ICTs to help stop spread of HIV/AIDS in Zambia

Author : Mildred Namwiinde Mpundu
Date added : 2003-09-25

Brief Project Background

Twenty-year-old Likezo Nyambe (not real name) lies critically ill on a dusty floor in a one roomed dingy
hut. Likezo’s family and the entire community in her village in Shangombo strongly believe that she has been bewitched, But, medical experts who visited and saw her say other wise. Likezo has symptoms of AIDS, a disease she could have contracted from a rapist believed to be a soldier from a warring neighbouring country. She has had one opportunistic infection after the other. Everyone is sure she will die soon. Ignorance haunts the people of Shangombo deprived of information on issues of health and development in general.

Shangombo is an inaccessible area in Zambia’s Western Province. The nearest health centre is hundreds of kilometres away. There is no way to get there except to walk for days on end.
Until recently, when the country’s former first lady Vera Chiluba’s Hope Foundation Organisation visited the place to deliver medicines, food and clothes to the people there, shangombo was unheard of. It was and still is a place where poverty rears its ugly head. People there still walk half naked, have no health facilities, no food and lack opportunities and choices that are most basic to human development.

However, for far-flung areas like Shangombo and Chilubi island in the northern part of Zambia and
many others, the situation is bound to change. Tele-health - online medical interaction is taking a
new dimension in Zambia, a Sub-Saharan African country of about 11 million people. For a long time in Zambia Patients have had to be referred from remote health centres to major hospitals like the University Teaching Hospital, Ndola Central Hospital and other Provincial hospitals. This has been time consuming, expensive and has caused congestion in major hospitals resulting in deaths that should not have been.

Recently, the E-brain forum of Zambia, a local organisation that looks into Information Communication
and Technology (ICTs) in conjunction with the Computer Society of Zambia held a public discussion on “Improving health delivery through use of ICTs.” It was a meeting aimed at answering questions as to whether there are any new initiatives that are promising improving the quality of health for every Zambian; and are ICTs in any way able to contribute to the provision of quality health service.
It is heartening to know that the Zambian Government seeks to make radical change in the collaborating of diagnostic information between health centres. Patients, including People Living With HIV/AIDS do not need to travel long distances to get treatment, but information will be transmitted by electronic means to major hospitals where medical experts will analyse the patient’s information and then issue a prescription online back to the patient. Even where there is only a nurse manning the health centre, she will be able to dispense medicine from the local pharmacy. The rural poor who have no access to the Internet will have health workers deliver information on health and HIV/AIDS.

Collins Chinyama, an information Technologist from Zambia’s Central Board of Health (CBOH) explains that tele-health, though not a new system in other countries is the use of Information Technology (IT) to deliver health services and information from one location to another, while tele-medicine Is a system of multi-media (voice, video and data) and telecommunications technology that can deliver medical services remotely. “The main objective of tele-medicine is to facilitate communication between rural based health workers and tertiary health workers,” Chinyama said. Families too, will have information to share with their sick relations and friends.

The system already installed at the UTH and in operation between South Africa and Zambia, including the United States will soon be extended to other districts in the country. While health centres have HF radios for their operations, these are not enough and a step needs to be taken further.
According to UNAIDS, statistics, Sub-Saharan Africa, by far the worst affected region is now home to over 29 million people living with HIV/AIDS. “A tiny fraction of the millions of Africans in need of antiretroviral treatment are receiving it. Many millions are not receiving medicines to treat opportunistic infections, either.”
“These figures reflect the world’s continuing failure despite the progress of recent years, to mount a response that matches the scale and severity of the global HIV/AIDS epidemic,” according to the UNAIDS AIDS epidemic update, 2002. How do the poor millions of infected and affected get information and help keep the rate of infection down?

In Zambia, a number of institutions and measures have been put in place to try and help reduce the impact of HIV/AIDS in society. Sadly, as UNAIDS puts it, “In the absence of massively expanded prevention, treatment and care efforts, the AIDS death toll on the continent is expected to continue rising before peaking around the end of this decade.”
“This means that the worst of the epidemic’s impact on these societies will be felt in the course of the next decade and beyond. It is not too late to introduce and augment measures that can reduce the impact, including wider access to HIV/AIDS medicines and socio-economic policy steps that genuinely shield the poor against the worst of the epidemics effects.”

Measures put in place to counter HIV/AIDS have, however, yielded little results. The poor still remain unprivileged in terms of getting vital information. The Zambian government and the United Nations
Development Programme (UNDP), this year launched the “Support to Multi-sectoral HIV/AIDS Response Initiatives.” The project aims at strengthening the national provincial and district level capacities to plan; coordinate, monitor and evaluate gender sensitive and rights based multi-sectoral responses to limit the effects of HIV/AIDS. Its objectives are to contribute to the reduction of the transmission of the disease by improving the planning, coordination, monitoring and evaluation of HIV/AIDS multi-sectoral district response initiatives and the reduction of the socio-economic impact of the disease through the support to organisations working with vulnerable groups.

Support will be directed among many others to the enhancement of national, provincial and district-level capacities, assessment and monitoring of the sectoral impact of HIV/AIDS.
To achieve the above objectives, the interventions will be gender sensitive and rights based with ICT
used as a tool. Are there any new initiatives that will quickly and effectively help spread information on HIV/AIDS, as well as provide prompt treatment for opportunistic infections in PLWAs who live in poor remote areas away from health centres in Zambia?
“Very inefficient methods have been used to get information on HIV/AIDS to rural communities especially. We are trying to bring in ICTs to totally change the strategy,” Dr Lemba Nyirenda, UNIDO Pilot Projects Coordinator and National Expert said. “We realise the problem and need new strategies that will link clusters of computers with information which can even go to firms with PLWHA so that they can monitor themselves at individual and family level.

Dr Nyirenda who is coordinating the establishment of a pilot project on voice and E-mail ICT- Teleconnectivity of Rural and Remote HIV/AIDS information Centres, said “if we continue to operate in the old way, there will be no real results in the fight against HIV/AIDS.” The project is intended to form part of the National HIV/AIDS strategic communication Network core; and for timely and effective implementation of National HIV/AIDS programmes including the Zambia National Response to HIV/AIDS Project (ZANARA). Targeted strategic partners are UNDP as the ICTs -Tele-connectivity Pilot Projects Promoter and Sponsor within existing project scope with the National HIV/AIDS Council under the “Support to Multi-sectoral HIV/AIDS Response Initiatives.”

UNAIDS would be the Projects Coordinator and Executor utilizing the existing Project management strategy developed under the UNIDO Renewable Energy Multi-purpose Rural Community Tele-centre microwave Tele-connectivity concept. The National AIDS Council (NAC) in conjunction with the Central Board of Health under the Ministry of Health will be the pilot Tele-connectivity systems Infrastructure operator and owner.

The idea, according to Dr Nyirenda’s UNAIDS-UNDP executive brief to the National AIDS Council, is:
· To design and build a reliable, cheap, multipurpose HIV/AIDS Strategic Communications Network Core interconnecting strategic remote and rural health Centres and the National AIDS Council Headquarters and HIV/AIDS research centres.
· Introduce real-time HIV/AIDS Impact Indicators through the “integrated Lifelines Infrastructure
Protection and National Disaster Reduction control Systems Framework in all development sectors of the
Zambian Economy.
· Design and Introduce basic training modules on routine and preventive maintenance of ICTs, mechanical and electrical appliances; tele-connectivity and electrical energy systems in order to guarantee reliable and efficient operation of the health centre services and support lifelines network infrastructure. Chiyunyu Health Centre, with a catchment of 26,000 people in Lusaka rural, is one of the places that have been selected as a candidate for a pilot project.

The community is building the physical infrastructure for a multi-purpose telecentre and OSISA under the suspended UNIDO ICT project. UNIDO has donated 15 out of 27 personal computers to the centre which will use solar power already available at the health centre. Chinyunyu also has a Teachers resource centre. Farmers in the area, with the help of Kasisi Training College have direct link with the European market through ICTs. Some hospitals, especially those that fall under the Christian Health Medical Association of Zambia are already using ICTs in the dissemination of HIV/AIDS information, diagnosis of disease and treatment. ICTs will also provide nutritional information as well as information on how to manage small businesses to PLWA so that they are able to maintain themselves and their families.

Dr Nyirenda said that linking research in institutions, to the infected and affected, to doctors and society as a whole in both urban and rural areas through ICT network is important. “Within tele-connectivity we will have the means of capturing, storing and processing information and sharing it out to a central database in a timely manner and covering the whole country,” he said.

The Ministry of Education has started a Multi-sectoral HIV/AIDS impact assessment study programme, which will provide it with information on the current and future impact of the pandemic on the education system, according to MOE Permanent Secretary, Barbra Chilangwa. The programme targeted at primary schools where the majority are not infected, and young people with the potential to develop the nation, involves the use of ICTs focusing on HIV/AIDS and nutrition. The project is bound to succeed as it has in some South-East Asian countries under the infoDev/UNAIDS project funded by the World Bank.

E-mail connectivity was provided to the Office of the National AIDS programme in these countries - the result was the South-East Asian regional AIDS discussion forum (SEA-AIDS), and the establishment of a file archive for HIV/AIDS related matters. There is now an exchange of information and experiences in the region with expanded and strengthened regional networks involved in HIV/AIDS. With the poor road and transport network Zambia cannot do without ICTs.

The consoling factor is that Zambia has schools throughout the country, and the strategy is to have tele-connectivity in all the schools, even in rural areas where the majority of the poor people are. ICTs require electricity as a backbone. The rural electrification programme is underway in Zambia. Where there is no electricity solar power is being introduced.

Communities should be trained in the installation and maintenance of software to be able to run the project on their own in future. Situations like Likezo’s will be unheard of once Zambia has established use of ICTs in poor remote areas.

Project Information

Country of activity: Zambia [ZM]

Contact Information

Mildred Namwiinde Mpundu
namwiinde@yahoo.co.uk

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