Virtual Doctors in Crisis Situations – The African Context

Early last year, West Africa saw the worst Ebola outbreak ever recorded in human history. Horrific image of bodies strewn across city streets and ailing patients in crowded makeshift hospital quarantines filled television screens across the world. A year later, the bustling metropolis of Johannesburg, South Africa went into frenzy as cases of the highly infectious typhoid fever and an eventual fatality were reported. Epidemics of different forms are a reality that most have to contend with. A lot of infrastructure and financial support is continually dedicated to mitigating the devastating effects of such disasters across the world. It is however difficult to contain highly communicable diseases, stretching economies and resources to breaking point in the process. The Zika virus that has ravaged South America in recent months is a prime example of how devastating a pandemic can be, despite immense intervention. The American Administration for instance looked to devote a total of $1.9 billion dollars towards combating the virusᶛ.

The afore – mentioned cases clearly illustrate the fact that the traditional approach to disaster response has its limitations. To begin with, poor transport networks and road infrastructure make it difficult to reach infected individuals in dire need of medical assistance. In Sierra Leone, for instance, ‘’inadequate road networks and infrastructure’’ resulted in some patients waiting at home for up to 6 days for a diagnosis, ‘’all the while leaving their families at risk of further infection.’’ᶞ A similar pattern can be observed in most of the “developing economies” in Africa, Asia and South America. While waiting for the relevant governments to develop better road networks may be a tedious effort, there can be an effective alternative. Introducing virtual doctors in Africa could make a great, positive difference in the lives that may be saved during times of outbreaks

Zimbabwe, a country in Sub – Saharan Africa went through a terrible cholera outbreak in 2008.    Once a bustling and growing state, economic ruin and a dysfunctional political framework systematically led to the country’s health sector deteriorating to deplorable conditions. At the time of the epidemic, the conditions in the country were described as having caused ‘’an unprecedented deterioration of healthcare infrastructure, loss of healthcare sector personnel and a drastic decline in the quality of health services available for the population.’’໊ Poor sanitation and access to clean water led to the disease quickly spreading across major cities and rural areas. The country was totally unprepared for a disaster of this magnitude and intensity. At Mutambara Hospital, a rural hospital in the eastern province of Manicaland, the writer witnessed diseased individuals, wrapped in refuse bags, being taken to designated burial sites, in wheelbarrows. These casualties were transported through neighborhoods populated by families, children and all. The risk to the surrounding community was heightened because of the lack of preparedness and capacity to deal with the crisis. In contrast, the presence of a virtual Doctor would have been a clever and efficient way to provide medical assistance while safeguarding the health of those in the vicinity.

Another application of virtual doctors in Africa has to do with safety and security. It is no secret that war, turmoil, civil strife and violence have been a vice that has plagued nations the world over. Africa has not been spared of this scourge either. Civilian insecurity takes many forms, sometimes state organized and at other times spontaneous. Regardless, life does not come to a halt and people make the most of whatever situation they find themselves in. In the year 2008 and 2015, violent xenophobic attacks against foreign nationals residing in South Africa erupted across the country. Lives were viciously taken, property destroyed and many displaced. In such situations both immigrants and sympathizers were looked at with disdain. Rendering medical aid to this sect of the South African society changed from being a routine appointment to a life threatening act overnight. Once again, employing virtual doctors in such a scenario would have made it possible for practitioners to reach needy patients sheltered in crisis centers across the country safely.

Whether it is to overcome infrastructural barriers or ensure the safety of the practitioner, the applicability of virtual doctors in Africa is undeniable. Crisis and epidemics are weaved into the history of Africa and will probably continue to be a risk facing a large part of the continental population. Rather than to solely depend on an over – subscribed medical framework battling numerous challenges, the innovation of virtual Doctors could go a long way in controlling and possibly preventing the spread of such outbreaks in future. Follow us on Twitter and find out what others are saying about virtual Doctors in Africa

Sources

ᶛ  Senate Approves $1.1 Billion in Emergency Zika Funding. The Wallstreet Journal, 2016/05/17 : http://www.wsj.com/
ᶞ A Long Way to Go: The Ebola response in West Africa at the sixty day mark. OXFAM,www.oxfam.org
໊Zimbabwe – Global Health Workforce Alliance. WHO, www.who.int

 

Telemedicine in Sub – Saharan Africa, Opportunity Unexplored

Africa like any other continent has a rich diversity that highlights differences in economy, population and welfare, among other things. Economies such as South Africa and Nigeria have experienced impressive growth over the past decades while the likes of Zimbabwe and Somalia have been plagued by fiscal stagnation and trade isolation. The overall disparity that characterizes the region has resulted in most countries lagging behind in areas of health and technology. A case in point can be made for telemedicine in Sub – Saharan Africa.

Background

Western countries such as the United States of America, Canada, Britain and the greater part of Europe have integrated telemedicine into their health sectors. The many demands of modern day life have resulted in the health industry evolving to accommodate patients’ needs. By incorporating high quality IT infrastructure with a skilled practitioner labour pool, superior medical care is made accessible to millions of patients. The marked growth in the telemedicine industry in the aforementioned countries is testament to the popularity of this method with patients. Benefits such as access across various platforms (e.g. Android, iOS and Windows), convenience and lower consultation costs have made telemedicine an obvious choice for numerous individuals.

The health situation in the opposite hemisphere unfortunately is not as progressive. According to UNICEF, 21 children [below the age of 5] die every minute, the highest rates being in Sub – Saharan Africaᶛ. On the contrary, there are only 1.7% of the world’s physicians practicing in the region according to a survey of Sub-Saharan African medical schoolsᶜ. The regrettable reality is that quality medical healthcare is largely inaccessible to most households in the region. A common trait across the expanse is the comparatively higher quality of medical care afforded by private practices and hospitals as opposed to public facilities. Bureaucracy, corruption and lack of adequate funding have progressively deteriorated state run clinics and hospitals in most Southern African countries. During 2000-2010 for instance, Zimbabwe had fewer than two doctors for every 10,000 people according to the World Health Organization (WHO)ᶝ.Telemedicine in Sub – Saharan Africa, though largely unexplored, provides an exciting solution to the problem of equitable access to quality healthcare.

The Rise Of IT Vs Telemedicine in Sub – Saharan Africa

Technological advancement has however, not been insular to the Northern Hemisphere. Digital innovations and the relentless search for consumer markets by IT manufactures has resulted in a steady proliferation of state – of – the art hardware and software across the continent. In June, 2014, there were 329 million unique smartphone subscribers in Southern Africa, equivalent to a penetration rate of 38%ᶞ.  The advent of cheap technologies and apps, particularly from the Asian bloc has seen a massive uptake of basic 21st century communication platforms such as instant messaging and social media. While these developments have had marked impact in such areas as showbiz, music and sport, the applications of technology in medicine, in the region, has been minimal at best. The majority of medical institutions still rely on dated, bulky machinery, a dwindling population of skilled practitioners and systems established during colonial eras.

Med-eSmart And The Future

Telemedicine, the provision of medical care from a distance, has made substantial strides in the northern hemisphere. Patients find themselves presented with numerous options of doctors and medical advice. The benefits of this model also extend to business and employers as people apply for less sick days and time off, for what would otherwise be minor and easily treatable conditions. It stands to reason that in Southern Africa, plagued by bureaucracy, systematic inefficiencies and outdated technologies. It is under this premise that Med-eSmart is established. Connect with the Med-eSmart Facebook page to become part of this exciting movement as we ensure “A Doctor For Every Child.”

Sources

http://www.unicef.org/
ᶜ A survey of Sub-Saharan African medical schools, Chen et al, Human Resources For Health, 2012, 10:4
http://www.our-africa.org/
ᶛGSMA The Mobile Economy – Sub Saharan Africa 2014: ssa.gsmamobileeconomy.com