And the award goes to...

The British Medical Journal Awards 2018, held recently, recognised doctors pioneering healthcare initiatives across the country. Of the many winners and nominees, we feature those who’ve used technology to improve accessibility

Published - December 10, 2018 04:04 pm IST

Maternal and child healthcare

Dr Aparna Hegde

During Dr Aparna Hegde’s residency in Sion Hospital, Mumbai, the uro-gynaecologist came to terms with the reality of the doctor-patient ratio. “The hospital would be crowded, doctors wouldn’t even have time to properly look at a patient’s face,” she recalls. “And that’s why most pregnant women wouldn’t return for a check-up.” She saw how the lack of information could lead to complications.

After she started her NGO ARMMAN, she decided to make information more easily accessible to pregnant women through the mMitra project in 2014. Under mMitra, the NGO calls women on their phones with a recorded voice message twice a week throughout their pregnancy and three months after, once daily for a week after delivering, and once a week until the baby is a year old. Women can select the language and a time slot for the call, according to when they will have access to a phone. The NGO also gives the women animated videos on maternal and child care counselling.

“In case the women miss our calls, we call back the next day; we do this thrice. Otherwise, they can give us a missed call, and we’ll call them back with the message. We also have a call centre for personal responses to additional queries,” she explains. The voice is “elder sisterly”, as Aparna puts it. “She should appear kind and considerate.”

Currently available in eight States, Aparna and her team reach out to women as soon as they are enrolled in a major government hospital. “However, most women don’t visit this hospital in the early stages,” she says, “That’s why we work with NGOs, to select specific women — Sakhis — who encourage other pregnant women from their communities to enrol themselves.”

For Aparna, mMitra goes beyond maternal care; it’s also about empowering the women in the family: making their own decisions, even getting their own phones. She recalls the case of a preacher’s wife from one of Mumbai’s slums. “She was pregnant with her second child as soon as she had delivered her first. When we reached out to her, we explained how such a small gap in childbirth could be risky. And that gave her the courage to convince her husband to try family planning!”

Robotic diagnostics in rural areas

Dr Vimarsh Raina

“We have some of the best diagnostic machinery in the world, in India. Name a surgery, and we can do it. Treatment is so cheap, we have become a medical tourism spot. And still we struggle with diseases that should have been eliminated,” says Dr Vimarsh Raina.

Founder of the Chimera pixel platform, Delhi-based Dr Raina aims to bring better diagnostic tests, and super specialists to people in rural areas, through his project. “Cities like Chennai, Mumbai, Delhi have fabulous technology, but only 20% to 30% of the population lives there. The labs in smaller cities may not be well equipped enough to diagnose samples,” he says.

With Chimera, Dr Raina and his team have turned microscopes into mechanised robotic equipment. The technician on site needs to just take the sample and slide it under the microscope. This will be controlled by a pathologist in a remote location, who will then diagnose the problem, exponentially enhancing efficacy by reducing the time and money involved.

He has tested it at a hospital in Delhi and a village in UP’s Hardoi district, and hopes to scale it up. “By streamlining diagnostics, we hope to create an electronic medical record that will help us study a disease like TB, in particular regions, better,” he adds.

Better childhood injury prevention

Dr Alex Joseph

‘Prevention is better than cure’ is more than a cliché for Dr Alex Joseph, who works with the School of Public Health at SRM University in Chennai. “Studies on injuries are usually based on trauma when people visit the hospital,” he says, “Not many studies are community-based. So we miss out on injury cases that miss hospitalisation,” he says.

In an attempt to provide targeted prevention of accidental injuries, Dr Alex started out with the tribal community in Sitteri panchayat, Tamil Nadu, and mapped the injury hotspots — places where injury was most likely to occur. “I wanted to concentrate on childhood injuries because India has the highest number of children under 14 years of age, and a childhood injury, if not taken care of, can lead to loss of productivity later on.” He classifies the injuries as falls, road accidents, drowning, animal bite, and poison.

Classifying injury as one day’s loss of activity, Dr Alex’s team visits each of 32 villages in Tamil Nadu once in two weeks in rotation. They then go door-to-door, speak to the villagers and collect data on the areas where children were injured. “We use an open data collection software to use questionnaires and get responses in real time,” he says. “Using that data, we keep updating the GPS locations of risky areas to create a map of injury hotspots.”

The map allows them to provide precise public health: Giving the right intervention to the right person at the right time. “We can now identify which area is dangerous, who is most susceptible to it, and their best solution to prevent it.”

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