Governments, charities, and businesses spend billions of dollars across Africa building hospitals and training doctors. But the doctor-patient ratio in many African countries is still one-twentieth or less of what it is in the U.S. and Europe, meaning many patients, particularly in remote areas, never get the specialist care they need.
Even in the best conditions, hospitals take time to build, and it can take more than a decade to train a specialist. Is the right approach to improving Africa’s health care therefore to build hospitals and train doctors?
I am the managing director of the first indigenous air ambulance in West Africa. In our experience, only a small percentage of patients require specialist services such as neurosurgery. The main problem is access to treatment.
That problem can be better addressed by “hacking” Africa’s existing infrastructure, rather than trying to build hospitals. The term "hacking” means modifying the features of a system to achieve a different goal. In development, it can describe rapid changes made by a society to advance without going through the intermediate stages. In other words, rather than following developed nations’ road map to progress, Africa can leapfrog the industrial revolution into the information revolution by using the resources it already has.
Africa’s best-known development hack thus far is the mobile phone. Africa hasn't built a comprehensive telephone cable network. As mobiles and smartphones proliferate, it will never need one. My medical work takes me to some of the most remote communities in Nigeria. Yet in these places I meet young people who listen to TED talks and are up-to-date with the latest breaking news on CNN. The Internet—now often accessed on basic phones or smartphones—breaks the boundaries isolating small, rural communities from the rest of the world.
That technology can be used for health care too. Video appointments, SMS consultations, and other mobile health strategies can provide cost-effective health care hacks that keep costs low while providing specialist care to those who need it the most. Instead of building more expensive, underused hospitals—diluting the small pool of specialist expertise we have—why not keep specialists in specialist centers and fly in the patients that need their expertise?
Meanwhile, health care workers can be trained to deliver services without leaving their communities, in collaboration with doctors in urban centers many miles away, using telemedicine. This is a model that is gaining widespread traction.
This power could also be harnessed for education. Children can learn skills through online education programs on cheap tablets and mobile phones. A Nigerian smartphone data package can cost around $15 per month; young people who can’t afford that can still access the Internet through cybercafes and hubs. Young adults can learn from online international open education programs, such as the Khan Academy. One could disrupt the education model completely by designing shorter online courses that teach targeted, tailored skills for the workplace.
Hacking will accelerate development. It will ensure Africa stops playing catch-up and begins to lead. It will produce global businesses that lift people out of poverty. As in health, hacking could be Africa's passport to a prosperous future.