Africa Must Leapfrog Its Way to the Future

13 August 2014

The conventional path for improving healthcare is to build more hospitals and train more doctors. But could Africa speed up progress by 'hacking' its way to success?

Governments, NGOs and businesses spend billions of dollars across Africa building new hospitals and training new doctors. But currently, the doctor-patient ratio in many African countries is one-twentieth or less of what it is in the US and Europe, meaning many patients, particularly in remote areas, never get the specialist care they need.

Even in the best conditions, hospitals take time to build and it can take more than a decade to train a specialist doctor. Is the right approach to improving Africa's healthcare therefore to build hospitals and train doctors?

The term "hacking" means modifying the features of a system to achieve a new goal. In development, it can describe rapid changes made by a society to advance without going through the intermediate stages.

Rather than following developed nations' roadmap to progress, Africa can leapfrog by experimenting with emerging tools, models and ideas. Foreign investors looking at Africa often say that while the prospects are exciting, the infrastructure is lagging. I believe that existing infrastructure can be hacked - which in itself is a huge opportunity.

Africa's best-known "development hack" thus far is the mobile phone. Africa never managed to build a comprehensive telephone cable network. And, as mobile and smart phones proliferate, it will never need one. Something similar could happen with education, manufacturing and road construction, and especially healthcare. Africa must leapfrog the industrial revolution into the information revolution by using the resources it already has available.

My medical work takes me to some of the most remote communities in Nigeria. Yet in these places I still meet young people that listen to TED talks and are up-to-date with the latest breaking news on CNN. The internet - now often accessed on basic phones or smart phones - breaks the boundaries isolating small, rural communities from the rest of the world.

This power could be harnessed for education and healthcare too. Children can learn skills through online education programmes on cheap tablets and mobile phones.

A cheap Nigerian smart phone data package can cost around $15 per month, but many young people who can't afford that still manage to access the internet through cybercafés and hubs. Young adults can learn from various international open education programmes online, such as the Khan Academy. One could disrupt the education model completely by designing shorter online courses that teach targeted, tailored skills for the workplace.

Meanwhile, healthcare workers can be trained to deliver services without leaving their communities, in collaboration with doctors in urban centres many miles away using telemedicine. This is a model that is already gaining widespread traction.

Do we really need more specialised hospitals? I am the managing director of the first indigenous air ambulance in West Africa and in our experience, a very small percentage of patients require specialist services such as neurosurgery.

The main problem is access to treatment. So instead of building more expensive, underutilised hospitals - diluting the small pool of specialist expertise we have - why not keep specialists in specialist centres and fly in the patients that need their expertise? Video appointments, SMS-consultations and other 'mobile health' strategies can provide cost-effective healthcare hacks that keep costs low while providing specialist care to those who need it the most.

Hacking will accelerate development. It will ensure Africa stops playing catch-up and begins to lead. It will produce global businesses that lift people out of poverty. As in health, hacking could be Africa's passport to a prosperous future.

Ola Orekunrin is a trauma doctor and the managing director of Flying Doctors Nigeria, an air ambulance service. She was a 2013 New Voices Fellow at the Aspen Institute.

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