Nowadays, many people can be seen with smartphones which has made information easily accessible for all, including medical and health care information.
When a person feels unwell, the first thing they do is google their symptoms. Self-diagnosis has become easier. Yet many health care practitioners and patients are wary of electronic health check-ups.
In Ethiopia, at a national level, there is just 0.1 percent doctors per 1000 people, according to the latest report in 2018 by the World Health Organization. Therefore, it might appear beneficial for the growing worldwide popularity of cell phones to create more convenient health care for all.
Bethel Samason, a 5th year medical student at Tikur Anbessa Specialized Hospital, created a medical app called ETEGE. Speaking to The Reporter about her journey, Bethel says that ETEGE mobile phone application is an Amharic guide to self-breast examination that was made to educate Ethiopian women on how to perform self-breast examination and raise awareness about breast cancer and early screening methods to the general population. Bethel said that it is currently available on Google Play Store and the company is working on adding more local languages and making the app available on the App Store and Java as well as incorporating other disease.
Bethel told The Reporter that the idea to make the app originated while working on a project called Double Impact under the Ethiopian Medical Student’s Association, while they were teaching about early screening methods for breast and cervical cancer. “I noticed that there were no available comprehensive education materials in our local languages and wanted to change that,” she told The Reporter.
Breast cancer is the most common cancer constituting around 23 percent of cancer in Ethiopia, according to a study conducted in 2018 by WHO.
Bethel said that so far the app aims at helping patients rather than professionals. ETEGE was made to decrease the amount of deaths from breast cancer by increasing the number of early health care seekers. She outlined that the hardest part of the applications is tracking the numbers of users as many just exchange apps using Xender rather than downloading them. She added that accessibility is something that is of concern because not everyone in Ethiopia has a smartphone which is a huge disadvantage. Bethel added that the responses have been positive especially from medical professionals, because many women pass away because of the late discovery of the illness and lack of awareness.
Smartphones can be very beneficial in a medical setting; however, many are concerned with the effectiveness and security of this devices. There are risks of patients’ private information being stolen. They can be ineffective in diagnosing a patient accurately and can fail to prescribe medication as well. But they can still be deemed useful as it can help decrease health care cost and increase the learning of healthy behaviors. For instance, for pregnant women, medical apps can be used as a guidance in additional to their medical visits.
In Ethiopia, a developing country, not everyone has a smartphone and internet is not accessible to many. This proves to be difficult for medical app to be more accessible within the society.
The Reporter also spoke to a doctor about the increased popularity of Medical Apps, Suraphel M. Alemu (MD), who is the founder of Doctors in Action, a health consultancy working to promote health in non-communicable diseases through community engagement. Doctors of Action has recently finished a six month project aimed at increasing institutional inclusion for people living with mental illness in partnership with the Ethiopian Psychiatric Association and the Ethiopian National Theatre. As the burden of non-communicable diseases is increasing in Ethiopia, we believe that community action through civic society partnerships will create a platform of context-based, sustainable solutions for increased health access. Suraphel (MD) has also previously worked as medical director of Selekleka Primary Hospital in Northwestern Tigray.
Dr. Suraphel told The Reporter that digitization is being adopted in all sectors in industry and life, and as such, the medical field is also undergoing fundamental changes towards integration of electronic based systems ranging from data collection to patient interface. In Ethiopia, although hindered by infrastructural drawbacks, various governmental and non-governmental agencies are implementing digital platforms in their health services. A number of observations can be made here like the level of fluency health professionals have with computerized workspaces and attitudes towards digitization of the patient-physician interface. He mentioned some medical apps such as ETEGE: the Amharic self-breast examination app and Icare, an app that is being used for electronic medical recording in major hospitals.
Dr. Suraphel outlined that medical apps increase the platform for health conversation, going a long way towards raising awareness and health seeking behavior from the community. They also increase the quality of health delivery in terms of enhanced interface with the right information. The only drawbacks in Dr. Suraphel’s opinion is that it would be the access of a variety of apps developed by various interests in the medical industry like any other industry. No computer can replace the empathy and human touch offered by a visit with the doctor. He explained to The Reporter that medical apps have the advantages of any app that is developed to make life easier, simpler and accessible to all people who can use a device. They can also offer a personalized approach to the user, both on the service user and provider side. Dr. Suraphel warned that the disadvantages include health data mining, increased anxiety over too much information, and self-medications without proper training.
Despite the advantages medical apps have, they can also undermine proper service under national clinical standards as oversight can be and is designed to be difficult in personalized apps. But they can also be of assistance in increased health promotion for users. Medical apps are going to keep being developed because of the increasing ease and demand for them. However, Dr. Suraphel advices that regulation to ensure ethical and medical guidelines are necessary, this perhaps may prompt the responsible government regulatory body to expand its oversight to the digital platform as well.
Dr. Suraphel concluded by saying that health is a basic public service that is a human right. As such, communities have the right and responsibility to individually and publicly participate in its delivery. This means that it is no longer an arena that is monopolized by a few service providers or institutions.
“The right to know about one’s health individually or in one’s community should be exercised through an active engagement with various faces of society. I think it’s about time that individuals navigated ways to increase the platform of health conversation in innovative, non-traditional ways,” he told The Reporter.
