Digital resources in the Eastern Cape South Africa

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 2

The bad side

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 4

Limpopo 5

Telkom + Eskom • Copper is valuable • No phones • No data • No power Photo: Gallo images http: //citizen. co. za/263549/cable-theft-caused-lenasia-outage/ Photo: http: //www. iol. co. za/news/crime-courts/kzn 6 ops-make-r 3 m-copper-bust-1. 1677121

• Headlines: – Eskom copper cable theft cost R 350 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 cabletheft areas – Copper-cable theft costing Britain a fortune (Daily Mail Online) Photo: Desiree Swart http: //www. moneyweb. co. za/moneyweb-gallery/cabletheft-in-moruleng? sn=Gallery 7

NHLS labs • In Mthatha – Power cuts, faulty electricity – Laboratory Information System • Trak. Care – – – Requires continuous online link 2013 -14 – copper cables stolen FOUR times Failure to change from Disa to Trak. Care Wireless (? 3 G, ? HSDPA? ) link needed to prevent theft Still waiting … 8

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 9

The good side

A lot is being done digitally 11

Forms of digitally aided research • Simple complex • Simple e-mail contact + data sharing • Skype, You. Tube 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 12

USA Google Flu Trends South Africa Google Recorded 13

Organisations Research Without Borders: Big Open Data Thursday, December 4 th, 2014 - 2 -4 pm Columbia University’s Faculty House 14

Don’t forget… http: //theglobalhealthnetwork. org or http: //tghn. org

Online training 16

Possibilities 17

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 18

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 19

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 20

Roche CAP/CTM • Mthatha • East London • Port Elizabeth Photos courtesy of Marie-Paule Henshall. Howard, GSH NHLS 21

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 22