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Solar-Powered Mobile Clinics to Boost Rural Healthcare in Africa

New UNOSSC banner Dev Cha 2013

Around the world, innovative thinking is finding new ways of using solar power technology to bring electricity to underserved areas of the global South. Innovators are experimenting with new technologies, new business models and new ways to finance getting solar power into the hands of the poor.

One recently launched new solution is a solar-powered mobile health clinic that is bringing 21st-century medical diagnostic services to rural areas.

The US $250,000 Solar Powered Health Centre has been built by the Korean technology company Samsung (http://www.samsung.com/africa_en/news/localnews/2013/samsung-launches-solar-powered-health-centre-model-to-bring-quality-healthcare-to-rural-areas).

A truck packed with medical equipment that draws electricity from solar panels, it is traveling to rural, underserved parts of sub-Saharan Africa.

The truck is seven metres in length and comes packed with medical goodies, including a fully equipped eye and blood clinic and a dental surgery. It hopes to make it easier to reach the six in 10 residents of sub-Saharan Africa who live in rural areas, and who are often very far from affordable medical services. There is a blood analyzer, spectacle repair kit, and a non-contact tonometry test to measure the inside of a person’s eye. People can also be tested for HIV, malaria and many other conditions.

Samsung (samsung.com) developed the truck as part of its efforts to create “Built for Africa” technologies. The truck was built in Johannesburg, South Africa, helping create local jobs and skills.

Samsung hopes to scale the initiative to a million people in Africa by 2015.

The clinics were launched in Cape Town at the 2013 Samsung Africa Forum and are being rolled out by Samsung Electronics Africa (http://www.samsung.com/africa_en/#latest-home) as part of what the company calls a “large-scale medical initiative on the continent”.

The roaming trucks will be staffed by qualified medical professionals and will educate people about the importance of preventive medical screening.

Targeted conditions include diabetes, high blood pressure, tooth decay and cataracts. The clinics will also conduct public health education campaigns about the importance of preventive medicine (http://en.wikipedia.org/wiki/Preventive_medicine).

“What many see as minor health issues will not only get worse over time, but will affect other aspects of quality of life. The child that cannot see properly cannot learn properly,” said Dr. Mandlalele Mhinga, a member of the Nelson Mandela Children’s Hospital (http://nelsonmandelachildrenshospital.org/). “Mobile solutions help address this issue by making medical services accessible to more people in rural areas, and educating them about health care at the same time.”

The mobile clinics hope to reduce the vast difference between the quality of health care available to rural residents and people in urban areas.

Even in countries such as South Africa with the highest level of development in the region, medical care coverage is patchy and unreliable. For those who can afford it, 20 per cent of the population, there are private medical schemes. But everyone else must rely on an over-stretched and under-funded public health sector.

Samsung has based this innovation on its first-hand experience with providing medical services to rural areas in Africa.

“This experience has shown us how desperately medical treatment is needed across the continent, and inspired us to develop a sustainable and innovative solution to reach the people who need it most,” said Ntutule Tshenye, Business-to-Government and Corporate Citizenship Lead for Samsung Africa. “While our CSR (corporate social responsibility) strategy in Africa is largely focused on education, our efforts to enrich lives will not be felt if people’s basic needs, such as access to healthcare, are not met.”

Samsung’s “Built for Africa” product range (http://www.samsung.com/africa_en/africancitizenship/home4.html) also has a wide range of other projects and initiatives to boost health and living standards on the continent. These include education programmes, such as the Samsung Electronics Engineering Academy, Samsung Solar Powered Internet Schools, the Samsung Power Generator, and the Samsung eLearning Centres.

Samsung Electronics Co., Ltd. is a consumer electronics multinational and employs 227,000 people worldwide.

By David South, Development Challenges, South-South Solutions

Published: August 2013

Development Challenges, South-South Solutions was launched as an e-newsletter in 2006 by UNDP’s South-South Cooperation Unit (now the United Nations Office for South-South Cooperation) based in New York, USA. It led on profiling the rise of the global South as an economic powerhouse and was one of the first regular publications to champion the global South’s innovators, entrepreneurs, and pioneers. It tracked the key trends that are now so profoundly reshaping how development is seen and done. This includes the rapid take-up of mobile phones and information technology in the global South (as profiled in the first issue of magazine Southern Innovator), the move to becoming a majority urban world, a growing global innovator culture, and the plethora of solutions being developed in the global South to tackle its problems and improve living conditions and boost human development. The success of the e-newsletter led to the launch of the magazine Southern Innovator.  

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ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021

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New Legislation Will Allow Control Of Medical Treatment

By David South

Today’s Seniors (Canada), December 1993

It isn’t the nicest thing to think about, but if accident or illness strikes, you could end up receiving unwanted treatment. 

But in 1994 things will change. The living will or advance directive – a document clearly stating a patient’s wishes about how they want to be treated – will become part of the doctor-patient relationship. 

A trio of acts passed last December – the Advocacy Act, the Substitute Decisions Act and the Consent to Treatment Act – allow, albeit in rather vague language, for Ontarians to set out in advance which medical procedures they would or wouldn’t accept and let’s them name a proxy in case they are incapable of expressing their wishes. 

This vague language – intended to allow patients to customize their wishes – means that writing a living will can prove to be a troubling and confusing experience. 

To aid decision-making, the University of Toronto Centre for Bioethics is offering advice through a “model” living will. 

The centre’s Dr. Peter Singer has geared the “model” to meet Ontario legislation and to offer a guide for anybody who doesn’t know where to begin. 

“We put a lot of detail in the advance directive about states of incompetence people get into, and also the sorts of procedures providers might recommend in those health states.”

Singer sees living wills as an effective tool aiding patients to control their own health care.

“Unless the doctor is a longstanding friend it’s hard to know what patients want. As a practicing doctor, I have run into an incompetent person where their family member has no idea what sort of wishes the person would have wanted. The goal of a living will is to provide the personal care the patient would want.”

But there is a danger. Dr. Singer urges the need for informed and detailed language in a living will. 

“If I have a couple minutes to make a decision I need a document that gives me a lot of confidence that this person wouldn’t want this treatment.”

In an emergency, the doctor might not even know of the living will’s existence. Dr. Singer advises giving a copy to your family doctor, lawyer, or proxy, and keep one with you at all times. When so-called “smart” health cards come along, Dr. Singer would like to see the living will recorded on the magnetic strip along with other health information. 

Read more health and medical journalism here: Taking Medicine To The People: Four Innovators In Community Health

Read more about transforming medical history scholarship in Canada here: Hannah Institute For The History Of Medicine | 1992 – 1994

More from Canada’s Today’s Seniors

Feds Call For AIDS, Blood System Inquiry: Some Seniors Infected

Government Urged To Limit Free Drugs For Seniors

Health Care On The Cutting Block: Ministry Hopes For Efficiency With Search And Destroy Tactics

New Seniors’ Group Boosts ‘Grey Power’: Grey Panthers Chapter Opens With A Canadian Touch

Seniors Falling Through The Health Care Cost Cracks

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021

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Health Care On The Cutting Block: Ministry Hopes For Efficiency With Search And Destroy Tactics

By David South

Today’s Seniors (Canada), August 1993

It’s search and destroy time at Ontario’s ministry of health: search out savings and destroy inefficiency and waste. But many remain apprehensive that not all the cuts are going to be logical and fear the province’s health and well-being will be affected. 

As part of the social contract deal, the Ontario Medical Association must find $20 million in cuts from the list of services covered by OHIP. The OMA and the provincial government are currently haggling over which procedures and examinations will be cut. 

“We look at services that aren’t medically necessary,” says health ministry spokesperson Layne Verbeek. “Because we were wealthier in the past, we were able to cover some services. We aren’t in that position now. But I don’t see how eliminating medically unnecessary treatments will affect the population.”

The fallout of the Rae government’s attempts to reign in costs and recover lost revenues may take years to unfold, but it is already apparent that Ontarians will be paying more. 

“Access to necessary treatment should not depend on a person’s ability to pay,” says health policy critic Carol Kushner. “What disturbs me about any delisting program is that virtually every medical service could be termed medially necessary. There are very few services that are an out-and-out waste of time.

“We often point to the fact that Ontario spends $200 million a year treating the common cold. Well, most of that is a waste of time. But delisting even that kind of service would be a detriment to the public’s health, because a small group of patients really do need to see a doctor when they have a cold.”

OMA spokesperson Jean Chow says it’s too early to pin down the exact cuts that will be made. “It’s a little premature to try and speculate what the final list will be.”

The newly-created Non-Tax Revenue Group is hard at work finding fees, fines and penalities the government can add or hike to boost revenue from this source from $5 billion to $10 billion a year. 

The spring budget saw the first hit, with the addition of $240 million in non-tax revenue. 

A radical reshaping of medicare is taking place. Private sector services – for which consumers pay directly or through insurance companies – now make up 34 per cent of Ontario’s health care funding, compared to 42 per cent in the United States, according to a recent study by the Canadian Medical Association. 

Health minister Ruth Grier has also floated the idea of widespread hospital closures. Both the Toronto and Windsor district health councils (DHCs) are carrying out feasibility studies on “reconfiguration.” The ministry is remaining tight-lipped about which hospitals will get the chop. 

“One suspects there’s room for efficiency – there are a lot of empty beds in a number of different places,” says ministry spokesperson Verbeek. 

“All hospitals are being reviewed, with a view to closing one or two hospitals,” says health planner Lisa Paolatto, who is working on a feasibility study on “reconfiguration” for the Essex County District Health Council, along with Toronto’s DHC. 

Closing hospitals could present a serious political hot potato for the government. In Britain, the Conservative government is still recovering from the bad feelings surrounding proposals to close world-renowned hospitals in the London area. The public feels great loyalty to local hospitals, a feeling that has been further fostered by hospital charities that raise millions a year from the communities’ good will. 

“This is going to open up new discussions of money between doctors and patients,” says Kushner. “Seniors are a unique group in Canada because they remember what it was like before medicare – what it was like not to be able to pay for the doctor, to forgo treatment that they thought was necessary. They understand the financial hardship that could occur if they were unlucky enough to have a family member who needs expensive medical treatment.” 

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More from Canada’s Today’s Seniors

Feds Call For AIDS, Blood System Inquiry: Some Seniors Infected

Government Urged To Limit Free Drugs For Seniors

Health Care On The Cutting Block: Ministry Hopes For Efficiency With Search And Destroy Tactics

New Seniors’ Group Boosts ‘Grey Power’: Grey Panthers Chapter Opens With A Canadian Touch

Seniors Falling Through The Health Care Cost Cracks

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021

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Specialists Want Cancer Treatments Universally Available

By David South

Today’s Seniors (Canada), December 1993

A newly-formed group representing cancer doctors says it is fed up with the inhumane and bureaucratic approach to cancer care in Ontario. 

Dr. Shailendra Verma of Access to Equal Cancer Care in Ontario (AECCO) says he’s had enough. 

“My group has served the government notice that we’re fighting on our patients’ behalf,” says Verma, who faces gut-wrenching quandaries every day in his growing Ottawa practice. “In a public health system, I’m damned if I’m going to be divided into giving one set of patients a Cadillac treatment and the other Hyundai-type treatment; I don’t think that’s why we have a public health system.”

Verma says cutbacks to health care funding have meant that doctors must leap increasingly high hurdles to get the drugs their patients need. 

In jeopardy

While chemotherapy drugs administered in hospitals are still free, he says the important drugs necessary for patient comfort and treatment effectiveness are in jeopardy. 

These drugs were once free under the Ontario Drug Benefit Plan (ODBP), but now their status is tenuous. One drug, GCSF – which is crucial in helping patients between treatments of chemotherapy – is now listed under Section 8 of the ODBP and requires doctors to plead with the government each time for coverage. Often the bureaucracy moves so slowly that the course of chemotherapy is seriously disrupted, Verma says. 

“As an oncologist I’m particularly interested in ensuring everyone has access to all treatment. I think we are at a very sensitive crossroads. Over the last three or four decades we’ve developed certain treatments for diseases that more often kill than cure. And now we are at a point where we’ve got new treatments that can make the older treatments more effective. Or we’ve got brand new treatments that we are hoping to apply, and the one thing that is holding us back is cost.”

Cost

“The decisions are not based on science, they’re based on cost. It would not be an issue if treatments cost a penny a shot.”

Verma says colleagues can’t introduce some new drugs because the costs would be too high to offer it to everyone. So no one gets it.

“We have patients who walk in and say they would like to pay for it,” continues Verma. “Ethically, as a physician do you allow a patient to pay for it while sitting next to a similar patient who can’t afford it?”

Update: Cancer drugs that stay one step ahead may give patients 40 years of life (The Sunday Times, November 15 2020)

More from Canada’s Today’s Seniors

Feds Call For AIDS, Blood System Inquiry: Some Seniors Infected

Government Urged To Limit Free Drugs For Seniors

Health Care On The Cutting Block: Ministry Hopes For Efficiency With Search And Destroy Tactics

New Seniors’ Group Boosts ‘Grey Power’: Grey Panthers Chapter Opens With A Canadian Touch

Seniors Falling Through The Health Care Cost Cracks

ORCID iD: https://orcid.org/0000-0001-5311-1052.

© David South Consulting 2021