By: Osita Aniemeka, PhD, Ambassador, Telemedicine Today, NIGERIA
Before the dawn of COVID-19, the effects of climate change were already being felt by people across Africa. Evidence shows that change in temperature has affected the health, livelihoods, food productivity, water availability, and overall security of the African people. According to the Climate Change Vulnerability Index for 2015, seven of the ten countries most at risk from climate change are in Africa. The continent has seen a decrease in rainfall over large parts of the Sahel and Southern Africa, and an increase in parts of Central Africa. Over the past 25 years, the number of weather-related disasters, such as floods and droughts, has doubled, resulting in Africa having a higher mortality rate from droughts than any other region. Africa, in the last couple of months, has seen changes that show that Africans can adopt a more sustainable way of living. Good social and health protection, economic recovery, and preserving the environment are the three mutually-dependent pillars that must form the foundation for African action in the wake of Covid-19.
The same socially-oriented approach that must be taken to defeat the coronavirus can, over the longer run, stop the climate catastrophe. Covid-19 has revealed some unexpected things about Africans – adapting rapidly to a common threat. It has not come easily and it’s demanding much more hope, but Africans, despite their state of unpreparedness, are showing that they can do it. At the same time, the virus has dramatically highlighted only a fraction of the damaging consequences that climate change could have. In this crisis, Africans have put their faith in science providing more impetus to trust the science of climate change and listen to the calls for a radical, people-centered transition to a carbon-neutral economy. The virus has demonstrated with brutal force how austerity has starved African health systems of resources, while employment policies have encouraged precarious work, which leaves people even more vulnerable as the lockdown affects the economy. African governments have eventually been forced to recognize the need to protect workers—through salary support, incentives, etc. The same approach is required to implement a fair and just transition to a green economy, avoiding massive job losses and damage to communities.
Africa is the least-equipped region in the world to fight coronavirus. As the continent struggles to stop the spread of the disease, the countries have imposed various forms of lockdowns that include curfews and border closures. With the lockdown on its second phase beginning this week, continent-wide, there’s looming meltdown as country-by-country, economic shutdown with devastating results are being recorded. Exportation has halted, tourism and foreign exchange earnings and reserves have dried up, and the continent’s private sector no longer operate. Worse still, resources for health expenditure are squeezed while millions of households that depend on daily wages are starving and protesting and Africa is looking to donors for help. From West, East and Southern Africa, some ray of hope trickled in to help just a handful of countries to stay afloat. The four countries from the three sub-regions – Togo, Sierra Leone, Rwanda, and Madagascar, have received IMF loans to mitigate the impact of COVID-19. The African telemedicine market has experienced substantial growth in recent years. From $18bn 2015, it’s expected to grow into a $41bn next year. Telemedicine is a great promise for Africa, especially for individuals living in geographically challenged areas. With the support of SeekMed, the platform for affordable telemedicine, that helps connect patients with quality international healthcare professionals via a user-friendly mobile application, Africa’s healthcare terrain has changed tremendously.
The Nigerian Story
When telemedicine arrived in Nigeria in January, 2010 via a pilot project at the Lagos University Teaching Hospital (LUTH), the interactive electronic mode of teaching, research and provision of medical services was embraced by lecturers, students and patients because of its efficiency and cost-savings potentials. Other colleges and universities in the country were encouraged to consider partnerships with IT companies that provide telemedicine infrastructure. In Nigeria, telemedicine employs modern technology to improve medical cellphone, COVID-19, and Climate Change in African education and services and is also a veritable tool for communication between medical experts in Nigeria and abroad.
It took the new coronavirus to bring the real potentials of telehealth the fore in Nigeria. In an unmatched approach, governments and health professionals became willing to deploy a technology that should have happened years ago, to not only save lives but bring quality healthcare to the underrepresented mass of the population. The most populated nation in Africa now seeks ways and means of deploying new telehealth strategies as Covid-19, the new deadly masquerade is forcing a new dance beat, creating a dance step.
Like other African countries, it’s the poor state of preparedness for the pandemic in Nigeria that is creating fear and anxiety as well as the doubts in the minds of many. The nation’s inadequate healthcare infrastructure is not just outmoded but also out-of-use. Nigeria’s healthcare system, copied and never corrected, was designed to bring patients together in a place – the hospital. The sick and the infected can only access healthcare by visiting hospitals. What Nigeria seeks now is a healthcare apparatus where healthcare personnel can provide care remotely – and arguably, more competently and commendably – than in a packed, health center. With COVID-19, Nigeria is experimenting with the notion that some local health issues can be resolved without the revered out-patient and in-patient approaches and, in some cases, with even the revered medic’s physical touch. The new coronavirus is making it clear that healthcare delivery can be approached another way, and perhaps even faster in reaching the masses, despite the distance and destination.
Cellphones are now everywhere in Africa. Over half the continent’s population has one and the countries have largely skipped over landlines and gone straight to mobile devices. In Tanzania, 97 percent of people have access to a cellphone, while only 27 percent have access to a landline. In Nigeria, more people have a cellphone than have access to hygiene utilities. The proliferation of this technology brings many gains. With cellphones in the hands of so many people, information can spread quickly in Africa and having such an easy means of communication lets groups of people mobilize like never before. Climate Change activism is now just a few buttons away. And now that smartphones make up a large chunk of the cellphones being used worldwide, people and organizations have even greater tools for Climate Change communication at their fingertips. In Africa today, cellphones are being used in Climate Change campaigns, including:
1. Clean Air Advocacy
Some African countries are now reporting air quality just by people walking around with cellphones in their pockets. Embedded sensors automatically record and send real-time air quality measurements and lead to highly accurate, crowd-sourced air pollution data.
2. Citizen Science
Africans are nature lovers and want to be more involved in the discovery of things. The cellphone cameras are good for scientific research because they put the power of observation and immediate recording and sharing into the hands of both citizen scientists and experts alike and the scientific community is realizing the potential of this crowd-science for Climate Change studies and solutions.
While the most Climate-Change-responsible thing to do is to consume less, Africans consume a certain amount of things and smartphones allow them to do so in the eco-friendliest way possible. While shopping online or buying locally is a toss-up depending on what people are buying, once they decide how they’re going to shop, apps like Jumia or Konga inform them of the most sustainable products to buy and the best businesses to buy from.
4. Energy Saving
Climate Change campaigns to save energy have been greatly simplified by smartphones. Apps for home energy management and conserving fuel abound in Africa. Home energy efficiency is often called the low-hanging fruit for helping to fight Climate Change and cellphones are making it easier than ever to achieve. Various apps are now available to make conducting home energy audits, tracking energy consumption, and making energy-efficient changes a snap.
5. Wildlife and the Environment
Cellphones are aiding in the protection of endangered animals and habitats all over Africa. For example, Save the Elephants Campaign uses cellphones to quickly communicate the locations of GPS-collared African elephants to farmers so that they can do what they can to avoid negative effects to their farm and ugly confrontations between themselves and the animals. Patrols at the Okapi Wildlife Reserve in the Democratic Republic of Congo text their GPS locations to a central operator so that if any threats to the reserve arise, they can be mobilized in the quickest and most efficient way to stop the problem. If well applied, cellphones can avert the herdsmen-farmers clash in Nigeria.
Cellphone and COVID 19
With the incursions of COVID-19 in Africa, the four cardinal points for cellphone success include:
1. Stemming The Spread
With the cellphone, COVID-19 spread has been stemmed faster and diagnoses made sooner. There are a handful tele-COVID services running at the moment and it is reported that the isolation centers who entered these services are able to identify the critical cases in a very short time for further isolation and attention. Testing is faster and emergency care is better directed.
2. Continuous Monitoring
There are some infected persons that need to be kept under observation round the clock and this is where the cellphone comes handy. Telehealth is currently being used in a lot of COVID-19 intensive care units because there, the patients need to be monitored continuously. With the technology, the experts get a permanent eye that helps them know about certain distractions, sudden changes, and other important signal(s).
3. Bolstering Second Opinion Syndrome
Second-opinion in medicine is a decision-support tool for ratification or modification of a suggested treatment by another physician. During the COVID-19 pandemic, second-opinion has a critical influence on testing, treatment, and prognosis. A simple phone call, a video from tele-COVID centers, etc., can provide that now.
4. Rehab at Home
When those infected recover from the pandemic or are still being treated in the remotest parts of the country, telemedicine is pretty useful for them. Healthcare professionals and specialists have kept a check on these persons even when they are at home, which means that if and when a patient starts acting weird, the healthcare personnel will immediately know about it will take help and rescue steps.
These are the four best ways, albeit in a few places, that show how the cellphone is helping to manage COVID-19 in Africa. The GSM has proven to be a blessing to healthcare delivery in the age of a pandemic and Climate Change communication on the continent. Telehealth is helping to reduce the risk of coronavirus infection and stop the climate catastrophe in Africa.
Osita Aniemeka, PhD, Founder and President, Sub Saharan Open University is Co-Ambassador, Telemedicine Today (TMT) in Nigeria. He oversees the Commonhealth for Africa Rural Emergencies (CARE) plinth of his University that brings healthcare specialists to rural Africa, where distances and quality of infrastructure hinder medics’ movements and patients’ access. Osita was Communications Director for STOPAIDS Organization, a Harvard Health and Centers for Diseases Control and Prevention program in Nigeria.