Harvard event: Can mobile apps improve health care in South Asia?

harvard event

Here’s how Wired describes HealthTap “A network of patients and doctors where patients can find doctors, and ask medical questions of specific physicians (for a fee) or to entire network. HealthTap already rates the doctors in its system based on how often they use the site to answer patient questions, and if other doctors agree with those answers. Now it’s adding information about which doctors get referred to the most so patients can find the most trusted MDs.”

Founder Ron Gutman will be at Harvard today to talk about  using the technology to improve health in India.

At 4 p.m.  in room K262, 1737 Cambridge Street, Cambridge. Free and open to the public.

For more health events this week, check out the BHN calendar.

Also, check out the story from “Daily Dose” blogger Deborah Kotz for the latest on good fat v. bad fat. 

What’s…clear is that Americans often received bad advice to eat as little fat as possible when it was first discovered that reducing saturated fats could reduce cholesterol, and especially after researchers demonstrated that the practice could prevent heart attacks. Too many of us embraced fat-free cakes and cookies after swearing off cheddar cheese and steak — and often gained weight as a result of the excess sugar and calories.

Partners in Health patron Tom White dies at 90

There would probably be no Partners in Health without Tom White, the Boston builder turned philanthropist who died yesterday.  He not only seeded the bold medical aid group, White believed in them when no in public health did. In today’s Globe obit, Dartmouth president and PIH founder Jim Kim called White “the real patron saint of hopeless causes. “He allowed us to tackle what are quite literally the most difficult health problems in the world,’’ including drug-resistant TB and untreated HIV. (Kim named his son after White.)

White in Haiti © PIH

In addition to the Globe story, see PIH’s own tributes, including one from Tracy Kidder, who followed PIH doc Paul Farmer around for a year for the book “Mountains Beyond Mountain.”

Recalling his first meetings with Paul Farmer, Tom said, “Paul was a lot younger than me, but he was way ahead of me, on service to the poor.” He smiled and went on, with a trace of wistfulness in his voice: “Sometimes I think how much money I used to have, before I met Paul Farmer.” Then he added, “But that’s all right. They give me a big steak now, and I can only eat half of it.” 

More here, including pictures.

Boston conference on technology and global health.

The World Health Medical Technology Conference, was a “workshop dedicated to exploring the opportunities and challenges of designing, building and funding medical technologies for the developing world.”

In other words, trying to find inexpensive tests and treatments that are simple to use and don’t require a lot of infrastructure, like labs and clean water.  

BHN sat in on the morning sessions at BU, which features presentations from local groups, including Cambridge’s “Diagnostics for All.”  Una Ryan, the group’s CEO, said: “We have all this advanced and innovative technology and we don’t know how to get it to the people who need it the most.”

So, the non-profit has created a tiny, paper diagnostic tool that works like a home pregnancy test.  Imagine a miniature game of Twister. Instead of a foot, health care worker can put a drop of blood on one of the dots. The dot then changes color based on, say, how well the patient’s liver is functioning.

 Since hepatitis and drugs for HIV and TB can cause liver damage, this simple, inexpensive test will allow docs to monitor patients even if in remote villages with no roads and a couple of generators for electricity.  The costs – ten cents. The group plans to use the technology to give rural health workers tools to test for and monitor TB, malaria, HIV/AIDS, and diabetes.

The session also featured a presentation on a Seattle group called PATH, which describes itself as an international nonprofit organization that creates sustainable, culturally relevant solutions, enabling communities worldwide to break longstanding cycles of poor health.” Among other projects, PATH is   working with a Cambridge start up called Daktari on an inexpensive hand-held device that can perform key blood tests on patients with HIV/AID.

Daktari was founded in 2008 by Bill Rodriguez, who has worked at both Harvard and at the Clinton Foundation, and Mehmet Toner, a Harvard/MIT engineer.

Innovation was the theme, as the morning speakers said many existing devices simply can’t be adapted to work in communities without water, doctors, or electricity.

“The technologies we use to diagnose diseases are way too complex,” Rodriguez said. “They were never designed to work in these settings.”

So for details, check out the Mass Device blog.

 

Infectious disease and Bostonians from Africa

Passing this along from the Running a Hospital blog, which is run by BIDMC chief Paul Levy. 

According to World Health Organization reports, nearly half of deaths due to infectious diseases globally, occur in the Sub-
Saharan Africa. Particularly, of all the people infected globally
by various diseases, 89% of those infected by malaria, 77%
of HIV/AIDS patients and 31% of Tuberculosis patients, in Sub-Saharan Africa die of these diseases.

There is a large population of Sub-Saharan Africans domiciled
here in Massachusetts.
The African Community Health Initiatives
(ACHI) has stepped up to help, not only to provide appropriate
education, but has increasingly become a conduit through which
people of African descent are sought after, screened for health
insurance, health/social service needs, and assisted with application/referral to appropriate health/social service providers.
ACHI also assists in the enrollment of clients in the Massachusetts state health insurance plans, namely, MassHealth and Commonwealth Care.

Gates Foundation under the spotlight

Aid groups built this well and supplied the bicycle to a child disabled by polio

Aid groups in Cambodia built this well and supplied the bicycle to a child disabled by polio. Photo by Tinker Ready, 1996

One saying about international aid goes something like this – Give a man a fish and you feed him for one day; teach him how to fish and you feed him forever.

Then there is another point of view – Give the guy the goddamn fish — he’s starving! Then worry about fishing lessons.

Having spent a year covering dysfunctional Cambodia, I learned a bit about international aid. These folks mean well, do a lot of good and face a lot of complicated issues. For example, do you want to hand a new hospital over to the government if you know they are going to turn it into another corrupt fiefdom?

The British journal The Lancet has a piece this week on one of the world’s biggest aid donors – The Bill and Melinda Gates Foundation.

Here’s what AP had to say about it.

 SEATTLE (AP) — A new study of the Bill and Melinda Gates Foundation illustrates its global reach with spending on health issues, but notes a need for accountability on whether the money is being spent in the most effective way.

The world’s largest philanthropic foundation focuses its global health giving on eradicating diseases such as malaria and AIDS. It also works to aid agricultural development in Africa and Asia and improve education in the United States.

”What we have is a private actor with a huge degree of influence, but not really a mechanism by which that influence is held to public account,” said Dr. David McCoy, the primary author of the study.

The Gates foundation was also the subject of a story from the journal Foreign Policy, which I read in the UTNE reader. The title says is all – “The New Colonialists.”

In much the same way European empires once dictated policies across their colonial holdings, the new colonialists—among them international development groups such as Oxfam, humanitarian nongovernmental organizations (NGOs) like Doctors Without Borders and Mercy Corps, and mega-philanthropies like the Bill & Melinda Gates Foundation—direct development strategies and craft government policies for their hosts. But though the new colonialists are the glue holding society together in many weak states, their presence often deepens the dependency of these states on outsiders. They unquestionably fill vital roles, providing lifesaving health care, educating children, and distributing food in countries where the government can’t or won’t. But, as a consequence, many of these states are failing to develop the skills necessary to run their countries effectively, while others fall back on a global safety net to escape accountability.

The issues are well-worth debating. But, I do know that some of the issues the Gates Foundation is dealing with — like malaria — were virtually ignored for years. Plus, they help fund one of the most thoughtful health aid groups around – Boston-based Partners in Health

(Windows Vista turned my computer into an evil demon, but that’s another story.)

So, choose your cliché – 1) The road to hell is paved with good intentions or 2) No good deed goes unpunished.

Latest Massachusetts flu updates

I can’t get them up fast enough. So check in below. As of Thursday early afternoon, the Globe was reporting that the Lowell brothers — the state’s only 2 confirmed cases –did not infect anyone on their little league team.

The Globe flu update.

  

Mass Dept. of Health 

 

 The New York Times has a “flu tracker”  map with updates.

 Keep this, also from the Times, in mind as you read: 

Without the news media the public would be dangerously unaware of the swine flu outbreak, but perhaps without saturation coverage on cable news networks and the velocity of information on the Internet, the public would not be so hysterical, medical professionals said.

“It’s a fine line between educating people and frightening them,” said Dr. Marvin J. Tenenbaum, the director of medicine at St. Francis Hospital on Long Island.

Breast cancer in developing countries

Update 4/16 — Webcast of the event

I didn’t intend to become a HSPH calendar of events this week, but this one stood out.  Plus, Jim Smith — who reported on Latin America  before coming to Boston — has the back story on in today’s Globe

Felicia Marie Knaul, a Harvard-trained global health economist living in Mexico, was 41 when she received a diagnosis of breast cancer and underwent a mastectomy. She responded by launching a nationwide early-detection project for breast cancer and sharing her own story of hair loss, chemotherapy, reconstructive surgery, and emotional survival.

This evening, when Knaul appears at a forum at the Harvard School of Public Health to discuss her work in Mexico, she’ll have a champion on stage with her. The host will be her husband, Julio Frenk, a leading global health policy specialist who became dean of Harvard’s School of Public Health in January.

“I have an ally in many, many senses,” Knaul said.

“All of the work to start the program, and most of the presentations, we did as a couple, with Julio speaking very openly about his experiences as a partner of a woman with breast cancer, and how to provide the dignity a woman needs, especially when she’s going through something like this.”

Frenk said he felt the forum would be an appropriate way for him and Knaul to introduce themselves to the Boston medical community because the personal issue they confronted as a couple is so closely aligned with his policy priorities as he takes the helm at the graduate school.

“All my life I have studied the health system. It’s been very revealing for me to be on the other side, on the receiving side, and to feel what a patient has to go through in diagnosis and treatment. It’s given me a whole different perspective of my patient – the health system,” Frenk said in an interview.

 

 

 

 

 

 

Tuesday, April 14
4:15-5:45 PM
Harvard School of Public HealthPPPHP_BC_smaller (PPPHP_BC_4.14.09_smaller.jpg)
Kresge Building, Snyder Auditorium
677 Huntington Avenue, Boston

Participants:

Julio Frenk
Dean and T & G Angelopoulos Professor of Public
Health and International Development, HSPH

Felicia Marie Knaul
Senior Economist, Mexican Health Foundation
Director, Breast Cancer: Tómatelo a Pecho

Jennifer Leaning
Co-Director, Harvard Humanitarian Initiative
Professor of the Practice of Global Health, HSPH
Associate Professor of Medicine, HMS

Lawrence Shulman
Chief Medical Officer and Sr. Vice-President for
Medical Affairs, Dana-Farber Cancer Institute
Associate Professor of Medicine, HMS

Walter Willett
Chair of the Department of Nutrition and
Fredrick John Stare Professor of Epidemiology
and Nutrition, HSPH

A webcast and podcast will be available after the event.

Jim Kim, Dartmouth and evidence-based public health

What does Jim Kim’s appointment as president of Dartmouth mean for health reform? Dartmouth Medical School is in position to play a big role in the push toward evidence-based medicine, a key element in the Obama health reform plan. 

And Partners in Health, which Kim co-founded with Paul Farmer, is an example of evidence-based medicine and public health.

PIH doesn’t just say – we need to treat the poor in places like Haiti and Rwanda. They do it, document the process and publish research that says – it is possible and here’s how we did it. For an example, see the October issue of the Lancet: “Treatment of extensively drug-resistant tuberculosis in Tomsk, Russia: a retrospective cohort study.”

I learned about PIH a few years back  when I went to an event to hear Noam Chomsky talk about health care.  He didn’t really – he sort of gave a talk about the Chomsky view of the world with little health care thrown in.

My toddler son was starting to get a little squirmy, so I was going to leave. Then, another speaker got up and starting talking about his research into curing drug-resistant TB in Peru. His work, however, went beyond research. Jim Kim told the story of Partners in Health.

Having spent 1996 in Cambodia, I had seen the limited treatment there for illnesses  most of us here don’t think twice about.  I decided to stay and listen to Dr. Kim. The story that emerged ran in 2001 in The Boston Phoenix.  

Since then, PIH has saved a lot of  lives and has the evidence to prove it.

Now, Kim is head of Dartmouth, not Dartmouth Medical School. But, he brings with him a sensibility that says – we need to do more than the right thing.  Let’s do the right thing and make sure it works.

 P.S. The Boston Globe’s Stephen Smith updates us on the growing use of genetic testing in cancer treatment with a story in today’s paper on the MGH program.  

Partners in Health: Using tech to cure the world

An MIT press release came across my desk this week about Partners in Health (PIH), the Boston-based, international health and human rights group. PIH has begun using PDAs in Peru to help track and treat drug-resistant TB patients, who need two years of intensive therapy.   

MIT PhD candidate Joaquin Blaya launched the PDA project in Lima,with PIH’s Peruvian sister organization. Socios en Salud.

“The way to solve healthcare problems is by involving the community,” Blaya says in the release.  Community health workers are key to the PHI approach.

More from the release:  

 Peruvian health care workers enthusiastically embraced the program, which started in two of Lima’s districts and has now been expanded to all five. In addition to saving time, the handheld devices are also more cost-effective than the paper-based system, the researchers reported recently in the International Journal of Tuberculosis and Lung Disease.

 You can find that abstract here. Click here for an article on how the PDA reduced errors and workload.

 For more on PIH see www.pih.org.  They’ve launched something called Health and Social Justice Video Network. Deserves a blog entry of its own.

For a literary perspective, see Tracy Kidder’s book-length portrait of PIH founder Dr. Paul Farmer, Mountains Beyond Mountains.

Also see my story on PIH from The Boston Phoenix.  

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Welcome

Welcome, the Boston Health News.  This site will offer original reporting and links to news about health in the Boston area. For a sample of what is to come, see www.tinkerready.com.  Check back in after we’ve grown a bit – BHN

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