Dear HIFA colleagues,
Here are some more extracts from the interview with Deb Van Dyke, Peter Cardellichio, and Raj Punjabi.
Health: The Videos Saving Lives in the Developing World
In 2008 I was running a medical program in a remote part of South Sudan. And late one night I got this urgent knock on my door. It was one of the local nurses and she said, ‘You have to come quickly, there's a baby that's just been born and it's not breathing.’ So we ran through the dark to this birthing tent. I looked around the room as I entered the tent, and I remember connecting to the worried eyes of the mother. And then I saw her baby, blue and lifeless on a table. We had a doctor and midwife that were trying to resuscitate the baby. One was giving chest compressions and one was trying to get the suction machine going. But they did not have the bag and mask which was forgotten in the corner. So I ran over and grabbed the bag and mask because that is what will bring the baby to life, is giving the baby breaths. So we started to give the breaths, and of course time crawls when you're in an emergency. But before too long that baby cried. I was so relieved and so happy for that new mother.
So the baby lived. But I remember realizing that health workers everywhere desperately needed that skill, and I envisioned video showing a lifeless baby coming alive with breaths delivered by that bag and mask. And I thought, I thought at that moment, I have to do something about this...
With no background in filmmaking, Deb started a globe-trotting video production house to help train frontline health workers. Her small nonprofit group, the Global Health Media Project, has produced 200 short live action films over the last 10 years about the basics of childbirth and other tasks at the heart of improving maternal and child health. The films use real health workers and real patients in hospitals from Nigeria to Nepal. And with hundreds of millions of viewers from virtually every country on the planet, these films are transforming the way health workers in the developing world are learning essential skills—and saving lives. And now in this age of viral pandemics, as lock-downs shut down conventional classrooms around the world, Global Health Media's videos have become more vital than ever. But let's start at the beginning—about as far from nursing and the developing world as Deb Van Dyke could get.
"That gap in basic knowledge and skills is one of many causes — probably the single biggest reason — for the low quality of care in much of the developing world. And it's a huge barrier to the concept of Universal Health Coverage, a sort of holy grail in the health world that says access to quality care is a fundamental human right, no matter where you live. The global health community has been trying for decades to make that a reality, but so far the skills gap is just too vast. Think about this: Out of a million newborn babies who die each year in Africa, the World Health Organization says about two-thirds of them could be saved if the health care workers who look after them had adequate training and resources."
What she learned, and what has guided her ever since, is the power of live action.
Real live health workers in real settings, similar to where health workers are working: It's instantly relatable and relevant. It's very empowering. Clinical signs, for example, are much more believable and memorable in live action footage, like babies have breathing problems or jaundice or lethargy. A real baby will make a deep and lasting impression. And there's the whole other aspect of modeling care that you don't get through animation—a gentle touch, a reassuring smile, eye contact—all the nuances and facial expressions and body language that we’re trained from birth to read.
The videos have been viewed more than 450 million times on YouTube, and they've been downloaded more than 200,000 times in 200 countries, all for free directly from Global Health Media's website. The project is mostly funded by foundation grants and individual donations, and more than 7,000 organizations—NGOs like Save the Children, national ministries of health, the WHO, UNICEF—they all use the videos in their country programs. And many of them pay for translation of the videos into dozens of local African and Asian languages—widely spoken ones like Swahili and Hindi, but also narrow dialects like Kinyarwanda in East Africa and Chuukese in Micronesia. That's a strong sign that the films are valued by the people who use them. In fact, based on feedback from these organizations, Peter Cardellichio estimates the films have helped train well over a million healthcare workers.
On average, right now, our videos are being watched at a rate of about 500,000 times a day, something on the order of 400 times a minute. So I always like to think somebody somewhere is always watching a Global Health Media Project video...
As compelling as they are on their own, the videos may have even greater impact when they're embedded in an education curriculum. Remember Patience, that Community Health Worker in Liberia who had trouble diagnosing a case of pneumonia? It turns out that she later enrolled in a Liberian Ministry of Health training program about pneumonia and a bunch of other topics which included Global Health Media’s videos—all put on a smartphone so that Patience could tap into them offline. When her supervisor came to assess her skill level a few months later, Raj Panjabi of Last Mile Health says Patience was able to diagnose and treat a case of pneumonia with about 95% accuracy, in large part, he says, because of the visual lessons she learned from Global Health Media's videos.
Dr. Raj Panjabi: This collision of modern technology with weak health systems, this collision of modern technology with the human compassion that someone like Patience brings, the combination of high tech and high touch care—I think is absolutely essential to addressing that quality gap. And I think Global Health Media is transforming the way community health providers and other frontline health providers learn. And that's very exciting.