1 digital resources in the eastern cape, south africa stephen korsman virologist groote schuur nhls...
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Digital resources in the Eastern Cape, South Africa
Stephen KorsmanVirologist
Groote Schuur NHLS / University of Cape Town2 December 2014
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Outline
• The bad side– Demographics– Telkom– Eskom
• The good side– Digital aids– Digital pathology– Other opportunities
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The bad side
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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
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Limpopo
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Telkom + Eskom• Copper is valuable
• No phones• No data• No power
Photo: Gallo imageshttp://citizen.co.za/263549/cable-theft-caused-lenasia-outage/Photo: Gallo imageshttp://citizen.co.za/263549/cable-theft-caused-lenasia-outage/
Photo: http://www.iol.co.za/news/crime-courts/kzn-ops-make-r3m-copper-bust-1.1677121
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Photo: Desiree Swart http://www.moneyweb.co.za/moneyweb-gallery/cable-theft-in-moruleng?sn=Gallery
• Headlines:– Eskom copper cable theft cost
R350 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 cable-
theft areas– Copper-cable theft costing
Britain a fortune (Daily Mail Online)
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NHLS labs
• In Mthatha– Power cuts, faulty electricity– Laboratory Information System
• TrakCare– Requires continuous online link– 2013-14 – copper cables stolen FOUR times– Failure to change from Disa to TrakCare– Wireless (?3G, ?HSDPA?) link needed to prevent theft– Still waiting …
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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
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The good side
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A lot is beingdone digitally
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Forms of digitallyaided research
• Simple complex• Simple e-mail contact + data sharing• Skype, YouTube 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
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Google Flu Trends
GoogleRecorded
USA
South Africa
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Organisations
Research Without Borders: Big Open DataThursday, December 4th, 2014 - 2-4pmColumbia University’s Faculty House
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Don’t forget…http://theglobalhealthnetwork.org or http://tghn.org
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Online training
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Possibilities
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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
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19Banach 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
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20Banach 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
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Photos courtesy of Marie-Paule Henshall-Howard, GSH NHLS
Roche CAP/CTM
•Mthatha
•East London
•Port Elizabeth
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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