[Health] [hifa2015] Map of Medicine trials in sub-Saharan Africa [2]

Edward Cherlin echerlin at gmail.com
Tue Apr 15 17:04:39 EDT 2008

On Tue, Apr 15, 2008 at 1:00 PM, Miriam Adhikari, South Africa
<HIFA2015 at dgroups.org> wrote:
> Dear Bruce
>  Can you email a copy of a map?

Yes, I and a number of my friends would like that too. I am copying
GIS (Geographical Information Systems) expert Tim Foresman on this. He
can connect you with more people in the community who can help or can
use your information. I am also copying this to One Laptop Per Child,
Engineers Without Borders, and the Black Data Processing Association,
all of which have a strong interest in creating and using such
information resources. One Laptop Per Child is sending 10,000 or more
computers to Rwanda and Ethiopia this year, and is in discussions with
education ministries and others in government all over Africa and
around the world.

I would personally love to see a variety of other health maps, such as

* bird migrations in China overlaid on swine, chicken and human flu
outbreaks over time
* River Blindness risk, incidence and treatment, with any indications
of resistance to medications among the worms responsible
* HIV-AIDS incidence and trends along with various government and
other education and prevention programs, and risk factors such as sex
* TB, including Multi-Drug Resistant TB, correlated with public health
spending and government policies
* Malaria correlated with bed net distribution and medication programs
* Availability and cost of medicines for these and other endemic
diseases of the poor correlated with patent and manufacturing data

I'm sure that anybody here can add extensively to this list. For each
of these, the first question is, who has any data? And then we have
the whole process of aggregating data, cleaning it, mapping it, and
making the maps publicly available to other researchers and to the
public. Then we can ask how to gather better data, and what to do
about the problems revealed in the maps.

All of this goes back to John Snow's mapping of cholera cases in
London in the 1854. He found that the distribution peaked around a
public pump near a disused cesspit. When the local council ordered the
pump handle removed, the epidemic subsided rapidly, although there is
some question whether it had already begun to subside due to residents
fleeing the area.

>  Miriam Adhikari
>  Professor M Adhikari
>  Professor & Academic Head
>  Paediatrics & Child Health
>  Tel 27 31 2604345
>  Fax 27 31 2604388
>  HIFA2015 Profile: Miriam Adhikari is Head of the Department of Paediatrics
>  and Child Health, and Head of Neonatology, at the University of
>  Kwazulu-Natal, Durban, South Africa. Her interests include neonatology,
>  nephrology, and medical curriculum development. ADHIKARI AT ukzn.ac.za
>  "Bruce Dahlman, Kenya" <HIFA2015 at dgroups.org> 2008/04/14 11:24 PM
>  Dr. Henwood and all,
>  Starting in 2003, Dr. Peter Drury came to AIC Kijabe Hospital, Kijabe
>  Kenya (where I had been medical director) and over several visits we
>  trialed the Map.
>  We started with an initial 25 or so Maps that seemed most appropriate for
>  use in Kenya AS WRITTEN.  We focused on their use in a village health
>  center setting staffed by a qualified nurse using a paper version of these
>  25 maps.  Because the paper volume is large, it would not be practical to
>  roll it out for the full 350+ maps.  Simultaneously, we introduced our
>  medical interns at the 230 bed hospital to the map via internet.  In
>  2005-6 we trialed use of the unfinished PDA version with some donated
>  machines with medical interns.
>  John Ollier of Informa was the point person for this Kijabe study.
>  None of this work had enough structure or rigor to publish on the
>  experience but we found that the Map was valued especially by the nurses
>  triaging serious from common problems in the village health centre where
>  they had few, if any, other resources to rely on for differential
>  diagnosis reference.
>  This preliminary experience was used to set up two further studies:
>  1. A current study done through WHO eHealth Unit and I believe headed by
>  Fatima Sanz de Leon - Technical Officer at several sites in sub-Saharan
>  African countries (of which Kijabe Hospital is one).  This uses the full
>  version of the Map - mainly in the internet version.   I am not directly
>  involved so cannot give the latest on this project but Fatima or Craig
>  Rhodes of Informa should have updates.
>  2. A full version of the current UK Map will be included amongst other
>  resources on MS Mobile PDAs in the Kenya Health Information Study to be
>  initiated as a pilot with medical interns at Kijabe in July.  Its purpose
>  will be to determine what (if any) commonly available resources from the
>  North (mainly UK related ones) are worth expending the considerable
>  editing effort that would be needed to make them useful as
>  "point-of-primary-clinical-care" resources.  A similar study is being
>  considered for recently graduated interns beginning practice in Southern
>  Sudan hospitals.  The goal is to confidently know what resources will be
>  most useful to invest in to edit/adapt/develop into a Digital African
>  Health Library of integrated and localized resources.
>  Eventually this could include country specific clinical guidelines,
>  formularies and triage protocols for use by primary care health workers.
>  I would be interested to hear from anyone interested in such an agenda.
>  bdahlman at aimint.net=20
>  Bruce
>  *HIFA2015 Profile: Bruce Dahlman is Director of the Institute of Family
>  Medicine (INFA-MED - www.chak.or.ke/infamed.asp), Nairobi, Kenya that is
>  assisting development of Family Medicine as a specialty in Kenya in
>  collaboration with Moi University Medical School in Eldoret and in other
>  East African countries. One project, the Digital African Health Library,
>  is being conceived as an innovative PDA/smartphone access to medical
>  knowledge database resources for use by clinicians at the point-of-care in
>  infrastructure-poor settings. He also serves on the Executive Committee of
>  the Kenya Association of Family Physicians that is introducing
>  practice-based small groups for continuing professional development
>  throughout Kenya.  bdahlman AT aimint.net
>  *************************************************
>  THE HIFA2015 GOAL: By 2015, every person worldwide will have access to an informed healthcare provider. Join HIFA2015: Send your name, organization and brief description of interests to HIFA2015-admin at dgroups.org
>  HIFA2015 email group website: www.dgroups.org/groups/hifa2015
>  Further info on HIFA2015: www.hifa2015.org

Edward Cherlin
End Poverty at a Profit by teaching children business
"The best way to predict the future is to invent it."--Alan Kay

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