> Hi Wayne,
>
> You are pointing out an important point.
>
> There is also another important issue to address: in developed
> countries, the great trend in ICT for health will actually be continuity
> of care and teamwork for chronic patients, that is - to be more accurate
> - to optimize the way we use our ultra-modern, ultra-expensive health
> technologies.
>
> A recent article in a French scientific paper was titled "Can't we stop
> a fire using non drinkable water";
That is a lovely analogy, and I bet that it is even more elegant in
French - can you give us the original title so I can mispronounce it to
my friends and colleagues?
> the writers demonstrated that our
> health technology has reached such a point in quality demand that it can
> no longer produces the (low level) drugs that could save hundreds of
> thousand lives in less developed countries.
As much as I hate to admit it, the Bill and Melinda Gates Foundation
have grasped this problem and are doing some good work by funding
research and development into drugs for "neglected diseases" in poorer
countries as well as vaccination programmes for common diseases. They
are not the only philanthropic or govt aid agency funding such work, but
probably one of the largest and best known. Indeed, one of my
colleagues, after reading about their work, said "That's a good reason
to buy Microsoft software!" I ventured to differ and proceeded to
explain why.
But just like the OLPC (One laptop per child) project (
http://laptop.org/ ), which aims to make computer technology affordable
in poorer countries, so there should be projects developing, for
example, low-cost but high-quality (and rugged) obstetric ultrasound
machines, which, together with appropriate training, would be an
enormous boon in just about very clinic in every poorer nation.
> I now feel the same problem with the continuity of care tools I am
> working on: is it worth something in developing countries... and worse:
> isn't it dangerous to use it in non-democratic places or in places where
> husbands will force their wives to show them their health history!
People working in health in poorer countries often say that protection
of privacy, which is a big concern in rich countries, shouldn't be
allowed to get in the way or delivery of health care in poorer
countries, and that there is little expectation amongst patients of much
privacy anyway. Both of those statements are probably be true, but I
don't think that the corollary that privacy doesn't matter in poor
countries is also true - for the sociological reasons to which you
allude as well as for political reasons in many places. As
privacy-preserving technologies are developed, it is important that they
find their way into FOSS projects for health.
> We will probably soon test the Ligne de vie in Africa... we have much to
> learn there... and we will have to be honest enough to check the
> benefit/risk balance.
Yes, and evaluating that could be quite a challenge - assistance from
ethicists and sociologists, disciplines not often associated with
information technology projects, might be be helpful.
Tim C
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