by Mimi Nicklin (@MimiNicklin) “He was pushed out of the train,” she told me. The young man’s mum explained that the train had been packed and, as the doors shut, a group of men pushed the 20-year-old firmly as the train pulled away, throwing him against the platform with force. The injured man walked himself to the clinic in his township on the way home. He waited three hours. He was prescribed Panado for “bruising”.
Three days later, the young man was in agony, with 72 hours of sleepless nights behind him and a desperation for his mother’s care that he hadn’t shown since his early teens. His mum knew his arm must be badly broken but the clinic explained (again) that they had had no means of ‘testing’ for such an injury and, without a police report, they couldn’t prioritise him for hospital. A sad state of affairs when a brush with crime is your only access to hospital care.
Eventually, after borrowing money, the mother paid to privately receive an x-ray and a cast, and her son is now healing well. She confirmed that people in her neighbourhood have learnt to ‘diagnose themselves’ so they know what to ask for from the clinic. A healthcare reality that the developed world may not fully understand, and one that is far easier with a broken arm than when diagnosing something far more serious.
All the tools, none of the trade
With the latest available data I could find, in the Eastern Cape alone, there were 83 healthcare facilities with X-ray equipment but no radiologists? This represents huge potential for healing and no opportunity to capitalise upon it. Often this is a South African reality and it is one we are fighting to overcome every day, given the lack of an even spread of health resources outside of cities. If it helps, dear reader, we are not alone in this challenge. Across developing countries, globally economic disadvantages have resulted in health care per capita spending that is almost two orders of magnitude lower than in developed countries and, in most of these countries, the health infrastructure is entirely ill-equipped to meet the increasing demand. There are 14 countries in Africa with zero radiologists. Zero radiologists?! No wonder consumers turn to their own devices (literally) to solve their woes.
What this tells us is that the biggest opportunity for healthcare providers and suppliers is to recognise the need to empower consumers (and their doctors) with tools providing more education, diagnosis and symptom-management support that allow patients to help themselves. Relying upon “the system” isn’t an option; therefore, equipping the urban hospitals with smarter machines is not making a dent in the everyday reality of consumer healthcare. There are multiple smart technological innovations that have been proposed as solutions to the crisis, but the key is in finding technologies that have high enough on-the-ground impact to make them sustainable.
Shiny and new isn’t always the answer
Smart thinking in this space came in the form of a doctor from Harvard who worked with the Eastern Cape a while back to prove that we can make tech work; however, it’s not a matter of an app or a “smart” device — it is actually a matter of looking at technology we already have and realising that new isn’t always better. By providing simple digital cameras, Photoshop and an email program, the doctor set up a system whereby SA doctors could effectively contact trained support and access the medical advice they needed to make a diagnosis from their patients’ X-rays. Unused x-ray machines miraculously came back to life and broken arms weren’t being missed.
Meanwhile , a “hole-in-the-wall” ‘ATM’ machine that dispenses antiretroviral drugs is being piloted at Thembalethu clinic in Johannesburg which allows consumers to dispense their own drugs via their own information-loaded ‘ATM’ card. No more five-hour long lines and missed shifts at work. The machine has its own power source and a link via a webcam to a centre where there will be a pharmacist on call, if needed. The e-pharmacy concept has sustainably been adapted for Africa, ladies and gentlemen.
Those at the top of the Silicon Valley tree are quick to point to brand-new tech to fill the gaps but the healthcare focus should be centered upon simple reinterpretation of technology that reaches the masses. In developed markets, medical tech is all about insurance companies’ premium offerings, smart-tracking devices and improving wellness data. In SA, we need to start with the tech that gives people a chance of curing themselves. They may not be able to administer the medication alone but, with a smart starting point, they stand a better chance of getting someone — anyone — to listen.
Mimi Nicklin (@MimiNicklin) has spent a decade in the advertising industry working across global brands in Europe, Asia Pacific and Africa, mainly within WPP. She most recently led GlaxoSmithKline business as global VP for Grey Group, based in Singapore. She relocated back to South Africa recently as a marketing consultant and to found her own business, www.merakicode.net, in integrated health and yoga therapy, inspired by her time in the east. Her regular MarkLives column, “The Surgery”, tracks consumer healthcare communications to drive awareness and passion for this growing creative and dynamic consumer industry within Africa and beyond.
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