Featured Story from Kenya
University of Nairobi
College of Health Sciences
Opening of WiRED Medical Information Center

Gary W. Selnow
Executive Director, WiRED

Thank you Dean Makawiti.

I would like to begin with a word of thanks to the many people who have contributed to this Medical Information Center that we are dedicating today, and to the Community Health Information Center work that has been ongoing in Kenya for more than a year. I am especially indebted to the volunteers in the U.S. and to the dozens of people here in Kenya who have made this work possible. I especially want to thank WiRED’s Country Director, Pauline Karani, and my good friend, Natasha Martin, for their extraordinary efforts on behalf of this project. I would like to thank Elizabeth Marum, at CDC, for her arrangements with today’s activities. I also want to thank the University of Nairobi officials assembled at this table for their vision and for their support of this Center which today will be placed into service for the students and faculty at this College of Health Sciences.

Two years ago we had the idea to use computer technology to deliver information about HIV/AIDS to the people of Kenya. WiRED’s work elsewhere had demonstrated the power of information, and it is our belief that information is essential in confronting the HIV/AIDS plague: before people tackle the problem, before they change attitudes and alter behaviors, before they address their own health concerns, they need information. Information is direction, information is motivation, information is encouragement, indeed, as has been said many times, information is power.

The Community Health Information Center concept we put in place more than a year ago, is based on a simple idea: Provide grassroots communities with information about HIV/AIDS and other health care topics. Offer this information in an interesting and useful format and provide assistance to help people use the information to their best advantage. The idea works because it puts in place the information and a support system to help people access it.

In January of last year, we installed five Community Health Information Centers around Kenya: Kilifi, Kajiado, Kiambu, Kisumu and Butula. Each Center has four computers, a trained staff of five and an extensive CD-ROM collection of HIV/AIDS and other health topics spanning a broad range of human medicine from Asthma to Zoonoses. We focus on delivering information to medical professionals, primary care givers, young people, and for more than 50 hours per week, we open the doors to everyone in the community. People come in groups, sometimes they come alone; they come because they are concerned and sometimes frightened, but they all come because they are interested in getting information and in learning.

Research from the test year shows clearly that the Center concept is extraordinarily effective in disseminating health care information to people at the grassroots. Tens of thousands of people use these facilities. In addition to the expected groups--the physicians and nurses, care givers and youth--we have been delighted to see a broader set of audiences coming regularly to the Centers.

I’ll never forget walking into the Center in Butula and seeing more than a dozen traditional healers and birth attendants who were listening to a local nurse translate information from one of the HIV/AIDS disks. They sat in rapt attention in front of the computer monitor as they learned about the illness and discovered how to protect themselves from infection in the course of their work. For instance, as a results of their study at the Center, the birth attendants now require women in the last months of their pregnancy to keep with them rubber gloves and disinfectant to be used in the course of delivery.

The birth attendants continue to come to the Center twice a week as they examine the information available on more than 120 CD-ROMS.

Some of the other important groups to use the Centers have been young people and teachers. Our Centers have formed alliances with nearby schools and regularly hold interactive classes on HIV/AIDS and other health topics. Visit a Center and you’re almost certain to see a group of 20 or more young people answering questions as trainers take them through specially designed CDs. In the past year, many thousands of students have attended these Centers.

But, why use computers you ask? Well, lots of reasons:
  • First, they stock entire libraries on a desktop (in this little case, we have the content of many thousands of books);
  • Computers deliver information at a fraction of the cost of books, and CDs are easily shipped;
  • Computer files are quickly updated, so information stays current;
  • Computers provide a special attraction especially to youth (for a child, two hours with a book is an eternity, two hours with a computer is but a moment);
  • Computers are interactive for more effective communication;
  • And a fringe benefit—this project introduces technology to tens of thousands of young people to help this generation compete in the global marketplace.

Yes, computers have many advantages, but there is something they lack and that’s where our staff members come in. This test year confirmed that the Centers are about more than computers. Technology starts the process with a promise: information. That gets people in the door. Then the local staff members—the hearts and souls of the Centers—take over. They talk with the visitors to learn their concerns, and then suggest information that may be of greatest help. When necessary, staff members translate and explain the material on the CDs, and when the situation calls for it, they listen and advise, encourage and support. At times, they’ll suggest counseling with professionals. The staff members promote testing, they teach, cajole, assist and sympathize. They are the indispensable human elements in this information delivery system.

In the year that these centers have been in operation, they have rapidly become community fixtures as schools, libraries, meeting places, support centers, referral stations, regional HIV/AIDS and health resource hubs. They start with the promise of information and follow up with a support system necessary to place information into the hands of the people, and to help the people apply this information to change behaviors and improve their health.

Here, at the beginning of 2003, we are embarking on significant additions to the network, inspired by the lessons from our test year. Perhaps the most significant element is this Medical Information Center we are opening today. This computer facility will enable students and faculty at the College of Health Sciences to access--through an extensive CD-ROM collection and the Internet—an extraordinary amount of current information available to the medical community around the world.

It will enable them to communicate directly with colleagues in any part of the globe and allow them to access the richest, most extensive medical databases anywhere. This facility will familiarize Kenya’s future medical professionals with computer-based information, and when they become practicing physicians, dentists and nurses throughout the country, enable them to step into any of WiRED’s Centers in Kenya for updated, medical information. This university Center and the field Centers will stock identical databases—updated every six months. That’s the equivalent of thousands of medical books, journals and conference proceedings available with a few key strokes.

We envision a country-wide Health Care and HIV/AIDS Information Network that will link the university with the local Centers. This network can accommodate student and faculty lectures, research and other field activities to strengthen the study and the practice of medicine. Further, it can improve the information available to health professionals in the field and strengthen the medical network among Kenya’s provinces and its leading university.

In addition to these exciting possibilities, we’re putting in place this year a variety of programs to expand the reach and the impact of this information network. To begin, with backing from supporters such as the U.S. National Institutes of Health and the Global Technology Corps at the U.S. State Department, we’re expanding to 18 the number of field Centers.

With possible collaboration with the CDC--the Center for Disease Control--in each Center, we’re expanding the outreach programs. Several times per week, two staffers will take a “Pack ‘n Go” computer on the road to locations far from the Centers. They’ll set up day-long activities in rural schools, churches and other organizations and support VCTs wherever possible. The Centers will also focus on special-interest groups such as the military, taxi drivers and boda bodas whose HIV rates are exceptionally high. In addition, we will create our own CDs to configure information specifically for local audiences.

We’ll test a special information program for disabled people, initiate a newsletter to further disseminate the most often-accessed topics and put in place other activities that bear on the simple concept that information is key to good health care.

It starts with the capacity of the Center we are dedicating today to provide Kenya’s medical students and faculty the very latest technical information, and it continues with a network rich with information for the many varied audiences throughout the country.

We at WiRED are pleased to be a part of this program and look forward to helping provide professionals and ordinary people alike with the information they need to combat HIV/AIDS and to live healthy, productive lives.
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