October 19 2014

8 ottobre 2013

In Congo per la seconda volta

Manca  solo un chilometro ,nel buio  quasi da notte della sera africana  la pioggia ha cominciato a cadere e ha trasformato  lo sterrato su cui viaggiamo  in un fangoso fiume in piena.

Manca solo un chilometro

a gauche, Alan, a gauche ! Grida Valerio, e prontamente Alan sterza a droit…..

come in una scena di un film “di azione” la  toyota verde militare messaci a disposizione dalla

prefettura della diocesi di Kananga si corica su un fianco,il destro,sprofondando  in un fossato

Al rallentatore rivedo la scena nella mia mente, Valerio che grida, l’autista che sterza, la macchina finita nel fossato alto circa un metro e mezzo, con l’acqua  mista a fango che comincia ad entrare da sotto lo sportello di destra

Io schiacciata  contro lo sportello destro dai bagagli  che trasportiamo, tutto il carico nel portabagagli che rischia di precipitare su tutto e tutti, la paura irrazionale che la macchina si capovolga

panico

bentornata in Congo!

Una notte serena, una delle poche di quest’ultimo pesantissimo anno, mi riconcilia con la vita, ma principalmente con la famiglia che son venuta a trovare qui, in Tshimbulu.

Felice di esere qui, je ssuis tres hereuse d’etre avec vous, mes amis, a tutti gli amici-studenti che non aspettano neanche che io mi sia vestita e sistemata. Monique, quel plaisir de voir vous, ma ami’….

je te veu tre bien….excuse moi, puor mon abbillement….

Cosi’ ancora in camicione da notte, con una confidenza nata dalle tante malarie che qui mi son venute e che tutti  con un amore straordinario mi hanno aiutato a superare, una confidenza veramente da famiglia,la famiglia del St Francois,  il mio giorno felice al St Francois ha inizio, la mia vita, per la seconda volta qui, con loro ha inizio.

Non e’ passato un anno, livie, bienvenu!!

Non sono stata qui dodici mesi fa

Ero qui ieri, come oggi

e non siamo mai stati lontani, vicino il cuore, sempre

Mi commuovo, grazie livie d’etre ici, grazie a voi, di essere qui con me

Mi tornano in mente delle immagini, figure colorate si muovono nel film dei miei ricordi

un anno , e’ passato un anno. Ancora una macchina, stavolta ben guidata mi porta a visitare Tshilimba , antica missione costruita dai Belgi e ancora luogo di misterioso fascino

Come un luogo incantato il posto evoca in me favole di fate, sogno di poter restare un giorno, una settimana, un mese, per  ritrovare me stessa,  meditare.

Le scarpette con un tacco a rocchetto della giovane suora, che esibisce come puo’ la sua malvolentieri celata femminilita’ mi riportano alla realta’del momento.

La macchina passa per i campi, Valer! Valer, gridamo i bambini correndoci pericolosamente accanto

Katia, Katia, chiamano.

 

Valerio, il giovane, illuminato direttore dell’Hopital de St Fraçois e’ riuscito a creare qualcosa di ben piu’ grande di un ospedale che funzioni.

Districandosi con paziente abilita’ fra le mille burocrazie, senza mia perdere la calma ha veramente creato una famiglia . Katia, la giovane volontaria che ha fatto irruzione nella sua vita e che in pochi anni e’ diventata sua moglie e la madre dei suoi due bellissimi bambini, ha fatto sua la famiglia

del  St Francois

e di tutto il comprensorio

Educando, coordinando, creando animazione per tutti i piccoli della comunita’, ed un rapporto speciale con tutti loro.

Katia, Katia! Chiamano i bambini vedendo la macchina.

I nomi gridati  testimoniano un amore percepito, corrisposto.

un esserci nel tessuto sociale della comunita’

e qui, in questa grande famiglia nata dall’amore di due volontari, io sono voluta ritornare

stavolta con una grande esperienza in piu’ e con l’intenzione di continuare il percorso che ha caratterizzato il mio ultimo viaggio.

Bangkok, grande citta’. Io che parto per essere “representative” della mia associazione in un partenariato con lo Yunus Cente in AIT

Versione ufficiale, giacca e cravatta, presentazioni, con mezz’ora di preavviso , pranzi interminabili, giostra di danza delle ombre , presentazioni lunghissime,  con delegazioni koreane, del bhutan, di Singapore. Cibo freddo e rapporti caldi

Si mangiava sempre alle tre del pomeriggio, dopo aver esaurito tutto quel che c’era da dire su chi eravamo e che facevamo

Uno per uno, prima loro e poi noi.

Mi ricordava un po’ il film il padrino, con le rappresentzioni sociali di un certo tipo

Anche qui, era un po’ un incontrarsi di clan , un  mettere in mostra i propri gioielli

per mercanteggiare su possibili, futuri accordi, tentando sempre di essere colui che ha la carta vincente.

Bangkok , sola, in versione ufficiale.

Avevo avuto paura, paura di non essere all’altezza, paura della grande citta’,

una paura incredibile, aumentata dalle ricerche su google

Mio figlio Vincenzo , venendo in mio aiuto  mi aveva regalato  un libro di Tiziano Terzani

“un indovino mi disse”, e cosi’ giorni prima della partenza, avevo scoperto un mondo, un mondo nuovo, che poi avrei cercato, trovandolo, nelle strade piu’ nascoste di Bangkok.

Contagiata dall’entusiasmo e dalla spiritualita’ di Terzani mi ero messa a cercare me stessa fra la gente.

Percorso lungo, difficile, forse senza risultati, ma la stessa ricerca in se generava giorno per giorno una felicita’ incredibile, rotta soltanto dalla impossibilita’ della condivisione. D’ora in poi avrei viaggiato in questa maniera, cercando la risposta.

Cosi’, in questo primo giorno, con l’ammirazione delle persone del luogo guadagnata per il viaggio finito nel fossato, (per loro emblema dell’avventura ) e con il sole nel cuore ,  alla fine della giornata- saluti.giro dell’ospedale.come stai? Bentrovata, io sono Marianne, ricordi, lavoro in medicherie’ dan la sal operatoire, Je suis Angelique, e..Boniface, va tu a marrier ?, Aziza, vous ete married? Je te voix  different….alla fine.

Dopo aver pianificato questionnaires, course pour le personnel delll Hopital e per il personale dei 17 centri satelliti,relazioni con patologi oltre frontiera (pap test qui dove il cancro dell’utero miete vittime fra le giovani donne )

ho finito la mia giornata uscendo dai cancelli, andando dove la gente, i bambini, ci guardano, dove i ragazzi giocano a pallavolo, ed infine al Cast, luogo di lettura, biblioteca, animazione per piccini e grandi ragazzi, luogo per chi sa gia’ che l’educazione e’ una via per poter cambiare le cose

Le due volontarie, servizio civile, Anna e Antonietta, si davano da fare, sommerse dalle richieste dei ragazzi.

Disponibili per tutti, pronte e col sorriso sempre presente

Ragazze fra i ragazzi, con la voglia di lasciare un segno, un cambiamento .

livia 8 ottobre ’13

 

 

 

13 ottobre

 

 

Promenade

 

Sabato, fine della settimana.

metto da parte in un angolo del mio cervello la settimana

Arrivo, saluti, studenti che  si fanno intorno, bienvenue…bienvenue..la piccola giovane famiglia del grande direttore, Valerio, Katia, come sa la conoscessi da sempre, Emanuele, la piccola Rita.

Una esplosione di felicita’.

Sabato, fine della settimana.

Un programma meraviglioso, stavolta viaggiamo tutti velocemente, mi sento un treno, come se il tempo fosse ridottissimo.

Sette settimane, calcola il direttore , Valerio.

Due screening, la paludienne qui e’ malvagia, quasi piu della malvagia volontaria

Resistente

Cattiva

La salute delle donne, la prevenzione di un cancro.  Senza speranza qui, dove tutto e’ piu’ difficile .

Sabato, fine della settimana si conclude con un progetto da costruire insieme, un sogno

Educare, connettere, legare al resto del mondo.

Partecipi ed entusiasti i due giovani medici, Remy e Gabriel , La suor Monique, grande ed intelligentissima donna, e Boniface, il bravo tecnico di laboratorio.

Valerio traccia le prime righe del  percorso che faremo, Io faccio le foto del suo schema.

Sabato, finalmente la settimana e’ finita.

Riesco finalmente ad inviare un lavoro on line, approfittando di una breve migliore connessione,

e, alle cinque del pomeriggio, con l’aiuto di un caffe’, faccio la mia prima promenade, in questa mia seconda volta a Tshimbulu.

Cammino lentamente seguendo un piccolo sentiero fa l’erba, il sole elegante leggero, rosso

d’ Africa , illumina il mio pomeriggio.

L’erba mi accompagna.

Una capra bela, ad attirare la mia attenzione, mi avvicino, ed io sistemo la corda che la lega.

Tre giri attorno ad un albero le impediscono di muoversi.

Cammino lungo il  sentiero  che arriva al fiume, serena, guardo il paesaggio, piccole case in fango, ordinate, pulite.

La bellezza  e la pulizia  del  sentiero mi colpiscono. La differenza con la citta’ che pure ha un suo fascino, bellissimo e cupo, mi colpisce anche stavolta.

Le persone, dell’etnia dei Lulua, il loro mondo , sereno  nonostante  ai limiti della sopravvivenza.

Mi vengono in mente le immagini di un Bangladesh felice, al ritorno da Dinajpur, donne  con bimbi giocavano nell’acqua nel sole del primo pomeriggio.

Dal finestrino dell’autobus che mi riportava a Dhaka guardavo i colori dei loro abiti che fluttuavano nell’acqua,  che si dissolvevano , che  ci lasciavamo dietro , e le loro grida felici mi arrivavano come una musica.

Cammino seguendo la linea di terra rossa del sentiero ; con i carichi dritti sulle teste ,appaiono file di donne, bambini, che  si dirigono verso il mercato dove  esporranno la loro mercanzia.  Venerdi’ e Domenica il mercato si anima ed in mezzo alla folla, voci, grida, confusione, uova, verdura, manghi e galline, risate e sguardi incuriositi.

Scendo verso il fiume, e all’incrociarci i nostri sguardi si salutano .

Bambini saltellano, tentando di comunicare, alcuni si lanciano in un welcome! and how are you, piccoli, nudi e laceri, che tentano di aggrapparsi  al mondo che li ignora .

Dalle due giovani, gentili volontarie , ho saputo che al CAST, il centro di formazione che opera nel dopo scuola, duecento franchi congolesi , 20 centesimi di euro per un anno, imparano anche l’inglese.

Con entusiasmo.

Il loro piccolo inglese, stridente in mezzo a tanta poverta’, mi commuove.

 

 

 

 

 

 

 

 

 

 

   

May 17 2014
April 30 2014

Working on m-health since 2008………

taken with a simle mobile with camera……

https://plus.google.com/u/0/photos/107116750892549449944/albums/5994695913530197601/5995809325777800706?pid=5995809325777800706&oid=107116750892549449944

https://plus.google.com/u/0/photos/107116750892549449944/albums/59946959…

https://plus.google.com/u/0/photos/107116750892549449944/albums/56437436…

https://plus.google.com/u/0/photos/107116750892549449944/albums/57389986…

Founder and president of MobileDiagnosis ( A NON profit association, aimed to advocacy of global education and connection for distance consult by mobile -m-health m-education )

The official site http://www.mobilediagnosis.net

Last publication on m-health :

http://link.springer.com/article/10.1007%2Fs12553-013-0073-4

and the last presentation :

http://www.slideshare.net/livia_bellina/mobilediagnosis-impact-2014

previous pubblicatons on m health

Bellina, L,.Missoni, E. Mobile Diagnosis: Bridging Sociocultural Gaps and Empowering Women Telemedicine and e-Health November 2011, 17(9): 750-750. doi:10.1089/tmj.2011.9976.
http://www.liebertonline.com/doi/abs/10.1089/tmj.2011.9976

Bellina,L:Missoni,E:MobileDiagnosis:an appropriate technology for tele-microscopy,an effective tool for training European Journal TM & IH vol 16,Supplement 1,October 2011,pag 88
www.blackwellpublishing.com/tmi

Bellina,LMissoni,E:M-learning: mobile phones’ appropriateness and potential for the training of laboratory technicians in limited-resource settings- Health and Technology 2011 October , DOI: 10.1007/s12553-011-0008
http://www.springerlink.com/content/a328n117r7775322/

Bellina, L., Missoni, E. Mobilephone image transmission for diagnosis. In: World Health Orgaization, Compendium of new and emerging health technologies, WHO/HSS/EHT/DIM/11.02, Geneva, 2011

Bellina,L In Good Practice-Mobile Diagnosis : The Grapevine -Summer Euripa Magazine [PDF] The Grapevine
www.euripa.org/…/GrapevineSummer11.pdf

Bellina,L:MobileDiagnosis, in Good Pratice-2011,July Freedom From Want(MDGC-AIT)
http://issuu.com/arcmdg/docs/aw_ffw2_final

Bellina L., Missoni E., Increasing connectivity of isolated health workers in poor countries using locally available technology. The International Journal of Tuberculosis and Lung Disease, 2010, 14, 11 suppl.2, pp. S46-S47

Grameen Kalyan :Training on Diagnostic Pathology 07-10 june 2010 Tutorial Book of Course for Healthworkers trained by Dr Livia Bellina ,assisted by Dr Baqui Supported by Regional Office Comilla Venue:Rajapur Health Center ,Comilla Unpublished

Bellina.L:Maugeri,M:Missoni,E:Hetical and public health concerns based on retrospective analysis of referrals for diagnostic parasitology of immigrants and autochthonous population in Lampedusa island (Italy)- European Journal TM & IH vol 14,Supplement 2,September 2009,pag 66
www.blackwellpublishing.com/tmi

Bellina, L., Missoni, E., Mobile cell-phones (M-phones) in telemicroscopy: increasing connectivity of isolated laboratories, Diagnostic Pathology, 2009, 4: 19
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706795/

Useful Links :)

http://www.patsnap.com/patents/view/EP2116884A1.html http://www.who.int/medical_devices/innovation/new_emerging_tech_10final.pdf
http://www.who.int/workforcealliance/members_partners/member_list/mobile…
http://www.bellagioinitiative.org/innovations/mobile-diagnosis-mobile-pr…
http://www.healthunbound.org/content/mobilediagnosis-global-project-base… technology-brain

April 11 2014

MobileDiagnosis, the correct path

Awesome night in Bangkok ! I met again a great man, “The Big” man
It is incredible the Energy” of this Man
as incredible is its humanity and its future vision
and also its lovely behavior and friendship with me 
He have believed in me and my work, MobileDiagnosis,
from the very beginning of my work

Thanks, Professor!


I am happy and excited to talk again of my projects to the presence of Professor Yunus in this very private dinner , 4 year after my presentation at Professor Yunus’ dinner for the Kaiser Foundation , in Dhaka.

As the Professor says , not exist little man or little woman, but only person who have not access to the possibilities,no chances ,no education.

All can do all. 

A ” bonsay” can grow up and become a strong forest
and help their communities

In my last 5 years I went to 7 countries, doing 8 courses and teaching to 199 people, of which 50% were illiterates

With my little, free, solitary work, I demonstrated that all can 
learn , and all can do a “little” diagnosis everywhere, with no many facilities or many money. 

In addition, thanks to a detailed analysis of the past experiences I understood where was the weak point of this ( and of several other ) project :

No benefit to single person who works in the rural health-centers , not additional benefits for the local work-forces. 

My students was poor and they are poor, still.

Thus, as teach Professor Yunus, here the solution, ethic and appropriate:

Applying the Social Business, not for creating 
careers or jobs, or for enrich a lot of people already rich, and leaving the local work-forces poor, still….

not

Apply the S.B. model to the last , poor, people: to last ring of the chain

The people working on peripheral community to diagnosis, will receive a very little fee for each diagnosis

The start up will be created thanks two possible mechanisms 

Now I can think, without fear to err , that we can start by creating a new generation of those that Mao called barefoot doctors

and, I say more, with the creation of “micro-welfare areas” for the wellness of the rural underserved poor communities

January 27 2014

MobileDiagnosis® Educating, Connecting , networking How it work


Livia Bellina

Medical Doctor, Pathologist

Livia Bellina ( born 25 August 1954) is an italian medical doctor pathologist, educator.

Livia founded the MobileDiagnosis, a Not for Profit Association and pioneered the concepts of global access to health- care and  medical education by m-phone technology and invented a new solution for training work forces in rural areas of developing countries.

Short Bio- Background-

2008, February -working as a pathologist on the Italian Island of Lampedusa, she found herself in the urgent need to confirm a diagnosis of malaria from a blood sample of an African immigrant. With no other means at hand,she took a picture of the microscopic field using the camera incorporated in mobile-phone, without additional devices, and sent it via MMS for tele-diagnostic purposes to a reference center. MobileDiagnosis was born.

2008-April-the described method has been filed for patent  with the sole purpose to protect the idea from commercialization and consent its free use and dissemination(EPO application number 09005054.3 2002 - 2008 April).

2009- February -Meeting Eduardo Missoni at congress of the Italian Society for Migration Medicine(SIMM) (Trapani, February 2009)  and starting the fruitfull collaboration.

2009-June – The work about low cost diagnostic image transmission (Bellina and Missoni) was published in Diagnostic Pathology (an Open Access Journal) Bellina, L., Missoni, E., Mobile cell-phones (M-phones) in telemicroscopy: increasing connectivity of isolated laboratories, Diagnostic Pathology, 2009, 4: 19


2009- with Eduardo Missoni she developed since 2009 the  website  
http://www.mobilediagnosis.net


 2010- In 2010 founded MobileDiagnosis® Onlus Association with Vincenzo e Giorgio Prestigiacomo, her sons, and Eduardo Missoni. 

 MobileDiagnosis® Non Profit is an association aimed at sharing knowledge and providing diagnostic support to health workers worldwide by using mobile phone technology. The association also provides educational support and guidance on the use of mobile technology, mainly for resource limited and rural settings.

MobileDiagnosis® association is composed of a creative team of young professionals in web design, engineers, project specialists and other  professionals. The team works to increase the visibility of Mobile Diagnosis, and to create opportunities for the development of new educational methods such as long distance training, learning, and to keep users up-to-date on diagnosis issues.

2011-  MobileDiagnosis have been recognized by Government as Non Profit Association  

2012-Rotary conferred to her the Rosario La duca Award, for humanitarian efforts.

2013-MobileDiagnosis-Livia  started a collaboration with Yunus Center AIT in Bangkok for expanding the activities in SEA

 

She attended  to several courses about poverty medicine including:
Advanced Course in “Basic laboratory for tropical disease and health cooperation”, at Verona Negrar Hospital (director Dr. Zeno Bisoffi)( October 2008 )
Advanced Course in “Tropical Medicine and Health Cooperation” (4 months), at Florence Careggi University (director Pro f. Alessandro Bartoloni) (March-June 2009 )
Course in “Management of transmissible disease in sub saharianan  Africa”, at Pemba (Zanzibar) Public Health laboratory, supported by De Carneri Foundation. (July-August  2010).
Master of Medicine of Poverty Marginalizationion and Migration 5° MEMP of Caritas –Rome Idente Foundation- Verona Negrar
 - for improve her skills for teaching to low-resource health-workers of  poorest communities

After that she went  to teaching as volunteer medical consultant and “on the job” teacher in rural communities of some of the poorest countries: Uganda (Gulu, 2009) Bangladesh (Bhuapur, 2010) upon  invitation of Professor Muhammad Yunus, Bangladesh with PIME (Dinajpur, 2011) and Afghanistan (Herat, 2011). In 2012 February  she went to Madagascar to find the best area for future projects, September-November in DRC, where done education  at local level, improved local health workers of St Francis Hospital . In  2013 she went to work in Thailand- in refugee champs bordering Mynmar  and in DRC for the second time-

In less of 5 years she trained more of 100 people

 2011 after an extraordinary experience with local rural living woman in Afghanistan. where she went for working as supervisor of Medical Laboratory of Children’s –Government Hospital of Herat, for training local health workers ,she done a study published together Eduardo Missoni, on health access for vulnerable subjects (Bellina, L,.Missoni, E. Mobile Diagnosis: Bridging Sociocultural Gaps and Empowering Women “Telemedicine and e-Health November 2011, 17(9): 750-750. doi:10.1089/tmj.2011.9976.    http://www.liebertonline.com/doi/abs/10.1089/tmj.2011.9976) and started to explore the  mechanism of m-learning, introducing a new communication method,and focusing the actions on the field mainly on local education.

 Her goal is the worldwide promotion of MobileDiagnosis® methodology for promoting the global access to health care and education by the use of a mobile-phone for taking and transmitting diagnostic images – (m-health and m-edu)  and educate, and on the real time control and management of diseases-

The main activities of MobileDiagnosis  -Sharing-Training-Connecting-Networking 

MobileDiagnosis works with three main mechanisms

1-Sharing -MobileDiagnosis- the  new-original tool for a simple, low cost telepathlogy-telemedicine : how take and transmit image with a simple mobile and a MMS

2-The new orginal method for educate  low skill and illiterate people

3-Creating a network for help rural low-resource work forces

4-(ongoing) working to a new open access educative  web based platform and an ITC linked network for an education in remote

 

Sharing images                                                                               

 

 

 

The Idea

Mobile phones can be easily used without any adapting device to take pictures of the microscopic field and send them for remote reference.

 

Technical note :

 

 

MobileDiagnosis® is based on the simple concept of using a mobile phones (m-phones) to capture clinically relevant images at the point of service (the nearest as possible to the patient’s home) and send them via Multimedia Messaging Service (MMS) to a distant reference center for confirmation of diagnosis, second opinion and advice.

 

The possibility to both capturing and sending images taken from the microscope, and by extension from any optical eyepiece of other medical devices (enteroscope, colposcope, etc.), with an MMS via the mobile cell- phone network represents an enormous breakthrough in terms of ease and access, given the penetration of the mobile network and transmission costs, in comparison to the landline broadband network or satellite connection on which the internet needs to rely. The ability to do this without recurring to additional complex and expensive devices represent an enormous comparative advantage with respect to other known solutions.

 

While the initial experience was based on images taken just with the in- built camera of an m-phone from an optical device (microscope), preliminary testing shows that in several other situations the use of m- phone in bio-medical imaging represents an effective and cheap  methodology in order to make a correct and timely diagnosis.

 

In order to contribute to achieve a universal access to appropriate health care in low resource countries and most remote areas, the project intends to apply MobileDiagnosis methodology on a wider scale, by introducing and disseminating the use of m-phone based tele-diagnosis and health workers training. This would be accomplished by associating the local use of m-phone based diagnosis and training with an adequate review of how information flows through local and national health systems, as well as by taking advantage of a global expertise network made available through ad hoc agreements.

 

An unconventional / creative approach to quality health care 

Traditionally, the access to specialized diagnostics was limited to population groups belonging to higher social classes, because of costs and concentration of specialized care in major urban centers.
The MobileDiagnosis methodology will allow public access to world class quality diagnostics for a large number of conditions, to everybody irrespective of the patients’ economic capacity or distance from specialized health centers.

 

Significant improvement will be possible thanks to three work- innovation (or introductions – or also changes ).

 

 One is the ease, after a  specific training ,  of taking and sending picture using a very common tool - the m-phone – “as it is”, i.e. without recurring to any additional device.

 

The second  change is the use of the m-phone as an educational tool which may empower health-workers and caregivers at every level, even at family and community level, to interact directly with the near referent   of  care.

The use of simple, relatively cheap m-phones for directly capturing images and sending them via MMS for tele-diagnosis represents a breakthrough in terms of appropriate use of technology (ease, accessibility, affordability) as compared with previously described and used telemicroscopy and other tele-diagnostic approaches, including both those based on complex photographic equipment using computers and broad band data-transmission network, and those based on tricky and still comparatively expensive, thus inappropriate, ad hoc cell-phone-connectable  microscopes. M-phones are nowadays available, affordable and commonly used in the most remote and poor areas of the world. Not everybody owns one, but hardly any community lacks one. Thus, using the use of m-phone for diagnostic purposes bears a negligible cost. The use of m-phones as an educational tool represents a relevant change.

Independently from the connectivity aspects, the possibility to share images on the m-phone screen and discuss them in a group, as well as comparing them with reference images in collections in print (atlases) or uploaded in the same m- phones, facilitates participatory learning and reduces learning times as compared with traditional teaching methods. Literally anybody can quickly learn how to take an image from a microscope or other device.

 

The third change relates to increased connectivity: to exploit the full potential of the adoption of MobileDiagnosis, the methodology facilitates the information flow in the health system.

 

Through appropriate community based training, people “where there is no doctor” may be empowered to deal locally with a number of pathologic conditions by resorting to distant advice. Health workers (MDWorkers) in remote duty stations can receive distant training and support in their daily work. Diagnostic confirmation of diagnosis based on microscopy can become almost immediate and epidemiological surveillance more accurate. As a result of mentioned improvements, transferral of patients for diagnostic purposes and related costs can be reduced.

 

Social Business for improving local income and economy –a future development

The   innovative side  of this project,  it his particular caracteristic, respect to  any of the other projects, is that  this project  is not looking for external  funders  but it same  will generate  a gain   thanks to  a local mechanism of Social Business

 All  local MDWorkers (local MD referent and MD operating work forces) after an adeguate training will become  local referent for Community and will provide diagnose   for the local mainly present  diseases  (water-born diseases,  soil-transmitted worms diseases , and finally some mosquito transmitted-diseases  as  malaria ).

The local, rural referents , named MDWorkers, will receive a gain for each diagnosis done , and this new opportunity  will produce a local improvement of income

 

This local job opportunity generated by  will generate a local money flux and a local  sustainibility of project -work .   Free from external funders or donors .

 

Finally, an opinion by a specialist obtained through national or transnational networking may represent a decisive asset in even more difficult cases which may not find a solution at the highest complexity level in a given country. The innovative methodology will ignite a review of traditional information flow, both nationally and internationally,  including integrating a solidarity based alert system that can make world class expertise available (at very low cost and ideally for free) 24/24, 7/7.  *

 

Investments in mobile-health technology and associated process improvements have the potential to improve the efficiency of health care delivery – enabling improved access to specialty care, a continuing challenge in remote rural communities by acting in a capillary way,  bringing the care to  the  isolated, poor communities . Instead of having a patient trip to see a specialist or vice versa, the specialist sees the patient  sample using MobileDiagnosis®, the m-phone based technology.  This has considerable potential to reduce travel associated with serving remote rural populations and to extend the reach of a specialist to isolated, poor and  underserved populations, and to educate low skill local workforces .

We focus on the use of  mobile  “store and forward” (analogous to e-mail with attached images and data) communications technology to transfer patient information via  rural md worker  to the referent specialist

 

Store and forward systems  provide specialists with attractive opportunities for  improve  local  wellness by  creating a job opportunity through a mechanism of Social Business, for otaine a twin goals :reduce costs and improve local incom

 

 

 

Educating with a new, original method  

The new orginal method for educate  low skill and illiterate people

                               

Sharing images by m-phone, together with a two- phase educational method, (phase of relation, with a personal approach to the student, and phase of contextualization, with an approach to local community problems)combined with the  use of logical didactic tables, proved to be a phenomenal   learning tool, immediately linked to students’ personal  perceptions.

Technical note:

A two-phase approach training (see below) was performed by using structured interviews, didactic tables, m-phones and computers as didactic tools

M-phone impact on practical training: role of m-phone as part of the educative method for training local health workers of rural areas of developing countries-Health and Technology-Springer   in press   ( DOI: 10.1007/s12553-013-0073-4)

http://link.springer.com/article/10.1007/s12553-013-0073-4

 

Connecting -Creating a network thanks to m-phone  with or withou (depend from the places) satellite internet connection for help rural low-resource work forces, also in the most isolated, underserved areas

 

The Partnership Scenario:
Global-Local Partnership and Sustainability of the Project.

MobileDiagnosis®works in partnership with local NGOs, by creating a network of local rural health-education posts, linked together and connected to the web platform of MobileDiagnosis- MEDTING - The web platform will share data, images and texts for education and  will store the images for creating of a central database for educational and distance-schooling

Tecnical note-MobileDiagnosis methodology is based on the use of mobile phone and mobile connectivity to improve diagnostic quality at the point of service in rural or otherwise remote and disadvantaged settings, thus contributing to better quality of care.

The m-phone is used both as an educational tool (training health-workers at both health units and community level) as well as tele-diagnostic mean. The full application of MobileDiagnosis methodology includes the redesign of health systems’ information flows and reassignment of expert staff in order to assure dedicated distant diagnostic support and advice to remote health units.

The project uses an incremental approach to enabling of health units and training.
The initial interventions will be focused on a limited number of health centers with adequate technical characteristics, medical and laboratory equipment and staffing (traditional lab and medical equipment are not provided through the project and their adequacy is a prerequisite for the health units to be included in the project). In those health units health workers will be trained applying MobileDiagnosis training methodology. Training will initially be based on pictures from the microscope and other optical devices

At the same time the existing information flow will be analyzed and redesigned to adapt to m-phone generated information and appropriate feed-back.
A reference center will be identified and assigned staff trained to respond to the requirements of the MobileDiagnosis system (lab and medical equipment, as well as staffing of the reference centre are not provided through the project and their adequacy is a prerequisite for staff training and activation of the Reference center. The Reference Center does not need to be a single physical unit, but must be identified as a defined function. Staff could also be located in different centres (and including at home) as long as they are equipped with computers adequately connected to the internet.

In the following years, the best among trained health workers, will teach to other health workers under the supervision of the chief trainer  progressively including all health workers in rural areas.
Results will be regularly monitored and shared widely.

 

The future  of the project- thanks to the m-network  and  , if need, satellite-internet and local ITC-provides to creating :

 

-An Open-source training centre,  with an images library and an interactive school, to which will be possible to access from the educational page of MobileDiagnosis® site.  http://www.mobilediagnosis.net 

 

-A Global Referents network – composed by all high-skill excellence specialists operating thanks a mechanism of time banking

 

 

Tecnical note

This proposal focuses on the first phase: implementation in one Health area (province, district, etc. ) with one reference centre (this could be the core of a future national reference centre).
A second phase is foreseen to consolidate results of the first project area and extend implementation to other health areas in the country. At the same time the transnational network (TN) will be developed.The TN is based on shared knowledge and distant highly qualified support to the national reference centre. The network will be based on a system of accreditation of high level individual experts and or institutions available to provide expert time for free (as part of a social responsibility program). Experts may indicate number and weekly distribution of hours in which they make themselves available to the network. During that time the system will automatically forward them the cases that the national reference centre identifies as requiring second opinion and advice. Their evaluation is then automatically re-conveyed to the Reference Centre, which, in turn will decide the advise to forward the guidance to the originating health unit (eventually translating into local language). Besides technical aspects, this second phase will take into account legal and procedural aspects related to diagnostic and therapeutic liability.  Progressive extension of MobileDiagnosis to more countries will require to parallel an increasing number of experts and of a global network of collaborating centers.

 Kindly those extraordinary Specialists gave their availability to be referents

Jeff Van den Ende  Institute of Tropical Medicine  Clinical Sciences  Antwerp.

 Francois Nosten, University of Oxford, Nuffield Department of Clinical Medicine, Thailand, Infectious Diseases.

Zeno Bisoffi   president of italian society of  tropical medicine-Director of Tropical Disease-Verona Negrar Sacro Cuore  Centre for Tropical Diseases, Sacro Cuore Hospital of Negrar - Federation of European Societies for Tropical Medicine and International Health             

Eduardo Missoni  Global Health founder the OISG, has been member of WHO, MAE, world secretary Scout Movement and co-founder of MobileDiagnosis

Alessandro  Bartoloni   general secretary of italian society of tropical medicine- Director of Department of Infectivology and Tropical medicine Florence Careggi

Marianne Stronhmeyer  Professor at-Tropical medicine Florence Careggi

Luigi Gradoni  Professor at Istituto Superiore di Sanità, Department of Infectious, Parasitic and Immune-mediated Diseases, Italy, Infectious Diseases

Lawrence B. Faulkner   Medical Coordinator  Cure2Children Foundation

 and  many others

MobileDiagnosis -How it works                                             

The Activities:
1. In developing countries: training local work forces

Creating a local “school” for the health education and training of local rural communities – health workers and non health workers (community representatives). Establishing or strengthening health centers for basic screenings , focused on parasitic diseases, neglected diseases, mother and child care, community health care, etc., and link them with the schools

2. In developed countries: training of trainers

Creating a new generation of trainers by activating courses of MobileDiagnosis and a central referent “office” with high skilled consultants and an open-source training centre, with an images library and an interactive school.

3. Planning a global course of MobileDiagnosis®, equitable care and affordable care, sustainable technologies.

The Project

Creation of a knowledge-centers network based on locally available and not expensive affordable resources and poor technology, and the improving of local health workers that, thanks to a domino effect will improve new health workers. It is operating on three levels:

1) Local level, using the mobile as didactic tool, to educate by showing and comparing the images.

2) National level, thanks to a “mobile to mobile” or “mobile to web” network.

3) Global level by a network linked to a web technology platform, thanks to collaboration with Medting started in 2011.

This system is operating locally-globally, and contributes to accelerate the Global Health care provision, distance consulting and education, by connecting the “fragile” subjects, especially in the hard contexts (war, migrations, sex discrimination, cast, clan, family) to a solidarity network of highly skilled specialists and to knowledge centers.    http://medting.com

 

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December 28 2013
Merry Christmas, my friends
Every day of the past year, we have lived, we have worked , loved, and dreamt  with joy and hope,without lose the path.
We believed in a better world,  we believe in a better world
We all together could represent a thousands of little drops, we all together can become an  hurricane  and change the world.
WE CAN , WE MUST  to build a better world where nobody will be a foreign
December 26 2013

Greetings


Merry Christmas, my friends
Every day of the past year, we have lived, we have worked , loved, and 
dreamt  with joy and hope,without lose the path.
We believed in a better world,  we believe in a better world
We all together could represent a thousand of little drops, we all 
together can become an  hurricane  and change the world.
WE CAN , WE MUST  to build a better world where nobody will be a 
foreign
Merry Christmas, my friends, with all my love
Livia
Open file with a browser  :)
September 24 2013

MobileDiagnosis and Livia Bellina News 2013 

Many thanks for your attention

Below some about MobileDiagnosis Progress and  me

 

I am founder and president of MobileDiagnosis ( A NON profit association, aimed to  advocacy of global education and connection  for distance consult  by mobile  -m-health   m-education )

 The official site   is     http://www.mobilediagnosis.net

 

In 2008 I put in pratice a method for capturing the images from microscope with a simple cheap mobile-phone, and for sharing them for education and for distance consultation (m-health and m-education references 1, 2, 3, 4 ).    Without any device

http://www.patsnap.com/patents/view/EP2116884A1.html

MobileDiagnosis has been included on Compendium of Innovative Technologies addressed to Global health Concerns of WHO http://whqlibdoc.who.int/hq/2011/WHO_HSS_EHT_DIM_11.02_eng.pdf

I tought my method in rural areas of Uganda, Bangladesh (upon invitation of Nobel Price  Professor Muhammad Yunus ) , and in Afghanistan, Madagascar,   Democratic Republic of Congo and , now, rural areas of Thailand (bordering Myanmar  ) with Shoklo malaria Research Unit , at Mae Sot. 

http://www.slideshare.net/livia_bellina/mobilediagnosis-2013-21779235

http://www.slideshare.net/livia_bellina/mobile-diagnosisproject-2012-presentation-13756445

My work is mainly focused on use of a mobile-phone for take and transmit diagnostic images – m-health and m-learning and on the real time control and management of diseases.

http://www.who.int/workforcealliance/members_partners/member_list/mobilediagnosis/en/

http://www.mhealthalliance.org/community/membership/our-members

http://www.bellagioinitiative.org/innovations/mobile-diagnosis-mobile- project/

There are already on the world  people working on-text transmission

I work on images transmission, and in the world are not much people working with a simple mobile-phone without devices .

In the recent past years , for sharing  my work  by education on the job,   I went to Uganda(Gulu); Bangladesh (Comilla Tangail Bhuapur, Dinajpur)Afghanistan, (Herat) Madagascar (Tulear Andavadoaka) DRC Tshimbulu ,

and recently I went  to   vbisit and doing education on the job  at  Shoklo unit in Mae Sot,   and to near refugee camps of Mae La and Wang Pa, in Thailand at border with Myanmar in May,   during my staying in Bangkok, where I has been as Expert in residence for a collaboration with Yunus Center at A I T

I entered in contact with SHOKLO malaria research unit, Prof François Nosten and Dr Stephan Proux, chief of laboratory staff (Malaria Consortium in Thailand- Oxford-Mahidol collaboration ) and I planned for a possible collaboration with SMRU in a next future

In the next months (   2013  october)  the  project is to do education to 17 rural health centers, and connecting these with central (pivot) referent hospital  St François -in Dem Rep of Congo-Thsimbulu, western Kasai, and to do

the same in Bolivia, educating and linking the network of 35 laboratories of  Bolivian Chaco ,

finally I will  return to Thailand(2014, 2 Q)for the Collaboration with AIT Yunus Center and  also with  SHOKLO Malaria research unit (SMRU Prof François Nosten, director and Dr Stephan Proux Chef of Laboratories )

 The future  goal is  to expand my project  and sharing  my method by collaboration in rural areas of developing countries

I hope  to largest amount of people who are need

 In my plans there is  also a residential(for professionals )  Course in AIT about practice m health for human development

 in the 2 Q of 2014

“Mobile Phones for Rural Development  : From the  Health to  the Environment  and to Social Welness , throught use of local frugal technology - m-technology  for the Human Development.”

 

I always thought that the union generates the force, and that it is better create a global net between people working to m-health  and to m-education, for building of a real powerful network

I hope that you agree  this idea

 

References and news

Bellina, L,.Missoni, E. Mobile Diagnosis: Bridging Sociocultural Gaps and Empowering Women Telemedicine and e-Health November 2011, 17(9): 750-750. doi:10.1089/tmj.2011.9976. http://www.liebertonline.com/doi/abs/10.1089/tmj.2011.9976

Bellina, L., Missoni, E. Mobilephone image transmission for diagnosis. In: World Health Orgaization, Compendium of new and emerging health technologies, WHO/HSS/EHT/DIM/11.02, Geneva, 2011

Bellina,L:Missoni,E:MobileDiagnosis:an appropriate technology for tele- microscopy,an effective tool for training European Journal TM & IH vol 16,Supplement 1,October 2011,pag 88 www.blackwellpublishing.com/tmi

Bellina,LMissoni,E:M-learning: mobile phones’ appropriateness and potential for the training of laboratory technicians in limited-resource settings- Health and Technology 2011 October , DOI: 10.1007/s12553-011-0008 http://www.springerlink.com/content/a328n117r7775322/

Bellina,L In Good Practice-Mobile Diagnosis : The Grapevine -Summer Euripa Magazine [PDF] The Grapevine www.euripa.org/…/GrapevineSummer11.pdf

Bellina,L:MobileDiagnosis, in Good Pratice-2011,July Freedom From Want(MDGC-AIT)

http://issuu.com/arcmdg/docs/aw_ffw2_final

Bellina L., Missoni E., Increasing connectivity of isolated health workers in poor countries using locally available technology. The International Journal of Tuberculosis and Lung Disease, 2010, 14, 11 suppl.2, pp. S46-S47

Bellina.L:Maugeri,M:Missoni,E:Hetical and public health concerns based on retrospective analysis of referrals for diagnostic parasitology of immigrants and autochthonous population in Lampedusa island (Italy)- European Journal TM & IH vol 14,Supplement 2,September 2009,pag 66 www.blackwellpublishing.com/tmi

Bellina, L., Missoni, E., Mobile cell-phones (M-phones) in telemicroscopy: increasing connectivity of isolated laboratories, Diagnostic Pathology, 2009, 4: 19 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2706795/

Grameen Kalyan :Training on Diagnostic Pathology 07-10 june 2010 Tutorial Book of Course for Healthworkers trained by Dr Livia Bellina ,assisted by Dr Baqui Supported by Regional Office Comilla Venue:Rajapur Health Center ,Comilla Unpublished

Useful Links

http://www.patsnap.com/patents/view/EP2116884A1.html

http://www.who.int/medical_devices/innovation/new_emerging_tech_10final .pdf http://www.who.int/workforcealliance/members_partners/member_list/mobil ediagnosis/en/index.html http://www.bellagioinitiative.org/innovations/mobile-diagnosis-mobile- project/ http://www.healthunbound.org/content/mobilediagnosis-global-project- based-most-relevant- technology-brain http://www.mhealthalliance.org/membership-info

 

September 09 2013

Letter to http://www.hifa2015.org

Letter to http://www.hifa2015.org

who accepted me ;)

Dear Friends

It is with great happiness that I am with you

I always thought the union generate the force

in all my life, I advocated the power of the Education, and  of

 the Inclusion of the poorest neglette communities in our “global” community

My idea, my work is based on development of   all people, who have the same capacities and must have the same   rights

Time ago, in a blog of GHWF, of  which I am part, I wrote about the most relevant technology : the brain

 http://www.healthunbound.org/node/1250

We all must work, together, for sharing our power, without any power

only with love

If we all will work together, we will change the world

I think it is possible

I worked with Professor Yunus, and He taught to me that if all people have the possibility to develop, they will become as big, strong  trees, 

if people have not opportunity,  become a “Bonsai”

So, I would like working with you, with all my forces and my passion, for permitting  to all people to became strong trees

Is it this that I am doing, educating, connecting, teaching that we all are the same, with the same possibilities, and where it is hard, I help my students to understand how they can help their community with logic and basic notions

and, where it is more hard, they know that they can contacting  me, always, for having a support, and they know also that, if I am not able to answer ,  I  can sharing they requests of help with my network of friends, great, good heart.

This is my work : create  a network that is moving with love for love

Hope we can be all together

Feel free to contact me 

All my best

Livia

January 16 2013

MobileDiagnosis in Tshimbulu : contextualize and focus our work on local exigences and wellness

http://www.slideshare.net/livia_bellina/mobile-diagnosis-in-tshimbulu-rdc-2012

From my country, from my island,(Sicily-developing country-I hope ) I am seeing the world as behind a glass

A world divided into two parts

In one part we can see all technologies, all tools and facilities , also telemedicine.
as a rich banquet , forbidden for the moltitude of people who needs, who are suffering

If we thinks to the world as a global family , you understand that the solution is easy, near, handy .

You have to use your brain, and teach to all “students” as use the brain , and as search the easiest solutions for resolve local concerns ….just as a family

If you, in addition, teach as expand the use of easy tools for resolve
more and more  local problems , you done a biggest gift

Without conditions or expectations linked to our satisfation or enrichment,
but who are linked only to local improvement or local wellness
Just as a family

Our goal have to be a global school -. a global family

My goal, and MobileDiagnosis goal is to share with all interested the tool and method easiest , and after the rural communities of Uganda, Bangladesh, Afghanistan, Madagascar, and Republic Democratic of Congo, expand the project and share with all who need.


It is easy ! If you like to learn more feel free to contact me.

December 23 2012

Wishing you a Merry Christmas and a Happy New Year!

Dear Friends,

special people who I had the luck to meet in my new life, in the last four years of my life..

Thanks for your estimation and availability

I tryed to build, with little steps and a lot of friends a great network of friendship , for donate a little of our lifes and of our competences to persons which have nothing .

Alone I never could

You gave to me the possibility to do much

You all are my force

In a world where the solidarity is a precious gift ,together ,we are giving a message

Is not needs much money or tools, for sharing our possibilities ,

it is needs only our commitment

It is possibility change the realty of last peoples

The global health seen as a gift , and you, we are rich of love

Thanks , my friends ,

I am sure that together we will change the world (or at least the way of thinking…)

Season’s Greetings and a happy new year!

Joyeuses fêtes et bonne nouvelle année!

¡Felices fiestas y prospero año nuevo!

Feliz Natal e próspero Ano Novo


Wishing you a Merry Christmas and a Happy New Year!

Buon Natale e Felice Anno Nuovo!

livia

December 10 2012

About

This is Livia Bellina's blog.
Livia is a medical doctor, Pathologist Medical for National Health System since 1987 
 In 2008, when a migrant with malaria come to her in Lampedusa, where she was doctor
she started to send image taken by mobile by MMS.

After this experience, she started to study tropical (poorly) medicine, laboratory and logic 
clinic in 
-Verona Negrar, ( course for tropical labs) 
-Florence Careggi -(course of cooperation and tropic diseases) 
-ISS f(or learn more of leishmoanian ane trip diseases) 
-Now she is completing a Master on Medicine of migration emargination and 
poverty in Roma, Caritas- Idente Institute
Just after Verona Course,(october 2008) livia realized that her mission was helping by teaching the rural low resource people in the most poorest and 
rural isolated community 
so, after she gave her availability to educate on the job the health workers 
and people of rural communities and she went in some from the most rural and poorest areas of the world

2009 -she went to Uganda -Lacor, Gulu, in St Mary Hospital, where trained the student of lab technicians course and where I has been 
supervisor of Main lab 
2010- she gave her availability to professor Muhammad Yunus(Nobel Price 
for Peace) and after invitation he went Bangladesh where improved the health workers 
of Grameen Foundation (Kalyan) and connected the rural health centers 
to central office with this "telemedicine of the poors...) 
2011- she returned in Bangladesh with PIME (Pope Missionary) In 
North,Dinajpur and made training to nurse(student!) sisters and 
illiterate people..... 
They learned with this new method immediately! 
2011- , with a MAE Project, she twent to Afghhanistan, Herat as 
consultant and teacher...also here people learned easily and quickly
2012- Livia done a explorative mission to Madagascar (Andavadoaka and ) for individuate the best area for future projects

In this years she founded MobileDiagnosis®Onlus recognized by Government as Non Profit

The Mobile Diagnosis association is composed of a creative team of young professionals in web design, engineers, project specialists and other professionals. The team works to increase the visibility of Mobile Diagnosis, and to create opportunities for the development of new educational methods such as long distance training, learning, and to keep users up-to-date on diagnosis issues.

All for solidariety
The next goal is the expansion a global level of MobileDiagnosis® Project

Mobile Diagnosis


To learn more about the method, visit Mobile Diagnosis official website