Health/vision

Visioning for OLPC Health Initiatives

The Importance of OLPC to Health

The OLPC project is an important and innovative initiative in the area of education. In large part this is because the project is so much more than just a new gadget; rather it is grounded in sound philosophy and theory, and presents a vision for a radical transformation of access to eduction.

OLPC's approach to education is predicated upon three basic tenets (from the Learning Vision page):

1. Learning and high-quality education for all is essential to provide a fair, equitable, economically and socially viable society;
2. Access to mobile laptops on a sufficient scale provide real benefits for learning and dramatic improvement of education on a national scale;
3. So long as computers remain unnecessarily expensive such potential gains remain a privilege for a select few.

Health initiatives must be similarly grounded, and direct analogues to these tenets can be drawn from, and adapted for, the health care field.

Further, health challenges are fundamental barriers to education; one cannot take part in learning or teaching efforts while struggling to have basic needs met, while sick or injured.

It is also easy to imagine that XOs, even while distributed under the auspices of an educational program, will be used by children and families to tackle whatever problems they may be dealing with in their lives and communities.

Principles

Our health initiatives must be about how we can support health promotion and public health efforts in resource-poor settings. The model put forward by OLPC suggests that this can be facilitated with ready access to these technologies, coupled with technical and social infrastructure development.

1. Good health and high-quality health care for all is essential to provide a fair, equitable, economically and socially viable society.
2. Access to mobile laptops on a sufficient scale can provide real benefits for health care, and could dramatically improve the quality and quantity of life for the most underprivileged.
3. Health initiatives must value local knowledge and expertise, while making free and ready access to an international wealth of health learning and evidence-based medical knowledge.
4. The initiatives, like the rest of the OLPC project, must incorporate a collaborative approach into every aspect of their implementation.
5. Children, youth and family members in affected communities must be viewed as potential experts, as self-healers, as self-directed learners, and OLPC health initiatives must increase direct involvement in healthy living rather than increase dependencies on outside support.
6. OLPC's approach to education in the community should be mirrored by a "care in the community" approach which seeks to value community members who are already serving in caring and supportive roles (community leaders, teachers, health workers, mothers, elders, etc...), build their capacity, and support them with infrastructural development and integration with networks of more advanced resources.
7. "OLPC is not, at heart, a technology program."[1] As with education, local health projects incorporating XOs will need to pay great attention to infrastructure by addressing long-term concerns and sustainability. Locally based institutional structures should be supported rather than forming dependencies on outside agencies.

Integrated Approach to Health Care

In the context of poor, isolated, rural communities, those health resources that do exist are invariably thinly-stretched. A low-cost, multi-purpose, and as ubiquitous as possible, communications and information processing device has the potential to play a role in helping to build healthy lives and communities. But to do so, it should take a broad view of health, and take into account an integrated view of health care and the many potential sites of therapeutic interactions.

Areas of health care:

• Training

• Primary care
  • Including pre-hospital, emergency, First Aid
  • Clinical setting or bedside

• Secondary care
  • Specialists, ongoing investigation, laboratory

• Tertiary care, chronic care, home care

• Follow-up, support, physiotherapy, occupational therapy

• Complementary medicine

• Patient education

• Prevention
  • Around all of these, we have prevention as ongoing education strategy

Activities

Health care is therefore about doing, about activities that promote better health, increase quality & quantity of life (increasing longevity, decreasing mortality rates).

Health care can be broadly categorized into three (sometimes overlapping) Activities:

• Prevention
• Assessment
• Intervention

Prevention -> Assessment -> Intervention

Sit on a spectrum of increasing:

• Technical knowledge required
• Sophistication of tools required & cost of those, access to materials, training time required
• Size of infrastructure required to support
• Barriers to access, in most places

Prevention

basically education

most like what is already happening with OLPC

needs new content (e.g. Hesperian foundation but also Wikipedia, etc...)

includes educational efforts directed at individuals and families, but also preventive work done by health promoters, paramedicals, public health initiatives, etc...

Assessment

needs some training & tools, but often can be pretty basic

can be done by paramedicals in lots of cases or even health promoters

Intervention

therapies

medicines

procedures

People

Definitions of the kinds of people involved in the chain of health care and the potential settings for interactions between people:

• Individual, community member, child
• Health-promoters
• Paramedicals
• Doctors
• Specialists

Between links in that chain, traditionally there are enormous barriers. As you move along it we find:

• Increasingly city-based, greater physical distance
• A decreasing availability of human resources
• An increasing level of education, time, money that must be invested
• Language barriers

Breaking down barriers

How can this model break down those barriers

Information flows along a chain of

Individuals -> Health Promoters -> Paramedicals -> Doctors -> Specialists

in one direction, traditional, health information, consultations are made

in the other

Individuals <- Health Promoters <- Paramedicals <- Doctors <- Specialists

training, delegation, standing orders

also, public health -process of agregating information & campaigns, looking at broad trends, geographic areas, socio-political & socio-economic factors across agregate populations

Base Hospital model

Expand the reach of doctors & specialists

Conduct and distribute training

Standing orders, delegated acts

Availability of health network resources (paramedicals, doctor & specialists) for consultation, telehealth