Medicine and technology in developing countries.

courtesy google images

It's a new age in the world today. It is called the information age, riding on the back of technology, internet and it's applications in the world.

Gone were the days when everything was analogue, I mean humans have to say everything, write everything and do everything. The days are here when recent technology capable of improving productivity are taking over previously difficult and laborious jobs. In fact in some areas, technology does it much better. Needless to say that some things are only possible through technology, but better technology are replacing them.

While the High-income countries have their healthcare system riding on the wings of technology, middle and low-income countries are not having it so smoothly.
Some countries have successfully digitized their patient records, appointment scheduling, laboratory reporting, and many other things being automated. It may be surprising that other countries are still struggling with the old ways of doing things which bring with it inefficiency and inaccuracies among other disadvantages.

The question of how technology has been shaping the medical landscape has a gold mine of answers. It has been applied in the clinical and the non-clinical aspects of patient care.
Firstly Patient records are being digitalized which makes it easier and faster to retrieve, process and also allows for safe long term record keeping which will be useful for studies in a hundred years to come.

Electronic patient record (EHR) also brings with it the ability to make an electronic prescription where the patients only go to the pharmacy to pick up the medications. With digital record keeping comes the advantage of helping care providers to guide against mistakes in diagnosis and dosing of medications. It also helps in making a quick and accurate referral.

This is looking very interesting if only we could adopt this in developing countries starting from the cities to the villages.

I‘ve only talked about one application of technology in healthcare and we are already salivating at an awesome possibility that awaits healthcare in Africa if only we could start soon.

The current realities:

African health system mostly has not changed since the 1950s when the missionaries gave us a template. Right now when you come into the hospital, you come without an appointment even though it’s not an emergency. The hospital might not have prepared for you or it might just fall into a day where every available doctor is very busy. The result is you are stressed, you spend a lot of time waiting and you stand a risk of being seen by a tired doctor or exhausted nurse on duty because of high workload. I have not even talked about the cumbersome process of opening a new hospital record card or retrieval of your old case note especially when you come without an appointment.

The challenges

• Most hospital's manpower is not skilled enough to work in a changing environment like an e-health enabled environment.
• The rate of illiteracy is quite high in Africa, which means a high-tech system may only help the ones who could read and write.
• Technology adaptation is helped by infrastructure backbone. In the case of Africa, the most important infrastructure (electricity) is not universal. Countries like Nigeria are worst hit with epileptic power supply and the high cost of diesel to power the system.
• High cost of initiation: The initial cost of deploying hard and software for facilitating paperless patient care may be costly considering that most are imported and the health budget for some countries simply can’t sustain that.

Possible solutions:

• Train and retrain health care providers from top to bottom, let their minds and hands be prepared for a positive change. Budget for targeted training. Let those who can’t be trained find another job in the system.
• Educate patient or provide help points for patients who are not literate but needs to do some writing, typing etc. After all, almost all banks are computerized and people who are not learned still access banking. The old and the new system can also be allowed to flow alongside. Most people will be forced to learn the new when they see its benefits. Furthermore, long-term effort should be made at reducing illiteracy. That can be done in just 30 years in a serious system.
• The problem of infrastructure must be settled. The first infrastructure to be fixed should be the electricity. No one should be in darkness in the 21st century. No nation will move forward in darkness.(lack of regular, accessible and affordable electricity)
• The government should invest in e-health. They should move from policy to implementation. Capital should be released and monitored to prevent stealing and corruption. Pilot projects should be run with a few hospitals and later scaled up. NGOS and multilateral organizations will be willing to help a country that is serious.

This is a long read, but I’ve only just started an eye-opening series.
Watch out for other articles on medicine and technology.
Please kindly leave your comments and questions. Together we can move African health system forward.