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TEDGlobal 2017

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

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In sub-Saharan Africa, power outages, low technology penetration, slow internet and understaffed hospitals plague health care systems. To make progress on these problems in Malawi, TED Fellow Soyapi Mumba and his team created a new system from scratch -- from the software that powers their electronic health records to the infrastructure used to support it. In this quick, hopeful talk, Mumba shares how his jack-of-all-trades mindset can help reshape health care in low-resource environments.

- Technology innovator
TED Fellow Soyapi Mumba creates technology solutions for low-resource environments. Full bio

Like every passionate
software engineer out there,
00:12
I closely follow technology
companies in Silicon Valley,
00:16
pretty much the same way soccer fans
follow their teams in Europe.
00:19
I read articles on tech blogs
00:23
and listen to podcasts on my phone.
00:25
But after I finish the article,
00:29
lock my phone and unplug the headphones,
00:30
I'm back in sub-Saharan Africa,
00:34
where the landscape is not quite the same.
00:36
We have long and frequent power outages,
00:40
low penetration of computers,
00:43
slow internet connections
00:45
and a lot of patients
visiting understaffed hospitals.
00:47
Since the HIV epidemic,
00:52
hospitals have been struggling
to manage regular HIV treatment records
00:54
for increasing volumes of patients.
00:59
For such environments,
01:02
importing technology systems
developed elsewhere has not worked,
01:04
but in 2006, I joined Baobab Health,
01:08
a team that uses locally based engineers
01:11
to develop suitable interventions
01:15
that are addressing
health care challenges in Malawi.
01:17
We designed an electronic
health record system
01:21
that is used by health care workers
while seeing patients.
01:25
And in the process we realized that we
not only had to design the software,
01:28
we had to implement
the infrastructure as well.
01:33
We don't have enough medical staff
01:36
to comprehensively examine every patient,
01:38
so we embedded clinical guidelines
within the software
01:41
to guide nurses and clerks
01:44
who assist with handling
some of the workload.
01:47
Everyone has a birthday,
01:50
but not everyone knows their birthday,
01:51
so we wrote algorithms
to handle estimated birthdates
01:54
as complete dates.
01:58
How do we follow up
patients living in slums
02:00
with no street and house numbers?
02:04
We used landmarks to approximate
their physical addresses.
02:07
Malawi had no IDs
to uniquely identify patients,
02:12
so we had to implement unique patient IDs
02:16
to link patient records across clinics.
02:19
The IDs are printed as barcodes
02:22
on labels that are stuck
on personal health booklets
02:26
kept by each patient.
02:29
With this barcoded ID,
02:31
a simple scan with a barcode reader
02:33
quickly pulls up the patient's records.
02:35
No need to rewrite their personal details
02:38
on paper registers at every visit.
02:40
And suddenly, queues became shorter.
02:43
This meant patients, typically mothers
with little children on their backs,
02:45
had to spend less time
waiting to be assisted.
02:50
And if they lose their booklets,
02:53
their records can still be pulled
by searching with their names.
02:55
Now, the way we pronounce
and spell names varies tremendously.
02:59
We freely mix R's and L's,
03:04
English and vernacular
versions of their names.
03:07
Even soundex,
03:10
a standard method for grouping words
by how similar they sound,
03:12
was not good enough.
03:16
So we had to modify it
03:18
to help us link and match
existing records.
03:19
Before the iPhone,
03:26
software engineers
developed for personal computers,
03:28
but from our experience,
03:31
we knew our power system
is not reliable enough
03:33
for personal computers.
03:36
So we repurposed touch screen
point-of-sale terminals
03:38
that are meant for retail shops
03:43
to become clinical workstations.
03:44
At the time, we imported
internet appliances called i-Openers
03:47
that were manufactured
during the dot-com era
03:52
by a failed US company.
03:56
We modified their screens
03:59
to add touch sensors
04:01
and their power system
to run from rechargeable batteries.
04:02
When we started, we didn't find
a reliable network to transmit data,
04:06
especially from rural hospitals.
04:11
So we built our own towers,
04:14
created a wireless network
04:17
and linked clinics in Lilongwe,
04:19
Malawi's capital.
04:22
(Applause)
04:24
With a team of engineers
04:29
working within a hospital campus,
04:32
we observed health care workers
use the system
04:34
and iteratively
build an information system
04:37
that is now managing HIV records
04:40
in all major public hospitals in Malawi.
04:44
These are hospitals serving
over 2,000 HIV patients, each clinic.
04:47
Now, health care workers
who used to spend days
04:54
to tally and prepare quarterly reports
04:57
are producing the same reports
within minutes,
04:59
and health care experts
from all over the world
05:02
are now coming to Malawi
to learn how we did it.
05:06
(Applause)
05:10
It is inspiring and fun
05:14
to follow technology trends
across the globe,
05:16
but to make them work
05:19
in low-resourced environments
05:21
like public hospitals
in sub-Saharan Africa,
05:24
we have had to become jacks-of-all-trades
05:27
and build whole systems,
including the infrastructure,
05:31
from the ground up.
05:34
Thank you.
05:36
(Applause)
05:37

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About the speaker:

Soyapi Mumba - Technology innovator
TED Fellow Soyapi Mumba creates technology solutions for low-resource environments.

Why you should listen

As Director of Public Health Informatics at Baobab Health Trust, Soyapi Mumba oversees development of electronic health surveillance and reporting systems for public hospitals in Malawi. Previously, he led the software development of Malawi's national electronic health record system which empowers low-resourced public clinics to serve large volumes of patients while following treatment guidelines and meeting reporting requirements.

Mumba is a TED Fellow and a prize winner of "Share an Idea, Save a Life" national competition for innovations in maternal, newborn and child health. His work has been featured in the book The Bright Continent: Breaking Rules and Making Change in Modern Africa.

Mumba lives in Lilongwe, Malawi, with his wife Miriam and their twin boys. He holds a Master of Science degree in Biomedical Informatics from University of Pittsburgh, Pennsylvania and a Bachelor of Science degree in Computer Science from University of Hertfordshire, England.

More profile about the speaker
Soyapi Mumba | Speaker | TED.com