The influence of technology in health systems around the world has changed many aspects of our healthcare, and each speaker gave his own outlook on the issue based on his area of expertise.
Dr. Jean-Pierre Unger from the Institute of Tropical Medicine in Antwerp, Belgium, offered us a European perspective, discussing the problems of the healthcare system in Belgium. He argued that prior to the 14-year hiatus on research run by a series of specialists, the Belgian healthcare system suffered from inefficiency, poor bureaucratic coordination and low use of information technology (IT). The system has benefited from several transformations. Most importantly, the role of the general practitioner (GP) has been enhanced. In-service training schemes were created to improve the GP's manual skills and handling of terminally ill patients. Participants appreciated the training and relationships improved within the local health system community. On a technical level, the increased access to computerized hospital files improved the management control systems within the hospitals. Dr. Unger maintained that this form of coordination can be reproduced, if there is a motivated group of health professionals working together. Most urban areas have systems in place that are quite effective, Dr. Unger points out; however, we must direct these developments towards rural areas.
Developing countries experience the world's technological advancements though on a small scale, particularly when it comes ot health systems. Dr. Madhan Balasubramanian from Apollo Hospitals Group, India, talked about how his organization has taken technology to rural areas. "The Apollo Hospital Group has been a pioneer in technology innovations in rural India," he pointed out. In the Stata of Andhra Pradesh, India, the Group is rapidly extending its services to rural care. Although it is a corporate organization, Dr Balasubramanian stated, the Group is looking at cheaper service costs for its rural hospitals in comparison to its urban hospitals, making it more accessible to the populations in these areas. Three main technological developments in the state of Andhra Pradesh are Tele-Health, Health-Highway and Apollo Reach, which all communicate the link between technology and rural healthcare.
Africa, more specifically Sub-Saharan Africa, is a region where technology is needed to aid the stagnant development of health systems in these countries. Dr. Georges Pariyo from Makerere University in Kampala, Uganda, discussed two important elements of technology and healthcare in Africa: firstly, the role of the hospital in Africa and secondly, the role of faith-based facilities which have become quite predominant in his native Uganda. "High-quality is acquainted with high tech," Dr. Pariyo said. The primary goal of the hospital should be to provide quality healthcare. Patients want quality and it is essential for them to receive quality care. However, hospitals in Uganda deal with severe problems due to under-staffing and under-financing, which do not permit them to provide the care needed. Also, high competition exists between public and private facilities. Dr. Pariyo gave the example of a recent open heart surgery that was performed at a private facility which was then followed by the national hospital Mulago. "[Other] hospitals cannot even offer a basic caesarian section," he remarked. Faith-based hospitals are often situated in rural areas and tend to be private, not-for-profit organizations. However, questions have been raised as to whether the poorer populations really have access to these facilities, because of the outstandingly high fees. Subsidies are being provided by the government of Uganda, Dr. Priyo explained, and as a result, there have been many political issues surrounding those institutions.
It is my aspiration that health will finally be seen not as a blessing to be wished for, but as a human right to be fought for.