Mo­bile health tech­nol­ogy helps tackle epilepsy in Bhutan

Bhutan Times - - Editorial - By Mar­cel Sangsari GLOBE COR­RE­SPOND ENT

In the deep, re­mote val­leys of the King­dom of Bhutan, a small coun­try in South Asia bor­dered by China to the north, a boy slips on a plas­tic head­set that looks like a shower cap.

Dr. Farrah Ma­teen, a 33-year-old neu­rol­o­gist at Mas­sachusetts Gen­eral Hos­pi­tal, stands next to him, pre­par­ing to col­lect a set of read­ings through the head­set on a new ap­pli­ca­tion on her cell­phone. This is how the boy will be di­ag­nosed with epilepsy, and it’s an ex­am­ple of how Ma­teen and her Bhutan Epilepsy Project are us­ing fast­grow­ing mo­bile health tech­nol­ogy to bring im­proved med­i­cal care to un­der­served parts of the world.

With the ar­rival of the Ap­ple Watch, and the com­peti­tors sure to fol­low, in­ter­est from hos­pi­tals in us­ing mo­bile de­vices to di­ag­nose, mon­i­tor, and treat pa­tients is ex­pected to speed up. A re­cent study by Re­search2guid­ance, a mo­bile mar­ket­ing re­search firm, found there are al­ready more than 100,000 mo­bile health apps, for ev­ery­thing from fit­ness rou­tines and diet sug­ges­tions to func­tions that al­low doc­tors to study images and mon­i­tor pa­tients.

Ma­teen’s quest to study the neu­ro­log­i­cal con­di­tion of pa­tients has taken her to China, Bangladesh, In­dia, Jor­dan, Le­banon, Zam­bia, and var­i­ous other coun­tries. The Bhutan Epilepsy Project is her lat­est en­deavor.

Just how un­der­served is Bhutan? It does not have a sin­gle neu­rol­o­gist, nor does it have any tech­nol­ogy to di­ag­nose epilepsy, one of the most com­mon neu­ro­log­i­cal dis­or­ders and one eas­ily treated with med­i­ca­tion.

Ma­teen, brim­ming with youth and in­tel­li­gence, has re­ceived fund­ing from the gov­ern­ment of Canada and the Thrasher Re­search Foun­da­tion to bring cut­tingedge mo­bile tech­nol­ogy to re­mote Bhutanese. Bhutan Epilepsy’s team of col­lab­o­ra­tors in­cludes med­i­cal spe­cial­ists, Bhutanese psy­chi­a­trists, data read­ers, and pro­gram­mers.

The “team is work­ing very hard to im­prove care of epilepsy,” said the soft-spo­ken Ma­teen. “Bhutan doesn’t have a neu­rol­o­gist . . . [but they] have re­ally em­braced the op­por­tu­nity.”

One rea­son is that its tiny pop­u­la­tion of 730,000 faces a high bur­den of epilepsy (es­ti­mated at 1 out of 1,000 peo­ple). And its geog­ra­phy — most Bhutanese live in ru­ral, moun­tain­ous vil­lages — pre­vents them from re­ceiv­ing trained help for their seizure dis­or­ders, Ma­teen said.

De­spite living in ru­ral ar­eas, the Bhutanese are ex­tremely well con­nected — more than 90 per­cent own a cell­phone — mak­ing the coun­try an ideal set­ting for Ma­teen’s project.

One com­pli­ca­tion is that the coun­try’s tra­di­tional faith-based prac­tices com­monly mis­con­strue epilepsy as a su­per­nat­u­ral curse, and so­ci­etal myths treat epilepsy as a so­cial stigma. So far, more than 200 Bhutanese with seizures have en­tered the study.

“Tra­di­tional medicine be­liefs [say] they have seizures on aus­pi­cious days,” Ma­teen said. “If they find this tech­nol­ogy helps them ex­plore their tra­di­tional be­liefs, it’s . . . a win-win.”

From her hum­ble roots grow­ing up in Prince Al­bert, Saskatchewan, a small Canadian town, Ma­teen has be­come a ris­ing star in the Amer­i­can med­i­cal com­mu­nity. Fol­low­ing her stud­ies, she com­pleted a stint at the Mayo Clinic and a fel­low­ship in med­i­cal ethics at Har­vard. She re­cently com­pleted her PhD in in­ter­na­tional health at Johns Hop­kins Uni­ver­sity.

Her Bhutan project is an­a­lyz­ing the mo­bile elec­troen­cephalog­ra­phy, or EEG, ver­sus the sta­tion­ary EEG tech­nol­ogy, which is the stan­dard epilepsy di­ag­nos­tic tool in Amer­i­can hos­pi­tals.

“The long-term goal is to train the [Bhutanese] re­search co­or­di­na­tors to be­come even more skilled at EEG so they can pro­vide that ser­vice. They are the ex­perts now, re­ally.”

But even ex­perts need to be able to com­mu­ni­cate with hos­pi­tals and health fa­cil­i­ties in other places. One com­mon ap­pli­ca­tion of mo­bile health is through sim­ple text and per­son­al­ized mes­sag­ing.

Medic Mo­bile, a non­profit op­er­at­ing across Africa, Asia, and Latin Amer­ica, is de­ploy­ing cus­tom­ized SIM cards for phones and lap­top soft­ware to connect com­mu­nity health work­ers with health fa­cil­i­ties.

“What we need to save . . . more lives . . . is co­or­di­na­tion,” said Josh Nes­bit, Medic Mo­bile’s chief ex­ec­u­tive. “It’s about com­mu­ni­cat­ing and mak­ing sure that ev­ery kid gets their vac­ci­na­tions, that ev­ery preg­nant woman gets ac­cess to ba­sic care.”

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