By: Charles Ebikeme
Around the time I started my masters course I met a doctor who worked for the NHS in the UK. He had on him at all times a standard-issue NHS PDA. He took great joy, like a child on Christmas morning, in showing me what it could do – from looking up symptoms and prognoses, to accessing patient records and x-rays. At the time I thought little of it other than it was a nice way to access relevant information for training medical students. As it turned out that was only the beginning of a health revolution of sorts.
In parts of the globe where the last time a doctor visited is not in living memory, where it’s hard to differentiate where people and animals live, where you’re only expected to live into your 40’s, and families are large to fight against crippling mortality rates… in these parts of the globe that same information and communications technology (ICT) revolution is taking place.
The initial concept of telemedicine now spans a wide spectrum of applications, labels, contexts, and platforms. Whether you call it m-Health, e-Health, or telehealth, the goal is the same – the use of information communication technology for health. The continuing change to the global health landscape comes with a new realization that cell and mobile phones can be used in many of the poorest and most remote regions has altered perceptions of what can be done.
More can be done with less. This realization came with changing availability of mobile devices and networks across the developing world. Throughout WHO member states, 5 billion wireless subscribers exist; a staggering amount of them, over 70%, reside in low- and middle-income countries. The ubiquitous nature of mobile phone networks surpass other tangible infrastructure, once thought of as a necessity for development, such as paved roads and electricity. It seems that mobile technologies provide a faster route towards the Millennium Development Goals (MDGs).
The doctor I met used his PDA to keep up to date with patients and new treatments. Kenyan health workers at Kijabe Hospital use PDAs to access comprehensive, up-to-date information on diagnosis and treatment, from HIV/AIDS, TB, malaria, abdominal pain, typhoid fever and the NTDs that cause diarrhea.
In Peru, the US and Peruvian Navy came together across multiple mobile platforms to track disease outbreaks. Chagas, dengue, and leishmaniasis are just some of the diseases benefiting from “rapidly improved disease reporting” allowing officials to “obtain quality data in real time, and, most importantly, facilitated improved response to disease outbreaks in a remote region.” EpiSurveyor, a similar platform, has been utilized in resource-poor areas in Africa. Employing standard Nokia phones to collect text-based data for many kinds of data collection.
Where there is a great health divide between rural and urban areas, ICT acts as that bridge, bringing doctors in the rural areas out of isolation, and helping deliver more complete and specialized patient care to the most remote corners of any country. The Indian Space Research Organization, for example connected 22 super-specialty hospitals with 78 rural and remote health centers across the country through its geo-stationary satellites.
A lack of clean water is the source of a number of NTDs. In areas where access to safe water is never guaranteed, ICT allows water projects to become sustainable, allowing field workers in the region to track and assess infrastructure. FLOW lets field workers, volunteers, and others record data from thousands of water points not just locally, but globally. Using simple Android smart phones and linking that to Google Earth data, the information can be displayed and accessed by anyone. Sustainability, transparency and monitoring – made quick and easy by ICT.
Bringing mobile tech to the forefront of the fight against NTDs is one holy grail worth striving for. Namely, highly efficient point-of-care diagnosis using the simplest of tools. Simplifying the test for some of the gravest NTDs so that health workers can accurately perform state-of-the-art diagnosis – the famed “lab-on-a-chip” – is the next step ICT is waiting to climb. Although not quite there yet several innovations are making headway. A device to diagnose eye disorders and infections like trachoma is only one many. Transforming the standard mobile phone into a range of devices that can act as diagnostic tools and transmit patient data remotely.
Although the most profound examples of ICT successes come from programs with the “big three” diseases of HIV/AIDS, Tuberculosis, and malaria, the focus is shifting to a more global approach. Today, 83% of WHO member countries have one or more m-health project in operation, limited in size and scope, across broad goals such as treatment compliance, education and awareness, data collection, and remote monitoring. ICT is only just starting to have an impact on NTDs. Such initiatives are spreading, transforming the way health services and information are accessed, delivered, and engaged; allowing an apparent health care infrastructure to exist where none did before.
Charles Ebikeme has worked for many years as a research scientist on African Sleeping Sickness. Possessing a MSc from the London School of Hygiene & Tropical Medicine, and a PhD in Parasitology from the University of Glasgow, Charles currently blogs and writes for the All Results Journals – a new publication system focusing on negative results – covering topics on the hidden side of the scientific publication process.