ictdchick

So last year, our co-winners in the Bears Breaking Boundaries IT for Society contest was a group of students working on attachments for cell phone cameras that could be used for microscopy diagnosis of diseases like malaria. Since then both of our projects have been taken up by the Blum Center for Developing Economies, and the Telemicroscopy for Disease Diagnosis project has been written up in the news by a number of media organizations, including a recent issue of the Economist.

It’s part of an interesting new direction for technology research - instead of just building faster, more high-resolution (and more expensive) devices, people are working on ways to build low cost devices that are more robust, can be mass produced, and can provide good enough information for primary triage.

On another note, these devices (as the economist article posits) could be well deployed with a good mobile-phone-based data collection system - collecting not just text and numbers, but images as well.

As part of the evaluation for the Uganda OBA project, Ben Bellows and his collaborators at Makarere University are conducting a household survey in the coverage area of the project and in a similar control area. As part of this survey they have to also do sexually transmitted infection (STI) testing, trying to determine the actual prevalence of STIs and not just an estimate based on who comes in for diagnosis and treatment. Can you imagine how much easier and verifiable these surveys would be if 1) the data collection could be done electronically, and 2) digital media for the testing could be integrated into the data collection records? Not that all diagnoses could be done with cell-phone microscopy, and you still need careful sample and slide preparation. But it’s still something to think about…

This is a bit belated (I’m something like 6 months behind on blog posts) but my group got an honorable mention at this year’s Bear’s Breaking Boundaries IT for Society competition. Our project, led by Laura Stachel (MD, studying for a DrPH in the School of Public Health) proposes to provide sufficient reliable power for lighting, diagnostic equipment, and communications to support emergency obstetric care for a rural hospital in Zaria, Northern Nigeria. It’s a really cool proposal - basically coming up with a series (aka "menu") of solar lighting and power packages for different climates. Lighting is provided through led flood-lamps, power is intended for diagnostic equipment, and charging of communications equipment, with everything completely independent of the main power system of the hospital (minimizing exposure to power spikes and unwanted drainages). I think the other good thing about this proposal is that it targets emergency care - an oft-neglected and sorely critical aspect of healthcare in developing regions. For more info, there’s a flyer here and you can contact us at wheretheresnolight at googlegroups dot com.

NPR’s All Things Considered recently interviewed Nicholas de Torrente of Doctors Without Borders (the American branch of Medicins Sans Frontiers) about their recently published their top ten under-reported humanitarian stories of 2007:

• Displaced Fleeing War in Somalia Face Humanitarian Crisis
• Political and Economic Turmoil Sparks Health-Care Crisis in Zimbabwe
• Drug-Resistant Tuberculosis Spreads As New Drugs Go Untested
• Expanded Use of Nutrient Dense Ready-to-Use Foods Crucial for Reducing Childhood Malnutrition
• Civilians Increasingly Under Fire in Sri Lankan Conflict
• Conditions Worsen in Eastern Democratic Republic of Congo
• Living Precariously in Colombia’s Conflict Zones
• Humanitarian Aid Restricted in Myanmar
• Civilians Caught Between Armed Groups in Central African Republic
• As Chechen Conflict Ebbs, Critical Humanitarian Needs Still Remain

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So I’m talking to my doctor about possible drug interactions between various prescriptions and he pulls out a… (drum roll) palm treo. Oh okay so that’s probably not a major revelation.. doctors love Palm devices and have loved them pretty much since 3COM started making them back in the 90s. (Can I say that yet? Back in the 90s?) And of course my immediate reaction is to ask him what software he uses, mentioning that I’m looking into what software might be useful for rural clinics in developing countries (e.g. Ghana and Uganda and D.R. Congo). He replied: you only need one! It’s called Epocrates.. like Hippocrates, but with an ‘e’! Clever, huh? (Okay I’m paraphrasing, but only a tiny tiny bit.) Then he proceeded to show me a drug database, a symptoms database, and a diagnosis database, all hyperlinked together.

Of course - before everyone goes off running to deliver this very fine product to the masses of doctors in developing countries, there are a couple of catches. The data is very much geared towards doctors in the US, which has a number of implications. 1) Only the drugs that are available in the US are listed, and then with the US names. So, for example, many of the newer malaria medications which haven’t been approved in the US (like Coartem) won’t be there. And other drugs like paracetamol (as it is known in the UK and former British colonies like Ghana and Uganda) will be listed as acetaminophen. 2) There’s a yearly recurring cost of $100. Of course, this might not be out of reach for these doctors, and certainly is about equivalent in price to the paper versions of these reference guides, and about 1000 times more portable.. 3) The pathology is different - a doctor in the US wouldn’t expect TB, where a doctor in Uganda or Ghana would know to look for TB symptoms.

I bring all this up because I spent part of this past summer in Uganda with the 2007 East Africa Blum Fellows visiting some of the Uganda Health Information Network (UHIN) deployment sites in Lyantonde and Rakai. What struck me most was not the specific programs offered by the project (digital submission of health outpatient statistics, and dissemination of malaria and pediatric health information), but rather how they appropriated the devices, installing and sharing their own applications, and using the Excel application to track inventory and patient logs. They just drink up this data, reading whatever they can get to learn more about how they can care for the wide variety of conditions they see every day. So.. in addition to whatever information management functions I can put into place, I hope I can also help put more information in the hands of the doctors and clinicians and nurses I’m working with.

There’s of course still a lot of other issues to deal with - everything from power for recharging to the cost of the devices themselves (~$70 for a Palm, and $300 for a Palm+Mobile Treo) to maintenance and sustainability. I still want to try putting this type of information in their hands, with all of the appropriate warnings, as well as more locally specific information, like local health bulletins or Hesperian’s translated Where There is No Doctor series. Let me know if you have any suggestions for mobile health applications!

Rowena sent me this cool visualization (courtesy of Coye):

And this is why I work in Africa…

As a follow-up to my missions trip to Goma this past summer my teammates and I did a two hour presentation for our church, talking about what we did, and what we’re planning to do.

Normally I’m pretty skeptical about missions. I mean really - what depth is there to going out to beaches over spring break and walking up to random strangers to tell them about God? It’s pure proselytization. But over the past few years I’ve been taking development classes and talking to people in Ghana, and I’ve realized that missions are not purely evangelical; many of the schools and hospitals in Africa are missions in which people have devoted their time and skills towards God’s mission of feeding the hungry, clothing the poor, and curing the sick. But still.. what can one do with two weeks? Short missions trips are always ultimately for the benefit of the person going and not to the community supposedly being served.

This trip was different. We gathered together as a multi-disciplinary group of people who wanted to go to Goma to listen to the people there, to hear what needs were there, and to serve in whatever way we could. We preached, installed wireless routers, and taught workshops on how to play with children. We even painted a mural! I really think we made a difference… and I can’t wait to go back.

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Hi all,

I gave a presentation at the Blum Student Symposium last Thursday.

For anyone that’s interested, the slides (65MB) are downloadable here:

http://tier.cs.berkeley.edu/~melissa/blum-symposium-oct-04-07.ppt

The talk was about current health information practices in rural health clinics in Uganda, how PDAs have been integrated into a particular district, and our projections for what we’re working on now.

The future symposiums look really interesting (See Blum Event Calendar for times and locations):

Legal Aid Organizations and the Rule of Law in Sudan
Presentation by Mark Massoud, Jurisprudence and Social Policy Program Graduate Student
Thursday, November 1st

Media and Development in Zambia
Presentation by Laura Hubbard, Visiting Faculty, Anthropology
Thursday, November 15

Reducing Rape and Mutilation in Darfur with Fuel Efficient Stoves
Presentation by Susan Amrose, Graduate Student, Energy & Resources Group
Thursday, November 29th

Hi all,

What: Goma Adult Ministries/Global Strategies Teams Report
When: October 14, 12:15–2:15 PM or 6:30–8:30 PM
Where: First Presbyterian Church of Berkeley, G202

On Sunday, October 14th, the Goma Missions Teams (including mine) will be giving a report on the Congo, what we did, and what we’re planning to do.  We’ll have two sessions, one at 12.15pm (following the morning service at 11am) and another at 6.30pm (following the evening service at 5.05pm) You are all invited to attend - I would love for you to meet my teammates and to hear about all the things we saw and heard and did.  There will be videos and music and (gasp!) time for questions.  If you are interested in attending the service, let me know and we can meet before. I hope you can make it!

Directions to First Pres:
http://www.fpcberkeley.org/directions.asp

(Official Announcement Below)

Melissa

Goma Adult Ministries/Global Strategies Teams
October 14, 12:15–2:15 PM or 6:30–8:30 PM, G202

Partnering with the HEAL Africa hospital in the city of Goma in war-torn eastern Congo, these three teams taught classes, led retreats, offered pastoral care to victims of the conflict that continues to rage in eastern Congo, provided in-service training for nurses, enhanced the hospital’s engineering and equipment needs, participated in a sports outreach and education ministry, assisted with pastoral visitation and the palliative care of HIV patients, painted a mural in the pediatric HIV clinic and much, much more. Learn more at the Goma Team Blog ( http://gomateam.blogspot.com ).

I’m terrible with the cross-posting..

For those of you interested in my work in Goma, Congo, check out my team blog:
http://gomateam.blogspot.com

Also, for a more recent technical update, you can check out Eric Nguyen’s blog here:
http://mindtangle.net/2007/09/08/work-update/

For those of you interested in learning more about HEAL Africa, PBS is showing a documentary called Lumo on KQED Channel 9 on Tuesday, September 18 at 11:00 PM. (Those of you not in the Bay Area can check your local listings on the website: http://www.gomafilmproject.org/ ). My church (fpcberkeley.org) is also hosting a preview viewing on Sunday, September 16 at 7:00 PM in G 202.

The announcement is here.

From the call for proposals:

AITEC Africa, Africa’s leading ICT event organiser, is inviting presentation proposals for the first ever ICT for Healthcare in Africa Conference, to be held in Nairobi over 11-13 September 2007.

Delivery of healthcare services remains rudimentary in most of Africa. To achieve any of the Millennium Development Goals (MDGs) related to healthcare there is an urgent need to multiply care delivery through effective IT and communication systems. The conference will provide a platform for health practitioners, managers and ICT professionals to share knowledge and experience and identify best practices in Africa and internationally for the deployment of effective ICT systems for healthcare.

The conference will target participants from the healthcare sector across Africa:

• Ministries of Health
• Government Agencies
• Health Management Organisations
• Public and Private Hospitals
• NGOs and other development agencies active in the Healthcare Sector

The conference will cover key topics for this audience, with top African and international experts contributing strategy briefings within the conference.
Issues to be covered will include:

• Current use of ICT in healthcare provision in different countries
• The role of ICT in National Health Insurance schemes
• Telemedicine for delivery in rural areas
• Smart card technology in healthcare
• Financing and sustaining ICT in healthcare (including Asset Management)
• ICT training requirements for health professionals
• National healthcare portals
• Information security and data protection
• National communication policies & infrastructure development
• Outsourcing healthcare information management systems

To propose a presentation in the conference, e-mail the title, together with a brief outline and information on the speaker to Sean Moroney seanm@aitecafrica.com

www.aitecafrica.com