Tag Archives: public health

Pros and Cons: Conflict Early Warning Systems

On the subject of ICT4Peace, an article by two Payson graduates, Phuong N. Pham and Patrick Vinck was written in August of 2013, and explains how early warning systems can be used as they are for disasters, but for peace. I am going to synthesize the key points made in this article because “conflict” early warning systems should be in place, and it is relevant to Joseph Kony or even Ukraine, for example, to trigger early intervention when Russian troops are on the attack. The authors compare public health early warning systems and conflict early warning systems, and one of the main problems is that public heath warnings trickle down to involve local stakeholders, while conflict warnings are generally only given to policy makers at the top. How can we use ICTs to increase the effectiveness of conflict early warning systems?

Actors and response order:

  • People-centered and community-based approaches (changing roles): changes in who generates information, how it is generated, and who accesses it changes how we respond to conflict situations and breaks up hierarchies, potentially even human rights offenders
  • Emerging principle of Responsibility to Protect (R2P): the duty to respond to early warning s of conflict by concerned governments and policy makers, including the UN

Key Challenges: Quality, ethics and response:

  • Responsibility to provide unbiased information: acccuracy and reliability of information in question, unequal access to ICTs
  • Ensure action is taken: requireeffort to respond to/address issues
  • Security of information: repressive regimes create new opportunities for human rights offenders when they monitor their citizens—this sensitive information must be kept secure and managed well…or else!
  • Ethical principles in research: protect human research subjects—is conflict early warning research? Can early warning systems create their own human rights violations?

Conclusion: Changes in early warning systems in response to ICTs will fundamentally change what is done and how. However, new ICTs also bring new concerns and ethical challenges. We must continue to monitor the effectiveness of programs and create practical guidelines for ICT4Peace practitioners.


“Smart” Undies

In class on Tuesday, March 18, we spoke about the difference between front office and back office in terms of the potential for ICTs in education. On Thursday we spoke of ICTs for health.  This article is about technologies that keep you away from the office altogether—the doctor’s that is.  Most of these technologies are mHealth technologies, defined by Meredith on her blog here.  There are eight initiatives: “smart” pill bottles, health tracking briefs, ThriveOn for customized mental health help, wearable fall protection underwear, baby monitor clipped to clothes, smart footwear, smartphone thermometer, and Scandu Scout to analyze vitals on your smartphone.  These are all new concepts that were on display at a recent South by Southwest conference.  I am going to analyze the two types of technological underwear.  Pixie Scientific is the company that created the health tracking briefs, smart diapers that contain an indicator panel that tracks UTIs and monitors hydration to prevent disease.  These diapers sound like a great idea for public health, more so than the ActiveProtective underwear with 3-D motion sensors to detect falls.

smartdiapers

However, if Pixie Scientific and ActiveProtective could combine the two?  How amazing!  They would be preventing UTIs by tracking hydration, injury with micro-airbags in the underwear, and a call for help.  The cons to these undergarments would be cost—Pixie Scientifics briefs are disposable and the infant version has been around for a while.  ActiveProtective must be brand new, because there is not any information online yet, but I can’t imagine micro airbags and whatever “call for help” technology is, is cheap.  Pixie Scientific seems to still be in its research stage.  I found a funding project for the program on indiegogo.  The company claims they will use the $21,491 raised to “fund manufacturing, a data-gathering study at UCSF Benioff Children’s Hospital, and another study meant to collect data for FDA registration”.  Mainly these diapers will screen for: urinary tract infections, prolonged dehydration, and developing kidney problems.  According to UrologyHealth, approximately 40 percent of women and 12 percent of men will experience at least one UTI in their lifetimes.  I’m a big fan of these diapers because I’m a public health major, and if they can reach their stretch goals: to search for endemic diseases and screen for early signs of type 1diabetes, that would be a huge deal in terms of promoting higher quality of life through disease prevention.


Personalized Development

A recent article in the Washington Post discussed the new use of mobile information technology in revamping the health care system. Ritu Agarwal, founder and director of the Center for Health Information at the University of Maryland’s Robert H. Smith School of Business, suggests an alternative to the current system. He suggests the creation and implementation of mobile technology that tracks and maintains the users information regarding health and their behaviors, ultimately serving as a constant reminder to stay on track. He calls for a restructuring of how Americans do health care to “personalized medicine,” where medicine, prevention, and treatment is entirely tailored to the individual.

In the American system of scientific medicine, doctors take a passive role in responding to patient’s systems as they arise. The holistic approach involves the individuals lifestyle and emphasizes prevention over treatment. So is it possible that the advent of mobile information technology can actually create a more holistic approach to healthcare? Could technology be used to help return the ways of our world to its more natural roots?

I believe so. But I also believe it could be used for much more. In many developing countries  the current health care systems are so inefficient and poorly managed that the implementation of “personalized medicine” would be meaningless. However, the International Telecommunications Industry’s 2012 report gives evidence that mobile technology is on the rise. Globally, active mobile broadband subscriptions increased nearly 40% from 2010 to 2011. This growth jumps to nearly 80% in the developing world in the same year . With the ubiquitous of mobile technology, couldn’t this “personalized healthcare” approach be transformed to “personal development.” Imagine software that helps an individual track their budget, warns them when an area has becomes dangerous, informs a woman on methods to confront her husband regarding contraception. Development, as we all know, is not one size fits all. What if we could tailor development to the individual?


Predict: USAID’s disease mapping tool

In class this week, we have talked a lot about how mapping technology can be used in disasters, such as the Mission 4636 project in the aftermath of the earthquake in Haiti. However, mapping technology can also be very useful in other areas of development, such as health. Online maps can track serious disease outbreaks and therefore help governments and scientists manage these outbreaks. For example, a few years ago the United States Agency for International Development (USAID) launched a mapping tool known as “Predict” that tracks animal diseases. While this might not sounds important, it is actually essential to international development because many of the most serious human disease outbreaks of the last several decades originated in animals. The virus that caused the SARS outbreak and Ebola, for example, are both thought to have come from bats. The USAID mapping project emerged specifically as a response to the H1N1 virus (more commonly known as swine flu), which contained a mixture of genes from both North American and European pigs. Interestingly, the H1N1 virus was never actually detected in pigs before it was detected in humans in Veracruz, Mexico. This is significant because it reflects a serious knowledge gap in the international health community. The goal of USAID’s mapping project is to track animal disease outbreaks that could eventually transform into threats to human public health.

Here is how the “Predict” works: it monitors data from over 50,000 websites, among them the alerts that the World Health Organization sends out, online discussions from experts, local news, and wildlife reports. The system then sorts through all of this information to find the most relevant data and put points on the map. The pin points on the global map are color-coded based on activity level, with yellow being low and red being high. The map can also easily be divided to focus on different regions or priority diseases. It is very user-friendly and open to the public, something that Damien Joly, an associate director for wildlife health monitoring in one of the map’s partner associations, says is essential to the mission of the project.

In my opinion, the “Predict” tool represents an efficient use of mapping technology to track disease and it is important because it focuses on animal disease that could pose a threat to human health, which is often overlooked in international development. The question now is how people will begin to use “Predict,” and whether it will become a tool for the general public, or will mainly stay in the realm of scientists and public health experts. You can read more about the launch of this mapping tool here.


The World Wide Battle for Health Care

health-care-resuscitation-1

This week in class we have been reviewing the role of ICTs within the health and wellness sector, as well as within the governance and government sector. The quickly changing political, technological, and medicinal landscapes not only within the developing world but within the highly developed world has meant progress in many arenas in terms of facilitating and reforming public health. It has come to my attention that since a large portion of aid and inter-sectoral projects to these LDCs has been within the purview of public health, it seems necessary to evaluate those very states that serve as the ‘examples’ of the very systems that hundreds of governments, agencies, businesses, non-profits, and NGOs are anxious to ‘replicate’. Obviously, no one state or system could possibly hold the key to the best method of administering/ overseeing the production of universal health to its citizens… or does one? This is the very question that I wish to explore and fuel with ample evidence and testimony from the field.

I also feel it would a be a disservice to this particular post, as this weeks’ posts are designed to reflect the appropriate subject area, if we do not mention the current and lively debate that is occurring within our own United States of America as the Obama administration carries out its implementation of healtcare.gov and the Affordable Care Act (aka- Obamacare).

My aim this week is to provide as many sources, documentaries, videos, op-eds, and expert testimonies as possible to provide a synthesis of data for our class to have either an in person or digital debate/conversation as to what kind of health system we feel will eventually be most effective in these very nations, tribes, communities, cities, mega-cities, and families that we all study so intently and care so much about.

I invite everyone to post and share their own reflective opinion after reading and watching what is available here to develop a well-informed, lively, and engaged discussion for this blog. Enjoy!

Op-Eds:

Ross Douthat, The New York Times, “But What if ObamaCare Works?” 10/26/2013

C.H., The Economist, “Why the Hysterics over Obamacare’s Software Glitch?” 10/23/2013

The Financial Times, Special Report: Global Health Policy, 8/01/2012 (link to a pdf)

Michael D. Tanner, The Cato Institute, “The Grass Is Not Always Greener: A Look at National Health Care Systems Around the World“, 3/18/2008

T.R. Reid, The Washington Post, “5 Myths about Health Care Around the World“, 8/23/2009

T.R. Reid, PBS: Frontline, The Four Basic Healthcare Models

John McDermott, The Financial Times, “What healthcare.gov could learn from Britain“, 10/22/2013

Interviews:

Professor Uwe Reinhardt, Health Economist, Princeton University, 11/10/2007

Ahmed Badat, M.D., General Practitioner, Shepherds Bush Medical Center London

Prof. Karl Lauterbach, Health Economist and Member of the German Parliament, 10/25/2007

Prof. Naoki Ikegami, Health Economist, Keio University School of Medicine

Pascal Couchepin, President of Switzerland, 10/30/2007

Nigel Hawkes, Health Editer, The Times of London, 11/1/2007

David Patterson, M.D., Consultant Physician and Cardiologist, Whittington Hospital, London

Reports:

l’Organisation mondiale pour la Santé, Research for Universal Health Coverage, World Health Report 2013, August 2013 (PDF english) (PDF français) (PDF español)

Michael Tanner, The Cato Institute, Policy Analysis, “The Grass Is Not Always Greener: A Look at National Health Care Systems Around the World“, March 18, 2008 (PDF english)

World Economic Forum + McKinsey & Company, Sustainable Health Systems, January 2013 (PDF english)

OECD, Health at a Glance 2011, OECD Indicators, November 23, 2011 (organization has reports on specific regions and countries as well)

Videos + Documentaries:

PBS: Frontline, Sick Around the World, April 15, 2008

One.org compiled list of 52 youtube videos about Global Public Health

Even More Resources:

PBS: Frontline resources for their special addressing international and domestic issues here


ICT Policy for Health Care in Rwanda

For Rwanda’s population, the country has a relatively low number of doctors. However, during the last decade, the country’s public health conditions have been taking huge leaps forward. Since 2000 the maternal mortality ratio has fallen by 60%, most people are now surviving tuberculosis, many people with AIDS are on antiretroviral drugs, and childhood mortality has dropped by 70%. Furthermore, Paul Farmer, the founder of Partners in Health, an organization that provides medical services to Rwanda and Haiti, said in this NY Times article that, “‘If these gains can be sustained, Rwanda will be the only country in the region on track to meet each of the health-related Millennium Development Goals by 2015.”

 What is it about Rwanda that has made the country so successful? Part of the answer lies in the fact that health insurance is very cheap and heavily subsidized by donors, resulting in 98% of Rwandans having medical insurance. Another big part of the answer is Rwanda’s national use of ICTs for doctors. The Rwandan government supports a national system of computerized medical records and village health workers can use text messaging to send medical records to hospitals. 

 Furthermore, Rwanda’s Treatment and Research Aids Centre (TRAC) has been using ICTs to provide real time information about HIV/AIDS to the entire country. TRACnet is a web and phone based system that provides treatment monthly indicators and information about drug shortages. TRACnet also allows patients to document their conditions and connect with doctors. TRACnet has gained international recognition for its effective use of ICTs. 

Image Rwanda is clearly on the right track with its ICT policy and it seems that the country’s public health conditions will only improve from here. Hopefully other countries will be able to follow Rwanda’s ICT policy model in the and see these vast improvements too.


Mapping Malaria in Africa

This article describes an innovative approach to using ICT for development initiatives. Malaria remains one of the deadliest diseases on the planet with a great deal of malaria cases occurring in sub-Saharan Africa.In order to track and prevent the disease, it is necessary to know where people live. Though this sounds simple, it is harder than one might think in Africa. A new project, the AfriPop Project, used cell phone records in Kenya to track popular travel routes between population centers, therefore mapping the location of almost 15 million people. The project then applied this map to a malaria transmission model to reveal how malaria is likely to spread in Kenya. The use of cell-phones, rather than GPS, surveys, and traffic flow data, provided exponentially more data, making the transmission model much more effective and powerful. This technique maximized very limited resources in order to help prevent the transmission of malaria in Kenya.

How could this technique be replicated in other countries? In what fields, other than disease transmission, might it be applicable? What are potential drawbacks of this approach?