Grants:Project/Rapid/Mgonzalezmillan/Wikipedia Project for Offline Education in Medicine (POEM) Guatemala/Report

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Report accepted
This report for a Rapid Grant approved in FY 2017-18 has been reviewed and accepted by the Wikimedia Foundation.

Goals[edit]

Did you meet your goals? Are you happy with how the project went?

The POEM team is satisfied with the project’s results. The goal of assessing if the Internet-in-a-Box would be useful in Guatemala was achieved through interviews with personnel from various institutions:

Government:

  • Health Commission, Congress of Guatemala
  • Ministry of Health, Alta Verapaz

Universities:

  • Universidad de San Carlos de Guatemala (USAC)

NGOs:

  • Friends of San Lucas
  • Tula Salud
  • Medicos del Mundo

Foundations:

  • Fundacion Tigo

Doctors, nurses, technicians, and medical students were also interviewed in a wide array of settings (improvised health facilities, posts, clinics, and hospitals). In particular, a team of medical students from the University of Wisconsin (led by Dr. Sam Zidovetzki), who were volunteering with Friends of San Lucas treating patients around San Lucas Toliman, used the device for one week during their practice and provided feedback.

The study allowed determining if the device can be implemented in Guatemala and possible ways to do it in the future. Overall, the results of the project will help Wikipedia learn how to get their medical content to remote areas without connectivity.

Outcome[edit]

Please report on your original project targets.

Target outcome Achieved outcome Explanation
Conduct research on information and communication technologies penetration and use among health practitioners Data gathered on information and communication technologies penetration and use among health practitioners ·    The majority of health facilities have electricity, although some experience blackouts.

·    Most low-level health personnel (traditional midwives, health technicians, and nursing auxiliaries) do not have smartphones because consider them too expensive. On the contrary, most high-level health personnel (nurses and doctors) use this technology.

·    Basic facilities like health posts and small rural clinics do not have computers. Some larger clinics and hospitals have computers but they are mostly used for keeping patients’ records and collecting data.

·    The majority of health facilities do not have internet installed. If so, (mainly in larger clinics or hospitals) it is used for keeping patients’ records and collecting data.

·    Some rural areas have access to mobile internet; the provider with the best coverage is Tigo. However, more remote areas experience no connectivity.

Conduct research on the current extent and use of medical information among health practitioners Data gathered on current extent and use of medical information among health practitioners ·    Health workers rely mainly on the Health Ministry’s guides in their daily practice. Others consult books.

·    Some health workers, especially younger ones, look for medical information online and even download mobile medical applications. However, most of them do not use Wikipedia (some because they don’t know about it and others because they consider it too broad or unreliable).

Determine the potential applicability of the Internet-in-a-Box and interest among health practitioners and other stakeholders Potential applicability of the Internet-in-a-Box and interest among health practitioners and other stakeholders determined ·    All interviewees found the device interesting and thought it would be helpful in rural health facilities in Guatemala.

·    Low-level health practitioners would be the most benefited by the device but they don’t have smartphones to use it. The NGO “Tula Salud” has distributed cell phones to health workers in rural areas for their telemedicine and remote training programs. Fundacion Tigo said they could collaborate providing smartphones. However, this type of workers would need training on how to use cell phones and how to look for information as they do not use this technology and have low levels of education. Moreover, most health posts are staffed with only one or two workers; therefore, the Internet-in-a-Box could be too expensive and become underutilized. The smaller model currently being developed by the company (at 10 dollars with less capacity and reach) could be a better alternative in this setting.

·    All interviewees agreed that the National Ministry of Health does not have the capacity to implement the device or conduct a pilot (currently with internal instability, under resourced, in conflict with the doctors’ union, and in the middle of implementing a new health model). The Ministry’s local offices have the autonomy to carry out their own project and there is interest from Congress to implement the device in Alta Verapaz.

·    Another group that could benefit from the device are practitioners working in NGOs in remote communities, although they experience the same constraints as the low-level practitioners. However, NGOs can mobilize resources to get smartphones and train users. The NGOs “Tula Salud” and  “Friends of San Lucas” already have experience implementing technological projects and are interested in collaborating with POEM.

·    Finally, medical students are natural users of the device. In a demonstration with recent medical graduates doing their service in rural clinics (EPS) from the Universidad de San Carlos de Guatemala (USAC), they found it useful. They are young and familiar with technology and using it to look for medical information. Moreover, the USAC is very interested in collaborating with POEM to start a pilot; it would be a solid partner in this regard.

Learning[edit]

Projects do not always go according to plan. Sharing what you learned can help you and others plan similar projects in the future. Help the movement learn from your experience by answering the following questions:

  • What worked well?
  • What did not work so well?
  • What would you do differently next time?

What worked well was engaging different stakeholders to get a complete perspective of the health environment in Guatemala. Having the participation of a doctor (M.D. Sam Zidovetzki) in the field was also very helpful. One thing that didn’t work as well is that we didn’t know of any institutions working in topics related to indigenous languages in advance, so we couldn’t interview them. Finally, a thing we would do differently next time is interviewing fewer institutions and more health personnel in public posts, clinics, and hospitals.

Finances[edit]

Grant funds spent[edit]

Please describe how much grant money you spent for approved expenses, and tell us what you spent it on.

Remaining funds[edit]

Do you have any remaining grant funds?

  • Flights: $683.86
  • Hotels: $462.46 
  • Transport: $141.46   
  • Food: $442.92 
  • Internet-in-a-Box: $260
  • TOTAL: $1,990.7

Anything else[edit]

Anything else you want to share about your project?

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