Improving Healthcare in Rural AreasWhether it’s a smartphone or a calculator, many people have technology right at their fingertips. With the world continuing to advance technologically, rural areas tend to be left behind. However, some technological advancements are benefitting rural areas in particular. Technological advancements in the medical world are saving lives and improving healthcare in rural areas.

5 Technologies Improving Healthcare in Rural Areas

  1. Virtual health services Virtual health services launch the list as one of the most popular, accessible healthcare advances. Prior to telehealth technology, all prescriptions were provided by a live pharmacist. Today, patients may communicate with their doctors and request prescriptions remotely. Live chat and video rooms provide healthcare for remote patients from the comfort of their homes. A recent survey found around 67% of U.S. adults are willing to try virtual healthcare; although, only around 20% have tried telehealth so far. It seems telehealth is here for good and here to stay.
  2. Virtual reality – Virtual reality is also improving healthcare in rural areas. Purdue University created augmented reality technology that may assist inexperienced doctors and surgeons. This newly emerging technology allows a more experienced medical professional to see the patient and lead the responder through the procedure. Preliminary trials show doctors in rural areas benefit from virtual reality technology. With fewer tools and materials to work with, feedback from a better trained professional can be critical. Juan Wachs, the leader of Purdue’s augmented reality research team, hopes that this new technology will decrease “the number of casualties while maximizing treatment at the point of injury.”
  3. 3D printing – Another healthcare advancement that benefits patients in remote locations is 3D printing. Before 3D printing became widespread, prosthetics would take weeks to make and could cost as much as $15,000. While the price of a prosthetic varies, 3D printing greatly reduces the cost. For example, biomechanics professor Dr. Jorge Zuniga from the University of Nebraska 3D printed a prosthetic hand for around $50. When 3D printing emerged, not only did prices decrease significantly, so did production time. A Canadian company called Nia Technologies predicts that a 3D printed model can be done in six hours. Therefore, 3D printing is particularly beneficial to patients in need of urgent care or with limited funds. As a result, advancements in prosthetic production benefit people in both rural and urban areas.
  4. Electronic medical records (EMRs)EMR is a networking system created by Sanford Health in South Dakota. EMR keeps track of patient and treatment data. This database helps establish a standard treatment for common medical conditions. Additionally, EMR reminds medical professionals to follow up with their patients. For example, if a nurse finds a patient has high blood pressure, EMR prompts the nurse to follow up with their patient, ensuring the patient checks in with their primary care provider. So far, Sanford Health’s EMR program has been implemented at 45 hospitals and over 300 small clinics; about two million individuals living in the Dakota areas are benefitting from the EMR platform. Technology like EMR may be used to increase efficiency and quality of treatment in other rural areas as well.
  5. Mobile Stroke Units (MSUs) Mobile stroke units also benefit patients in rural areas. An MSU is an ambulance-like vehicle that specializes in diagnosing and caring for patients who suffer from strokes. In places like rural Australia, MSUs are crucial for patients since strokes require urgent care. While 77% of urban patients have access to stroke units in hospitals or clinics, only 3% percent of rural patients have access. With the aid of Mobile Stroke Units, rural patients have a better chance of getting critical care in time.

Because rural areas are difficult to reach, healthcare is often less accessible. Travel costs are a barrier to healthcare, particularly for people in poverty. However, innovative technological advancements like these continue to improve the quality, cost, and accessibility of healthcare in rural areas.

Karina Wong
Photo: Flickr

Women During COVID-19Amidst the COVID-19 pandemic, women have assumed positions of leadership in several fields to fight the virus. Women work hard at home to take care of their families, while also constituting a majority of those on the front lines in the global healthcare industry. They are discovering innovative new ways to generate income through agriculture, and are even manufacturing masks in refugee camps. Here are a few of the many heroic responsibilities undertaken by women during COVID-19.

Women at Home

Worldwide, almost 22% of women care for their families through unpaid labor, while only about 2% of men provide this kind of care. As caregivers at home, women play a crucial role in maintaining the safety of their families and communities. This task goes well beyond managing others’ physical health; women cook, clean, supervise children and elders and gather resources like water and wood. In addition, with lockdown measures, kids and other family members are home more often, increasing demands on these women.

Women in Healthcare

During the COVID-19 pandemic, women have taken the lead in providing medical care for patients. Because women make up 70% of the global healthcare and social services industries, many women have now become essential workers and hold the huge task of caring for patients, often at the expense of their own safety.

Healthcare workers like Dr. Entela Kolovani of Albania have been treating patients day and night since the pandemic hit in March. Women in healthcare are juggling several roles as they take care of those who are sick while trying to avoid endangering their families. Women are working longer hours and facing new challenges every day. In describing her nurses, Dr. Kolovani said, “Their work never ends, from making up the beds of patients, to performing therapies, taking tests and filling in documents. I am so deeply grateful to them.”

Women in Agriculture

The role of women during COVID-19 is not just limited to the healthcare field. Globally, nearly one out of every three women are employed in the agricultural industry; women in rural settings have inspired their communities to take safety precautions and earn income through farming. For example, in northwestern China, women in rural villages are ensuring compliance with social distancing practices are met and learning the trade of pig farming to earn extra income for their families. One such woman, Yan Shenglian, is training other women in this trade and teaching them the importance of women in the agricultural sector during COVID-19.

In addition, women in Cote d’Ivoire worked with UNICEF and the World Food Programme to spread health and sanitation measures to other women farmers. Along with the work already being done to encourage efficient farming practices, women in these rural villages are prioritizing food security and safety during COVID-19.

Women as Refugees

Of those affected by the pandemic, refugees have been disproportionately impacted. Nearly 80% of refugees are concentrated in low-income countries, where access to proper sanitation and basic resources is limited. As nearly half of all refugees are girls and women, the effect of COVID-19 on women refugees is especially high. However, these individuals have also stepped up to fight the pandemic. In partnership with the U.N., Rohingya women in the world’s largest refugee camp have made more than 50,000 masks for distribution. This initiative involved almost 50 families with female breadwinners, allowing these women to bring additional income to their families and teaching lasting leadership skills.

Looking Forward

Women have stepped up to lead the fight against the pandemic in a plethora of ways. They are keeping communities safe while generating income. These are just a few examples of the many critical roles adopted by women during COVID-19; there is no doubt that their presence will continue to be instrumental throughout the pandemic and beyond.

– Anita Durairaj
Photo: Unsplash

measles in democratic republic of congoThe Democratic Republic of the Congo declared a measles outbreak in June 2019. Since then, more than 310,000 have been affected by this epidemic. Measles is an extremely contagious and airborne disease that can cause rashes, fevers and coughing. The virus is especially dangerous for children. Most developed countries can combat measles through vaccinations, but developing countries aren’t able to fully eradicate and achieve a herd immunity of a sizeable population majority, leading to constant outbreaks.

How COVID-19 is Affecting the Situation

Due to COVID-19, more than 117 million children could not receive their measles vaccine following the halt of vaccination campaigns. Measles may kill more people in developing countries than COVID-19 if outbreaks continue. At least 6,500 children have already died from measles in the DRC. Most world leaders are focusing on COVID-19 rather than the vaccine-preventable diseases that could potentially wreak havoc on developing nations. The Democratic Republic of the Congo is currently leading the world in the highest numbers of measles cases. This trend is likely to continue without significant aid and the continuation of vaccination campaigns. The DRC also has an incredibly weak healthcare system, so it greatly relies on NGOs and foreign aid to administer vaccines & life-saving medicines to the country.

Other Diseases in the DRC

In addition to measles, the DRC is currently combating cholera, polio, COVID-19 and Ebola. “On June 1, 2020, the Democratic Republic of the Congo declared its eleventh Ebola outbreak.” This is before the tenth outbreak was declared over on June 25, 2020; however, WHO has stated that these two outbreaks are separate. Due to the limited resources caused by the COVID-19 pandemic, this outbreak will be harder to contain than previous outbreaks.

In the past, multiple Ebola outbreaks have drawn more attention than the measles in the Democratic Republic of the Congo. Now, COVID-19 is drawing more attention than measles. However, all three diseases need to be dealt with alongside the other diseases harming the DRC. During an Ebola outbreak in earlier months, measles was overlooked, which led to a resurgence. Measles in the Democratic Republic of the Congo must receive the attention necessary to combat it. In addition to the disease itself, the DRC is also suffering from malnutrition, food insecurity and economic uncertainty. All of these factors make the population more vulnerable to other diseases, particularly children.

How To Help

The best way to help combat measles in the DRC is to ensure vaccination campaigns can start again. An increase in foreign aid will help the nation reach this goal. The DRC needs to achieve 95% vaccination to recover, but that goal seems incredibly unlikely due to the current COVID-19 panic. With the majority of the world also focused on COVID-19, it is unlikely that the DRC will receive all the international aid they require at this time. An additional $40 million will be needed on top of the $27.6 million received to successfully fight measles in the Democratic Republic of the Congo.

Organizations like Doctors Without Borders are continuously working to fight measles outbreaks in DRC. As of June 2020, the organization has succeeded in vaccinating 82,000 children after “three back-to-back campaigns.” Doctors Without Borders cautions the world that measles cannot be ignored even with the current COVID-19 crisis. They are taking extra precautions during this time to reduce the risk of co-infection.

While COVID-19 is an important and urgent issue, it is imperative that leaders continue to send help to those abroad struggling with the fall-outs of poverty whenever possible. Measles in the Democratic Republic of Congo is one example of how important foreign assistance and vaccination campaigns are in saving lives in developing countries.

– Jacquelyn Burrer
Photo: Flickr

healthcare in Chad
Chad is in the top ten countries for oil production in Africa. However, very little of the revenue of oil sales goes into improving the living conditions and healthcare in Chad.
 In Chad, it is reported that 66% of the population is living in poverty. The World Bank reported in 2018 that 88% of the Chadian population does not have access to electricity. Additionally, it is estimated that 44% of the population does not have access to clean drinking water. These factors create obstacles for the healthcare system. Here is what you need to know about healthcare in Chad.  

Access to Health Services 

Chad has a very low number of healthcare professionals. The World Health Organization reported that there are 3.7 doctors per 100,000 people. This number is well below the global average of 141 doctors per 100,000 people. The number of healthcare professionals remains low in Chad due to the many insecurities the Chadian population faces. Due to ongoing violence, 122,312 people have been internally displaced in Chad. This factor causes an obstacle that inhibits the population from seeking education and training. 

Chad spends approximately $30 per capita on healthcare. Spending on healthcare in Chad fell by $14 per capita from 2014 to 2017. The decrease in funding has caused many healthcare facilities to be poorly equipped and unable to pay healthcare workers, leaving the Chadian population with minimal access to medical services. 

Maternal Health 

Maternal health is considered to be a major indicator of the strength of a healthcare system in a country. Currently, in Chad, 80% of births are not attended by a skilled professional, whereas in the United States, only 1% of births are not attended by a skilled professional. This lack of access to maternal health professionals causes Chad to have one of the highest maternal mortality rates in the world. In 2017, the World Health Organization reported the mortality rate in Chad to be 1,140 deaths per 100,000 live births. This number is far higher than neighboring countries such as Sudan and Libya, who have mortality rates of 295 and 72 deaths per 100,000 live births, respectively.

The lack of access to maternal healthcare in Chad is made more severe by many young teenage girls becoming pregnant in Chad. UNICEF reported that 68% of girls below the age of 18 are married and under five percent of these girls have access to contraception. The World Health Organization cites that maternal complications are the leading cause of death in girls aged 15 to 19 years old. Mothers under 18 years old are also more likely to experience systemic infections and neonatal complications. These complications can become fatal to young mothers in Chad due to the lack of access to maternal health services.  

Malnutrition

Chad experiences some of the highest levels of malnutrition in the world. In the central Chadian town of Borko, almost half of all child deaths are due to malnutrition. Also, 40% of Chadian children experience growth stunting due to a lack of access to food. Chad goes through periods of severe drought causing food insecurity and lack of income for many families. The Alliance for International Medical Action (ALIMA) has set up a hospital in Chad. ALIMA reported that the malnutrition ward is overrun and the organization had to expand malnutrition treatment services to cope with the demand. 

The Burden of Diarrheal Disease

Diarrheal disease is among the leading causes of disease burden in developing countries. In 2017, diarrheal disease caused 1.6 million deaths globally and 528,000 of these deaths occurred in children under the age of five. In Chad, mortality due to diarrheal disease is 300 per 100,000 people. Chad’s diarrheal mortality rate is higher than the mortality rate observed in developed countries, which is reported to be 1 per 100,000 people. Diarrheal diseases are perceived to be treatable; however, they are highly fatal in Chad due to the lack of healthcare services.

Healthcare Improvements

Due to the instability in Chad, external organizations are working to improve the living conditions and access to healthcare in Chad. The Bill and Melinda Gates Foundation has partnered with the United Nations to provide immunizations and sanitary facilities to Chadian children. The initiative aims to decrease the mortality rates of diarrheal disease and other communicable diseases such as measles and pneumonia. 

Doctors Without Borders is another organization working to improve the conditions in Chad. The organization is currently running projects in six different areas around Chad. In 2018, these programs conducted 142,400 health consultations. Doctors Without Borders focuses healthcare efforts towards treating and preventing malaria, HIV/AIDS and malnutrition.  

The World Food Programme has established the School Meals Program to help decrease childhood malnutrition. The program ensures that all children at elementary school receive a hot meal throughout the school day. The program also encourages families to send their daughters to school by giving girls in grades five and six a ration of oil to take home. The School Meals Program aims to feed 265,000 elementary-aged children.

Healthcare in Chad faces many challenges regarding the high burden of disease, political instability and low availability of healthcare training. With a heavy reliance on outside organizations, the Chadian healthcare system needs to improve to be able to effectively tackle these challenges. Healthcare in Chad requires foreign aid funding to be able to increase access to healthcare and properly train medical professionals. The United States currently spends less that one-percent of its annual budget on foreign aid. With increased funding, the United States government has the power to increase healthcare for the Chadian population.

Laura Embry

Photo: Flickr

Improvements in Healthcare in Syria
The Syrian Arab Republic (more commonly known as Syria) is a Middle Eastern country fraught with danger and grief. It has claimed the news headlines for the past decade. Its violent civil war has led to a shattered government with little to no control over its infrastructure and a diminished ability to provide services to its 17.5 million citizens. Proper healthcare in Syria, especially care focused on women and children, has been a service that suffered. UNICEF is a leading organization that is spearheading efforts in Syria to improve healthcare for women and children. These efforts have led to significant improvements in the health and well-being of both women and their children as years have passed.

Improvement in Numbers and Data

One of the easiest ways to identify the improvements in healthcare in Syria lies within the raw data. The life expectancy of Syrian citizens is one major indicator of healthcare improvements. In addition, life expectancy at birth is steadily increasing in Syria. It reached 71.8 years in 2018 after several years of declining numbers after 2006. This indicates a slow but steady return to its peak in 2005 when life expectancy was 74.43 years of age.  This new incline could be due to a variety of factors. However, healthcare is definitely an important piece of the puzzle in improving life expectancy in a nation’s population.

Both infant deaths and neonatal deaths are steeply declining in Syria. Infant deaths have nearly halved since 2000, with numbers of deaths falling from 10,099 to 5,994 in 2018. Moreover, neonatal deaths have lowered from a peak of 8,804 in 1982 to an all-time low of 3,740 in 2018. These two statistics indicate that even at the earliest stages of life when people are the most vulnerable, healthcare in the Syrian Arab Republic is positively progressing in protecting the fitness of its citizens.

Improvements in Female and Child Care

Both women’s and children’s healthcare have seen an uptick in quality in the past few years. UNICEF supported primary healthcare in Syria for more than 2.2 million women and children despite the country’s crisis and war. For instance, the opening of 61 clinics targeted at displaced or deprived communities allowed for 56,000 vulnerable people (20,000 of whom were children) to receive vaccinations and newborn care. Additionally, UNICEF has provided guidance to hundreds of thousands of people, among them 600,000 caregivers, on proper dietary balance and diversity. This effort led to 1.8 million women and children receiving screening for malnourishment. Among those, 11,500 children were able to receive life-saving treatments for malnutrition. With this new training and healthcare infrastructure beginning to take root in hard to reach places within Syria. Women and children will hopefully have an even better standard of life to look forward to.

The data and efforts to date have significantly impacted Syria’s healthcare system. However, it is important to note that all of this progress is occurring despite a lack of assistance from large funding sources. Therefore, it is imperative that Syria receives enough support via other means to ensure that this progress can continue without experiencing delay or derailment. This is a nation in trouble. However, with aid and care from people and organizations like UNICEF, healthcare in Syria could finally know relief.

Domenic Scalora
Photo: Flickr

Healthcare in Paraguai
Healthcare in Paraguay has improved tremendously over the past decades. The life expectancy of both males and females has increased by about 10 years since 1990. In the same period of time, the mortality rate of children under 5 years old decreased from 34.6 deaths to 14 deaths per 1,000 live births. Still, many communities remain underserved and face the repercussions of limited access to healthcare.

The Rural-Urban Divide

The improvements in Paraguay’s healthcare system have occurred mostly in urban areas. This makes sense considering that more than 60% of Paraguay’s population lives in the urban perimeters of Asunción and Ciudad del Este. In fact, about 70% of healthcare workers operate within the Greater Asunción area.

In contrast, rural populations do not receive the same access to healthcare. While the more rural regions located to the West of Asunción represent 61% of the national territory, only about 31% of the national paved road network reaches these regions. As a result, transportation from isolated rural communities to urban areas with better access to healthcare is not an easy feat.

The Family Health Units and Coverage

In 2008, the Ministry of Public Health and Social Welfare created family health teams to carry out healthcare in a coordinated, comprehensive and continuous manner. Each team is organized in Family Health Units (USF in the Spanish acronym) and serves the populations to which they are assigned. These teams must provide consultation, home care and ongoing medical evaluation to their communities.

While USFs have successfully improved the health of urban populations, they have largely left behind those who live outside of urban centers. For example, only about 50% of the Alto Paraguay residents have USF coverage.

The following reasons help explain this disparity in USF coverage between city and country areas:

  • Rural areas generally have low population density and exist between small towns. Therefore, providing USF coverage to many rural communities can be inefficient and challenging.
  • Many healthcare workers who are originally from rural areas often decide to either move to urban areas or leave Paraguay completely due to the poor working conditions and precarious employment contracts.
  • There are few incentives for healthcare workers to practice in rural areas.

As a result, rural areas, where poverty rates are the highest, are also most susceptible to experiencing USF shortages.

The maternal mortality rates (MMRs) by region reflects the disparity in USF coverage. In 2015, the rural areas of Boquerón, Amambay and Canindeyú recorded MMRs of 347, 190 and 167 per 100,000 live births, respectively. This data stands in stark contrast to the average MMR of the entire nation which is 132 per 100,000 live births. Clearly a significant imbalance in healthcare access exists between geographic locations in Paraguay.

Addressing MMR in Rural Communities

Several initiatives emerged to address this problem, although some deemed some of them unsuccessful. The Maternal Health and Child Development Project, which operated from 1996 to 2004, aimed to improve the health of mothers and their children in underserved areas. As the World Bank notes, the outcomes of this project were unsatisfactory.

A joint project between the Pan American Health Organization (PAHO) and the World Health Organization (WHO) is currently in effect with the goal of strengthening the care of mothers and children and improving responses to obstetric emergencies. PAHO and the WHO implemented this project in 19 municipalities across Bolivia, Argentina and Paraguay, reaching approximately 400,000 people. It is too early to discern the impact of this project as it only emerged in 2017. Nevertheless, since it only serves a few municipalities in Paraguay, many rural, underserved Paraguayan communities have not received the assistance necessary to improve their MMR.

The COVID-19 Pandemic

In spite of the challenges Paraguay faces in terms of its healthcare system, the country has kept COVID-19 under control in rural and urban communities alike. As of July 19, 2020, there have been confirmations of 3,721 cases and 31 deaths in a country with over 7 million people. One can attribute this successful containment of the virus to the government’s quick and effective response. The first COVID-19 case in Paraguay received confirmation on March 7, 2020, and the country went into full lockdown on March 20, 2020. While the country is not in the clear yet, Paraguay is among the most healthy South American countries with regards to COVID-19.

Bringing Healthcare to Rural Areas

The situation for rural regions, however, is not hopeless. Since urban areas observed significant successes in healthcare through the implementation of the USFs, one could reasonably apply similar tactics to rural areas. Having said that, the biggest hurdle in bringing healthcare access to rural areas will be providing incentives for healthcare workers to settle in areas with low population density.

Luckily, in 2010 the Ministry of Public Health and Social Welfare launched a rural internship program that incentivizes doctors to work in rural areas. As a result, the concentration of healthcare workers in rural areas should increase as more doctors graduate from medical school.

Nevertheless, the Ministry must continue to pay special attention to rural areas, especially those where impoverished and indigenous people reside. The healthcare system has historically underserved these communities while urban, wealthier communities continue to experience improvements in healthcare. In order to provide healthcare for all residents of Paraguay in an equitable manner, the government must ensure that all Paraguayans can receive the same basic healthcare regardless of geographic location.

There are certain challenges that should receive special attention as Paraguay continues to improve its healthcare system for residents. Many regions still struggle with maternal mortality, especially in rural areas. In addition, viruses that mosquitoes transmit, such as Zika, chikungunya and dengue, cause intermittent regional epidemics. Lastly, about 18,000 people in Paraguay live with HIV or AIDS. However, given the government’s swift and effective response to COVID-19 as well as the success of USFs across the country, these challenges certainly are not insurmountable. If USFs expand significantly into underserved areas, Paraguay should be better able to effectively handle these health challenges.

– Alanna Jaffee
Photo: Flickr

India is the second-largest country in the world and covers an area of over 1.269 million square miles of land. With agriculture being the main occupation in India, 66% of the country’s population inhabit the rural landscape, and only 34% of the population lives in the urban regions. There are very few doctors and healthcare providers who volunteer to relocate to villages to provide healthcare. While 67% of the doctors live in cities, only 33% of the doctors serve the rural population. Therefore, healthcare is not equally accessible to the entire country. People from various remote places still have to travel several miles before reaching a healthcare provider. The WHO recommends the doctor to patient ratio to be 1 doctor for every 1000 people, while a government doctor in India, on an average, attends to 11,082 patients. To make healthcare available evenly to the entire population and to prevent overburdening of the doctors, technologies have become indispensable. Major cornerstone technologies of Indian healthcare have been used to improve equity in healthcare access.

4 Cornerstone Technologies of Indian Healthcare

  1. Mobile AI radiology inferences: One-fourth of the world’s tuberculosis patients live in India and are more concentrated in the villages. NCR, a renowned hospital in Delhi, along with the government of Haryana, developed a mobile van that conducts digital chest x-rays as it travels through several villages. These x-rays are later processed using Artificial Intelligence (AI). This initiative was successful in identifying 244 tuberculosis patients in the first three months. This technology played a vital role in providing a timely diagnosis to people with inaccessible and unaffordable healthcare beyond geographical barriers.
  2. Smart clinics: Biocon, an Indian pharmaceutical company, has developed smart clinics named ‘eLAJ’ in rural areas of Karnataka and Rajasthan. When a timely diagnosis of diseases occurs at the primary healthcare centers, the burden on the secondary and tertiary healthcare centers will reduce significantly, and ailments in several patients can be proactively diagnosed before they become severe. Hence, these smart clinics specialize in primary healthcare by digitizing medical records (Electronic Medical Records) of the patients and making them available on distinctive, real-time dashboards. These EMRs help monitor the outbreak of diseases over various regions so that a clinic or relief camp can be set up where it is most needed. The records are also connected to the Aadhar cards (government-issued unique identification number) of the patients so that their health history over long durations are centrally available to any physician at any given place or time.
  3. iBreastExam: iBreastExam is an FDA-cleared tool that has been in operation since 2015. It consists of a small wireless sensor, marginally bigger than a barcode scanner, with 16 sensors to detect tissue stiffness in women’s breasts. The results are relayed in real-time to a mobile app. The test costs only four dollars and isn’t painful or time-consuming. The effectiveness of this tool was established in a study involving 900 women in Bangalore.
  4. e-Aushadi: e-Aushadi is a drug procurement, storage and distribution company. The company keeps real-time, electronic data about the quality and quantity of drugs stored in several warehouses of various districts. These records ensure that no medicine is in deficit and that they are continually restocked, so quality medicines reach the customers on time.

The Indian government has realized the potential and indispensability of technology in healthcare. It has proposed to increase the healthcare expenditure from 1.3% of the GDP to 2.5% of the GDP by 2025. The Rajiv Arogyasri program in Andhra Pradesh requires all hospitals to have computers with an internet connection to maintain electronic medical records. This program provides interest-free loans to make sure that all the hospitals are equipped with the necessary technology. Nearly 5000 startups are involved in developing healthcare technologies in India and raised a total of $504 million from 2014 to 2018. Despite being a developing country, India is advancing in healthcare technologies and has room for more innovative ideas to evolve. These four cornerstone technologies of Indian healthcare are just a start.

– Nirkkuna Nagaraj
Photo: Unsplash


In 2017, Australia’s medical system was ranked 2nd globally by The Commonwealth Fund. The country scored well on care, efficiency and health outcomes. However, the Australian health care system scored poorly on equity of care across the population.
Those largely affected by the healthcare discrepancy are members of the indigenous community. Australia is working to decrease the inequity in Aboriginal healthcare. 

Health Challenges for the Aboriginal Healthcare

The average lifespan for indigenous Australians is about 71.4 years, which is 10 years lower than the life expectancy of non-indigenous Australians. About two-thirds of the indigenous population die before the age of 65. Only 19% of non-indigenous people die before 65. Indigenous children under the age of four are also twice as likely to die than non-indigenous children. The common issue of chronic disease is a burden across all age groups of the indigenous population. Indigenous peoples are also over twice as likely to struggle with issues such as addiction and diabetes.  

 The National Aboriginal Community Controlled Health Organisation (NACCHO) reports that the problems facing the Aboriginal healthcare system come from five major health concerns. These five health factors are injury, mental disorders (including substance abuse), cardiovascular disease, respiratory diseases and cancer. Many of these major health concerns are considered to be preventable

 Another discrepancy in Aboriginal healthcare is access to maternal health services. In 2016, 40% of indigenous women lived in very remote areas of Australia, where the access to hospitals equipped with a birthing ward is very low. Women were forced to travel long distances in order to access birthing services. The Australian Institute of Health and Welfare cites that access to “culturally appropriate” care is a major barrier to women seeking maternal services. However, the Australian government has taken a new approach to bring healthcare to indigenous Australians.

The Aboriginal Community Controlled Health Services Initiative (ACCHS)

In Australia, healthcare centers operated by the local indigenous community have shown success in providing medical services to the Aboriginal population. ACCHS aims to provide healthcare to indigenous communities in a way that fosters ongoing medical relationships. These relationships between Aboriginal healthcare providers and the Aboriginal community have been 23% more effective in retaining patients when compared to other healthcare centers. NACCHO believes that a major factor in patient retention is that ACCH centers provide a sense of “cultural safety” within its healthcare practices.

In 1970, the first ACCHS was established and, as of the year 2020, over 140 ACCHS centers are now being operated around Australia. ACCHS centers currently address 61% of the healthcare demands of patients in regional communities. The use of ACCHS centers is continuously growing within the Aboriginal population, demonstrating the success of the initiative. Over a span of 24 months, the NACCHO reported an increase of 24,030 patients.

The Future of ACCHS and Indigenous Communities

The ACCHS initiative also provides opportunities for regional and remote Aboriginals to gain entry into the healthcare profession. The census in 2006 reported that 99% of healthcare workers out of all of the Australian medical workers are not of indigenous descent. Over half of ACCHS workers are indigenous, however, many of these workers are non-clinical staff members. NACCHO strives to create pathways for Aboriginal health care workers through the ACCHS centers. These pathways will allow indigenous community members to operate ACCHS centers, potentially increasing the relationship between patients and healthcare providers. 

 

The Australian government has developed Closing the Gap targets to help decrease the discrepancy of healthcare between indigenous and non-indigenous Australians. The target states that Australia should have equity in Aboriginal healthcare by 2031. The NACCHO and the ACCHS centers are a key factor for Australia to reach the Closing the Gap targets.

– Laura Embry
Photo: Flickr

Healthcare in North Korea
To research healthcare in North Korea is to perform a balancing act with government information, witness testimonies and internationally funded research. While the North Korean government provides free healthcare under the socialist government that Kim Il Sung implemented, famine, lack of resources and lack of education make this socialist paradise seem like a distant dream to most North Koreans.

The Problems

According to multiple North Korean refugees, the free healthcare policy applies only to the uppermost classes living in Pyongyang. These people are the ones that the Kim dynasty hand-picked as its favorites. These citizens come from long lineages of people devoted to the socialist regime, and as a reward, they receive the benefit of free healthcare. The majority of North Korean citizens, however, have to pay not only for medical procedures but also have to supply medical instruments and medications needed for most procedures. Most hospitals have no heating or electricity.

Although other countries and international organizations provide aid to North Korea, much of the medical supplies they provide end up in the hands of merchants who sell them for inflated prices. Many North Koreans bypass hospitals altogether and instead buy medical advice from street vendors in the markets. For many, this is often cheaper and safer than going to a hospital.

Because state-run hospitals are so expensive and unreliable, many North Koreans turn to doctors and surgeons who practice illegally and discreetly in their own homes. These doctors provide resources, expertise and convenience not found in government hospitals.

The Solutions

The state of free healthcare in North Korea took a heavy blow when famines ravaged the country throughout the 1990s. Since then, the country has become increasingly accepting of international aid and advice. Officials in the Ministry of Public Health and at Kim Il Sung University are beginning to admit the country’s health challenges to the outside world. A study that the United Nations conducted in 2019 estimated that over 43% of North Koreans suffer from malnourishment. Another study that North Korea’s Ministry of Public Health conducted showed that the prevalence of tuberculosis has been increasing for the past 25 years. In 2016, estimates determined that 640 per 100,000 people suffer from tuberculosis. Luckily, some nonprofits are attempting to improve healthcare in North Korea. Here are three organizations working to provide sustainable medical aid and healthcare to North Korea.

  • Amnesty International conducted research into the healthcare system in North Korea in 2010. It found that North Korea spent less than $1 per person per year on healthcare, less than any other country in the world. Amnesty International continues to urge countries to increase aid to North Korea based on need rather than political considerations.
  • UNICEF’s work with the North Korean healthcare system divides into three sections: health, nutrition, water sanitation and hygiene. It has implemented the Integrated Management of Newborn Illnesses (IMNIC) program in 50 counties, providing the residents with medicine kits and training 5,000 doctors per county to provide basic curative services. UNICEF has also partnered with the North Korean Ministry of Public Health to treat severely and acutely malnourished children.
  • The Gavi Vaccine Alliance has provided North Korea with more than $12 million in aid. It focusses primarily on strengthening the existing healthcare system and providing vaccines and equipment to local facilities. Because of these vaccinations, there have been no reported cases of measles in North Korea since April 2007.  Together, Gavi and UNICEF have provided equipment transport vehicles for every county in the country.

Healthcare in North Korea is far from being free and accessible to everyone. However, by being open with the outside world about the dire nature of their health challenges and allowing international aid, North Korea has taken the first few steps to create a brighter future for the health of its people.

Caroline Warrick-Schkolnik
Photo: Wikimedia Commons

health technologies for developing countriesIn recent years, there have been numerous innovations in medicine and new health technologies for developing countries. These technologies target a large variety of issues including medical testing, identifying safe drinking water, filtering dirty water and decreasing infant and maternal mortality rates. Some innovations that have had a significant impact on global health and show potential for future interventions include Hemafuse, Embrace Warmers, 3D printing in medicine and SMS services to identify counterfeit medicine in Sub-Saharan Africa. 

Hemafuse

The Hemafuse is a recent example of new health technologies for developing countries. Autotransfusion is a medical procedure that recycles a patient’s blood back into their system. This practice can be extremely useful when there is no donor or matching blood type in injuries with large volumes of blood loss or internal bleedings. Blood transfusions are necessary for many medical situations. A significant number of maternal deaths in developing countries result from blood loss. Medics in Sub-Saharan Africa often use an extremely unsanitary technique of blood transfusion that involves a kitchen soup ladle because of the lack of alternatives. Before being reinfused into the patient’s system, the blood is filtered using gauze.

Sisu Global Health developed the Hemafuse for women with ruptured ectopic pregnancies to prevent life-threatening internal bleeding. The handheld device recovers blood from internal bleeds, filters out clots and impurities and reinfuses it the patient. Sisu Global Health is hoping to expand its design and impact 14 million lives. The device is easy to use and has the potential to decrease maternal mortality rates in developing countries. This is because it is sterile and does not require donor blood.

Embrace Warmers

The Embrace warmer is one of the health technologies for developing countries created to help newborns. The warmers were designed as portable incubators and warmers for newborns who are born premature or are lacking body fat. Lack of electricity and heating in hospitals can lead to complications such as neonatal hypothermia for newborns in developing countries. Jane Chen designed Embrace warmers at Stanford University and the device costs less than 1% of what regular incubators cost. More than 300,000 newborns in 22 countries benefitted from Embrace warmers. Organizations around the world have recognized this innovation, as well as influential people including Beyoncé and Barack Obama.

3D Printing for Developing Countries 

3D printing technology has resulted in huge advances in medicine. Specifically, 3D printing as a form of health technology for developing countries can help improve access to medical supplies. Developing prosthetics, setting up field hospitals and creating medical devices are all ways in which 3D printing can improve healthcare in developing countries.

Around the world, 80% of individuals who need prosthetics don’t have access to them. The e-NABLING the Future project is a network of volunteers who bring affordable 3D printing designs for hands and arms to those in need. There are many people in the developing world who have lost fingers or hands to war, natural disasters or disease. Through the 3D printing of prosthetics, these individuals have the opportunity to regain the use of their hands and fingers.

Doctors Without Borders has been looking into how 3D printing could be used for field hospital setups. Additionally, 3D printing allows for medical supplies to be produced directly in developing countries instead of being imported. This process can help spark medical development in poor areas instead of relying on products from other countries. Medical supplies produced by 3D printers include water testing kits that test for bacteria to determine if the water is safe for drinking and lab-in-a-box kits that are solar-powered and test for various diseases.

SMS Texting for Fake Drugs

Another increasingly pressing health issue is counterfeit medicine in sub-Saharan Africa. It is difficult to know exactly how many counterfeit drugs are circulating because the market is underground. However, there have been many counterfeit drug seizures in recent years. One out of every 10 medical drugs in all developing countries, and therefore most of Africa, is counterfeit or not standardized according to the World Health Organization (WHO). The WHO also estimates that counterfeit medicine causes 116,000 deaths annually in Sub-Saharan Africa, costing $38.5 million every year.

While there needs to be structural reform to address the issue, a company founded in 2009 by Bright Simons from Ghana has developed a text messaging system so that users can verify whether the drugs they have are legitimate. The company has since grown and has helped more than 100 million individuals. Users must scan the drug’s barcode with their phone camera or text a code from the drug’s label to a hotline for verification.

Many exciting health technologies for developing countries have been introduced in recent years. These innovations can be extremely effective and have the potential to tackle global health issues, but proper access remains an issue. Simply developing these technologies does not ensure that underserved communities have access to them. Some of the most common issues regarding access are affordability, low supply and low production. This is due to the underestimation of the demand for products in developing countries. Developing access plans that take into account all of the social, economic and cultural barriers to access is crucial to ensure that these innovations can make an impact on global health in developing countries.

Maia Cullen
Photo: Flickr