Medical tech designed to meet Africa's needs | Soyapi Mumba

Translator: Nika Kotnik Reviewer: Matej Divjak

Like every passionate software engineer out there,

Kot vsak strasten programer,

I closely follow technology companies in Silicon Valley,

skrbno sledim tehnološkim podjetjem v Silicijevi dolini,

pretty much the same way soccer fans follow their teams in Europe.

tako kot nogometni navdušenci v Evropi sledijo svojim ekipam.

I read articles on tech blogs

Berem članke na tehnoloških blogih

and listen to podcasts on my phone.

in na telefonu poslušam podcaste.

But after I finish the article,

A ko preberem članek,

lock my phone and unplug the headphones,

zaklenem telefon in izvlečem slušalke,

I'm back in sub-Saharan Africa,

sem nazaj v podsaharski Afriki.

where the landscape is not quite the same.

kjer pokrajina ni čisto ista.

We have long and frequent power outages,

Imamo dolga in pogosta obdobja brez elektrike,

low penetration of computers,

slabo razširjenost računalnikov,

slow internet connections

počasno internetno povezavo

and a lot of patients visiting understaffed hospitals.

in veliko pacientov, ki pridejo v bolnišnice s premalo osebja.

Since the HIV epidemic,

Zaradi epidemije HIV-a

hospitals have been struggling to manage regular HIV treatment records

so se bolnišnice trudile z obvladovanjem običajnih kartotek zdravljenja HIV

for increasing volumes of patients.

za naraščajoče število pacientov.

For such environments,

V takih okoljih

importing technology systems developed elsewhere has not worked,

uvoz tehnoloških sistemov, proizvedenih drugje, ni deloval,

but in 2006, I joined Baobab Health,

a leta 2006 sem se pridružil ekipi Baobab zdravje,

a team that uses locally based engineers

ki uporablja lokalne programerje

to develop suitable interventions

za razvoj primernih ukrepov,

that are addressing health care challenges in Malawi.

ki bi obravnavali izzive zdravstvene oskrbe v Malaviju.

We designed an electronic health record system

Zasnovali smo elektronski sistem zdravstvenih kartotek,

that is used by health care workers while seeing patients.

ki ga uporabljajo zdravstveni delavci med obravnavo pacientov.

And in the process we realized that we not only had to design the software,

In med tem procesom smo spoznali, da ne potrebujemo le programske opreme,

we had to implement the infrastructure as well.

ampak tudi postavitev infrastrukture.

We don't have enough medical staff

Nimamo dovolj zdravstvenega osebja,

to comprehensively examine every patient,

da bi podrobno pregledali vsakega pacienta,

so we embedded clinical guidelines within the software

zato smo v programsko opremo vdelali klinične smernice

to guide nurses and clerks

v pomoč medicinskim sestram in delavcem,

who assist with handling some of the workload.

ki prevzamejo nekaj delovnih obremenitev.

Everyone has a birthday,

Vsak ima rojstni dan,

but not everyone knows their birthday,

a ne ve vsak, kdaj je rojen,

so we wrote algorithms to handle estimated birthdates

zato smo napisali algoritme, ki obravnavajo okvirne rojstne dneve

as complete dates.

kot celotne.

How do we follow up patients living in slums

Kako sledimo pacientom iz slumov,

with no street and house numbers?

brez imen ulic in hišnih številk.

We used landmarks to approximate their physical addresses.

Uporabili smo razpoznavne znake za približno določitev njihovega naslova.

Malawi had no IDs to uniquely identify patients,

Malavi nima osebnih izkaznic za unikatno prepoznavanje pacientov,

so we had to implement unique patient IDs

zato smo morali vpeljati unikatno pacientovo identiteto (ID),

to link patient records across clinics.

da smo povezali kartoteke v različnih klinikah.

The IDs are printed as barcodes

Te ID so natisnjene kot črtne kode

on labels that are stuck on personal health booklets

na nalepkah, ki so na osebnih zdravstvenih knjižicah,

kept by each patient.

ki jih ima pacient.

With this barcoded ID,

ID v obliki črtne kode

a simple scan with a barcode reader

enostavno preberemo s čitalcem

quickly pulls up the patient's records.

in hitro dobimo pacientovo kartoteko.

No need to rewrite their personal details

Prepisovanje osebnih podatkov v register

on paper registers at every visit.

ob vsakem obisku ni več potrebno.

And suddenly, queues became shorter.

In nenadoma so se vrste zmanjšale.

This meant patients, typically mothers with little children on their backs,

To pomeni, da so pacienti, ponavadi mame z majhnimi otroki na hrbtu,

had to spend less time waiting to be assisted.

manj časa čakale na obravnavo.

And if they lose their booklets,

In če knjižico izgubijo,

their records can still be pulled by searching with their names.

lahko z njihovim imenom še vedno najdemo kartoteke.

Now, the way we pronounce and spell names varies tremendously.

Način izgovorjave in črkovanja imen izredno variira.

We freely mix R's and L's,

Prosto menjamo L in R,

English and vernacular versions of their names.

angleško in izvorno obliko imena.

Even soundex,

Celo soundex,

a standard method for grouping words by how similar they sound,

standardna metoda za združevanje besed glede na to, kako podobno zvenijo,

was not good enough.

ni bila dovolj.

So we had to modify it

Zato smo ga morali prilagoditi,

to help us link and match existing records.

da nam je pomagal z ujemanjem in povezovanjem že obstoječih kartotek.

Before the iPhone,

Pred iPhonom

software engineers developed for personal computers,

so programerji razvijali programe za osebne računalnike,

but from our experience,

a iz naših izkušenj vemo,

we knew our power system is not reliable enough

da naš energetski sistem ni dovolj zanesljiv

for personal computers.

za osebne računalnike.

So we repurposed touch screen point-of-sale terminals

Zato smo na novo uporabili zaslone na dotik,

that are meant for retail shops

ki so namenjeni prodajalnam,

to become clinical workstations.

da so postali delovne postaje na klinikah.

At the time, we imported internet appliances called i-Openers

Takrat smo uvozili i-Openers, internetne naprave,

that were manufactured during the dot-com era

ki jih je v obdobju "dot-com" proizvedlo

by a failed US company.

propadlo ameriško podjetje.

We modified their screens

Prilagodili smo ekrane

to add touch sensors

in dodali senzorje na dotik

and their power system to run from rechargeable batteries.

ter njihovo napajanje, da ga je lahko poganjala baterija za polnjenje.

When we started, we didn't find a reliable network to transmit data,

Ko smo začeli, nismo našli zanesljivega omrežja za prenos podatkov,

especially from rural hospitals.

še posebej iz ruralnih bolnišnic.

So we built our own towers,

Zato smo zgradili lastne stolpe,

created a wireless network

ustvarili brezžično omrežje

and linked clinics in Lilongwe,

in povezali klinike v Lilongweju,

Malawi's capital.

prestolnici Malavija.

(Applause)

(Aplavz)

With a team of engineers

S skupino programerjev,

working within a hospital campus,

ki delajo v bolnišnici,

we observed health care workers use the system

smo opazovali, kako zdravstveni delavci uporabljajo sistem

and iteratively build an information system

in iterativno zgradili informacijski sistem,

that is now managing HIV records

ki sedaj upravlja HIV kartoteke

in all major public hospitals in Malawi.

v vseh glavnih javnih bolnišnicah v Malaviju.

These are hospitals serving over 2,000 HIV patients, each clinic.

Vsaka od teh bolnišnic skrbi za okrog 2000 pacientov.

Now, health care workers who used to spend days

Sedaj lahko delavci, ki so prej porabili dneve

to tally and prepare quarterly reports

za pripravo četrtletnih poročil,

are producing the same reports within minutes,

to storijo v nekaj minutah,

and health care experts from all over the world

in strokovnjaki s celega sveta,

are now coming to Malawi to learn how we did it.

sedaj prihajajo v Malavi, da vidijo, kako nam je to uspelo.

(Applause)

(Aplavz)

It is inspiring and fun

Navdihujoče in zabavno

to follow technology trends across the globe,

je slediti tehnološkim trendom po svetu,

but to make them work

a da delujejo

in low-resourced environments

v okoljih z malo viri,

like public hospitals in sub-Saharan Africa,

kot so javne bolnišnice v podsaharski Afriki,

we have had to become jacks-of-all-trades

moraš biti sam svoj mojster

and build whole systems, including the infrastructure,

in zgraditi celoten sistem, vključno z infrastrukturo,

from the ground up.

od samega začetka.

Thank you.

Hvala.

(Applause)

(Aplavz)