Healthcare at Sea: Mercy Ships' Infrastructure Solutions with Presidio

Digital transformation has become one of the buzziest of buzzwords. This podcast is where we decode and deconstruct digital technologies, strategies, and best practices that are impacting the way companies deliver value to their customers. No buzzwords, nobs, Let's get to it. Hello and welcome to another episode of the Digital Dcode, brought to you by Persidio and our partners over at Cisco.

I'm your host, Alec Brust, and today we have a really exciting story to talk about, a really exciting project that we've worked on with a company that's doing great things around the world for healthcare, and I'm going to just jump right into it. This is our story about our project that we have done with Mercy Ships, specifically on the Global Mercy Hospital Ship. Today joining me, I have Bert Wilhelm and Quinn Madrine from the Presidio side, and we also have Jonathan Dyson joining us from over at Mercy.

How are you guys doing doing great? Thank you for having us doing well, doing great? Alec so happy to have you guys on. I'd love to do some introductions, starting with you Jonathan absolutely well.

First off, thank you for having me. My name is Jonathan Dyson. I'm the director of IT, Strategy and Governance at Mercy Ships and I've been here for going on nine years, i think, and been involved in the Global Mercy build as you mentioned, since the beginning, and it's been a very exciting project. Exciting to see that ship come out and go into the field service in Africa.

I'm excited to work with partners like Presidio. All right, Bert, you can be next. All right, thank you, Alex, thanks again for having me. Yes, my name is Bert Wilhel.

I'm the senior solutions architect for Presidio. I've actually worked with Jonathan for like the last seven years on the Global Mercy It's been a fantastic journey to be able to design architect and be able to implement the dream that we have I'd always talked about and so I'm really excited about on this podcast. Thank you of course. Quinn, last, but not least, Yeah, that leads me.

Yeah, I appreciate it. Quinn, senior account manager here over at Presidio. I've only had the pleasure of working with Mercy Ships for about three years now, but men, that of the honor is all mine. I really appreciate their mission statement and like Bert said, seeing what we were able to design and see the fruition of that, it's really powerful.

So excited to be here as well, thank you. Yeah. Absolutely. I've obviously only been working with Mercy Ships for about the past six months when I heard about the story here at Presidio, and it's been really exciting to, you know, go out to the campus and see all the incredible work that you're doing.

And so I guess that's a perfect segue, Jonathan. I would just love to give our audience just the general overview of what Mercy Ships is and what you guys are doing around the world. Yeah. Absolutely, Well, Mercy Ships has been around for a little over forty years.

We're a nonprofit organization and we have hospitals and our main focus is on the about five billion people who lack access to safe and affordable surgical care. Of course, we can't tackle all of that all at once, so we have a multi pronged approach. First, we provide direct medical services. We do that via our hospital vessels that spend about ten months or so in a field service as we call it in Africa, mostly focused in West Africa.

The last several years though the Africa Mercy is going to Madagascar here or as a Pactually we've just arrived in Madagascar today. But we take the approach that we want to come alongside the host nation, the host governments and their local infrastructure, the local medical systems and figure out how do we provide the medical care that they're not otherwise able to provide, whether they it's because they don't have the training, or they don't have the people, or they don't have the facilities.

And so we have a number of surgic areas that we facilitate, and that's in the areas of tumor removals, ficilas, cataracts. We do a dental care type program, and there's several others that we specialize and we bring surgeons and nurses, volunteers and a number of other types of volunteers on board our vessements from all over the world. About fifty nations I think are represented on our ships right now. They come from all over and that's what they do.

They sit there, they spend their time on the ships figuring out how to provide these kind of immediate life changing, life saving in some cases surgeries that change the way that the individuals who have those afflictions are seen by their community, how they're able to interact with whether it's a school as a child or to find work as an adult and be able to live healthy lives. And so that's one area. The other area is through education, training and advocacy, where we don't just want to give them a fish, but teach them how to fit, so to speak.

And so the approach there is working with local surgeons and nurses, working with hospitals, working with the ministries of health. We're working on programs to help them revitalize their own medical systems and that allows us, of course to bring in some industry standards, World Health Organization type standards to provide safe and surgical care there, as well as training the nurses and surgeons on new techniques, training them on board our vessels in those surgeries where we have the specialists flying in and being able to give that entire package.

And so that's what we do. We've got two vessels right now, as you already mentioned, the Global Mercy and we've got the African Mercy as well. It's just finished her refit and she's going into there's gotten to Madagascar now and starting that field service where the Global Mercy has been in Sierra Home for the last several months to be there for some time. No, I mean just incredible work that you are all doing over at Mercy Ships.

But I mean another big part of this what Mercy Ships is doing that is so unique to me is having it physically on a I don't know, you'd call it a huge vessel. And how many people did you say are usually on that vessel volunteering? Well, so it's a complicated answer, to be honest with you, because the Global Mercy, for example, can how's about six hundred people, that's about six hundred beds, But that's not the reality of the mission and the daily operation. Our turnover because we have volunteers, is three hundred and fifty percent, so we have a very significant number of people coming and leaving all the time.

On top of that, six hundred people isn't enough to maintain a vessel and do the surgeries and things that we're doing. So the Global Mercy also has an additional about three hundred and fifty what we call day crew, so it's individuals that live there in that country and that port, and we bring them in. We find them if they have this skill set and areas that we need their paid crew fundamentally, and so it's a good work experience for them and we get the additional hands that we need.

So it's really closer to about a thousand people for the Global Mercy and several hundred for the Africa Mercy as well, where we are all working together. We've got people there at one time, you know, performing those surgeries, but it is a constant turnover, so it's a lot of people involved, yes, And that kind of brings me into you know, what I wanted to talk about today, and how Persidio helped Mercy ships build out that infrastructure on the Global Mercy. It's just so unique.

You got all these people coming and going, you're performing surgeries, you're training all of your volunteers, and you're doing this all on a ship that may not have the best environment for a network. So I'd love if you guys could talk a little bit about that, and if Bert, if you would chime in just kind of give us an overview of the project that we recently finished on the Global Mercy. So I think one of the things that when I was first involved with Mercy Shift and especially the Global Mercy.

Remember, one of the things that was really important in paramount for the mission was to keep this network what we call always on network, and that dealt with working making sure that we designed and architected the data center. There's actually two data centers on the Global Mercy on different decks of the ship and different sides of the ship. So all of the majority of the Mercyship's applications, whether it's finance, HR or even especially medical applications, they reside on those data centers.

And it was very important for us to design an architect Again, like I said, that we provide reliability and redundancy, so should any of those various resources for mercerships where to go down, the second data center was able to pick that up. So that was also in the data center. What was also important was in the various ideas for it closets within the ship, and there's quite a number of them, and they each one of those clausets actually has a redundant link to each of those data centers, and it's going to be the same process over there as the volunteers or doctors or staff members when they need access to the various applications.

Again, we had to make sure that we had that availability for for the folks to continue on with the mission. Yeah, I think I'll jump in and add there, Bert, I think that's a great point. You know, the overall the overall design for redundancy and high availability is critical for a ship, and that's really applicable to any ship. And the reason for that is you've got things that a lot of people probably aren't really familiar with, but you've got some kind of regulations such as you know, fire zones on a ship.

You've got to have these different fire zones where you've split the ship vertically, and that's in case the fire breaks out on a ship, which is there's actually one of the highest dangers on a ship out at sea is actually fire more than sinking, as might be the thought that you have. So we have these vertical fire zones and we have to be able to keep those connected in the event of an emergency. So, like you said, two data centers, they're in different fire zones, different decks for that exact reason, and the entire network was designed that way.

And the great thing I think with the partnership is, as Bert was saying, it's been a long time partnership, and we started building the Global Mercy in twenty fifteen and having really the solid conversations beginning at twenty sixteen around network design and what does that need to look like. You know, we said, we know we've got these things. We know we have this redundancy that needs to be there, and here's the use case. We've got this vessel.

It's got a hospital in it, of course, but it's also it's more than that. It's a little floating city. We've got an internationally credit academy. We've got finance, we've got operation, we've got marine operations.

That marine operations is everything you think of in a city, such as plumbing and electricity and so on. Along with marine operations are all of the safety features that are involved in a fully functional ship. So you have to be able to close your water tight doors, those fire zones are incredibly important, the fire suppression systems, there's backups, to backups to backups, all really based on international maritime law and things of that nature and regulations. So we have to be able to have those things on board.

And so those requirements for overall safety for our crew, for our patients. The vessel filtered down to the technology, and that's really at the end of the day, we said, hey, you know, Presidio, we've got this, We've got all these different these pieces and parts. We need to make sure it's redundant. And that's what Burt and the rest of the Presidio team did.

They came in and said, hey, here's an overall design and basically built the bulletproof design for network reredominancy. Yeah, and if I remember, Jonathan, I think one of the other areas that we focused on was scalability as well. You know, just because when we were working on this back in twenty sixteen, we had an idea of the various applications that you were going to be deploying, but we didn't have an idea of what could be deployed in three years time, four years time, etc.

And so I remember when we were working on this, scalability was a huge issue as well, and especially when you're talking about a ship that's got very tight quarters and we have a very limited space in the MDF the core of that ship. I remember that we had to make sure that we put in the appropriate technology and that's why we focused quite a bit on Cisco and Nexus infrastructure to provide that scalability for you guys, as well as also in the various IDF closets. I remember the ability to add kind of switches and the ability to be able to add you know, various switches onto it to include into that various stack.

That was also very important for us to make sure we had that scalability with that. Yeah, yeah, I mean that at the end of the day, you know, from our perspective, you know, we're a nonprofit. We can't have this huge IT team, and so you know, when we're sitting there making architectural design decisions, you know, we have to rely a bit on you know, in this case, we've relied on Presidio very heavily on expertise, but also in the area of deciding for the core network that we want to go with Cisco is you know, you just have to have that kind of industry standard technology that's that's out there that people know that that works, it's reliable, it's been proven time over time, and then when we bring people in, they're used to seeing it and they're used to working with it.

So from an overall you know, architectural design decision point and a supportability point. That was a good overall call there, I think on the next of switches. And you're right, scalability was a big issue in twenty sixteen. You know, we were working on the ship and we had a we think we know when the shipyard is going to finish it, but we're not one hundred percent sure.

And even then, you know, we were at that point still talking about some of the stuff that we're doing now with CRM and HRIS and some of these other big enterprise application softwares, and they were just a discussion point, and so we had no idea what we needed, but we knew we needed to be scalable on So that's really you know, to your point, the design was for that purpose and it was good for that. I'm glad you brought that back up, Jonathan. I was curious as you guys were talking.

I wasn't there for the design. I was really only there for the implementation of it for the GLM for the Global Mercy. How much did that change along the process that I never asked Bert. So this may be out of left field here, but you know, this is the first ship you built from the ground up and I'm just curious, and you had a lot of assumptions.

I think you're basis had you had this big a gamut of Hey, I don't know what we're going to need, let's plan for this. Did that ever refine or did it? Did it wave in and out? I'm just curious how we prepared the changes.

Yeah, No, I think that's a great question. I'm going to shout out here to Bert because I think we had to make some slight adjustments here or there, very little ones minor, but overall, the original design document from twenty sixteen is still solid. That's what's in place. And furthermore, and this was really great to be able to do as well, is we were looking at the Africa Mercy.

The Africa Mercy's technology, some of it it's been in or had been in since two thousand and seven when she was originally refit, and so we said, if we're going to do it on the Global Mercy, we want to be able to do on the Africa Mercy as well and bring that up to date as well as the International Support Center in East Texas and so those that same kind of effort and fervor, if you will, on making this design redundant and scalable and so on. We took those same principles and a play across the board, or we were able to do that.

But yeah, fundamentally the design approach hasn't changed. It's just been duplicated across our locations. You know, I want to jump into something kind of from the design standpoint and also just kind of from my own curiosity. Ships they're made of metal, they have metal walls, and to me, that means it's going to be a very difficult place to have Wi Fi connectivity, which, obviously, with all these moving parts that you have all just discussed, is a pretty difficult thing to attain.

So I want to know how did you overcome that challenge of getting Wi Fi connectivity through all the metal walls. Yeah, that's a great point, and everybody that works in vessels is going to know about this because you know that, you know, going through the process of figuring out the sort of power settings for your access points and placement of your access points, it's tedious. It's very tedious, I'm sure. And it's another area where we relied on presidio.

I mean, we had to go through the process of first saying okay, well here's a drawing of every deck of the ship, and here's what most of the walls are made of. From a design material perspective. We went and got that from the shipyard and provided that, and that all went into a calculation to sit there and do the wireless heat maps and figure out, okay, this is where we think they need to be. And then so because of that, then you go through and say, okay, well this is where the cabling needs to be in the yard is going to be the install of the cabling.

So then the cabling goes in, you actually put the wireless access points in, and then you say, oh no, I missed some spots and you have to go back through and do that heat map and assessment again. And it's pretty normal for vessels. But I would say Persidio came along again in this area and helped us through that and even trained up our team to be able to do that a little bit more frequently on their own, which was great, so that we could sit there and make those adjustments as they come up over the years.

Yeah, thank you, bet Bert Quinn. Anything to add I mean, that's a good point though about self servicing, right, Brad just to your point, you have to train these guys and have tools at our disposal, and so I mean, the team us some great tools. I've been able to see how those would work, but hey, how can you wear a device? It helps with that Instead of having all the knowledge appear, how can you enable someone with all the infratructure they put in place to be remote from back end to have those smart nands that are already on ship.

I know that was a big challenge and I had to give a shout out to Chris Clark, one of our top engineers in the wireless space. He did a tremendous job. And so you're right. So you know when Jonathan was talking about that we can do some fort predictive analysis if you're will by putting the aps and seeing the heat map.

It's different when when you install it and then you start doing a post survey. And that's where Chris really came in to fine tune and survey the various areas that was having either too much covers or very little coverage or whatever, and having that ability and having the tools that we use to provide that and more importantly the engineering background and his uh, just just the entering piece of it that he's got. It has helped us be able to tune the Wi Fi network to allow a good coverage, a very very good coverage throughout that throughout the ship.

Now, I would add, I think the you know, the coverage is important. I think everybody recognizes, you know, I need, I need to have wireless to do the different things that I have. We've all got, you know, our phones or whatever mobile devices we've got, and it's no different for us on our vessels. I think one of the things that's a little bit different is the people that work on board our vessels also live aboard our vessels, and so there's really not a disconnection between the kind of work life balance, so to speak.

I mean the culture of Mercy ships on board our vessels is that you live and work and eat together. I mean we have the galley and everything on board, so so you very much live life together with the people that you work with. And so that picture allows you to kind of envision what it's like a little bit to say, Okay, well I've got my device and I need to be able to transition from home and to work without having that, you know, disconnect, because I don't have a physical disconnect.

It's easy for me if I go to you know, our support center, I connect, I go home, I connect. But there's this disconnect and I think anybody who knows anything about it is that transition for mobile devices from one access point to the other is often painful. And what I think Prasidio has helped us to do is it's not a painful transition. You can seamlessly move throughout the vessel.

We have the coverage. You can move between you know, our personal devices on the personal network to our business devices on the business network and stay connected. And that's important because you know, a surgeon wants to go home for lunch, so to speak, but they still need to be available. They're homes, you know, maybe twenty feet above their head, and so they have to be able to have that easy transition so that they can continue to do the work they have, but also be able to disconnect a little bit, which is difficult for our crew a lot of the times is being able to disconnect and you know, have a feeling of not being in that mission, you know, twenty four to seven, three sixty five, because they've got to be able to connect to family, back home.

They've got to be able to connect to their sponsors and people that are donating so they can be there. Having that wireless capability across the ship allows them to move seamlessly from one place to the other and logically from one place to another. Right, I mean, like you said, it is a floating city. It's not just a workplace that you get to come to and go home.

You have all of those different intermingling things that are going to affect that connectivity. I did want to ask though, and I'm curious because this is also another super unique aspect of this type of healthcare. Is you're in Africa. You know, you're not just off the coast somewhere in the United States or somewhere where you're going to understand how the connect of these going to be.

There might be a bunch of things jumping out up from left field. And I know you guys mentioned how sd when kind of helped you to adjust to those different environments. Can you talk a little bit about that? Sure?

Yeah, I mean I'll talk to the overall pain points because I've been sure involved in that for years now. But I'll kick it over afterwards to Burt to talk a little bit more about the technology because they've just been again another area where they've just stepped in and really helped. But you know, as you mentioned, Alec, I think being in a vessel, you know, you have to deal with satellite, marine satellite, right, and marine satellite is a little bit different. Most people don't think about it too differently because you can get satellite at your house, but marine satellite is very different.

It's also very expensive to maintain because you're moving all the time and you have to stay connected all the time. So it's not like I connect, you know, a satellite intent in my house. A house doesn't go anywhere, and so it's a lot easier to support that. And so because of that, you know, there's only so much bandwidth that we can afford.

There's only so much bandwidth even available in the areas that we're supporting, because there just isn't the need for it. It's really up to businesses that are working in that area and how much they're willing to pay. And so we have a great partner in that space. But I mean, it's logically there's only so much we can get.

So what we do is we spend several months before we get to the port that we're going into the host nation, working with our local team on the ground and figuring out who the potential internet service providers are. This is something that's only really kicked off in the last several years since since I've been working on it, because before that all we had was satellite. And so with the local service providers, they're increasing and there is fiber being ran along the coasts of Africa, but that last mile can sometimes be really difficult.

It can be a challenge for that internet service provider to either to provide it at all, or provide the bandwidth at all, or provide what they say they're going to provide, or is it relying. I mean, we've been in places where because of different regulations or whatever, the service provider had to string fiber up between buildings and trucks would drive through and just snap the fiber over and over. Now, so you know, we need the bandwidth, we need to be able to increase our use of applications and our applications off ship, but we also have this constraint of what's available and so you know, that was one of the things that again we came to Presidio and we said hey, look, you know we've got this and we sort of have some kind of of bandwidth optimization going around between our firewalls, but it's not sufficient.

We can pay for more than we can use fundamentally, and what we can pay for isn't that much. So we need to be able to use every little bit of bandwidth that we have, and we need to be able to optimize every single thing because otherwise we just can't continue to grow and provide the services that the ships need. Really. Yeah, and Jonathan, if I remember when we were working on that particular part of the project, we would have a multiple least two or three local internet providers coming in and providing us to various links.

I remember one miss Fiber one was actually a Wi Fi last mile and the ability for us to intelligently route the applications and provide quality of experience over those two various links for multiple links was very important, and that's where st Win really came into play. To allow us to have that type of pass selection for the applications, whether it's voice, video or other mission critical applications. We were able to be able to provide that type of experience for the users.

And I know that was a big challenge, especially on the West coast of Africa with the various internet service providers out there. Sometimes they could provide fifty megabits, sometimes they could provide I don't know, one hundred to two hundred, and we're here and we're here in a space we're used to fiber at a gig, So it's a very big challenge and so sd wayIn really helped us sort all of that out with past selection of the applications. But really importantly is what were those applications that were allowed to go across and we were able to optimize those as well, So that was really that was actually a very fun area for us to work on.

Yeah, yeah, I mean it's a challenge. I've talked to a number of professionals in different industries and their sd WAN implementations and they're pretty basic compared to some of the stuff that we're doing with you guys. So it's been really great, I would say overall working with Persidio and you guys, training our teams, getting them up to speed, learning that environment, how to optimize and really fine tune things as much as humanly possible. And you're right, I think that's one of the key areas within SDUN and we use a real a silver Peak in this instance, we were able to turn those various knobs, if you will, to really help optimize it.

And the siver Peak platform also allowed us to have that optimization pretty relatively easy just coming out of the box. So I think that was one of the really cool areas that we were able to really show the power of the sd WN, especially in Africa. Absolutely, And you know, I think it's just this whole story and everything that we've just discussed is just such a testament to how technology is really helping in these really niche areas of healthcare. And so I'm really excited to see what our relationship, the Presidio and the Mercy Ships relationship is going to become.

I know that we'll be working with you guys in the future. Hopefully I can get back down to Dallas and hang out with you once again. If you guys want to see a really great video with Jonathan and Quinn's faces in it, we'll link that in the show notes. I'm just going to wrap it up here because we are at thirty minutes.

I'd once again like to thank you all our guests, Quinn Jonathan Bert. It's great to have you on and please like, review, and subscribe to The Digital Decode podcast wherever you get your podcasts, and make sure you give Presidio a follow on LinkedIn, x and Instagram. And once again, thank you for our sponsors over at Cisco. Thanks for listening everyone, and thank you for joining me everyone, Thanks for having us, thank you, thank you.

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