Africa is becoming a world leader in mobile phone applications for health and healthcare. Despite dramatic improvements to the quality of hospitals and the number of qualified doctors, the continent’s healthcare services are still a patchwork, with rural and slum dwellers poorly served and the stresses of treating patients with contagious diseases like HIV/AIDS and malaria pushing resources to the limit.
But innovative inventions are coming along to provide new tools to doctors and medical personnel and to better engage patients with remote services.
South Africa’s Afridoctor (http://twitter.com/afridoctor) mobile phone application claims to be Africa’s first personal mobile health clinic. It lets patients use its “SnapDiagnosis” system to submit photos of their ailments and in turn receive advice from a panel of medical professionals, or use the mapping feature to find doctors, clinics and health industry-related services nearby.
Afridoctor was conceived to fill the gap across Africa for basic health information that is reliable and trustworthy.
There is an emergency feature to notify next of kin during a medical emergency and provide a location. Other features include symptom checkers, first-aid information, health calculators and quizzes.
Expert feedback comes within 48 hours after submission of a request.
A winner of a Nokia competition, Afridoctor was developed by the labs of media company 24.com (http://20fourlabs.com) of Cape Town, South Africa.
“It is more for external use – like dermatology – for things like a bee sting or a snake bite and you don’t know what to do or how to diagnose it,” Werner Erasmus, who created the app, told the BBC.
The “find a doctor” system uses Google Maps to geo-locate local health services including doctors, hospitals and emergency clinics.
The distress feature enables users to contact a family member or friend at the touch of a button. It does this by storing the mobile phone number of a selected relative. When the distress button is pressed, they are notified of the phone’s location.
Developed in just three weeks, to enter mobile phone company Nokia’s contest (http://www.callingallinnovators.com) for mobile phone applications, Afridoctor went on to win the competition in 2009. It is now being expanded to be usable on most, if not all, smart phones.
As in the rest of Africa, mobile phone use in South Africa has dramatically increased in the past 10 years. It is estimated that over 70 percent of South Africans now have access to one.
Another application getting attention is Ghana’s mPedigree (http://mpedigree.net). Designed to combat the damage done by counterfeit drugs in Africa and across the South, mPedigree works by letting a person send a text message by mobile phone to the mPedigree service to check a drug’s authenticity. A message comes back confirming whether the medicine is authentic or not.
The World Health Organization (WHO) has estimated that 25 percent of medicines sold around the developing world are counterfeit. Some contain no active ingredients, and others are even harmful.
mPedigree uses cell phones to build networks to tackle and identify counterfeit drugs. Website: http://mpedigree.net/
AirStrip Technologies: Securely sends vital patient information electronically to a doctor’s mobile phone device. Website: http://www.airstriptech.com/
Instant ECG: Uses the iPhone to interpret ECG (electro-cardiogram) waves. Website:http://www.instantecg.org/
iStethoscope: An application for the iPhone that turns the phone into an electronic stethoscope. Downloaded already by over 3 million doctors around the world, and is being praised for how it helps doctors in remote regions. Website:http://itunes.apple.com/us/app/istethoscope-pro/id322110006?mt=8
OsiriX: An Open Source programme for computers and devices allowing doctors to stream medical imaging data live. Website:http://www.osirix-viewer.com/
Star Analytical Services: Have developed an app that allows patients to cough into a phone and receive a diagnosis. Website:http://www.staranalyticalservices.com/
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.
Access to good quality drugs is a serious problem across the South. The International Narcotics Control Board estimates that up to 15 per cent of all drugs sold around the world are fake or counterfeit, and in parts of Africa and Asia this figure jumps to 50 per cent. The US Food and Drug Administration estimates counterfeit drugs make up 10 per cent of the global medicine market. The US Centre for Medicines in the Public Interest predicts counterfeit drug sales will reach US $75 billion globally in 2010, an increase of more than 90 per cent from 2005.
Fake drugs are a major cause of unnecessary death and destroy public confidence in medicines and health services. While counterfeit drugs have been on the rise, there is little co-ordinated or effective action to counter this menace afflicted on the sick.
But in Ghana, a solution has emerged that shows a way to guarantee that quality drugs get to the sick who need them. CareShop Ghana uses the franchise model – where licenses are sold to approved vendors who adhere to strict guidelines – to ensure that the quality, accessibility and affordability of essential medicines in and around Accra is guaranteed. CareShop has made deals with close to 300 franchisee pharmacies – often modest operations – who sell over-the-counter drugs.
In Ghana, preventable and curable illnesses like malaria and diarrhoeal diseases are among the leading causes of death. Their treatment pushes many people to financial despair; they can ill afford the extra burden of worrying about counterfeit drugs and the harm they do. Like many countries in the South, Ghana’s public healthcare system is unable to meet these needs and so most people turn to the private sector for help.
An estimated 65 per cent of people turn to licensed pharmacies. But many of these operate haphazard businesses, dispensing expired or counterfeit drugs.
GSMFEL makes a small profit as the franchisor by selling high-quality drugs to the franchisees. The key to CareShop’s success is imposing standardization on franchisees, so they have to stick to common diagnosis, quality and pricing. They make more money when they adhere to these rules than when they break them. To ensure there is no tampering with the drugs, they are delivered straight to the vendor’s doorsteps, and it is all backed up with health and business training support and branded materials.
The tide can be turned around on fake drugs: in 2002, the WHO reported that 70 per cent of drugs in Nigeria were fake or substandard: by 2004 that figure had fallen to 48 per cent.
Stimulating private sector solutions to African healthcare problems is now receiving an additional boost from a new fund established by the World Bank’s private sector arm, the International Finance Corporation. Launched in 2007, it offers cash and loans totalling US $500 million to commercial healthcare projects in Africa. According to its own statistics, 60 per cent of health expenditure in sub-Saharan Africa is privately funded, and the market, excluding South Africa, is worth US $19 billion.
Published: May 2008
Resources
SafeMedicines.org is a website offering the latest reports on fake medicines and is a good place to report incidences. Website:http://safemedicines.org/in_the_news/
A paper on the global threat of counterfeit drugs: Click here.
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.
A social enterprise is seeking to capture the power of the sun to bring light and economic opportunity to women in Africa. Using a direct-marketing distribution system, it sells solar lamps and lanterns to some of Africa’s remotest communities. Solar Sister (www.solarsister.org), launched in Uganda in 2010, is hoping to do for power generation what mobile phones have done for communication in Africa: make a technological leap to a model of grassroots power generation, rather than waiting for large-scale power schemes to eventually reach the poor and rural.
More than 1.7 billion people around the world have no domestic electricity supply, of which more than 500 million live in sub-Saharan Africa (World Bank).
Solar power is being creatively used in many countries to tackle energy poverty and give women, in particular, viable sources of income. In India, whole villages are already using solar energy and improving their standard of living. Various companies and projects are selling inexpensive solar appliances – from cooking stoves to lanterns and power generators – across the country.
A billion Africans use just four percent of the world’s electricity (The Economist). Energy poverty is already harming further economic growth and development gains. With Africa’s population expected to double to 2 billion by 2050, the gap between people’s needs and the power available is stark: in Nigeria, out of 79 power stations, only 17 are working (The Economist).
A report by the International Finance Corporation called the sub-Saharan solar market the largest in the world – a market of 65 million would-be customers, who could access off-grid lighting over the next five years (IFC). The report anticipated high growth rates of 40 to 50 percent for anyone entering the market, with less than one percent of the market currently being served.
Being able to see at night unleashes a vast range of possibilities, such as being able to work or study later. But for the very poor, lighting is often the most expensive household expense.
As Solar Sister founder Katherine Lucey points out, households “rely on kerosene lanterns and candles for light. They spend up to 40 percent of their family income on energy that is inefficient, insufficient and hazardous. Widespread use of kerosene has an adverse impact on local air quality as well as on global climate change.
“Poor lighting, smoke and rudimentary lanterns are responsible for a large number of infections and burn injuries. Within the household, women are responsible for kerosene purchases and use – in order for new clean energy technology to be adopted at the household level, women have to ‘buy in’ to the technology.”
And this is the challenge: to find an affordable – and sustainable – way to bring electricity and energy to people living in remote and rural areas. These are places that face stark options: to remain off-grid and energy poor, or to abandon their communities and join the many millions across the global South on the march to urban and semi-urban areas in search of income and opportunity.
Lucey says that could be “a recipe for disaster”.
“In a country like Uganda, with a population of 32 million people, it is not possible to have them all move to Kampala to access electricity,” she said. “It would overburden already stretched infrastructure and services and disrupt the social and economic structures of an entire population. In the end, it can challenge the stability of entire nations.”
The Solar Sister direct-marketing model works like this: micro-investment capital of US $500 is invested in one Solar Sister Entrepreneur and she receives a ‘business in a bag’: a start-up kit of inventory, training and marketing resources. As her own boss, she has a strong incentive to succeed. She uses the money to purchase a consignment of lamps or lanterns, which she then sells, encouraging people to replace kerosene lamps with solar lamps: healthier, safer and better for the environment. She is encouraged to use her existing networks of family, friends and neighbours to reach rural and hard-to-reach customers.
The Solar Sister, after succeeding in selling the first consignment of lamps, then receives training in marketing and inventory and business skills. She can then move on to be a team leader and recruit other Solar Sisters. She earns a commission from the lamp sales, which help to improve her ability to pay for healthcare, education and food for her family. She then repays the cash for the lamps and the cycle starts all over again with a new consignment.
The model will sound familiar to many: it is what has built successful marketing machines like the famous all-women’s make-up and beauty products seller Avon (www.avon.com). Or the other famous direct marketing behemoth, Amway (www.amway.co.uk).
The Solar Sister model is heavily dependent on the success of word-of-mouth to grow:
“What we have found is that the women are the best distribution system for bringing new technology to rural households since they sell through their trusted networks of family, friends and neighbours,” Lucey said. “They use the lamps themselves, and then talk passionately about the benefits: the better light, the money they save by not having to buy kerosene, the amount of time their children are able to study, the cleaner air and safer environment for their kids.”
According to Lucey, the business model “brings solar technology right to the women’s doorstep. The Solar Sister business model developed as a grass-roots solution to the gender-based technology gap. Women make up 70 percent of the rural poor, but are often left out ‘in the dark’ when it comes to technology solutions.”
It is still early days for Solar Sister, which has been in operation for just over a year and now has 107 Solar Sister Entrepreneurs working in 10 teams reaching 34 communities in three countries – Uganda, Rwanda and Sudan. Lucey says the goal is to build a network of 1,500 female entrepreneurs in Africa over the next two years, benefiting over 1 million people.
Apart from the business model and the new technology, there is a radical concept at the heart of Solar Sister: to replicate for electricity generation the distributed and rapid growth that has been seen with mobile phones. In just five years, the availability of mobile phones in Africa increased by 550 percent.
“Distributed energy, such as solar, puts the investment in energy generation rather than transmission, and breaks the problem into smaller, achievable, components that do not have to wait for political processes for implementation,” explains Lucey. “It allows for the possibility that people can solve their own problems rather than wait for government or NGOs to come solve their energy problems for them. Distributed solar has the potential to leap-frog the 20th century grid-based solution, much like mobile phones have done in the telecom industry.”
One of the solar lanterns for sale is manufactured by D.Light Design. Their newest lantern model is called Kiran (http://www.dlightdesign.com/products_kiran_global.php). It sells for US $10 and provides up to eight hours of light on a full battery, its manufacturers say. D.Light Design calls it the “$10 Kerosene Killer” because it believes it has the right mix of price and technology to trump the need to use kerosene lanterns. The lantern gives off a white light powerful enough so people can read, study or do domestic tasks. A solar panel sits on top of the lantern, which is shaped like a drinking thermos with a large carry handle on top.
Other solar lamps/lanterns have been burdened by cost, ranging in price from US $15 to US $30: a prohibitive price for many poor people.
The ubiquity of mobile phone payments in Africa has made it much easier to transfer funds back and forth between the entrepreneurs and Solar Sister. And since its launch, Solar Sister has learned how to change and adapt to local conditions.
“These women are the experts in their local communities of what works and what doesn’t,” Lucey said. “Solar Sister Voila (http://www.solarsister.org/voila-uganda) decided to visit the roadside market stalls at night when shopkeepers were burning kerosene lamps for light. She got their instant attention with the high brightness of her solar powered lamps.
“Solar Sister’s mission is to bring more and more women from the veils of smoke, darkness and anonymity to the forefront of a clean energy revolution.”
2) Lighting Africa: Lighting Africa, a joint IFC and World Bank program, is helping develop commercial off-grid lighting markets in Sub-Saharan Africa as part of the World Bank Group’s wider efforts to improve access to energy. Lighting Africa is mobilizing the private sector to build sustainable markets to provide safe, affordable, and modern off-grid lighting to 2.5 million people in Africa by 2012 and to 250 million people by 2030. Website:www.lightingafrica.org
4) How We Made It Africa: A website detailing success stories on businesses investing in Africa and how people are making the most of opportunities on the continent. Website:www.howwemadeitinafrica.com
5) Barefoot College: The College is training women to be solar engineers, developing both useful skills and a new income source. So far, Barefoot College itself has solar electrified some 350 villages across India and dozens more in sub-Saharan Africa and even war-torn Afghanistan. Website:www.barefootcollege.org
6) Solar Power Answers is a one-stop-shop for everything to do with solar power. It has a design manual and guides to the complex world of solar power equipment. Website:www.solar-power-answers.co.uk/index.php
8) ToughStuff has developed a modular range of affordable solar powered energy solutions to the three main power needs of poor consumers in the developing world – lighting, mobile phones and radios. Website:www.toughstuffonline.com
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.
A whole wave of high-tech, innovative products are now being developed and marketed for the world’s poor. These products are designed to raise the quality of life of poor people and treat them as a market with real needs, rather than a mass of people to be ignored.
One of the major challenges of the 21st century is finding ways to make these products affordable for the poor – bringing significant development gains in health and quality of life – without increasing the burden on the world’s environment. In India, this vast new market is rapidly coming alive, with new marketing channels reaching deep into the country’s slums and aided by a lively media scene turning people on to new products.
India is turning its large number of well-trained engineers and product designers to the task of making relevant products for the country’s millions of rural poor.
An Indian refrigerator – the ChotuKool fridge (http://www.new.godrej.com/godrej/godrej/index.aspx?id=1) – is designed to stay cool for hours without electricity and to use half the power of conventional refrigerators. Priced at US $69, it is targeted at India’s poor – a population of over 456 million, almost half the total Indian population (World Bank).
Manufactured by Godrej and Boyce and weighing just 7.8 kilograms, it is designed around the stated needs of the poor, who wanted a fridge capable of cooling 5 to 6 bottles of water and 3 to 4 kilograms of vegetables. Portability was crucial as well, since it needed to be moved when large family gatherings take place in small rooms.
As a video shows (http://www.youtube.com/watch?v=dtCRlynp0bM), the fridge looks more like a drinks cooler than the typical large refrigerator. It works by replacing the standard compressor motor found in most fridges with a battery-powered heat exchanger.
A group of village women was involved in the design process from the beginning. The fridges are being distributed by a microfinance group.
While people in developed countries take it for granted they will have both a refrigerator and a steady supply of electricity, the world’s poor have few options for keeping food cool.
There is a strong economic advantage to refrigeration: many farmers have to throw away vegetables or sell at high discounts because they are quickly spoiling in the heat. By refrigerating, they can keep them fresh and get the higher price. For somebody living on less than US $2 a day, this is a big economic boost.
Keeping food cool also comes with health advantages: it slows bacterial (http://en.wikipedia.org/wiki/Bacteria) growth, which happens at temperatures between 4.4 degrees Celsius and 60 degrees Celsius. This is called ‘the danger zone’, when some bacteria double in just 20 minutes. But when a refrigerator is set below 4 degrees Celsius, most foods will be protected from bacteria growth (USDA).
Through refrigeration, the poor not only can avoid food poisoning, but also benefit from better quality foods, more dietary variety, and better take advantage of buying and storing food when prices are lower. For example, eggs in a refrigerator can last for up to five weeks. Fresh fish can be stored unfrozen for up to two days.
The quality of life improvements from refrigeration are obvious. But with conventional refrigerators costly and dependent on a steady supply of electricity, the poor will not buy them.
An Indian government survey in 2007/08 found daily pay in rural areas ranged from 45 rupees a day (US $1) to 110 rupees a day (US $2.40). This means the ChotuKool fridge costs between one and two month’s wages for a rural worker.
Some argue even the cost of the ChotuKool is still too prohibitive to many poor people. And there are other initiatives out there to offer low-tech solutions to cooling food.
In Nigeria, grassroots inventor Mohammed Bah Abba has designed a cooler called the Zeer (http://practicalaction.org/?id=zeerpots). It works like this: two ceramic earthenware pots of different sizes are arranged one inside the other. The space between the pots is filled with wet sand and kept moist. The user then places their drinks or vegetables inside and covers with a damp cloth. As the water from the moist sand evaporates (http://en.wikipedia.org/wiki/Evaporation), the air inside the centre pot is cooled several degrees, enough to preserve some foods and drinks.
Another Indian innovation is also targeting the rural poor consumer: a water filter. Called the Swach water purifier (http://www.tata.com/article.aspx?artid=TtOdcdNuSRk=), it is aimed at households and stands just less than 1 metre (just over 3 feet) in height. The filter is designed to do bulk water purification and is the result of 10 years’ research. It is aimed at the one billion people in the world who do not have access to clean water. It will sell for 1,000 rupees (US $21.50).
It is very slick and modern in design, with a mix of white and clear plastic, resembling the commonly used Brita (http://www.brita.net/) water filters found in many homes. It works by using ash from rice milling to filter out bacteria. The ash is impregnated with silver particles to kill germs that cause diarrhoea, cholera and typhoid. It is able to purify 3,000 litres of water before the cartridge needs to be replaced.
It is manufactured by the Indian industrial giant Tata.
“It was the pressing need of people trapped by the effects of natural disasters such as the (2004 Indian Ocean) tsunami that saw the deployment of one of the earliest versions of this product,” said Tata vice chairman S. Ramadorai. “A key part was the insight that a natural material like rice husk can be processed to significantly reduce water-borne germs and odours when impure water is passed through it.”
2) Zero Mass Foundation: No-frills banking specially aimed at India’s rural village poor. Website: http://www.zero-mass.org/
3) iNext Billion: Development Through Enterprise catalyzes sustainable economic growth by identifying market opportunities and business models that meet the needs of underserved communities in emerging economies. Website: http://www.wri.org/project/nextbillion
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.
David South Consulting 
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