Impactful digital health transformation through a clear vision and values: insights from Eswatini
Aug 2, 2024
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Echo Vanderwal, Executive Director of The Luke Commission, leads transformative healthcare for underserved communities in Eswatini. She discusses innovative telehealth hubs using shipping containers for better access to care. Drones are employed to deliver vital medications like antivenom quickly and efficiently. Vanderwal emphasizes the importance of community involvement and building compassion in healthcare staff. She also shares insights on developing local capacity for drone operations and navigating funding challenges in digital health initiatives.
The Luke Commission effectively utilized telehealth solutions and mobile clinics to overcome transportation barriers for rural patients in Eswatini.
Compassionate care was emphasized as essential for improving patient engagement and breaking down stigma in the healthcare sector.
Innovative digital systems fostered accountability and streamlined operations, enhancing service delivery and ensuring patient-centered care in healthcare facilities.
Deep dives
Origins of the Luke Commission
Eko Vandoval shares how the Luke Commission began their healthcare journey in Eswatini, a country deeply affected by the HIV pandemic. The founders felt a calling to provide healthcare in Africa and arrived in Eswatini in 2004, where they quickly identified significant barriers to care, such as access to transportation and stigma at health facilities. Their initial efforts included mobile outreach clinics in rural areas, where they tested a high number of people for HIV but faced the challenge of limited access to antiretroviral therapy. Over the years, the Commission has grown significantly, now employing a large team and serving around 300,000 patients annually while remaining committed to compassionate, patient-centered care.
Establishing a Centralized Healthcare Hub
The acquisition of a centrally located 70-hectare site in 2013 allowed the Luke Commission to establish a comprehensive healthcare facility that serves as both a referral center and a supply chain hub for care delivery. The site provides specialized and tertiary care, including becoming the largest provider of ICU care in the country. By including engineering and maintenance support teams, the organization has built and maintained its own infrastructure, promoting a culture of ownership among staff. This centralized location has helped streamline operations and contribute to the successful delivery of healthcare services across Eswatini.
Importance of Compassionate Care
Eko emphasizes that compassion is critical in improving healthcare delivery, particularly in a society where many patients feel stigmatized. The Luke Commission has implemented training programs for all staff, including those in supporting roles, to ingrain a culture of compassion and understanding into their interactions with patients. They recognize that high-quality care requires not just technical expertise but a human touch that makes patients feel valued. By treating patients as family members, they aim to create a supportive environment that encourages individuals to seek care earlier and remain engaged throughout their treatment journeys.
Leveraging Technology for Healthcare Delivery
The introduction of digital systems has played a vital role in improving accountability and transparency within the supply chain, significantly impacting access to care. Eko reveals the development journey of their scheduling system, which evolved into a comprehensive digital ecosystem that addresses multiple pain points faced by healthcare staff. By keeping developers close to end-users, the organization fosters rapid feedback and iterative improvements to the technology. This mobile-first approach ensures that the systems are designed with the patient's experience in mind, focusing on enhancing service delivery rather than just meeting administrative requirements.
Innovative Solutions for Remote Care
The Luke Commission has introduced telehealth solutions to reduce the burden of travel for patients requiring routine care in remote areas. By using solar-powered shipping containers equipped with technology, patients can access essential medications quickly through a streamlined process. The integration of telehealth not only lessens the strain on healthcare facilities but also enhances the patient experience, allowing clinicians to focus on more complex cases. This innovative approach demonstrates the Commission's commitment to efficient care delivery that meets patients where they are, reducing barriers to access.
Episode 6:What can we learn about creating real impact for underserved communities from The Kingdom of Eswatini, a tiny country enveloped by South Africa?
Join us on the latest episode of the Global Perspectives on Digital Health podcast where we hear from Executive Director of The Luke Commission, Echo Vanderwal about the way that set up healthcare services for those who needed it most and added digital in a way that enabled healthcare workers to deliver compassionate, high quality care.
If you want to see how to create real impact for patients who have real transportation barriers rurally, then hear about what the Luke commission have done with :
Telehealth hubs out of shipping containers with access to doctors by video, and secure vending machine for simple non controlled medications, all enabled via Starlink
Drones piloted by local staff that deliver critical but high value medications like antivenom rapidly and effectively - and the impact this has had on the people who can now survive Black mamba neurotoxic envenomation
Or if you want to learn how they:
Enabled their community health workers by creating their own bespoke EHR and admin tool that was clinician centred and based on the fastest feedback loops possible (see the clip!)
Created a culture of treating patients with compassion to overcome and the values that helped them make decisions and get through some challenging times
Used the end goal of what they wanted great healthcare to look like, and made decisions on how digital could help them get there
Proactively worked with the country’s Civil Aviation Authority to work together on how to get in place what was necessary to be safe and deliver a high quality and reliable drone service (lesson here for regulators and developers on working closely together in unchartered territory with the end goal in mind - Stephen talked in episode 5 about how the regulator could and should be a facilitator.
There’s so much insight packed into this episode - it was energising to record it to say the least and I’m really inspired by the work and impact they have had.
If you are a healthcare leader, developer or working to create impact for the people rurally, you have got to give this one a listen and share it with others who might benefit from Echo’s insights.
