The chairman of Eleta Eye Foundation, Dr Gboyega Ajayi, in this interview with SADE OGUNTOLA says that technology-driven innovations have great potential to reduce the burden of avoidable blindness by empowering people to take charge of their eye health.
YOUR institute is developing the Vision Health Detective App. What is this new app all about?
The Vision Health Detective App is for vision screening. Many people have eye problems that they are unaware of. We are developing this app so that people can screen their vision in the comfort of their homes or offices for any vision-related problem.
There are three functional examinations of the eye that can be carried out: visual acuity, colour vision, and visual field. Our ability to see objects and recognize them is what is termed visual acuity. Colour vision is the ability to perceive colour while the visual field is how much vision you have in an area in front of you. Though a person’s visual acuity may appear good, he may, in fact, be going blind from a disease like glaucoma which affects the “side” or “peripheral” vision first. Imagine that glaucoma might have started about 10 years ago and had gradually destroyed the eye. But because the individual is still seeing very well or even with glasses, he may not make any effort to visit a hospital or to see an ophthalmologist. He assumes that his sight is perfect even though he is gradually losing his peripheral vision. That is why some people only see things and people standing in front of them but cannot see things by the side.
There are many apps already out there for measuring visual acuity. However, the Vision Health Detective App is the first of its kind to try to screen for both visual acuity and peripheral, or what on this app is called “surround” vision. That makes it unique and it can detect some cases of glaucoma in their advanced forms, at least long before the patients even feel the need to come to the hospital or see an ophthalmologist due to poor eyesight.
How does this app work and why was the app developed?
Our intention with this app is to be able to examine as many people as possible. And that is what is going to make it unique. We just don’t want to throw it onto the Google play store or any other platform for those interested to go and access the app. People interested in using the app need to be members of the Partnership for Sight Initiative of Nigeria (PASSION). This is to ensure that we get more people to use the app too and also to be able to get feedback from them. The detailed result from the app may be relayed to their eye doctor if such a doctor is a registered member of PASSION and the user consents to this.
After downloading the app, all it takes is for you to look straight into the camera of your smartphone for the picture of the eye to be taken and follow the instructions you will be given as it is with say an ATM. Of course, you will be required to input basic information like name, gender and age. Some of the information is not for the app, but for the membership of PASSION. It will assess the eye’s visual acuity and surrounding vision.
Has the app been officially launched?
It is about being launched but will only be initially available to members of the PASSION. The reason we are releasing it this way is that the app is still under development and based on the evaluation and feedback we receive from the initial users, we would be able to add more features as well as refine it. Yes, our preliminary results are promising, but we still want to use this means to test it further on a larger population.
How is the development of this app likely to influence the quality of sight of Nigerians in general?
It’s going to have a tremendous impact. By my calculations, a few years ago, if every Nigerian was to see an eye doctor at least once a year for a comprehensive eye checkup, it would take 77 years. Nigeria currently has less than 500 active ophthalmologists in its population of 210 million. And by the calculation, it is assumed that the eye doctors will see each person for 15 minutes and must work round the clock and all through the year, nonstop. That means even if people want to come forward to have their eyes examined, Nigeria does not have the capacity to deliver. But this app will make this possible. Initially, it is not going to be able to pick every case that needs treatment, but it can pick some that will not have gone to the hospital but for that app. And with this, I think we would have succeeded.
So, what future do you see the use of appropriate technology in the health sector availing Nigerians?
Without technology, we can forget about the future. The sad thing about Nigeria is that we are not proactive about the use of technology to better the health of Nigerians. Medical care is being revolutionized by technology every day. For instance, when I was in medical school, nurses had to do so many things manually for the patient, including bathing, taking blood pressure and pulse rate. Now, we have devices that can do all that. It has been taken away from nurses, thanks to technology.
Years back while undergoing the postgraduate course in ophthalmology, you would have to admit nine out of every 10 patients that required eye surgery for at least one week before the eye operation. Now, thanks to technology and innovations in medical science, you don’t have to do that. The patient comes in that day, gets the surgery done and leaves that same day. He starts seeing on the same day he has the surgery. That is how technology has changed things and will continue with such things as the Vision Health Detective App.
Right now, we are training the community health extension workers and the other workers in Primary Health Care Centres on how to use the app for eye screening and with a bit of telemedicine, relay the information directly to an ophthalmologist for some minimum intervention. It is for this same reason that all medical students should be well grounded in information technology. They must be able to use IT meaningfully to aid medical care and services. With IT, they can do so much and can even be trained faster. Gone should be the days when we did science for the sake of it. Technology that is related to day-to-day living needs to be taught at all levels of education. No doubt, if the technology for day-to-day living is taught in medical schools, the workload and waiting time in our hospitals will be reduced and new disciplines in medicine will be created. So, we must change and we must move away from the past. The new specialities in medicine must reflect the technology of today. Technology is the in-thing. In fact, without technology, we can forget about the future.
No doubt, technology is very broad. But nothing stops Nigeria from tapping into its wasted resources to find technology-driven innovations to answer prevailing health challenges in Nigeria. There are many innovations out there waiting to be adapted to our day-to-day living. Every day, we read about Yahoo boys being caught and jailed for different offences. I am so angry that we have these boys and we cannot tap into their skills and brilliance with technology. If somebody can hack into my laptop or my computer, it means he is better than the person who made the software to prevent unauthorized access to my data. Some of the best brains working for the Pentagon in the US are Nigerians and they are well-paid. So, if these boys are smart enough to be able to do some of these things, why don’t we harness their energy for more productive functions, rather than locking them up?
Can you, therefore, rate Nigeria’s adoption of technology in moving its healthcare delivery system forward?
Whatever technology adoption there is in Nigeria is currently more in the private sector. And it is limited. Indeed, development must start from the private sector because the inhibitions are not there. The bureaucratic processes in the government sector tend to limit innovations. For things to improve, the private sector must be encouraged by the government to drive the process of a technology-driven health sector.
Ensuring a technology-driven health sector will also involve changing the educational system in Nigeria to technology-based education. For instance, in Finland, there is no formal education like we do here in Nigeria. They adopt a more hands-on approach to their educational system. They learn relationships and technology, including how to operate what they use every day. And that’s how this should be and then they move faster. There are people, including children, who have made robots in this country but have never been to a university. So, let’s harness all these and then restructure our education. Technology is key; it is the solution to the future. That future is now.