Wellness & Fitness

Innovative rubber stamps cut misdiagnosis in slums


Dr Pratap Kumar, founder and CEO of Health E-Net, explains how the rubber stamp technology works. PHOTO | SARAH OOKO

For a majority of Kenyans who live in crowded slums, poor ventilation, open pit latrines and raw sewage which flows freely cause many infectious diseases.

For most patients, the choices are few. Public hospitals are overcrowded that people are forced to rely on private laboratories and clinics set up in the slums.

But despite their proximity, these clinics and labs dispense inaccurate tests and drugs.

Magdalene Owuor, a wife and mother of six in Mathare slums, said that she nearly lost her son last year due to a severe case of diarrhoea.

“I rushed him to a private clinic just here in Mathare and the doctor we found prescribed lots of antibiotics that didn’t work. My child was becoming weaker and weaker by the day,” she said.

A neighbour noticed her distress and advised her to rush the child to a public hospital. As per the national guidelines, the doctors there prescribed oral rehydration salts (ORS), which saved his life.

Mercy Wairimu, another resident, nearly lost her unborn baby as a result of eclampsia (high blood pressure during pregnancy) due to late diagnosis.

If left untreated, this complication can cause miscarriages, kidney failure and even death among expectant women.

Such cases of misdiagnosis are replicated countless times in most slums, but there are already beams of hope in the horizon.

Dr Pratap Kumar, founder and CEO of Health E-Net (a social enterprise addressing gaps in quality healthcare services), was inspired by this challenge to develop a low-cost innovative solution to the problem using rubber stamps and mobile phones.

He says the rubber stamps provides clinicians at these private facilities with a checklist that guides them on what to look out for, and questions to ask the thousands of patients that walk into their clinics.

Pregnancy complications

All of the facilities that Health E-Net works with are given rubber stamps for each of the myriad conditions that they normally handle.

For instance, private clinics attending to many pregnant women and young children will get a rubber stamp for pneumonia, a second one for diarrhoea and another for pregnancy complications.

If a child presenting with diarrhoea-like symptoms visits any of private facilities, a clinician will take the diarrhoea rubber stamp, coat it with blue ink and press it on a sheet of paper.

In just seconds, he or she will get an image of the diarrhoea checklist template on the paper, complete with symptoms to look out for, questions to ask the patients as well as treatment options for the condition.

Each of the above actions on the checklist is followed by multiple choice responses. The clinician picks the appropriate responses (through shading) based on feedback received from patients, medical observations they make and treatment recommendations that they choose.

Using a smartphone camera, they then proceed to take shots of the filled checklists and send them electronically to the Health E-Net servers.

The team of professionals at the organisation (Health E-Net) receives the information seconds later in an already processed format (not as an image).

Their systems have image recognition software that detects the responses shaded by the clinicians (on the checklists) and rapidly creates digital medical records of patients seen at a particular private health facility.

This allows the Health E-net team to have a detailed record of the demographics of patients visiting health clinics in various slums that they work in, which include Mathare, Mukuru, Korogocho, Githurai, Kahawa West and Baba Ndogo.

The team is also able to determine the various types of ailments people are diagnosed with and how the diseases are managed and treated at the clinics they visit.

“Through this continuous monitoring, we can easily identify disease management gaps in the selected health facilities,” said Dr Kumar, who is also a lecturer at Strathmore Business School.

They share the feedback with affected clinics and thereafter proceed to train and sensitise health workers on the recommended Health ministry national treatment guidelines on the management and treatment of various health conditions.

Chronic diseases

This innovative use of rubber stamps as checklists for clinicians and template for collecting useful patients’ data is already bearing fruit.

For instance, Dr Kumar notes that misuse of antibiotics has drastically reduced in most private health clinics in the slums.

The drugs were previously being prescribed for almost all conditions, as was the case with Ms Owuor’s son. This drives resistance to these life-saving medicines and endangers patients’ lives.

The innovative approach has also improved case management and referral of maternal complications and chronic diseases like diabetes and hypertension in most slum clinics.

Consequently, he says that many private clinics in the slum are increasingly buying into the new approach to improve the quality of healthcare services offered to their clients.

Due to the success of the low-cost health innovations, Dr Pratap was among the 17 social entrepreneurs from Africa that were was recently selected to be part of the inaugural General Electric (GE) mentorship initiative dubbed Healthymagination Mother and Child Programme.

Jay Ireland, President and CEO for GE Africa, said the programme is aimed at boosting entrepreneurial ventures across the health sector that can be scaled up to solve various health challenges in Africa, especially those touching on maternal and child health.

He noted that the programme, being rolled out by GE in partnership with the Miller Centre for Social Entrepreneurship in New York, will train and mentor entrepreneurs like Dr Kumar in how to successfully take their innovations to the next level whilst saving lives and also making profit.

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