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Digital resources in the Eastern Cape, South Africa. Stephen Korsman Virologist Groote Schuur NHLS / University of Cape Town 2 December 2014. Outline. The bad side Demographics Telkom Eskom The good side Digital aids Digital pathology Other opportunities. The bad side. Demographics.
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Digital resources in the Eastern Cape, South Africa Stephen Korsman Virologist Groote Schuur NHLS / University of Cape Town 2 December 2014
Outline • The bad side • Demographics • Telkom • Eskom • The good side • Digital aids • Digital pathology • Other opportunities
Demographics • Largely rural • Poor infrastructure • Most people do not have running water • Roads are poor • People are poor • Cell phones are common • Internet access is poor
Copper is valuable No phones No data No power Telkom + Eskom Photo: Gallo images http://citizen.co.za/263549/cable-theft-caused-lenasia-outage/ Photo: Gallo images http://citizen.co.za/263549/cable-theft-caused-lenasia-outage/ Photo: http://www.iol.co.za/news/crime-courts/kzn-ops-make-r3m-copper-bust-1.1677121
Headlines: Eskom copper cable theft cost R350 million One village, over 700 cable thefts in four months One electrocuted, three charged for Eskom cable theft Telkom cable theft wreaks network havoc: pictures Telkom 'no' to lines in cable-theft areas Copper-cable theft costing Britain a fortune (Daily Mail Online) Photo: Desiree Swart http://www.moneyweb.co.za/moneyweb-gallery/cable-theft-in-moruleng?sn=Gallery
NHLS labs • In Mthatha • Power cuts, faulty electricity • Laboratory Information System • TrakCare • Requires continuous online link • 2013-14 – copper cables stolen FOUR times • Failure to change from Disa to TrakCare • Wireless (?3G, ?HSDPA?) link needed to prevent theft • Still waiting …
NHLS labs • Outside Mthatha • Even poorer infrastructure • Hospitals usually have running water • The lab may not always be linked up • TB testing done using collected rainwater • False positive due to harmless environmental mycobacteria • Do we expect these hospitals to run an online LIS successfully? • Northern Cape – minor problems with connectivity • Eastern Cape – huge problems with connectivity
Forms of digitallyaided research • Simple complex • Simple e-mail contact + data sharing • Skype, YouTube conferences / talks • Not just videos of funny cats! • Online / shared databases • HIV, HBV drug resistance • HIV genomic studies • Vaccine development • Online data tracking / monitoring • Not just Big Brother watching you! • Microscopy across the web
Google Flu Trends USA South Africa Google Recorded
Organisations Research Without Borders: Big Open Data Thursday, December 4th, 2014 - 2-4pm Columbia University’s Faculty House
Don’t forget… http://theglobalhealthnetwork.org or http://tghn.org
Digital pathology • Walter Sisulu University • Anatomical Pathology • High resolution digital microscope = Nikon Coolscope • Connected via ISDN, later ADSL, to NHLS intranet • Sites with Coolscopes: WSU, East London, Port Elizabeth, Stellenbosch Univ, MEDUNSA • Anyone with internet could reach the microscope • Login was controlled • Second opinions from Stellenbosch University • Officially opened in 2007 • Part of WSU’s digital medicine programme • Included clinical consultations
Banach L, Stepien A, Schneider J, Wichrzycka-Lancaster E. Dynamic active telepathology over National Health Laboratory service network, South Africa: feasibility study using Nikon Coolscope. Diagn Pathol 2008;3:Suppl 1
Banach L, Stepien A, Schneider J, Wichrzycka-Lancaster E. Dynamic active telepathology over National Health Laboratory service network, South Africa: feasibility study using Nikon Coolscope. Diagn Pathol 2008;3:Suppl 1
Roche CAP/CTM • Mthatha • East London • Port Elizabeth Photos courtesy of Marie-Paule Henshall-Howard, GSH NHLS
Opportunities • Telephonic consultations with pathologists • Ongoing, underutilised • Live access to local instruments via the internet • In development • Sharing of log files or run data for pathologist validation of assays • Not yet done • Easy to do, smaller labs don’t do many tests with portable run data