Paul Farmer, president and co-founder of Partners in Health, has dedicated his life to the idea that the problems of the world’s poorest people are humanity’s problems writ large. Having recently returned from West Africa, Farmer spoke at Harvard Medical School and appeared on the Colbert Report last week, calling for a stronger response to the Ebola outbreak.
“We want to have a radical inclusiveness,” Farmer told the Harvard Medical School audience. “We readily acknowledge that we are overwhelmed by this.”
The hackathon, produced by Boston Children’s Hospital in collaboration with MIT Hacking Medicine, brought out many common themes: Helping kids with chronic illnesses track their symptoms, take their meds and avoid lots of clinic visits. Helping parents coordinate their children’s care and locate resources. Helping pediatric clinicians make better decisions with the right information at the right time.
Hackathons have a simple formula: Pitch. Mix. Hack. Get Feedback. Iterate. Repeat—as many times as possible.
Malaria. Cholera. Now Ebola. Whatever the contagion, the need for new, or better, vaccines is a constant. For some of the most devastating public health epidemics, which often break out in resource-poor countries, vaccines have to be not only medically effective but also inexpensive. That means easy to produce, store and deliver.
Paula Watnick, MD, PhD, an infectious disease specialist at Boston Children’s Hospital, has a plan that stems from her work on cholera: using a substance produced by the bacteria themselves to make inexpensive and better vaccines against them.
Cells do all the work
Bacteria produce biofilms—a sticky, tough material composed of proteins, DNA and sugars—to help them attach to surfaces and survive.
TEDMED2014 focused on a powerful theme: unlocking imagination in service of health and medicine. Speaker after speaker shared tales of imagination, inspiration and innovation. Here are a few of our favorites:
$100 plastic car stands in for $25,000 power wheelchair
In the first (and likely only) National Institutes of Health-funded shopping spree at Toys R’ Us, Cole Galloway, director of the Pediatric Mobility Lab at the University of Delaware, and crew stocked up on pint-sized riding toys.
Galloway’s quest was to facilitate independence and mobility among disabled children from the age of six months and older and offer a low-tech solution during the five-year wait in the United States for a $25,000 power pediatric wheelchair.
The hackers jerry-rigged the toys with pool noodles, PVC pipe and switches, reconfiguring them as mobile rehabilitation devices to promote functional skills among kids with special needs.
My father had a favorite bit of advice as we embarked on our adult lives: “Go big or go home.” Going big is exactly what OPENPediatrics is doing, empowering physicians and nurses to care for children across the globe.
The Web-based digital learning platform was conceived 10 years ago by Jeffrey Burns, MD, MPH, chief of critical care at Boston Children’s Hospital, and Traci Wolbrink, MD, MPH, an associate in critical care. It concluded a year-long beta test in April 2014, and version 1 has now been launched.
Developed to impart critical care skills, OPENPediatrics uses lectures, simulators and protocols to deliver training. In the process, it has helped save lives.
The world paused for a moment when the news broke last week that two Ebola-infected American missionaries working in Liberia had received an experimental therapy called ZMapp. As I write this, both patients are back on U.S. soil, and seem to be responding well to the treatment.
But was it ethical?
That difficult question can be divided into two. First is the question of whether it was ethical to give the two patients a drug that, up to that point, had never been tested in people. The second—in some ways thornier—question is: Was it ethical to give the treatment to two Americans but not the nearly 1,850 West Africans infected in the outbreak (as of August 11)?
Zulfiqar Bhutta, MBBS, PhD, inaugural chair in global child health at the Hospital for Sick Children, Toronto, and founding director of the Center of Excellence in Women and Child Health, Aga Khan University, Pakistan, is a global child health superstar. Presidents, prime ministers and princes welcome his advice. Yet India ignored him when he called its proposed innovation to curb infant mortality “nonsense.” “I was dead wrong,” says Bhutta. “What happened is remarkable.”
Sobering news keeps coming out of the West African Ebola outbreak. According to numbers released on August 6, the virus has sickened 1,711 and claimed 932 lives across four nations. The outbreak continues to grow, with a high risk of continued regional spread, according to a threat analysis released by HealthMap (an outbreak tracking system operated out of Boston Children’s Hospital) and Bio.Diaspora (a Canadian project that monitors communicable disease spread via international travel).
“What we’ve seen here—because of inadequate public health measures, because of general fear—is [an outbreak that] truly hasn’t been kept under control,” John Brownstein, PhD, co-founder of HealthMap and a computational epidemiologist at Boston Children’s Hospital, told ABC News. “The event started, calmed down and jumped up again. Now, we’re seeing movement into densely populated areas, which is highly concerning.”
If you’re interested in keeping tabs on the outbreak yourself, there are several tools that can help.
Elaine Nsoesie, PhD, is a research fellow at Boston Children’s Hospital’s HealthMap, Harvard Medical School and Virginia Bioinformatics Institute. In this post, which originally appeared on HealthMap’s Disease Daily, Nsoesie looks at the trend of detecting disease digitally by monitoring mentions on social media. She delves into one of the major limitations of this technique—namely telling those who are curious about a disease apart from those who actually have it.
There are plenty of studies about tracking diseases (such as influenza) using digital data sources, which is awesome! However, many of these studies focus solely on matching the trends in the digital data sources (for example, searches on disease-related terms, or how frequently certain disease-related terms are mentioned on social media over time, etc.) to data from official sources such as the Centers for Disease Control and Prevention. Although this approach is useful in telling us about the possible utility of these data, there are several limitations. One of the main limitations is the difficulty in distinguishing between data generated by healthy individuals and individuals who are actually sick. In other words, how can we tell whether someone who searches Google or Wikipedia for influenza is sick or just curious about the flu?
However, two under-recognized, highly preventable chronic conditions—spina bifida and hydrocephalus—have not declined in low- and middle-income countries. Each year, there are an estimated 200,000 new cases of infant hydrocephalus in sub-Saharan Africa alone, and 100,000 neural tube defects in India alone. As other causes of death and disability recede, data suggest that spina bifida and hydrocephalus are gaining a larger share of mortality in young children.
A multi-institution conference at Boston Children’s Hospital on April 11 sounded a global call to action, convening a mix of surgeons, pediatric neurologists, international patient advocacy groups, food fortification proponents, health economists, obstetricians, neuroscientists and others. Many innovative approaches are being explored, including two that caught Vector’s eye.