A presentation at Stanford University Medicine X about bridging the medical education gaps in South Africa with a digital platform focusing on a ONE health, global approach from an e-Patient perspective.
GM everyone. My name is Vanessa Carter and I’ll be presenting about medical education in South Africa from a patient perspective.
So let me start with a few pieces of my story. When I was 25, I qualified as a graphic designer and started an advertising business. I was incredibly ambitious and my outlook on life lead me to believe I would be successful oneday with hard work.
I never imagined those pieces completely demolished by a car accident. The paramedics shocked the life back into me on the side of a road in Johannesburg where I blead internally, had broken pelvic bones and a severe head injury that smashed half my facial bones. For a decade after that I fought to put the pieces back together.
Complex facial injuries like mine need a multidisciplinary team. Each puzzle piece of damage in my face needed its own specialist but finding them was difficult. I didn’t know where to begin, they didn’t network across disciplines so they couldn’t refer me to each other, they weren’t visible online and each doctor focused on his own piece which I had to connect in the end. 53 medical reports later and my surgeries were failing.
After my sixth year, I developed a resistance to antibiotics and battled with the flesh eating bacteria called MRSA. I was set back by years. I had never heard of this disease until then.
I couldn’t really prove where it came from. MRSA can be caused by many things like too many surgeries or it could have been acquired in hospital, overprescribed antibiotics or my own non-adherence. In my heart I felt that a broken system was a major contributor.
The bottom line was that I had this deadly superbug and it was untreatable. It was scary because it made me realise that each and every one of us is vulnerable. We don’t control disease with technology as well as we think we do so it’s important to work as a team.
A fully functional health system isn’t just about doctors and nurses, it goes beyond that. We need to include everyone from the ground-level. The community workers, cooks, drivers and even cleaners because they are all a piece of the puzzle. Imagine my doctor did everything right but the theatre wasn’t sterilised correctly. Maybe that’s how I got MRSA? Could that improve if education about disease control were designed for cleaning staff?
A One Health approach is important because 6 out of every 10 infectious diseases in humans are spread from animals. The World Health Organisation recently announced a global action plan to research the impact of animal, food and environmental factors because these determinants are all connected to human health.
Disease also knows no borders. Building a global health workforce to manage disease on every continent is important to everyone on this planet.
Developing countries like South Africa have a shortage of health workers and the world’s highest rate of AIDS and TB, which are becoming drug resistant too. In recent years it was reported that 36 000 students applied for the 1 770 places in our medical schools and the rest, 34 240 were turned away. What a waste of potentially good health providers every year.
An educated patient who can report an outbreak in real-time in their community is a major asset to public health and their narrative about an emerging disease might also have a major impact on academic research. Their ability to self-care better is also a fundamental piece of our system.
Healthcare isn’t just made up of modern medicine either. In South Africa, we have close to 200 000 traditional healers and 70% of the population consult them. They are important contact points in the rural community. Medical education programs should be designed with this in mind. If community health workers like this are enrolled on an incentive program where they can capture digital data, we might also improve our chances of managing disease outbreaks.
So is there a way we can bring all of these pieces together? Does it make sense that our picture of human health is so broken? Does it make sense that it’s so difficult to navigate and collect data? Technology is exploding and we see a mass of innovation, but for users who are on the lower end of the digital divide, how can we simplify it? How can we reach and educate those users, the missing pieces of the puzzle? The cleaners, the traditional healers, the patients? How can we create a digital ecosystem where we can learn, network, find resources matched to our needs and share our stories.
In South Africa Sustainable Development Goals are an important guide for the implementation of health systems and ICTs. This is a diagram from the World Health Organisation which demonstrates the intersections clearly. I encourage you to study the intersections and think about what global goal 3 means to you.
We have run out of time for this puzzle. In closing, thank you to everyone who participated in my research for this presentation. A copy of the Symplur transcript and my abstract can be viewed on the hashtag #MedXedAFRICA. Please share your thoughts on that hashtag. Thank you.