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by Allison Kozicharow
No medication or medical device can do as much to promote good health in remote regions as a population’s knowledge of good health practices. For the people of Kisumu, Kenya, WiRED’s Community Health Information Centers (CHICs) provide the only source of basic health information, especially HIV/AIDS prevention. In July WiRED Director Gary Selnow, Ph.D., traveled to Kenya to revitalize the CHIC program by using technology upgraded since the start of the program nearly nine years ago.
 WiRED’s objective during this trip was to update the medical information and broaden the reach of the program to grassroots communities in this region near Lake Victoria and outfit the two CHICs in the Kisumu neighborhoods of Obunga and Pandipieri (watch a brief video of Obunga). In both locations, WiRED provided new computers and new health education software. WiRED also undertook training the local staff to 1) use the new software, 2) help clients get the information and refer them as needed to clinics and HIV testing facilities, and 3) master reporting procedures and research protocols for data collection and preparation procedures.
According to Dr. Selnow, WiRED met these goals successfully: “I can't tell you how rewarding it was to see the people open our new WiRED-created training programs. They love this approach and said it was a big improvement over the old CD-based program. I have to agree that the interactive features make it a very appealing approach to health education.”
The new CHIC program, supported almost entirely by individual donors, will serve as a working model for potential funders. The aim is to demonstrate the capacity of the program to serve large numbers of grassroots people with information that engages people in their own health. About 10 percent of the material is devoted to HIV/AIDS prevention; the rest covers illnesses and ailments, simple to serious, that affect people in East Africa. To date, the WiRED CHIC programs have reached more than one million people.
In addition to the CHIC modules, WiRED is developing extra medical information stored in a “side library” of the CHIC database. Dr. Selnow explains, “This side library will serve as a place for any health-related information—everything, in any format, we can get our hands on. During the next six months we plan to develop an additional 70 modules and add a lot of other material to the side library, so the database will expand by 10 times.”
The Kisumu project will not only recharge the program but also demonstrate to potential funders the extraordinary impact of the CHICs on population health. In a way the CHIC programs are demos. If the work there can’t interest and attract donors, the programs will slowly disappear. Dr. Selnow observes, “That would be a great loss because no other such program exists. We are the only source of HIV/AIDS prevention and health information for many people.”
Reaching the youngest audience with information about HIV/AIDS presents a unique challenge. WiRED designed a special cartoon to get some of the points across. It’s the only scenario-based module. It tells about an antibody named “Buddy,” a detective, and the HIV monster. It can be viewed by children one by one, but most kids gather in an audience. Interacting with the program becomes a group activity.
Dr. Selnow says, “It was rewarding to see 20 or more kids, led by one of our staffers, going through the ‘Buddy’ cartoon, watching on an LCD projector. Every minute or so, the cartoon would halt and the program asked the audience to answer questions to help Buddy out of a jam. The questions all have to do with HIV/AIDS. The staffer asked the kids their thoughts about how to respond, then took a vote. He clicked on the selected answer to see if the consensus was right or wrong. He then reinforced the correct answer.
“Our team spent a lot of time developing this cartoon and watching the kids’ enthusiasm and seeing them learn this material was a great confirmation. Imagine if we were able to help just one kid in that group make a wise decision later in life.”
Beginning its work in Africa in 2001, WiRED developed a network of 19 centers in Kenya, working in partnership with community-based organizations. The work was started with a developmental grant from the U.S. National Institutes of Health. At that time, health and medical information was primarily on CDs; today, that information has shifted almost entirely to the Web. The Web isn’t available to the Centers, so WiRED has developed a series of training courses (called modules) that covers a broad range of health topics. The course material is installed on hard drives and, thereby, avoids the need for Internet access.
“During a training session on a previous visit, a 20-something staffer pulled me aside during a break and said he wanted to tell me something. The young man was HIV positive, and he was beginning to display the symptoms of AIDS. He looked me in the eye and said something I’ll never forget: ‘If we had a CHIC in my community six years ago, I would be alive today.’ His choice of words shocked me; he already saw himself as dead. I never forgot this story; it drives me to do everything I can to keep this program going.”
—Dr. Gary Selnow
A four-person team—consisting of a physician, an editor and two information technology professionals—developed the first installment of 50 topics and is working on an additional 70 topics. The process begins with Miriam Othman, M.D., who also holds a Masters of Public Health (M.P.H.) degree. Dr. Othman researches and writes the modules and sends the text to Tom Turkle, a technical editor in Kansas City. Edited text then goes to Max Hurwitz, in Los Angeles, who shapes the modules into interactive programs. Finally, the completed modules go to Brian Colombe, also in Kansas City, where the programs are configured into libraries on computer hard drives.
In Kenya and elsewhere in more than 12 countries on four continents, WiRED continues to act on its philosophy that:
- Basic health information, put to practice, saves human lives. That’s the value of the WiRED program.
- People in the places WiRED works are often out of sight, out of mind, and out of touch. WiRED does everything it can to connect with them around the issue of health.
- WiRED strives to provide the best health information possible to the world’s most needy people.
- People in underdeveloped regions have come to believe that many illnesses, including HIV/AIDS, strike at random or are a matter of fate beyond their own influence. WiRED shows them how to participate in their own health care.
- Our interactive programs demonstrate that information presented in an appealing and accessible format can increase knowledge, shape attitudes, and alter behaviors.
- AIDS medication keeps people alive, but patients take the pills forever and still they suffer mightily. AIDS prevention costs less and spares the human agony, yet prevention programs are shortchanged.
- More prevention means less need for a lifetime of drugs and suffering and shortened lives.
The revitalization of the CHIC program in Kenya—and its continued progress and success—is an important part of WiRED’s mission to provide medical and healthcare information, education, and communications in developing and war-affected regions worldwide.
An earlier story about the work in Kisumu was written by Stacy Trevenon.
Edited by Dr. Elizabeth Fine, layout by Brian Colombe.
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