Omar Metwally, MD
University of California, San Francisco

Distributed Data Sharing Hyperledger (DDASH).
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   Github repository
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   Project website
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Like blood rushing through a major artery, the Nile flows north from its origins in eastern Africa, nourishing hundreds of millions of people in Ethiopia, Sudan, and Egypt. Through millenia, the world’s longest river has turned otherwise uninhabitable deserts into fertile farmland, giving birth to civilizations that depend on its water for sustenance and trade. Herodutus, the ancient Greek historian, described Egypt as “the gift of the Nile,” and in the southern Egyptian cities of Aswan and Luxor, the Nile’s critical importance into modern times is ubiquitously apparent.

I step outside Aswan airport into a warm, brilliant January morning. A sweet breeze and southern Egyptians’ lightness greet us, a stark contrast from Cairo’s frenetic bustle . A charming Nubian man drives us to our hotel, and as we pass acres of hydroelectric generators and the Aswan High Dam, the Nile’s modern day importance to a country dependent on its every last drop comes into focus.

The Ethiopian government began constructing The Grand Ethiopian Renaissance Dam in 2011, making it Africa’s largest hydroelectric power plant. Although the $6.4 billion project is well underway, the ramifications of this project remain incompletely understood. The potential threat of depriving downstream countries (the Nile flows from south to north) of water and hydroelectric energy has raised concerns about its potential impact on human life.

While hydropolitics is a step removed from my field of Clinical Informatics, this complicated situation involving numerous parties with conflicting interests (sound familiar?) piqued my interest. The U.S. healthcare system, like this sensitive hydropolitial situation, is plagued by the major problem of many conflicting interests with little incentive to cooperate. Stifled health information exchange has bred a climate of competition rather than cooperation, ultimately to the detriment of individuals. I began my career as a blockchain researcher in 2014 when I realized this paradigm’s potential to create equity and promote cooperation. The conflict surrounding the Nile and the Renaissance Dam is a vivid demonstration of how the Ethereum blockchain can help nations solve a geopolitical conflict surrounding a scarce natural resource through cooperation rather than competition. My core thesis on blockchain, a technology that bridges computing, psychology, and economics, is that opportunities for cooperation will arise naturally as individuals benefit from increasing opportunities to participate in decision-making on all scales.   

To demonstrate these principles and test the above hypothesis, I spent several jet-lagged nights deploying a Nilometer contract on the Ethereum blockchain. This Ethereum contract lets parties bid for a minimum Nile water level and send a variable amount of Ether to support their bid. If the next month’s water level meets this minimum, these funds move from digital escrow to a pre-determined recipient (for example, a government, non-profit, or corporation). 

Hydrological Time Series data were obtained from Technical University of Munich (Deutsches Geodätisches Forschungsinstitut an der Technischen Universität München).