Medical Information via Satellite:

A prescription for better health in developing countries

A crisis of public health afflicts the developing world. Pervasive poverty and a lack of medical facilities render large portions of Africa and Asia exposed to diseases like malaria, influenza and severe diarrhea that disproportionately kill the youngest and most vulnerable.

Faced with great needs and terribly limited resources, one quantity holds immense potential for improving the health of developing countries: widespread distribution of information. Supplying information on hygiene and nutrition to all will empower people to take better care of themselves and their families. Delivering specialized information to medical practitioners will make them more effective in their difficult work.

The question is how to accomplish this important objective. With a dearth of broadcast stations and insufficient networks for transmitting data, how can developing countries economically distribute information to everyone? The answer is to employ bold new methods to face an enormous challenge.

Imagine hundreds of physicians in remote settlements across Africa getting medical advisories via a compact receiver that gets programs directly from a satellite in space.

Picture daily bulletins on diagnostic techniques going to clinics throughout India and Pakistan, even in areas where Internet service is sporadic or nonexistent. The far-flung clinics use a small, inexpensive device that gets satellite transmissions and downloads the information to a personal computer.

Finally, imagine millions of people across Africa and Asia using satellite radio to get information about nutrition, hygiene and practices to stop the spread of HIV/AIDS. Receivers for this system – identical those used by the physician in the Serengeti and clinics in India and Pakistan – would be inexpensive, easy to operate and would run off mains power, batteries or even solar cells.

Abundant Medical Information from the Skies

Envisioning these possibilities might be an act of imagination but not fantasy. A satellite radio system is now in operation for all of Africa and Asia. WorldSpace Corporation, the world leader in satellite radio, has created this system, which uses satellites in space to broadcast digital audio and multimedia programs directly to compact, portable receivers. Founded in 1990, the Washington-based firm operates two satellites: AfriStar™, serving Africa, the Middle East and Europe, and AsiaStar™, which serves Asia. Together, the two craft reach a potential audience of over three billion people.

WorldSpace designed its system expressly to serve the developing world. Satellites provide vast coverage. Digital transmission ensures quality and reliability. Plus, digital technology gives the WorldSpace system versatility far beyond traditional radio. Anything that can be perceived with ones eyes or ears can be delivered via WorldSpace, including text, data, images and even streaming video. Connect a WorldSpace receiver to a personal computer and that receiver becomes a wireless modem, capable of downloading hundreds of megabytes an hour. This data transmission capability has critical importance where Internet access is expensive, unreliable or simply nonexistent.

With an ability to surmount barriers of geography, ethnicity and poverty, the WorldSpace system holds great potential for improving clinical practice and public health across Africa and Asia. To realize this potential, WorldSpace Corporation is working with leading international organizations to launch a Health Channel.

As a curtain raiser to the Health Channel, several pilot programs are taking place. Two recent efforts are of particular interest: an audio/multimedia conference held in August that linked three continents and a live debate session that took place in September.

The participants in the August event got to experience an inventive methodology that integrates the audio and multimedia capabilities of the WorldSpace system.

An Innovative Application for an Ingenious System

CLASS – Combined Live Audio and Slide Show – is an innovative solution developed to leverage the capabilities of the WorldSpace system for distance education in developing countries. The CLASS service from WorldSpace is unique in its ability to economically merge content creation and delivery to vast territories. It uses the WorldSpace system to provide error-free digital transmission of presentations, lesson plans and other multimedia material.

CLASS technology facilitates a smooth integration of media to support education across vast territories. The result is an array of valuable capabilities:

· Delivering live lectures with accompanying PowerPoint presentations directly to students’ PCs (direct-to-home, or schools) at a scheduled time.

· Enabling students to hear live commentary from the best teachers while following associated presentations and getting real-time updates as the teacher works through the material.

· Enabling students with Internet access to pose questions via a text-chat or voice mode.

· Delivering presentations, lesson plans and other multimedia materials to students, thus complementing and expanding the classroom lecture.

Besides CLASS delivery, the WorldSpace system, of course, provides digital audio with fade-free, crystal-clear reception across vast territories. Reception requires a WorldSpace radio. These units are reasonably priced and available from vendors throughout Africa and Asia.

CLASS in Action

CLASS was put to the test on 8 August 2002 at a seminar on “Prevention of HIV Transmission from Mother to Child.” Leading medical experts from three locations – London, Washington, D.C. and Atlanta – spoke to an audience of doctors, nurses and public health authorities at A.I.C. Kijabe Hospital in Kijabe, Kenya.

The seminar opened with a presentation from Dr. Nathan Shaffer, Director, Maternal-Child Transmission Program for Africa, Center for Disease Control. From his office in Atlanta, Georgia, Dr. Shaffer gave a presentation using 25 PowerPoint slides. Throughout, he annotated his slides in real time. The WorldSpace system and CLASS enabled participants in Kenya and London to listen to Dr. Shaffer, look at his slides and ask questions using the CLASS “chat” mode.

Dr. Shaffer’s presentation was followed by an audio conference of high-level medical practitioners from Africa, Europe and North America, chaired by Dr. H. W. McConnell of the London-based Interactive Health Network, addressing the subject of preventing HIV transmission from mother to child.

As a keynote for the audio conference, Dr. J. Volmik of the Global Health Council presented the lecture, “Extracts from Clinical Evidence.” Dr. Luis Gabriel Cuervo of the British Medical Journal then converted Dr. Volmik’s lecture to 13 PowerPoint slides and presented them to all participants. An extensive Q&A session followed. In response to questions, additional material – in the form of three .pdf documents – was transmitted to participants using the “Send File” option of CLASS.

CLASS Assessed

Medical professionals know the importance of assessing the success of a procedure. To gauge whether the 8 August WorldSpace/CLASS broadcast was successful, Dr. Bruce Dahlman, Medical Education Director at the Kijabe Hospital, assembled a detailed questionnaire and distributed it to all participants in Kenya. Among the responses, the Kenyan participants observed:

· The human touch of hearing and seeing adds interest to the material;

· Questions can be asked easily whenever needed;

· The program allowed interaction with some of the world’s leading experts in this field;

· Compared to a videoconference, there was more focus on the lecture rather than the distraction of the video feed switching between headshots and slide material.

· The chat functionality was “great;”

· The voice quality was excellent, once telephone feedback was muted at each site; and,

· The forwarding of additional .pdf files sent by the second speaker was good. These could be viewed off line on a .pdf application but with the speaker commenting on this additional material, with the listener scrolling through the actual file.

The key presenters were impressed with the ease of using the CLASS “chat” mode to control telephone feedback and manage the interactive message/answer/question session. Although the speaker software was set up only a day before the presentation, the installation and operation were flawless.

Technology on Trial and a “Trial” via WorldSpace

A second pilot for the Health Channel took place on 18 September. The International eHealth Association was holding its annual meeting in London. On of the meeting’s feature events was a debate on the right of health information for primary care providers in low-income countries.

The debate followed the format of a court proceeding. The “judge” was Dr. Richard Smith, editor-in-chief of the British Medical Journal, with medical authorities taking positions for and against the proposition. Cross-examinations took place and people cast their votes and a final judgement was rendered.

The two-hour session was carried live by transmitting the debate to the WorldSpace uplink site in London. There was live audio from two other sites summarizing the views of the participants at those locations. Listeners from any of the locations were able to send questions or comments by e-mail to a specific address to contribute their views to the closing session. In addition to the many doctors and technologists who received the broadcast, the event reached other organizations, like the National Law School in Bangalore, India, where more than 50 participants had gathered.

From Pilot Stage to Permanent Phase

The seminar in August and the debate in September were two convincing demonstrations of the WorldSpace system and the CLASS methodology to serve medical professionals and the general public. Other pilot programs are now in development as WorldSpace and its partners work to make the Health Channel a reality for Africa and Asia.