Imagine your 7-year-old son’s face, abdomen, and legs begin to mysteriously swell one morning. Your initial reaction as a parent would likely be to worry first. However, your second instinct is probably to rush to your computer and search the Internet for what might be going on. This is easy enough for the roughly 72% of people in America who have a computer with Internet access in their homes.
Now, imagine you are no longer in America but in rural Mozambique. And, unfortunately, you are not part of the 3% of the population that has access to the Internet. Even if you were able to get online, let’s say that you are also not part of the 47% of the population that is literate, rather the majority that would have no way of navigating a website like WebMD where most of us in America would within minutes find a list of possible causes and could begin to guess that a doctor’s visit was necessary.
Spending a day on the pediatric ward in a public hospital in Mozambique, I began to think about what it is like to be one of the many mothers accompanying their children for treatment of what are often life-threatening conditions. For the most part, the women have no idea what is going on with their sons and daughters, and the cases arrive at the hospital in extremely advanced states, almost the opposite of the US where anxious parents regularly bring their children in for relatively harmless coughs and colds. I saw several swollen faces, abdomens, and legs that day, many of them cases of childhood nephrotic syndrome, a condition that responds well to steroid treatment but can be dangerous if left untreated for too long.
But what if those kids didn’t have too long? What if they had appendicitis, which commonly appears as a stomachache with fever, nausea, vomiting, and diarrhea? In a country where all of these symptoms are actually relatively common, often caused by poor sanitation and infectious agents, a case of appendicitis (which is already difficult to diagnose in children even in the US) wouldn’t really cause a stir initially.
But what about when your child begins screaming in pain, shrieks that any parent could know meant something was very wrong? And what if you no longer lived in the capital of Maputo, but in the northern city of Pemba? Given that the only 2 pediatric surgeons in the country are in Maputo, you might consider the trip to save your child’s life. The distance from Pemba to Maputo is roughly 1500 miles by road (41 hours by bus over several hundred miles of unpaved road). For perspective, the distance from San Diego to Seattle, essentially the western coast of the United States, is only 1250 miles. I think the dilemma is apparent.
Examples such as these highlight the tremendous impact that a combination of education and technology has had on prevention and early diagnosis in America. Access to health information has allowed people to not only know when a situation is serious enough for a hospital visit, but also how to appropriately manage conditions at home, as well as how to prevent reoccurrence of sickness.
In countries like Mozambique and others with similar socioeconomic situations, the ability to easily access health information is literally the difference between life and death. Sub-Saharan Africa has the worst information technology infrastructure in the world, with a recent Gallup poll indicating that many countries have less than 1% population access to the Internet. Recent initiatives to increase rural Internet access by Google and others could, if accompanied by increased efforts for literacy and education, truly revolutionize prevention efforts in Africa and around the world, greatly reducing what is an otherwise avoidable burden on already challenged healthcare systems.
Abraar Karan is a medical student who blogs at Swasthya Mundial.
