We talk a lot about working from within. We talk a lot about solving problems from the inside out. We’ve even called this paper Inside|Out. But what exactly are we trying to be inside of?

It’s simple, really. The aim is to be inside of the space where the problem lies. This means working from within the region, town, community, organisation, hospital or school whose needs are being met. In other words, the innovator who comes up with the solution actually lives or works inside that space and so understands it practically, empathetically, deeply.

But wait. What happens if you come from the outside? What if you’re an academic, practitioner or innovator of any sort from an external institution, community or region? What if you come from another country or even continent than the one in which you’re trying to have an impact? In other words, how do you work from within when your starting point is without?

That’s what this issue is all about. It’s about finding the meeting point, striking the balance between local context and external ideas. As always, there’s something to be taken from both – a message that was patently clear at the inaugural Inclusive Healthcare Innovation Summit, held in Cape Town in January 2014. As part of the Inclusive Healthcare Initiative (launched jointly by the University of Cape Town’s Faculty of Health Sciences and the Graduate School of Business’ Bertha Centre for Social Innovation) the Summit was the first of its kind in Africa. It brought together local and international healthcare educators and innovators, and highlighted innovations created by doctors, nurses, students and other frontline health workers to successfully meet patient needs.

These are the people who know and understand that space, practically, empathetically, deeply. And this issue of Inside|Out features many of their projects – as they appeared in the 2014 Health Innovator’s Review, released at the Summit.  It starts here…

A student creates a solution that works

Saadiq Moolla, Medical student, University of Cape Town

“Mobile Xhosa is a free-to-access, cellphone-based tool that aims to help doctors and other healthcare workers communicate with their Xhosa-speaking patients.

“I built the site as an aid for myself, a handy reference on my phone. I was inspired [by] my own healthcare experiences overseas, as well as the problems I’ve encountered while working in the hospital during my studies. It provides translations for commonly used phrases in history taking, examination, side-room investigations, special investigations, treatment and health promotion. It also has a Xhosa-English dictionary.

“Mobile Xhosa aims to be one of the tools doctors can use to overcome the language barrier during medical consultations, along with interpreters and language training. It helps so much to be able to explain to a patient that you will be taking blood, for example, so that they understand what you’re doing and why. It reduces anxiety and improves the quality of care.”

For more, visit the Mobile Xhosa website

Doctors Are Trained to meet African needs

Professor Bongani Mayosi, Head of the University of Cape Town’s Department of Medicine

“As everybody knows, we have a shortage of specialists on the African continent, and it’s a critical barrier to progress. But the problem is that our model for creating those types of specialists is based on European and US models, and often you’re trained far beyond what your country requires.

“We’re positively driving the brain drain out of the continent, because we have uncritically adopted training models that work for other countries. So what we’ve started doing now is training the cardiologists in a modular manner, according to the needs of their country.

“Dr James Russell [Sierra Leone’s Medical Doctor of the Year in 2008, trained in echocardiography and high care at UCT] established Sierra Leone’s first cardiac service whereby a patient can get a diagnosis by someone who is competent in imaging, and can receive high care. And that’s exactly what Sierra Leone needed. It does not have the equipment for open-heart surgery, but it does for diagnosing certain conditions.

“Dr Russell is now coming back to spend another six months with us, to learn cardiac pacing. He will then go back again, having added to the skills and knowledge that he already has.

“So we’re beginning to see a situation in which you start training a person to address a country’s needs; then they go back and develop a service; then that service demands a higher level of training; and so they come back for more advanced training. And it spirals from there.”

A SOURCE OF GREAT THINGS

This health innovation feature has been adapted from the 2014 Health Innovator’s Review, compiled by Inclusive Healthcare Innovation, a joint initiative between the Bertha Centre for Social Innovation and Entrepreneurship at the University of Cape Town Graduate School of Business, and the UCT Faculty of Health Sciences.

Health Innovator’s Review, 2014

Editors: Dr Lindi van Niekerk and Dr François Bonnici

Contributors: Gus Silber, Mark van Dijk, Dirk Hanekom, Rachel Carter, Adam Shear, Sebastian Basler, Anjali Sastry, Wim de Villiers, Andrew Jack, Gary Marsden, Richard Perez