The world's largest medical deserts are Sub-Saharan Africa and Southern Asia: the World Health Organization estimates that two million healthcare professionals are required there to be able to develop functional healthcare systems. Looking more closely, doctors are concentrated in the capitals of these countries, even when they may not have enough work, and wish to emigrate to the North rather than setting up their services in rural areas. Consequently, the patients need to head for the big cities, when they are able to, taking roads that are often long and challenging.
In 2000, a group of young doctors in Mali who were prepared to go to rural areas, set us a challenge: use your digital tools to support doctors who want to set up their practices, so that they can remain in contact with specialist doctors and their colleagues, to continue receiving training and advice when they encounter a difficult case, to decide if a patient really does need to be transported to the city. Help us to move our expertise, rather than moving patients or doctors. After pilot projects in Mali and Mauritania, the Francophone African Network for Telemedicine (RAFT) began in 2003. The name is evocative of a rather basic undertaking, but one that enabled us to overcome an obstacle, to reach another horizon. And this is the chosen approach: using simple, resilient computer tools that are adapted to local conditions to facilitate communication, collaboration and distance learning, to “de-isolate” health professionals and improve their working conditions and their effectiveness, and as a result, the quality of patient care. Up to 2014, more than 1,000 professionals had participated in RAFT in some 20 African countries: continuing education courses, help with remotely interpreting an X-ray, an ultrasound image, an electrocardiogram, a photo of a skin lesion, or to obtain advice for handling a difficult case.