Prayer flags during the COVID-19 pandemic. Empowerment platform Fuzia is concerned with their audience's mental health. Credit: Ankita Gupta Pramanik

By Fairuz Ahmed
New York, Oct 5 2021 (IPS)

Telemedicine and health-related information have experienced a massive uptake since the COVID-19 pandemic began last year. While online health services are seen as a panacea for many ills, disinformation and fake news reports have tarnished their credibility.

The Reuters Institute Digital News Report 2021 found that many consumers have rapidly adopted new digital behaviors during lockdowns. This has opened up new digital opportunities and highlighted the next set of challenges. Across countries, almost 73% of the population now access news via a smartphone, up from 69% in 2020. During the pandemic, governments worldwide have focused on these personal devices to communicate. Consumers now depend more and more on personal devices to read up on Government restrictions, report symptoms, book appointments for vaccines, and access news.

Research done in 12 countries indicates that 66 percent of users use one or more social networks or messaging apps for consuming, sharing, or discussing news. Facebook, TikTok, Telegram, Instagram, and WhatsApp are among the leading social media platform for user engagement and news sharing.

Nina Jain, who lives in Connecticut, USA, says she has used online health information extensively since the start of the pandemic.

“I was frantically looking from one portal to the next, trying to make sense of what is going on with the pandemic. Being a mother of five children and taking care of elderly in-laws, it was imperative to navigate well and stay prepared. Community health centers were closed in our areas, and getting appointments at the doctor’s offices was very difficult,” Jain said in an interview with IPS.

“Telephone helplines, nurses-on-call, and government sites were my go-to portals for credible health news and services online. It took me and my family a lot of convincing to make my parents, who reside in India, agree to use online portals to book appointments and get treated. As a caregiver, this was a breakthrough and much-needed adjustment.”

An article published in Fierce Healthcare says telemedicine demand is expected to grow annually by approximately 38% over the next five years. Worldwide, innovative telemedicine companies and social media platforms are stepping up to meet this trend and are increasing telemedicine’s reach and improving what it can do.

Throughout the pandemic, women empowerment platform Fuzia has been concerned about ensuring its readers have credible and up-to-date information.

Fuzia co-founder Riya Sinha says this aligns with the website’s ethos of empowerment, diversity, inclusion and supports good health and well-being in line with the Sustainable Development Goals.

“Through our community, we have begun to organize events and webinars and have tried to become a knowledge sharing and an experience-sharing platform, where real users express their concerns about menstruation, polycystic ovary syndrome (PCOS), mental health, depression, stress, teen issues, and overall health factors,” Sinha says.

Fuzia’s co-founder Shraddha Varma agrees: “We do not want women to just be givers of care, but we also want them to be receivers of care. To actually take some time off and just listen to what the body is telling us, to not constantly feel like they deserve to suppress their voices.”

The site has more than 5 million followers. They have an active user base on Facebook, Instagram, Twitter, and LinkedIn and use its extensive global presence to create a safe and creative space for users.

Dedeepya Tatineni, a user of the platform, found herself suffering from mental health problems during the pandemic. She made use of the forum and its counselors.

“The counselors of Fuzia are really helpful. I do not feel depressed now, and I feel a lot better. Expressing myself on Fuzia has made me feel more confident and happier,” Tatineni said.

Empowerment platform Fuzia assists communities through outreach programs. Credit: Fuzia

Research has indicated that as the pandemic spread throughout the world, it caused considerable fears – the disruptions during lockdowns and its effects on livelihoods exacerbated the impact.

An article in Nature indicates that early results from studies on mental health suggest that during the pandemic, “young people rather than older young people, are most vulnerable to increased psychological distress, perhaps because their need for social interactions are stronger. Data also suggest that young women are more vulnerable than young men, and people with young children, or a previously diagnosed psychiatric disorder, are at particularly high risk for mental health problems.”

For many women around the world, wellness, in general, is perceived as a luxury. Men often get priority for healthcare. Topics like menstruation, pregnancies, female hygiene, teen and tween’s mental, physical, sexual, and emotional well-being, postpartum depression are overlooked or not discussed because they are taboo.

Women and girls too are affected by “period poverty,” where lack of access to sanitary products, menstrual hygiene education, toilets, handwashing facilities, and waste management students miss classes and stay indoors.

Menstrual health is not just a women’s issue. Globally, 2.3 billion people live without basic sanitation services, and in developing countries, only 27% of people have adequate handwashing facilities at home, according to UNICEF. Not using these facilities makes it harder for women and young girls to manage their periods safely and with dignity.

Varma and Sinha are determined that Fuzia remains committed to providing a judgment-free zone and prepared for difficult discussions about taboo topics.

• This article is a sponsored feature.

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There are thousands of miles between Chanyanya Rural Health Clinic, a basic medical centre in Zambia’s rural Kafue District with no resident doctors despite being the main centre for nearly 12,000 people, and the New York University (NYU) Teaching Hospital, one of the world’s most prestigious medical schools.

Mercy Nalwamba, the clinical officer general of Makeni clinic in Chilanga District. Credit: Amy Fallon/IPS

The two are worlds apart, not only when it comes to geography.

Yet when Florence* broke out in a strange rash two weeks after she began taking ARVs for HIV in 2011, the clinic, about 90 minutes from the capital Lusaka, was able to connect to a NYU infectious diseases expert on the other side of the world with just a few clicks of a computer mouse.

Through the Virtual Doctor Project (VDP), a telemedicine initiative being pioneered in Zambia linking rural clinics across the southern African country with volunteer doctors around the globe using the local broadband network, Florence was prescribed the correct medication.

Her rash had been “all over the body”, recalled Kebby Mulongo, the clinical officer who first saw her.

“It was just about two days in between [when] the doctor [in New York] was able to get back to me. The expert in New York knew what the problem was ASAP,” Mulongo, 30, told IPS.

“And that’s what I was happy about, because after that I kept on treating the patient in the ward. Within a week or so the patient improved instead of me sending the patient to the hospital.”

A smiling Mulongo added: “Medicine is about consultation. If we can consult at the click of a button like that, it’s better for us.”

The VDP, now running live in six Zambian sites, use eHealth Opinion software to submit patient files electronically. Clinical officers, trained to screen patients before they see a doctor, access this using Fizzbook laptops. The dust-proof, splash-proof, robust laptops can be easily transported and a battery backup means they can withstand Zambia’s power cuts.

The software allows the clinical officers to build a patient file which is compressed and sent to one of the VDP’s medical experts in Zambia, the UK, U.S., India, Pakistan, China, Nigeria, New Zealand or Malaysia. The file includes the patient’s basic details, medical history, prescription and the specific questions the Zambian clinical officers need answered.

All clinical officers are given a basic Samsung HD camera with which they can take photos of X-rays. These can be uploaded to the computer and included in the patient file along with lab reports. The “virtual doctor” then reviews the information they’ve received and offers diagnostic and treatment advice with another click of a button.

Operational in Zambia for six months, the VDP, set up by an eponymous charity, are due to go live at three more sites this month. They hope to have at least 12 sites live by the end of the year. They’re also looking at expanding into Tanzania in the near future, along with other African countries.

Just before Christmas four new clinical officers were trained in Zambia’s new Chilanga District.

“Effectively it’s a platform for you to be able to talk to somebody else about a patient that maybe you’re not too sure on. The idea is not to take any responsibility for ownership away from you,” project co-ordinator Heather Ashcroft told the trainees.

“You still are and you remain the first port of call, you have the final say on how you diagnose or treat a patient. The idea behind the system is that you get a bit of a sounding board.”

Mercy Nalwamba, 22, was one of two female clinical officers who attended the Dec. 23 training session. A recent graduate of Chianama College of health sciences, she is now the clinical officer general of Makeni clinic in Chilanga District and sees about 50 patients daily, the majority of them suffering from respiratory tract infection, diarrhoea and malaria.

Nalwamba said having access to the VDP experts at Makeni would mean the clinic would have to make less referrals to other centres further away for nonemergency cases, the project’s main aim. But she told IPS, “I can’t wait to hear their opinions and new ideas. It will enhance my work, I’ll gain more experience and knowledge.

“I think there will be less work and we’ll be getting more information on how to go about (treating) chronically ill patients, how to manage them and when we’re referring them we can at least make the patients a little bit stable.”

Ashcroft says the Memorandum of Understanding (MOU) signed with Zambia’s Ministry of Health (MoH) states that VDP will provide the equipment, training and software for free for the first 12 months, giving the system time to “bed in and have a positive impact on the clinic’s referral rates”. The government is supporting them in motivating and encouraging health staff to use it.

“Following this, we will continue to support the clinical officers, however, a small surcharge will be made to ensure that the system can be upgraded and maintained in the health centres,” Ashcroft told IPS. “All equipment, and licenses for donations is provided by charitable donations, so our aim is to equip the clinics with everything they need for the service to become a self-sustaining, yet integral part of the day-to-day running of the health centres.” The charity is one of the increasing number of NGOs accepting Bitcoin donations.

Andrew Phiri from the MoH is confident the government will be able to support VDP after its first year, stressing it’s a much-needed project.

“We’ve got a lot of people living in rural areas, they have to walk long distances (to clinics). We don’t have a lot of ambulances. You find that our health facilities are not closely linked, they are huge distances apart,” Phiri told IPS.

“Through consultation you are going to give the best quality of care that the patient requires. It will be a very good outcome because, really, in medicine you need to consult, you cannot work alone.”