A New Paradigm for Namibian Health Care and Wellbeing

Dr. C.M de Villiers (Pain Intervensionist) - Namibia is a unique country in that it has a small population of 245 million people spread over 845 000 square kilometres translating to 2,25 people per square kilometre. Yet it has outstanding roads and infrastructure with 4G telecommunication networks. A Virtual Health Platform (VHP) is therefore ideal to be utilized as a smartphone application to seamlessly link all Namibians to the interactive structured Health Network with its own diagnostic tool to diagnose, triage (assign acuity) and manage the patient across all the points of service delivery. This includes from Primary Health Worker (PHW) at a Rural Clinic to a Principal Surgeon in a specialized theatre such as the Robotic Spinal Theatre to be built in Welwitschia Private Hospital in Walvis Bay.

In order to achieve this on a National Basis a systematic approach is needed i.e., Disease Entities with ICD 10 International Designating Coding as well as best practice protocols i.e., diagnostic test of choice (DTOC) e.g., blood smear for Malaria and Drug of Choice (DOC) which must be adhered to. This process will simplify medical supply lines; cold storage of vaccines and a uniform tender system for bulk buying of drugs and surgical equipment and material per region based upon population and disease profile for each region.

How can this be achieved? Quite simply by linking all Namibians via smartphone to a structured healthcare platform where the spectrum of diseases is grouped together to causality i.e., the infective agent or noxious stimulant into 7 disease types. This will allow epidemiological data capturing and proper Health Planning in future.

The 7 diseases are:

• Lifestyle Disease e.g., Obesity / Diabetes

• Inherited Genetic Disease e.g., Cystic Fibroses

• Infectious Disease e.g., Malaria / Covid-19

• Mental Disease e.g., Anxiety / Depression

• Occupational and Travel Disease e.g., Asbestosis / Yellow fever

• Trauma e.g., MVA and Mass Trauma

• Environmental Disease e.g., Radiation / Asbestosis

The My Virtual Health diagnostic Manikin is useful to identify the site of the pain e.g., stomach, its radiation e.g., into the right groin and the intensity (VAS 8/10) for a duration of 24 hours. These critical clinical data sets are compared with vital signs i.e., Temperature, Blood Pressure, Respiratory Rate and Oxygen Saturation as measured health watch or health monitoring ring.

All the above classical questions together with the pain drawing (site of pain). Intensity and duration of the pain is analysed, and the patient is referred:

• Early and timeously

• To the correct level of care

• With a working diagnosis e.g., Appendicitis

• The Health Professional then completes a more disease specific questionnaire using the patient’s vital signs i.e., Pulse /Temperature / Blood Pressure / Respiratory Rate / Blood Sugar Level to refine the diagnosis and treat the patient according to a Best Practice Protocol.

• If the diagnosis is not yet confirmed a Diagnostic Test of Choice e.g., MRI is done and the patient is referred to the next relevant level of care e.g., Abdominal Surgeon who will operate and remove the appendix.

The My Virtual Health Platform communicates to all clinical providers on a need-to-know basis within the Rules of Poppie. Hence all records are kept at every level of care and data can be analysed to improve the healthcare delivery system. My Virtual Health, a Platform for Acute and Chronic Health will be out by October 2022. – [email protected]