Farmer: Researchers Identify New Swine Flu Strain -  a strain with a “molecular twist” that merged avian and swine components. Not only did it infect pigs, but mice and ferrets in the lab so was well adapted for mammals. This particular strain, which was found in 2006 in two separate herds that, notably, both drank from ponds frequented by migrating waterfowl, hasn’t been seen again and likely presents little threat to humans. But the point is they saw the mix. It happens. And, given all the range of swine strains – some of which have passed from humans to pigs -  the opportunity to hit the pandemic jackpot has been steadily ratcheting up.

More digging would no doubt have turned up many more studies, but these two sketch out the basic issues.

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CAFO’s

The next clue came from a swine flu outbreak timeline compiled by Dr. James Wilson, CTO and Chief Scientist of Veratect, a biosurveillance service:

April 6

Veratect reported local health officials declared a health alert due to a respiratory disease outbreak in La Gloria, Perote Municipality, Veracruz State, Mexico.  Sources characterized the event as a “strange” outbreak of acute respiratory infection, which led to bronchial pneumonia in some pediatric cases. According to a local resident, symptoms included fever, severe cough, and large amounts of phlegm. Health officials recorded 400 cases that sought medical treatment in the last week in La Gloria, which has a population of 3,000; officials indicated that 60% of the town’s population (approximately 1,800 cases) has been affected. No precise timeframe was provided, but sources reported that a local official had been seeking health assistance for the town since February….

…Residents believed the outbreak had been caused by contamination from pig breeding farms located in the area. They believed that the farms, operated by Granjas Carroll, polluted the atmosphere and local water bodies, which in turn led to the disease outbreak. According to residents, the company denied responsibility for the outbreak and attributed the cases to “flu.” However, a municipal health official stated that preliminary investigations indicated that the disease vector was a type of fly that reproduces in pig waste and that the outbreak was linked to the pig farms. It was unclear whether health officials had identified a suspected pathogen responsible for this outbreak….

Although health officials ruled out influenza, they started a vaccinating the locals…

Confined Animal Feeding Operations, a.k.a CAFOs, a.k.a factory farms have revolutionized agriculture over the past 20 years. This is agriculture on steroids. Sometimes literally. Poultry, cattle and pigs are raised in such ferocious, relentless quantity, the animals  require a battery of drugs and chemicals simply to live long enough to be slaughtered. The waste streams and accompanying stench are a nightmare for anyone and anything down wind or down stream. Stats defy comprehension.

According to a 2006 Rolling Stone‘s Jeff Tietz’ tour de force expose on hog CAFO king, Smithfield Farms (of which Granjas Caroll, the CAFO in Vera Cruz, is a subsidiary):

• “Hogs produce three times more excrement than human beings do. The 500,000 pigs at a single Smithfield subsidiary in Utah generate more fecal matter each year than the 1.5 million inhabitants of Manhattan.” (Granjas Caroll processes nearly a million pigs annually)

• “The immobility, poisonous air and terror of confinement badly damage the pigs’ immune systems. They become susceptible to infection, and in such dense quarters microbes or parasites or fungi, once established in one pig, will rush spritelike through the whole population. Accordingly, factory pigs are infused with a huge range of antibiotics and vaccines, and are doused with insecticides. Without these compounds — oxytetracycline, draxxin, ceftiofur, tiamulin — diseases would likely kill them. Thus factory-farm pigs remain in a state of dying until they’re slaughtered. When a pig nearly ready to be slaughtered grows ill, workers sometimes shoot it up with as many drugs as necessary to get it to the slaughterhouse under its own power. As long as the pig remains ambulatory, it can be legally killed and sold as meat.”

• “Industrial pig waste also contains a host of other toxic substances: ammonia, methane, hydrogen sulfide, carbon monoxide, cyanide, phosphorous, nitrates and heavy metals. In addition, the waste nurses more than 100 microbial pathogens that can cause illness in humans, including salmonella, cryptosporidium, streptocolli and girardia. Each gram of hog shit can contain as much as 100 million fecal coliform bacteria.”

Egads.

A report from the Pew Commission on Industrial Farm Animal Production goes into more microbiological detail. CAFO’s are a major source for the development of antibiotic resistance and water and air pollution disaster. Pig and poultry CAFOs are cauldrons for dangerous flu strains.

David Kirby’s Huffington Post article, Swine Flu Outbreak — Nature Biting Back at Industrial Animal Production? ties it all in a bow:

… Dr. (Ellen) Silbergeld thinks the genetic swimming pool that is found in modern swine – or poultry – production is probably the place from whence this killer bug evolved.

“CAFOs are not biosecure,” she told me. “They have high rates of ventilation and enormous number of animals that would die of heat stress unless the building was ventilated. We and others have measured bacteria and viruses in the environment around poultry and swine houses. They are carried by flies, too. These places are not bio-secure going in – or going out.”

“These mixing bowls of intensive operations of chickens and pigs are contributing to speeding up viral evolution,” Dr. Silbergeld added. “I think CAFOs are contributing.”

But, what about traditional outdoor farms? Aren’t those animals even more susceptible to wild type viruses than animals kept indoors, as industry claims? “Well, let’s say that animals in confinement are ten times less likely to be infected by wild animals,” she said, “But there are 100 times as many of them. You do the math.”

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MAPPING

Only time will tell whether the ongoing swine flu outbreak peters out as a local tragedy or develops into a full-blown global catastrophe. Only diligent epidemiological investigation will prove if there is indeed a CAFO link. But we would be foolish not to see this as a last ditch wake up call for stricter controls over CAFOs. The risks are simply too great, too inevitable.

So, as maps are developed charting the progress of the outbreak, I hope they are layered with the kinds of information that explain not only how this happened, but also to help visualize vulnerabilities.

• CAFO location: Where are they in relation to human cases?

• Hog shipping routes: Contaminated trucks have been implicated in other animal disease incidents

• Data on swine/avian strains documented in pigs – even those that don’t cause clinical illness

• Data on swine flu outbreaks at pig operations: In many areas, including the Vera Cruz region in Mexico, the disease is considered endemic. Were pigs vaccinated? Would the vaccine have protected against this strain?

• Bird migrations, especially of waterfowl

• Human vaccine status: Have cases diagnosed in the U.S. been milder because the patients had been vaccinated while patients in Mexico had not? Although the vaccine targeted different strains, was their any cross protection?

• State of patients at time of first doctor visit: Do poor patients wait longer to seek medical help?

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PUBLIC HEALTH DISCONNECT

The last point raises some inconvenient truths for public health. Here in the U.S. where over 40 million are uninsured and probably an equal number are under-insured, it is unrealistic to tell people to see a doctor (they may not have one). Likewise, skipping work is a tough choice for families living paycheck to paycheck. According to a new study published by the Kaiser Family Foundation, nearly 60% of Americans delayed or deferred health care over the last year. Prescriptions went unfilled and treatments skipped.

Public health goals and private realities simply aren’t meshing .

Advising residents of Mexico City to keep 6 feet away from one another is equally unrealistic.

For that matter, if flu protection is a national – an international -  priority, why not make flu shots free for everyone?

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more reading:

Swine-flu outbreak linked to Smithfield factory farms (Grist/Tom Philpott)

Fast Food Nation: The Dark Side of the All-American Meal (Eric Schlosser)

The Omnivore’s Dilemma (Michael Pollan)

The implications for public health, particularly in poor developing countries, are, of course, enormous. This also has the potential to be a game-changer across the board, putting a “lab” in every doctor — or community health worker’s — pocket, dramatically reducing the time and cost of tests. Imagine: health-care costs that go down.  (Although, as my colleague Ed Jezierski at InSTEDD points out, if it turns out that proprietary component of the test is expensive, the bargain disappears.)

The Wired story was grouped on TrackerNews with a Technology Review article providing a more detailed explanation of the imaging system (which can also be used for testing water):

The counter has high throughput–while it’s capable of detecting small numbers of cells, it can image as many as 100,000 cells in a 20-centimeter-squared field of view in one second. The counter can, for example, determine the concentration of red blood cells in an unprocessed blood sample with 90 percent accuracy. Red blood cell count can be used to diagnose anemia, to monitor malaria, and to monitor patients’ responses to chemotherapy.

For those wanting even more detail, the Ozcan lab’s website has links to several technical journal articles. And for those, like me, who could use a fast backgrounder on bio photonics – Wikipedia to the rescue!

Origami Diagnostics

If you haven’t got cell phone handy, George Whitesides at Harvard can whip up a diagnostic chip out of paper and tape. It turns to be surprisingly easy to create channels on the stamp-size pieces of paper  to control the flow of sample fluid — a drop of blood, for example. By creating layers separated by tape, a single chip can be used for multiple tests. The results appear as tiny dots of color that can be easily and quickly analyzed, much like a pregnancy test.

Whitesides’ nonprofit, Diagnostics for All, which was created to scale up and commercialize the concept, won both the 2008 Harvard Business School Social Enterprise Business Plan Contest and the MIT $100K Entrepreneurship Competition, so is further along the tech transfer trail than most.

Looking for the Unknown Germ

Both the the phone and the paper chip are designed to test for known pathogens. But what about the new ones that keep popping up, such as SARS, or those expanding into new regions, such as West Nile virus in the U.S., or chikungunya in Italy? Ian Lipkin’s team at Columbia University have developed  GreeneChips, glass slides with “over 30,000 pieces of genetic material, representing thousands of different pathogens. which can test for almost all known viruses, bacteria, fungi, or parasites,” and Mass Tag PCR, a “multiplex platform that allows epidemiologists and doctors to simultaneously test one sample for the presence of up to 30 different agents.” When a faced with a novel pathogen, the tests can quickly determine what its closest relatives are, which, in turn jumpstart the investigation as to whether it is a vector-borne, air-borne, food-borne or water-borne disease. Although Mass Tag PCR is provided free to WHO Network partners, these are still pretty boutique technologies.

But who knows? A Greene paper chip or a Mass Tag cell phone could be just around the corner….

( *twitter-friendly url: http://tinyurl.com/6vv6rr)

HeroRAT

I knew I’d seen that face before. Those cheeks. Those whiskers. That long, long tail. The giant African pouched rat – a.k.a., the giant Gambian pouched rat (Cricetomys gambianus) – was all over the headlines five years ago, fingered as the likely culprit in a first-ever outbreak in the U.S. of monkeypox (a smallpox relative).

Shift continents and the villain becomes a hero. In fact, a “HeroRAT,” with a genius for sniffing out landmines and diagnosing TB.

Bart Weetjens, an engineer with Apopo, a Belgian organization focused on “vapour detection technology,” with a emphasis on land mines and disease detection, hit upon the idea of using pouched rats about 10 years ago. The rats are smart, thrive on repetitive tasks, have a top-notch sense of smell, are cheaper to train than dogs ($3,000 to $5,000 vs. $40,000+) and literally work for peanuts. Despite its giant-by-rat-standards size (a pouched rat can weigh as much as 9 lbs), it’s too light to trip off a mine. In any case, as one journalist noted, “(t)he bonds between rats and humans are looser.”

Maybe. But on the HeroRAT website, you can read all about Allan, Chosen One, Kim and Ziko, and even Adopt-a-Rat. In their own little pouchy way, they’ve got Ratatouille charisma. Jane Goodall’s a big fan.

They’re pretty efficient, too. In 30 minutes, a rat can sniff out an area that otherwise would take a couple of days to clear. And they’re just as good at detecting plastic mines as metal ones.

There are an estimated 100 million landmines in over 90 countries, so the scale of the problem is beyond daunting. Using existing technology, it would take centuries to remove all the mines. In the meantime, dozens of people are maimed and killed each day, while social fabric fractures when people are kept from their homes and farmland is kept out of production.

The Pox

"Easy to raise and breed"

Still, as I read about interest in using HeroRats beyond their native Africa, my thoughts went back to 2003 and a sick little girl in Wisconsin who sparked a bioterror scare.

Giant Gambian pouched rats had become popular pets, a development that would, no doubt, have amazed and amused Africans who generally see them as pests, or possibly dinner.

The disease chain was convoluted, but for those tracking zoonotic diseases (illnesses that affect humans and other animals) and concerned about the largely unregulated “exotic” pet trade, it was all too predictable.

It started when a shipment from Ghana of 800 animals (9 species), including some clinically-healthy but infected pouched rats, was delivered to an outfit in Texas. The rats were then sold to a vendor in Iowa, who sold them to a dealer in Illinois, who also stocked prairie dogs. The rats infected the prairie dogs, which were then shipped to at least a dozen other states. The prairie dogs began falling ill (a rodent replay of what happened to American Indians after exposure to the smallpox virus carried by Europeans). At least one sick “doggie” ended up at a swap meet in Wisconsin, where a little girl bought it, was promptly scratched and became ill. The specter of monkeypox made the West Nile virus outbreak look like child’s play. Fear drove speculation: Was it bioterrorism? Would the virus infect wildlife and become endemic? What about person-to-person spread? Were sick patients a risk to doctors and nurses?

Thanks to some phenomenal epidemiological legwork and some lucky breaks (no person-to-person transmission), the outbreak was contained and panic faded. Monkeypox devolved into a harmless punchline on late night talk shows.

Imports of giant African pouched rats were, of course, quickly banned, but hundreds, if not thousands, were already here. Escaped rats had begun to roam wild and multiply all over Grassy Key, Florida – Jimmy Buffet territory. Last year, the Florida Depart of Natural Resources mounted what was supposed to be a final campaign to eradicate them. It didn’t work. A native Grassy Keysian I spoke with today reported seeing a rat on her driveway recently that was so big, she thought it was a cat at first. They are so big, actual cats won’t take them on.

Naturalists worry the rats will eventually find their way into the Everglades, with devastating implications. Whether as a carrier of an invasive disease, or as an invasive species infecting an ecosystem, giant African pouched rats pose a significant biothreat. That’s an important consideration for HeroRATS deployed outside of Africa.

Lab Rats: “That’s ‘Dr. Rat’ to You”

Still, as long as they’re here, perhaps we should put them to work. HeroRATS are also being trained at the Apopo lab in Tanzania to sniff for the tell-tale scent of tuberculosis in human sputum.

HeroRAT Sniffing for TB

The standard microscope test is both time-consuming and pricey. A rat can zip through 40 samples in 10 minutes with an 85+% accuracy rate, according to early tests. It would take a lab tech at least a day to do the same. Rats have even correctly diagnosed samples missed by microscopy. Considering that nearly 30% of all new TB cases are in Africa, a local, scalable solution for cheap rapid diagnostics is clear winner.

The Skoll Foundation thinks so, too, and gave Apopo a $1 million grant for social entrepreneurship last August. With funding now secure, hordes of HeroRATS will be trained to sniff for all sorts of trouble. Imagine that: Saved by rats.