Wednesday, September 17, 2008

FIC Expanding ICT Use

According to the NIH Fogarty International Center (FIC) newsletter “Global Health Matters”, FIC is looking for new ways to use communications hardware and software to help in hard-to-reach regions. The goal is to make ICT an integral part of Fogarty’s new strategic plan. ICT is a broad concept encompassing computers, cell phones, broadband, video-conferencing, and distance learning. Fogarty grantees are working to adapt fairly standard Western technologies to low resource setting.

Dr. William Tierney of Indiana University with a small Fogarty grant, created the first electronic medical record system in Kenya. He was instrumental in developing similar systems based on low cost open source tools now in use in more than a dozen countries on three continents.

After visiting a Fogarty program in Haiti, Dr. Rebecca Dillingham with the University of Virginia Center for Global Health and a former grantee herself, started using cell phones to communicate with HIV infected people in rural parts of Virginia. Under her pilot project, free phones were given to patients to remind them through text messages to take their medications, refill their prescriptions, and the date and time of their next clinic appointment.

In Peru, grantee Dr. Walter Curioso built an interactive computer system using cell phones to help individuals adhere to antiretroviral treatments by collecting adverse events in real-time. Dr. Curioso sees the cell phone as the ideal tool for a mobile team plus the equipment is less likely to be stolen as compared with laptops or PDAs.

Dr. Pamela Johnson of Voxiva, a global health telecom company working with some of the grantees, reports that the fastest growth in cell phone use is in Africa and according to Dr. Johnson by the end of the year, there will be more cell phones used in Africa than in North America. Her company reports there are now 3.5 billion cell phones in the world, and by 2010, 90 percent of the world will have coverage.

Fogarty is taking steps to incorporate technology into its programs to help grantees connect students, clinicians, and patients with both general information and research data. They are using internet 2, Open Course Ware, a device called “Internet in a Box”, and the Virtual Hospital. Fogarty’s focus is to use distance learning to train researchers on building sustainable health infrastructure in countries with the greatest need.

Dr. Thomas Cook, a professor and environmental health grantee at the University of Iowa, has helped to develop an offline method of transferring medical information called the “E-Granary Digital Library”. The system with more than 700 CDs worth of educational resources from 1,000 web sites is shipped to institutions in Africa, India, Bangladesh, Azerbaijan, and Haiti for installation on computers and local networks and used with an internet connection. Dr. Cook also advocates using web conference software such as “Elluminate” to provide cost effective educational information to regions where classrooms are not easily available.

A Tufts University program under grantee Dr. Jeffrey Griffiths is collaborating on developing curriculum with Makerere University and the University of Dar es Salaam to rely heavily on a digital library linking computers in resource poor areas. The program seeks culturally appropriate responses to health problems.

A Harvard program with Fogarty grantee Dr. Richard Mollica, focuses on mental health trauma induced by natural disasters. He initially brought students together for two weeks to study the problem which was then followed by five months of web-based training with close faculty supervision and strong peer learning.

“ICT and distance learning have the potential to transform health systems”, says Dr. Ariel Pablos-Mendez, Managing Director of the Rockefeller Foundation, “but there are still huge disconnects, computer interoperability, and relatively low financial investment in ICT.” Dr. Mendez wants to see public health needs become the highest priority for developing countries and sees this happening within the next 10 years.

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