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