Cardiopad: Reaching the Hearts of Rural Communities in Africa

By Edward Harris, Communications Division, WIPO

In a remote clinic in Mbankomo, down a crimson-earthed road in Cameroon, a doctor attaches electrodes to the chest of a patient lying on an examining table. Murmuring reassurances, the generalist records the patient’s heart data on an African-designed touch screen medical tablet. The readings are then transferred wirelessly, over the mobile-phone network to specialists in distant urban centers for interpretation, diagnosis and prescribed treatment.

Video: Meet Arthur Zang, Inventor of the Cardiopad Video | Watch on YouTube

By making it possible to perform tests, such as an electrocardiogram (ECG) in far-flung villages, the tablet is bringing high-quality cardiac care to remote and often poorly equipped countryside clinics where many Cameroonians go for their health care. It connects rural patients suffering from heart disease, many of whom do not have the means, the time, the contacts or the strength to travel to the big city, with Cameroon’s few, primarily urban-based cardiologists.

The potentially life-saving Cardiopad – designed in Cameroon to address a Cameroonian problem, but which is also widespread across Africa – is the brainchild of 26-year-old engineer Arthur Zang. For now, the heart reading and interpretation are just a simulation – but that will change soon if Mr. Zang gets his way.

The winner of numerous overseas awards and grants, Mr. Zang hopes that his invention – imagine an iPad with home-build software built for deployment in the African bush – will revolutionize cardiac care in Cameroon. And for him, his business is also personal.

“There are a lot of people in my family who suffer from cardiac illness,” he says referring to the recent heart-related death of his uncle. “So personally, this has affected me but above all I would say it has impassioned me, because I know personally the daily existence of people living in the village … I lived myself in a village and I know how difficult it is to get specialist care.”

According to Mr. Zang, Cameroon has only a few dozen cardiologists in a country of around 22 million people and these are clustered in urban centers like the capital, Yaounde, or the main seaport town of Douala. Roughly half of Cameroon’s population lives in rural areas, according to the World Bank, while many others live in urban areas that do not have access to heart specialists.

Life-saving potential

The young engineer saw a problem and set out to try to fix it. In 2009, while still a student, Mr. Zang began developing a software product that could help doctors monitor the health of their patients’ hearts. He made contact with a Yaounde-based cardiologist, Professor Samuel Kingué, who helped him better understand the type of technical solutions required. With these insights, the young engineer finally wrote a program that he loaded onto an off-the-shelf device. But he soon realized he needed the flexibility of his own platform, and so turned to developing his own hardware – the Cardiopad. – the first medical tablet in Africa, says Mr. Zang.

The Cardiopad has a simple-to-use, touchscreen interface that is adapted to the needs of remote health workers who may lack familiarity with the latest computing devices and the know-how required to use them. In tests by the Cameroonian scientific community, the Cardiopad has proven 97.7 percent reliable. It is solidly built to withstand the humid climate and the shocks incurred while being carried over rutted, often unpaved dirt roads like the one leading to the clinic at Mbankomo. The device is also built to withstand the frequent power cuts experienced in Cameroon and across Africa. Equipped with a battery, it can run independently for around six hours at full power.

With some 30,000 euros funding from the Cameroonian government, Mr. Zang was able to create a prototype and eventually travel to China, where he found a factory that could produce a limited run of Cardiopads while he searched around for partners to help fund his venture. Obtaining investments has been difficult. Finding the right contact in overseas companies is a challenge and the pitch is no easier. The device is designed to help Africans in rural, impoverished communities;  something that not all companies see as a promising prospect, Mr. Zang says. That’s why he intends to tap into a very modern financing model – crowd-funding on platforms such as Kickstarter, where users can donate funds to, or purchase shares in, fledgling firms.

For now, he is searching for more funding, hoping to build upon the CHF 50,000 grant he received as a Rolex Award Young Laureate 2014. While funding issues have been a constraint, the pilot tablets he has been able to produce are now being tested in hospitals in Cameroon.

Mr. Zang’s aim is to produce and sell his device for around 2,200 euros which is significantly cheaper than other commercially available, less portable devices. The hope is that hospitals purchasing the low-cost Cardiopad will be able to lower the price of medical examinations and speed-up medical diagnoses.

Patenting the Cardiopad

He also turned to the intellectual property (IP) system to help advance his work. In December 2011, he applied for a patent via the Organisation Africaine de la Propriété Intellectuelle (OAPI) in Yaounde [see box]. OAPI later granted him a patent (No. 16213) on his technology, covering some aspects of both the software and the hardware.

Obtaining a patent was an important step for Mr. Zang. “I did it to reassure myself,” he said, “also to protect the product, and to have a lot more credibility in the eyes of, for example, partners with whom I wanted to sign contracts in order to be able to produce and then sell the product.”

When funds permit, he also plans to register the Cardiopad, and his company, Himore Medical, which currently produces the tablet, as trademarks.

“The intellectual property system can help us in Africa – it can add credibility to African products. And credibility has repercussions on the business plan because if you aren’t credible, it’s difficult to sell your product,” says Mr. Zang.

Driving new developments

The budding entrepreneur is already in collaboration with other young Cameroonian engineers to develop a range of additional medical devices and technologies for rural areas. He points to what he views as a disconnect in the innovation environment in Cameroon: in the medical space, in particular, many of the creators and inventors are young like him – roughly half of Cameroon’s population is under the age of 18 – so they rarely suffer from the diseases that products like the Cardiopad are designed to address.

Further, with a rapidly urbanizing population, urban dwellers may all too easily overlook the specific needs of those living in remote rural areas. For Mr. Zang, innovation requires a flexible mindset, a deep understanding of an entire economic ecosystem and an ability to commercialize ideas.

“You can’t only have engineering ideas,” he says. “We have to go further, into researching the problems confronting Africans and then pursue research into solutions, subsidize the creation of companies, create business incubators that can help nurture projects, researchers, engineers and really help them move from the laboratory to the factory.”

Pursuing a dream

Ultimately, Mr. Zang’s dream is to continue working to “improve life conditions” by branching out into other areas of medical technology, envisioning specially adapted devices for echography and radiology.

In the Mbankomo clinic, the lack of these higher-end materials is evident. Surrounded by a tidy plot of well-brushed soil dotted with shade trees, the one-story clinic is austere. Patient consulting rooms are cooled by open windows, but little advanced machinery is on display. Mr. Zang says doctors at the facility are overwhelmed by the health needs of patients, which range from the mundane to the mortal. Connecting these clinics to better-resourced hospitals elsewhere via the mobile phone system is establishing a lifeline.

Mr. Zang hopes ultimately to manufacture the Cardiopad in Cameroon, and to help the country develop as a manufacturing center for lower-cost devices specifically tailored to low-resource environments and markets, like those in West Africa.

“This will help lower the cost of medical exams and the cost of good health across the regions, in the villages,” he says. “That’s it, that’s the dream that is smoldering in me.”