Mobile devices are vital for health care, especially for African communities that are many miles from clinics, say several scholars who recently visited the University of Wisconsin-Madison.
“I tell people tech will take over,” says Sicily Mburu, a public health consultant in the Kenyan government under the Ministry of Health.
Mburu was one of 25 leaders from 19 African countries who were brought to the UW-Madison in summer 2016 as part of the Mandela Washington Fellowship, a program under President Obama’s Young African Leaders Initiative (YALI). Several of the public health leaders have a keen interest in using technology to improve access to health care, including Mburu. Her peers, Babafemi “Femi” Adebola from Nigeria and Julius M. Gilayeneh from Liberia, also understand that technology can transform care.
“I tell people tech will take over.”—Sicily Mburu, Kenyan physician and public health consultant
One of the key issues facing rural African communities is a lack of nearby clinics. With poor roads, far-off clinics and a lack of connection between rural communities and medical hubs, people may walk 20 hours to a hospital only to find the medication they need is not available or they cannot get in to see the doctor. In several African countries, including Kenya where Mburu says mobile phone network coverage is “remarkable,” technology offers a solution.
Based on Pew data from Spring 2014, 82 percent of people in Kenya and 89 percent of people in Nigeria own a cell- or smartphone. “People know the importance of communication,” Mburu says. People with barely enough money to live on will often have two mobile phones because of their value as a source of information and a platform for mobile banking.
In Nigeria, “the average person can afford a phone but not hospital bills,” says Adebola, an emergency medicine physician. “If people have access to a phone, they should have access to a doctor.”
Using mobile to thwart AIDS
Mburu founded AIDS No More, an awareness organization based in Kenya, to improve access to care in young people in both urban and rural communities. The organization, which began with youth volunteers engaging others in discussion on the HIV/AIDS epidemic, is now expanding its reach with a cell phone texting service. The new service will be used together with ongoing social media initiatives to educate more young people and provide an outlet to overcome the stigmas of the disease.
“If young people register with AIDS No More, they can ask us very specific questions over text,” Mburu says. “We can answer their concerns, direct them to places for treatment and send reminders for medications and clinic visits.”
Many times the stigma and discrimination against carriers of HIV/AIDS prevents people from seeking medical attention or asking questions, Mburu says. “This first obstacle is what we aim to overcome.” Through social media, AIDS No More also allows an open, and if-desired, anonymous, platform for discussing the disease.
While anonymity is always respected, Mburu hopes that creating a space for conversation and sharing other’s stories on @AIDSNoMore will educate the community and reduce the shame of talking about the disease or walking into a clinic. “We have seen remarkable open attitudes once we link (patients) up with health care personnel. They come out to share their experiences,” Mburu says.
Taking advantage of mobile-friendly infrastructure in Nigeria
Similar efforts are being implemented in Nigeria, one of the most mobile-friendly countries in Africa, where traveling to clinics and the cost of medical services also limits access to care.
“If people have access to a phone, they should have access to a doctor,” Babafemi “Femi” Adebola, Nigerian physician
Taking advantage of mobile, Adebola co-founded the HiDoctor app to provide free access to health information for Nigerians. A doctor responds when patients call HiDoctor and follows up as the patients get to a health care facility.
Maybe a child is convulsing and parents wonder what can they do. Through the app, the doctor on call will tell them how to help their child and also direct the family to the nearest care facility. “We don’t prevent people from going to the hospital,” Adebola says. “We still recommend getting to the hospital and show them reasons to do so.”
Looking forward, Mburu and Adebola plan to improve their use of technology. Mburu and her co-founders at AIDS No More hope to include information on additional medical needs beyond HIV/AIDS, along with expanding into Mozambique, where the prevalence of HIV is high, particularly among young women. The HiDoctor team hopes to expand their reach by recruiting more doctors.
Seeing opportunity in Liberia
While Mburu and Adebola have already tapped into mobile’s potential in Kenya and Nigeria, Julius SM Gilayeneh dreams of bringing up-to-date technologies into the Liberian health care system.
“Simple investments in mobile technology can make a very big difference in infrastructure.”— Julius SM Gilayeneh, physician, Liberia
“We need to invest in our countries and see technology as one of the most efficient and effective ways to improve the health care system,” says Gilayeneh, one of two medical doctors at Chief Jallah Lone Medical Center in Gbarpolu County. Working in such a remote county in rural Liberia, Gilayeneh is particularly keen on the benefits of mobile health care services such as texting or calling to ask doctors for advice.
“Simple investments in mobile technology can make a very big difference in infrastructure,” he says. “We must look beyond the physical infrastructure and make sure (doctors) are accessible. We need to provide the appropriate technology first.”
Travel is always an issue, as medical hubs are not often near rural communities. Other than improving the road networks, Gilayeneh believes that technology can eliminate unnecessary lengthy trips by tracking where medications are available.
Having medical professionals discuss symptoms and care over mobile phones also eliminates the immediate need to travel by “helping people make the right decision about where to go and when to go,” he says.
Before mobile technology can be fully implemented, however, Liberia needs to expand its mobile infrastructure. One of the leading communications companies in Liberia started a mobile health initiative to connect patients to doctors via phone calls, but with such poor cellular reception and the high cost per minute, the service is not as beneficial as it could be. “More than 60 percent of the rural communities do not have network coverage,” Gilayeneh says.
With expanded network coverage, Gilayeneh is confident technology can improve care. “Where technology has been used to increase access to health services, the outcomes have been good,” he says, adding without the technology, communities will continue to struggle. “I fear we may in the future have something worse if we don’t get the technologies very soon.”
By Lily R. Hansen / December 4, 2016