Lung Disease in Developing Countries
A high-school senior recently developed a low-cost device to monitor lung function and improve the fight against lung disease in developing countries.

The device — called a spirometer — was unveiled by Maya Varma at the 75th Annual Intel Competition. She built the device using approximately $35 worth of common electronic parts. A similar, hospital-grade spirometer can run into the hundreds or even thousands of dollars, yet Varma’s prototype has been proven to be just as accurate.

To use the spirometer, patients blow into a mouthpiece while a smartphone app, also developed by Varma, analyzes the results. Doctors can use this data to monitor various chronic pulmonary conditions, such as asthma. Varma has already applied for a patent and has plans to conduct further research and testing before hopefully bringing it to market.

The high school senior was inspired to build the device after discovering the difficulties people in developing countries have in obtaining proper health care. According to Doctors Without Borders, one-third of the global population lacks access to proper medical care. In less developed areas, such as parts of Africa and Asia, that figure rises to one-half.

This stems in part from the fact that some medications are too expensive or no longer produced. Diagnostic tools are also rare in developing countries due to their high price tag. This prevents doctors from properly identifying certain diseases and patients from receiving the necessary care.

There is a serious need for more affordable tools to detect lung disease in developing countries. According to the Smithsonian, the high cost of spirometers, in particular, is a key factor in the high number of deaths from chronic obstructive pulmonary disease (COPD): because doctors lack the equipment to make early detection possible, it ranks as the fourth leading cause of death around the world.

Thankfully, as Varma works to perfect her device, a study out of Stanford University has shown that foreign aid is directly linked to increases in life expectancy and better health in developing countries.

In countries that received the most aid, life expectancy rose by as much as four years. According to the researchers, the more dramatic increases occurred when health aid was used effectively by targeting diseases with improved technologies that allowed for better, more efficient treatment — technologies such as new vaccines, bed nets and antiretrovirals.

Or, perhaps one day soon, Varma’s spirometers.

Sabrina Santos

Photo: Flickr

Medic_MobileMedic Mobile, a nonprofit technology company specializing in mobile health, has enacted 21 projects in Africa, Latin America and Asia to provide patients living in impoverished regions with healthcare they may not be able to afford or find otherwise. In total, 7,836 community health workers were using technology and supplies provided to them by Medic Mobile in 2013—a 71 percent increase from the previous year. The company uses open-source platforms such as FrontlineSMS, Google Maps and HealthMap to develop tools for healthcare specialists to reach isolated patients.

Their tools assist with disease surveillance, childhood immunizations, drug stock monitoring and antenatal care. Medic Mobile works to train local staff on healthcare and how to use their tools, design workflow and assess opportunities for their health system. Health workers in these communities can now take numerous actions to help decrease mortality rates and increase knowledge of health and illnesses.

Using Medic Mobile technology, healthcare specialists can register every pregnant woman in their community, which allows them to schedule visits and set reminders, detect problems early on and report these issues to a clinical team, and to ensure they are able to deliver in facilities with skilled birth attendants. This increases the chances of maternal and newborn survival.

Immunization of infants can help decrease the spread of polio, measles, diphtheria and tuberculosis. Medic Mobile is used by many to register infants, create appointments and use digital scheduling to send alerts so appointments are not missed.

One of the biggest tools Medic Mobile provides communities is disease surveillance. Disease surveillance helps to detect diseases, supply individuals with immunizations and treatments and help connect isolated patients with urgent medical care. For example, in Namitete, Malawi there is one hospital for 250,000 patients, and for many of these patients, the hospital is over 100 miles away. This causes high rates of HIV/AIDS, tuberculosis and other illnesses. Medic Mobile makes it possible for individuals to receive advice about treatment and emergency referrals electronically.

Medic Mobile can also be used by medical facilities and pharmacists to prevent stock-outs, which can have life-threatening consequences. A study conducted by Oxfam, an international confederation working to end poverty, found that in developing communities only nine percent of local health facilities had fully stocked medical supplies. Medic Mobile is used to record stock levels every week to prevent stock-out.

Their toolkit is a free software toolkit that combines analytics, data collecting and messaging and is designed for health workers and systems in regions that are hard to reach. The software supports any language and works with or without Internet connectivity. The toolkit can run on basic phones, Smartphones, tablets and computers.

John Nesbit created Medic Mobile in 2008 as a six-month project. After its success, Medic Mobile has continued to provide tools to developing communities to provide their tools and services as an ongoing project.

Julia N. Hettiger

Sources: Matador Network, MedicMobile, Skoll Foundation
Photo: MedicMobile

Lymphatic_FilariasisNeglected tropical diseases, or NTDs, are preventable illnesses that impact the poorest regions of the world. The NTD Lymphatic Filariasis (elephantiasis, LF) threatens millions of people across India today. The disease causes intense pain and physically disfigures the bodies of those it plagues.

LF, like other NTDs, is preventable. In many cases across the world NTDs infect millions in extremely poor regions because there is no treatment available.

In India this is not the case; treatment is being made widely available. The Indian government has recently launched an ambitious goal of eradicating LF, providing treatment to around 460 million people in 17 different Indian states.

The reason LF remains present in India today is due to lack of disease awareness and education surrounding the disease. There is also a general suspicion towards pharmaceuticals distributed by the government or by large organizations. For these reasons, people simply do not consume the pills they receive.

Almost half the population of India is at risk of contracting LF. LF takes around eight to ten years to begin visibly showing its damage; and this delay often makes people forget about the danger of this NTD. Prevention of LF, despite the public’s hesitancy toward it, is extremely easy. It requires only the consumption of pills.

To raise awareness about LF and prevention and to try to persuade Indians to take the pills they receive, The Indian Ministry of Health and Welfare along with the Global Network for Neglected Tropical Diseases has created a public service campaign called “Hathipaon Mukt Bharat” or Filaria Free India in the hopes of eradicating LF through education on the disease and the importance of pill consumption.

The creative campaign includes three TV and cinema videos in 10 languages; radio, newspaper and print, cellphone, and online advertisements are also a part of the campaign. The goal is to create awareness and a shared sense of nationalistic determination to unite all and help eradicate the disease.

Research indicates that in advertisements, audiences react much more strongly to positive messages. And the campaign is simple and uplifting, that LF pills are safe and free, and together India can overcome LF. Powerful imagery also captures the audience’s attention; a man in late stages of LF stands disfigured at a small hospital clinic. He explains to children how he “never thought it would happen to me.”

India is a diverse country, celebrating over 780 languages. The background music of the campaign is in Sanskrit,the language of ancient India that many religious texts are written in. It is not spoken today and only a few scholars and religious people know how to read it. It unites the country with its rich history. The lyrics translate to “Every sign or indication leads us to the path of knowledge. And the journey across that path of knowledge leads us to absolute truth.”

Over 200,000 health workers in 14 Indian states were involved in the initial campaign drive. They helped expose over 300 million people in India to information on LF.

“India has made great strides over the last decade to eliminate lymphatic filariasis in endemic states and we are now on the verge of reaching elimination targets nationally. However, the last mile of the journey is often the most difficult. We are employing a wide range of new communications tactics and partnerships that will help us encourage all people at risk from this disease to consume their free dose of medicine during our annual mass drug administrations” explained Mr. C.K. Mishra, Additional Secretary and Mission Director of the National Health Mission at the Ministry of Health & Family Welfare.

Margaret Anderson

Sources: WHO, Impatient Optimists, Sabin
Photo: National Geographic

In a region of the world that has such a large portion of the world’s population (25 percent), health issues in Southeast Asia can reflect many general health concerns. Recent disease scares like the Avian Flu, Swine Flu and the SARS outbreak all had origins and outbreaks in Southeast Asia. Thus, the recent declaration by the World Health Organization (WHO) that polio has been eliminated in the region can be considered a great victory in the fight against global poverty.

The declaration was the culmination of an intensive effort that involved 2.4 million volunteers in India, which had accounted for half the world’s polio cases in 2009. Despite that prevalence just a few years ago, the country has had no reported cases of polio since 2011.

The project cost a billion dollars, largely funded by the Indian government. Former U.S. ambassador John E. Lange said about the announcement, “This is… a proof of concept that polio can be eradicated in some of the most difficult places to work in.” Thanks to the encouragement of the WHO and the collaboration by the Indian government, Southeast Asia looks to have set a model for future regions to follow.

With the official polio-free announcement for Southeast Asia, it can be said that 80 percent of the world’s population lives in polio-free regions. The only two world regions that are still plagued by polio are the Eastern Mediterranean and Africa. Those regions will need time as there is significant resistance in those regions.

Pakistan in particular has been an area resistant to polio eradication. While it would seem that the elimination of polio is a movement that anyone could get behind, the movement has become closely associated to United States intelligence efforts in the region. The Taliban in Pakistan has acted out against polio workers and citizens helping the polio effort. Closely following the news of eradication in Southeast Asia were reports of the kidnapping and murder of a polio worker in Pakistan. With entrenched resistance groups there and in Nigeria, the further eradication of polio might prove difficult going forward.

Also, the Syrian civil war will keep health worries going in that region. Syria had one of the best health care systems in the region prior to the crisis, but the massive displacement of the Syrian population helps spread these dangerous diseases. A spokesman from the UN Relief and Works Agency for Palestine Refugees said, “The current polio outbreak in Syria… is arguably the most challenging outbreak in the history of polio eradication.”

Despite the difficulties in the remaining areas, the eradication of polio in Southeast Asia proves that no matter the circumstances in the present, a dedicated effort can make real progress. The work that the Indian government and WHO have done in the last five years could prove to be successful in other regions. Organizations like The Borgen Project encourage this type of work to continue, and for the United States to step up their support in regions that are dealing with these difficulties.

-Eric Gustafsson

Sources: LA Times, NPR, WHO, The Guardian
Photo: NPR