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Daniel Daugaard

Our scientific meeting in Latur

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Our day starts in Hotel Aroma Latur with a scientific meeting arranged by RHPT and the Indian Medical Association, which is their national association. People are excited to meet the world leading doctors from The Lancet Commission and a formal round with introductions of the chairpersons takes place. Doctor Arun clearly outlines the purpose of the day. “My wish with this scientific meeting is to have an interaction between The Lancet Commission, CDC, Heeple and our local hypertension specialists, to better understand the scientific contents of Global Hearts and how the key actions from the commission can be implemented in practice”.

The first spokesperson is Ms. Kristy Joseph, who delivers an outstanding global perspective of NCD’s and the need for action. Next up are Doctor Ernst Rietzchel and Doctor Angelo Scuteri from The Lancet on “A call to action and a lifecourse strategy to address the global burden of raised blood pressure on current and future generations”. It is a captivating speech with 10 very concrete key actions that are strongly endorsed by both CDC and WHO. Both doctors are world leaders and have impressive insights that captivate people. After Ernst and Angelo we receive an interesting speech from Doctor Sanyaj Shivapuje on “Angina Pectoris: An evidence-based approach”.

Before lunch the final speakers are Doctor Arun More and myself representing Heeple on “Technology integration for evidence based management of hypertension and diabetes”. I’m quite excited and simultaneously humbled to stand in front of so many passionate doctors together with Doctor Arun and explain how technology will play a major role in health care and rural India in the future years to come. Our proposition is to develop a digital rural health monitoring eco-system consisting of 1) systems for patient management, 2) systems for program support and 3) a patient registry. Our desire is to make RHPT a lighthouse case that can create a foundation for an international roll-out of the Global Hearts program. The entire concept of digital health is new to many in the crowd but the project is received with much enthusiasm and positive feedback.

We are both excited to uncover the very ambitious plans of digitalizing the Global Hearts program in a cooperation with The Lancet, CDC, Heeple and RHPT and with Doctor Arun as the local implementation champion.

After lunch the scientific meeting continues with more insights on prevention and control of diabetes, before Doctor Arun once more gets on the scene to introduce all to the activities of the RHPT. He delivers an excellent speech, focussing on the implementation of key actions by the Lancet Commission and the Global Hearts program.

Both Simone and I are exhausted but also enlightened after an amazing day in company with highly passionate doctors. We return to our hotel for a quick rest before a private dinner with Doctor Arun and his family.

A slow tsunami

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The day starts with a trip to the main office of the Rural Health Progress Trust (RHPT), in the city of Murud. We ride in a mini bus with our driver Mr. Shankar, who excellently dodges the chaotic traffic on the dirt roads. A larger group of people from Murud greets us in front of RHPT and we are humbled by their excitement. While the Chai (a traditional Indian sweet tea) is being served, Doctor Arun delivers an excellent presentation outlining the key challenges with NCD’s (non-communicable diseases) in rural India and the fantastic results achieved by the RHPT programs. We learn about awareness activities targeting schools, kids, teachers and religious organizations. We also understand how Doctor Arun intelligently uses local media channels to create more trustworthy attention and how he exceeds in converting local people to skilled health care workers. We hear how active management of hypertension and diabetes is carried out in the primary, secondary and tertiary care centres and how mobile hypertension clinics treat poor and immobile people on-site. Doctor Arun explains how “self-help groups” improve medication access in rural villages and how on-site blood pressure and sugar checkpoints help with early diagnosis and prevention. Lastly, RHPT convey guideline based knowledge to local doctors. This empowers them to deliver better treatments, while simple smartphone apps help to digitalize the health care support.

After the presentation we visit the village Ter in the Osmanabad district. Here we see a secondary public and rural health facility. We start with an indepth interaction with the local community and the personnel at the hospital. This becomes a unique opportunity to observe how the facility functions and how it benefits the local society. We observe that the facility only has one doctor although it should have had multiple doctors on-site. As we leave we are presented with a flower each and it seems that most of the local villagers have arrived to meet and greet us. It is a nice experience, where you simply wish you could stay and spend more time with these kind people.

The next village on our journey is Mhodarwadi. Here we see very practical examples of the programs and initiatives that are run by RHPT. The mobile hypertension clinic is an impressive setup, where local villages get easy access to blood pressure measurements, blood sugar readings and an Electrocardiogram (ECG). The ECG runs on a smartphone device with a customized ECG app, that takes advantage of the phone’s computing power. It is also connected to a label printer, which allows the citizens to store their health data on paper. The introduction of smartphones has made technology like this more accessible in rural areas and it is a good example of how digital health is shaping the developing world. We gather around in a circle in the middle of the village and are greeted by the village Sarpanch (the village chief), who introduce us to the elderly that suffer from hypertension and diabetes. We hear their patient stories and learn how they take control of their disease with better education and access to basic medicines such as Amlodipine, Ramipril and Metformin. We also hear how local women are responsible for micro saving health programs, that improve continuity of care and access to compliance checks.

The third village on our road is Borgoan. They actively reached out to the RHPT on their own to join their programs and improve overall health in the village. Once again people are very welcoming and at we feel privileged to visit them and learn about their challenges.

The last village visit is Jagji, where we experience a fully functional primary health clinic. It has space for 10 beds and performs numerous important functions for the local area including management of chronic diseases, poisoning from snake bits, management of maternal and child health and family planning operations (sterilization).

In the local village we receive a beautiful and authentic Indian lunch at the house of one of the founders of RHPT. From Borgoan we travel to Murud to meet with local physicians, general practitioners and government officials in the RHPT office. A handful of doctors and public officials presents in front of the CDC, the Lancet Commission and us as representatives of Heeple. They delivered insightful perspectives of the different health functions in India and the on-ground work performed by RHPT.

After a very long day in rural India we drive back to Latur for dinner with Doctor Arun. Here we have a chance to reflect on our experiences and discuss our experiences and observations. I personally sat with a mixed feeling of being overwhelmed by the healthcare challenges but at the same time experiencing a growing hope and optimism for better conditions in the future. There is so much to achieve in India and it is uplifting and motivating to see how Doctor Arun and RHPT pave the way for a stronger, heathier, better, and more digital health care sector in rural India.

Doctor Arun More

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From Mumbai we continue our journey by air to Aurangabad. In the city we meet Doctor Ernst from Belgium and Doctor Angelo from Italy. Both doctors are part of The Lancet Commission on Hypertension and play a major role in the project.

From the airport we continue by car and are greeted by three additional Indian Doctors and Cardiologists – Muneer Ahmad, Manoj Gerela and Ranjit Kadam. The doctors accompany us on the remaining part of the journey and in the car we get thoroughly educated on the national healthcare situation in India. We learn about the different healthcare tiers, the major challenges, how modern technology plays a role, how culture impacts medication compliance and about the ambitious intervention plans for the future. 

After six hours on very bumpy roads we meet with Doctor Arun More. Doctor Arun has been a driving force behind arranging this trip and is the founder of the Rural Health Progress Trust (RHPT) in India. RHPT works to improve awareness and treatment of hypertension and diabetes in rural India. It is a novel cause and in the last years Doctor Arun has successfully impacted thousands of lives with activities.

By 1 am we land at our hotel and have a late dinner with all the doctors before heading to bed.

Launch of Heeple

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It is by no means an ordinary day in the office today. After several months of hard work, we are finally ready to launch Heeple!

Heeple is a new type of charity organization. Our roots are deeply embedded in the software industry and our mission is to use modern technology to improve prevention and treatment of lifestyle related diseases.

To me personally, Heeple is a journey into unchartered and deep waters. We know software, but we have absolutely no experience with charity and first aid in the world’s most venerable areas. We have commercial success, but can we find ways to fund activities in developing countries that are non-profit? We believe there is huge potential for helping people, but can we convince others. We believe modern technology will be a game changer, but can we verify that smartphone apps, interconnected devices, telemedicine and big data are ground-breaking technologies in first aid care… can we educate people to embrace this so far from home.

There’s a million questions running through my head as we board the flight in London heading to Mumbai in India.

As we touch down in Mumbai and watch the Indian country unfold through the window, everything suddenly makes sense. I have no answers to all my questions, but Simone and I are on an exploratory and educational journey with the simple desire to help people.

My three wonderful colleagues from Duckwise – Christina, Janis and Simone