Africa to be declared polio-free

Yahoo - AFP, Sophie Bouillon with Aminu Abubakar in Kano, August 25, 2020

A child in Kano, northwest Nigeria receives the vaccine in 2017

The World Health Organization (WHO) is set to certify on Tuesday that the African continent is free from wild polio, four years after the last cases appeared in northeastern Nigeria.

"Thanks to the relentless efforts by governments, donors, frontline health workers and communities, up to 1.8 million children have been saved from the crippling life-long paralysis," the WHO said in a statement.

The official announcement is due at 1500 GMT in a videoconference with WHO director-general Tedros Adhanom Ghebreyesus and key figures including philanthropist and Microsoft founder Bill Gates.

"Happiness is an understatement. We've been on this marathon for over 30 years," said Tunji Funsho, a Nigerian doctor and local anti-polio coordinator for Rotary International.

He said it marked a crucial step in the total eradication of the illness at the global level.

"It's a real achievement, I feel joy and relief at the same time," he added.

Poliomyelitis, or "wild polio" is an acutely infectious and contagious disease which attacks the spinal cord and causes irreversible paralysis in children.

It was endemic around the world until a vaccine was found in the 1950s, though this remained out of reach for many poorer countries in Asia and Africa.

As late as 1988, the WHO counted 350,000 cases globally, and in 1996 said there were more than 70,000 cases in Africa alone.

Thanks to a rare instance of collective global effort and financial backing -- some $19 billion over 30 years -- only Afghanistan and Pakistan have recorded cases this year: 87 in total.

Trust

Nigeria, a country with 200 million inhabitants, was still among the trouble-spots in the early 2000s.

In its northern Muslim-majority areas, authorities were forced to stop vaccination campaigns in 2003 and 2004 by Islamic extremists who claimed it was a vast conspiracy to sterilise young Muslims.

It took a huge effort in tandem with traditional chiefs and religious leaders to convince populations that the vaccine was safe. 

"People trust their local traditional leaders who live with them more than the political leaders," said Grema Mundube, a community leader in the town of Monguno, in the far north of Nigeria.

"Once we spoke to them and they saw us immunising our children they gradually accepted the vaccine," he told AFP.

However, the emergence of violent Islamist group Boko Haram in 2009 caused another rupture in the programme. In 2016, four new cases were discovered in Borno state in the northeast in the heart of the conflict.

"At the time, we couldn't reach two-thirds of the children of Borno state -- 400,000 children couldn't access the vaccine," said Dr Funsho.

Inaccessible children

The security situation remains highly volatile in the region, with the jihadists of Boko Haram and a local Islamic State affiliate controlling vast areas around Lake Chad and the border with Niger.

"International agencies, local governments, donors -- all partners took the bull by the horns to find new strategies to manage to reach these children," said Dr Musa Idowu Audu, coordinator for the WHO in Borno.

In these "partially accessible" areas, vaccination teams worked under the protection of the Nigerian army and local self-defence militias.

For areas fully controlled by the jihadists, the WHO and its partners sought to intercept people coming in and out along market and transport routes in a bid to spread medical information and recruit "health informants" who could tell them about any polio cases.

"We built a pact of trust with these populations, for instance by giving them free medical supplies," said Dr Audu.

Today, it is estimated that only 30,000 children are still "inaccessible": a number considered too low by scientists to allow for an epidemic to break out.

Despite the "extreme happiness and pride" felt by Dr Audu, he never fails to remember the 20 or more medical staff and volunteers killed for the cause in northeast Nigeria in recent years.

The challenge now is to ensure that no new polio cases arrive from Afghanistan or Pakistan and that vaccinations continue to ensure that children across the continent are protected from this vicious disease.

"Before we couldn't sleep at all. Now we will sleep with one eye open," said Dr Funsho.

'Unofficial' world's oldest man dies in South Africa

Yahoo – AFP, RODGER BOSCH, August 22, 2020

Fredie Blom may have been the world's oldest man

A 116-year-old survivor of the 1918 Spanish Flu believed to be among the world's oldest people died Saturday in South Africa, his family said.

Born on May 8 1904, Fredie Blom had "lived this long because of God's grace," he told AFP this year.

Guinness World Records lists the oldest currently living man as Briton Bob Weighton, aged 112, but South African media have described Blom as "unofficially" the world's oldest.

Blom's entire family was wiped out by the Spanish Flu pandemic when he was just a teenager.

But he himself survived and went on to raise the three children of his wife of 46 years, Jeanette, as his own, becoming grandfather to five over the years.

"Two weeks ago oupa (grandfather) was still chopping wood," family spokesman Andre Naidoo told AFP fondly, recalling the old man using a 4 pound hammer.

"He was a strong man, full of pride," he added.

But within 3 days, his family saw him shrink "from a big man to a small person".

Born in the rural town of Adelaide, tucked near the Great Winterberg mountain range of South Africa's Eastern Cape province, Blom died at Tygerberg Hospital in Cape Town.

His death was "not a COVID death at all, it's normal natural death," Naidoo said in reference to the coronavirus pandemic..

Madagascar virus potion scorned because it's from Africa: president

Yahoo – AFP, May 11, 2020

Madagascar's President Andry Rajoelina sips Covid Organics, which he
touts as a remedy for coronavirus (AFP Photo/RIJASOLO)

Antananarivo (AFP) - Madagascar President Andry Rajoelina on Monday batted away criticism for promoting a homegrown "remedy" for COVID-19, charging that the West has a condescending attitude toward traditional African medicine.

"If it wasn't Madagascar, and if it was a European country that had actually discovered this remedy, would there be so much doubt? I don't think so," he told French media in an interview.

The World Health Organization (WHO) has repeatedly warned that the Covid-Organics infusion, which Rajoelina has touted as a remedy against the deadly coronavirus, has not been clinically tested.

The drink is derived from artemisia -- a plant with proven anti-malarial properties -- and other indigenous herbs.

"African scientists... should not be underestimated," he told France 24 and Radio France International (RFI).

"I think the problem is that (the drink) comes from Africa and they can't admit... that a country like Madagascar... has come up with this formula to save the world," said Rajoelina, who claims the infusion cures patients within 10 days.

Already Equatorial Guinea, Guinea-Bissau, Niger and Tanzania have taken delivery of consignments of the potion, which was launched last month.

"No country or organisation will keep us from going forward," Rajoelina said in response to the WHO's concerns.

He said proof of the tonic's efficacy was in "the healing of our sick".

Madagascar has officially reported 183 coronavirus infections and 105 recoveries, with no deaths.

"The patients who were cured were cured through the administration of Covid-Organics alone," the president said.

He referred to the remedy as "an improved traditional medicine", adding that Madagascar was not conducting clinical trials but "clinical observations" in accordance with WHO guidelines.

Related Article:

WHO cautions against use of Madagascar anti-virus potion

WHO cautions against use of Madagascar anti-virus potion

Yahoo – AFP, Philippe Alfroy, May 7, 2020

Madagascar's President Andry Rajoelina drinks a sample of Covid Organics which
he touted as a remedy for coronavirus (AFP Photo/RIJASOLO)

Johannesburg (AFP) - The World Health Organization on Thursday advised governments to clinically test a herbal drink touted by Madagascar's President Andry Rajoelina as a remedy against coronavirus.

The Covid-Organics infusion is derived from artemisia -- a plant with proven anti-malarial properties -- and other indigenous herbs.

Rajoelina hopes to distribute the infusion across West Africa and beyond, claiming it cures COVID-19 patients within 10 days.

Equatorial Guinea, Guinea-Bissau and Niger have already received consignments of the potion. Others such as Tanzania have expressed interest.

But the World Health Organization (WHO) has repeatedly warned that there are no published scientific studies of the herbal tea and that its effects have not been tested.

"We would caution and advise countries against adopting a product that has not been taken through tests to see its efficacy," WHO Africa Director Matshidiso Moeti said in a press briefing on Thursday, calling on Madagascar to take the drink "through a clinical trial".

Moeti said that in 2000, African governments had committed to taking "traditional therapies" through the same clinical trials as other medication.

"I can understand the need, the drive to find something that can help," Moeti said. "But we would very much like to encourage this scientific process in which the governments themselves made a commitment."

Rajoelina defended his tonic during a coronavirus screening campaign in Madagascar's eastern city of Toamasina on Thursday.

"The WHO has indicated that artemisia could lead to a cure for coronavirus," the president said, promising to submit the drink to clinical trials.

Scepticism remains

Earlier this week, the WHO recognised artemisia as a "possible treatment" for COVID-19. But the organisation also repeated its calls for more rigorous testing.

South Africa's Health Minister Zweli Mkhize on Wednesday said Madagascar had reached out for "help" with scientific research.

"Our scientists would be able to assist with this research," Mkhize tweeted, adding that South Africa would only "get involved in a scientific analysis of the herb".

The country has the highest number of coronavirus cases in sub-Saharan Africa, with 7,808 infections and 153 fatalities recorded to date.

Neighbouring eSwatini -- a tiny landlocked nation wedged between South Africa and Mozambique -- said it would not consider Rajoelina's tonic for the time being.

"It is important as a country to first ascertain where such herbal products have been tested," she said Health Minister Lizzie Nkosi on Thursday.

"We have to do adequate proper research and be sure that the product works."

To date eSwatini has reported 123 cases of coronavirus, including two deaths.

Meanwhile, the Economic Community of West African States (ECOWAS) has debunked claims that it had ordered a package of Covid-Organics from a "third country".

"We are aware that several claims of a COVID-19 cure have been made in different parts of the world," ECOWAS said in a statement on Wednesday.

"But we can only support and endorse products that have been shown to be effective through scientific study."

Last century's epidemics more deadly than today's

Yahoo – AFP, Jean-Philippe CHOGNOT, Olivier THIBAULT, February 5, 2020

The deadliest epidemic of the haemorrhagic fever Ebola broke out in West Africa
in December 2013 and lasted more than two years (AFP Photo/CELLOU BINANI)

Paris (AFP) - Before the emergence of the new coronavirus, which has sparked worldwide panic, other epidemics had struck earlier in the 21st century, but were less deadly than the previous century's pandemics.

An overview.

21st century epidemics

2013-2016: Ebola

The deadliest epidemic of the haemorrhagic fever Ebola broke out in West Africa in December 2013 and lasted more than two years, killing more than 11,300, mainly in Guinea, Liberia and Sierra Leone.

First identified in 1976, Ebola is less contagious than other viral diseases, but is particularly lethal, killing around 40 percent.

The virus re-emerged in August 2018 in the eastern Democratic Republic of Congo where it has so far killed more than 2,200.

The World Health Organization (WHO) says 18,500 died of so-called "Swine flu", 

or H1N1, which was first uncovered in Mexico and the United States in March 

2009 (AFP Photo/LUIS ACOSTA)

2009-2010: Swine flu

The World Health Organization (WHO) says 18,500 died of so-called "Swine flu", or H1N1, which was first uncovered in Mexico and the United States in March 2009.

The Lancet medical review, however, puts the toll at between 151,700 and 575,400.

The pandemic alert was launched on June 11, 2009 and lifted on August 10, 2010 but the virus turned out to be not as deadly as first feared.

Vaccines were rushed out, but in hindsight, the West, particularly Europe, and the WHO were criticised for overreacting at a time annual influenza epidemics every year kill between 250,000 and 500,000, according to the Geneva-based UN health agency.

Severe Acute Respiratory Syndrome first emerged in Guangdong in southern 

China in November 2002 before sparking a health crisis in mid-2003, in particular

traumatising Asia (AFP Photo/SAMANTHA SIN)

2002-2003: SARS

Severe Acute Respiratory Syndrome first emerged in Guangdong in southern China in November 2002 before sparking a health crisis in mid-2003, in particular traumatising Asia.

It killed 774, four fifths of whom were in China and Hong Kong. It was transmitted to man from horseshoe bats, eventually spreading to around 30 countries. It had a mortality rate of 9.5 percent.

2003-2004: Bird flu

The deadly H5N1 strain of bird flu killed more than 400 people, mainly in Southeast Asia, after appearing in 2003. It first ravaged poultry farms in Hong Kong, before being transmitted to humans. The WHO declared a global health emergency, but the toll remained limited.

20th century's big pandemics

AIDS, by far the most deadly epidemic of modern times: according to UNAIDS 

some 32 million people around the world have died of the disease (AFP Photo/

Dibyangshu SARKAR)

1981-to date: AIDS

By far the most deadly epidemic of modern times: according to UNAIDS some 32 million people around the world have died of the disease which affects the immune system and leaves people vulnerable to opportunistic infections.

Today around 24.5 million people have access to retroviral drugs which when taken regularly efficiently stop the illness in its tracks and heavily reduce the risk of contamination.

1968-1970: The Hong Kong flu

Around one million people died of this disease, according to the US Centers for Disease Control and Prevention (CDC).

Transmitted around the world between mid-1968 and early 1970, it in particular killed many children. It first started in Hong Kong, spread through Asia and reached the United States in late 1968. After lying low for several months it then hit Europe in late 1969.

For epidemic experts, this flu went down in history as the first of the modern era, due to the advent of high-speed air travel.

1957-1958: Asian flu

Around 1.1 million people died of Asian flu, according to the CDC.

The pandemic hit in two aggressive waves. The virus first appeared in southern China in February 1957. Several months went by before it reached America and Europe.

The disease, which results in serious lung complications, in particular affected the elderly.

Spanish flu hit the world's population in the wake of WWI, killing up to 50 million, 

according to the CDC, and is considered the most deadly in history over such 

a short period (AFP Photo)

1918-1919: Spanish flu

Spanish flu hit a large part of the world's population in the wake of World War I, killing up to 50 million people, according to the CDC.

Striking between September 1918 and April 1919, it is considered the most deadly in history over such a short period.

Five times more people died of it than did in World War I. The first victims were recorded in the United States, before it spread to Europe and then around the world.

Its mortality rate was estimated at more than 2.5 percent, according to the CDC.

Babies born on floor as Zimbabwe's health system totters

Yahoo – AFP, Ish MAFUNDIKWA, with Zinyange AUNTONY in Bulawayo, December 4, 2019

Where a child is born: Esther Gwena, 69, who acts as a midwife but has no
training, lays down sheets in her rundown apartment -- a makeshift maternity
unit (AFP Photo/Jekesai NJIKIZANA)

Harare (AFP) - The floor is dusty, the walls filthy and the furniture decrepit, but for two weeks last month a tiny flat in a Harare township was transformed into a maternity clinic where scores of babies were born.

Its owner, 69-year-old Esther Gwena, says she helped to deliver 250 infants as Zimbabwe's health sector tottered -- a feat that earned comparisons to Florence Nightingale, the pioneer of modern nursing.

Hundreds of junior medics at state hospitals began a strike three months ago because their salaries -- less than $200 a month -- are not enough to live on in a country gripped by 500 percent inflation.

Nurses are only working two days a week.

Those who can't afford private care -- the majority of the 14 million people reeling under an economic crisis compounded by acute food shortages -- suffer at home or seek help from people like Gwena.

Senior doctors, in a letter last week, said state hospitals had become a "death trap" and warned of a "slow genocide".

Gwena, a widow and member of the local Apostolic Faith sect, is a self-taught midwife.

When the health services strike peaked last month, she came to the rescue.

In need: Monica Bepu, 33, heavily pregnant with her second 

child, sits on a bench in the passage outside Esther Gwena's 

two-room flat in Harare (AFP Photo/Jekesai NJIKIZANA)

'I had to do something'

"A man came to me and said there were two women in advanced labour at (a nearby clinic) but the place was closed because the nurses were on strike," she told AFP in her two-room flat in Mbare township.

She rushed there and found that one of the women had a baby which had died.

"I took the other one to my place, where I helped her. The baby survived. From that time, I knew I had to do something," she said.

Word that she was helping deliver babies for free spread quickly.

The state-owned television ZBC described her as "a modern Zimbabwean version of Florence Nightingale" and First Lady Auxillia Mnangagwa visited Gwena and donated food, detergents and blankets.

A funeral services company chipped in with a mobile water tank and pitched a tent outside to serve as a waiting room for women before they went into advanced labour.

"I helped to deliver 250 babies ... (they) are alive and kicking and at home with their mothers," Gwena said.

Two weeks later, the government asked her to stop after a nearby maternity clinic reopened.

Winnie Denhere, 35, cradled her two-day-old baby boy outside the clinic, where she had taken him for an immunisation injection.

"Everything went very well, she didn't ask us for money," she said, speaking of Gwena, who brought her child into the world.

A moment for prayer: Gwena belongs to an Apostolic religious sect where she 

says she got her calling to take up midwifery. She says she has delivered as 

many as 250 children (AFP Photo/Jekesai NJIKIZANA)

'People dying'

But while some laud Gwena as a selfless do-gooder, doctors worry that she exposed herself, the mothers, the babies to infection.

"We need to do something about our facilities so no one goes to her," Harare's director of medical services Prosper Chonzi, said.

Medicines have been in short supply and broken machines go unrepaired.

The government has fired 448 junior doctors for striking.

Senior doctors last week also stopped work in protest over the sacking of junior colleagues. Dozens marched in Harare on Monday.

"People dying has become the order of the day in our hospitals," said the vice-president of the Senior Hospital Doctors Association Raphael Magota.

He told AFP machines were breaking down and that intensive care units were only able to treat two or three people "due to lack of equipment".

A senior doctor, speaking on condition of anonymity, said the situation has become untenable.

Gwena collects water in a bucket as she prepares for a long day (AFP Photo/

Jekesai NJIKIZANA)

"There is no public health in Zimbabwe at the moment; everything has come to a standstill," he said.

Even the scarce equipment is often not right.

"One needs gloves that fit just right when performing delicate operations, but we get old gloves that are too big," said another doctor.

A UN special rapporteur on food security, Hilal Elver, last week spoke of "disturbing information" that public hospitals had exhausted food stocks, forcing them to seek humanitarian aid and that medical equipment in some cases was "no longer operational".

In the second largest city of Bulawayo, Zimbabweans living abroad are helping in a small way by crowdfunding and sending money back home to offer health care for the vulnerable.

One such initiative is Citizwean Clinic, which opened its doors last month and attended to hundreds of patients in the first five days -- providing free consultation and drugs.

"We go to the hospital these days it's bad, there are no doctors. We heard that there were doctors here," said hypertensive patient Elina Dzingire, 63.

"We've really been helped here," she told AFP from the clinic in the city's Cowdray Park township.

Health Minister Obadiah Moyo admitted the situation in hospitals is constrained but says the government will soon advertise the posts left vacant by the sacked doctors.

Malawi tobacco pressured as US butts in over labour abuses

Yahoo – AFP, Jack MCBRAMS, December 1, 2019

Tobacco is known locally in Malawi as "green gold", but the southern African nation
must wrestle with allegations of child labour if the industry is to have a future
(AFP Photo/GIANLUIGI GUERCIA)

Blantyre (Malawi) (AFP) - Malawi is being forced to confront child and forced labour practices after the US restricted tobacco imports from the impoverished southeastern African nation over allegations workers including children were being exploited.

Although exports to the United States make up only a small part of Malawi's total, the US move could make it harder selling its tobacco elsewhere and has sparked anxiety among farmers who fear they will be forced to accept lower prices.

As tobacco, known locally as "green gold", is Malawi's top crop in terms of employment, foreign exchange earnings (60 percent) and tax revenue (25 percent), any trouble the sector runs into could quickly reverberate throughout the economy.

The US decision piles even more pressure on the tobacco sector, already confronted with global anti-tobacco campaigns.

The trouble began in late October. British law firm Leigh Day announced it was preparing a landmark class action case against British American Tobacco (BAT) on behalf of 2,000 Malawian farmers, including hundreds of children, for forced labour and poverty wages.

BAT, which says it "takes the issue of child labour extremely seriously", has denied any wrongdoing and noted that it buys tobacco from Malawi via international dealers who are required adhere to a code of conduct that does not tolerate child and forced labour.

The US suspended imports of tobacco from Malawi, saying it had information that reasonably indicated it was being produced using forced labour and forced child labour.

Third of children work

According to a survey conducted in 2017 by the country's statistics agency the use of child labour in Malawi is extensive. It found that 38 percent of the country’s children aged between five and 17 were working.

Although the survey did not provide specific information about the tobacco sector, it is widely acknowledged that child labour is a problem.

Betty Chinyamunyamu, who heads an association of smallholder farmers, said incidents of child labour occur despite efforts to eliminate the practice.

"In some cases, farmers may think that that is the way things are supposed to be without knowing that they are engaging in child labour," she said.

Tobacco and Allied Workers Union general secretary Raphael Sandram accused the government of dithering in addressing child labour in the industry.

"In our labour report in 2015, we raised the issue that there were some irregularities in the industry that government needed to address," he said.

"The fact that the government did not respond according to the requirements of the US government means that they delayed to act on these issues. But these issues have been there for a long time," he said.

Malawian children carrying tobacco leaves on a farm in 2009. A government survey 

conducted two years ago found that more than one in three childen work (AFP Photo/

FELIX MPONDA)

Pushing for compliance

Agriculture Minister Kondwani Nankhumwa acknowledged pockets of child and forced labour in Malawi, but downplayed the US action saying it "is not a ban, they are just pushing for compliance".

US authorities said firms wishing to import Malawi tobacco into the country will need to demonstrate it was not produced with forced labour. But what will be needed to convince US authorities and how much effort firms will be willing to take is unclear.

Nankhumwa said 80 percent of Malawi's tobacco was grown under a special scheme which is free from child or forced labour.

"So, we are only grappling with the 20 percent within which there is also some kind of compliance," he said.

The law firm Leigh Day described a tobacco farming system that puts farmers under extreme pressure.

Leaf buyers who sell to multinational tobacco firms make contracts with landowners who then engage tenant farmers who spend 10 months on the plantations. Each tenant farmer is allotted around a hectare but needs four workers to work that amount of land.

"However, the amount the tenant farmers are paid for their crop is too low for them to be able to afford to employ workers to help on the farms. As a result, they have no option but to rely on their children to work on the farms," said Leigh Day in a statement.

Bone of contention

Nankhumwa pledged Malawi would conduct the necessary policy reviews to protect the tobacco industry and bring the country into compliance with global standards.

"The government is reviewing the tenancy system, which is a bone of contention but also perceived to be catalyst for child and forced labour," he said.

Farmers -- who are starting to prepare their fields for the next planting season -- are distraught at the prospect of being squeezed further by falling prices.

"We are baffled and confused," said Alick Yagontha, a small farmer in the northern Rumphi district who has been growing tobacco for two decades and harvested 28,000 kilograms this year.

He fears there will be "no future for tobacco farming in Malawi" if prices fall.

In Ivory Coast, telemedicine revolution proves blessing for heart patients

Yahoo – AFP, David ESNAULT, September 14, 2019

Thousands of heart patients in Ivory Coast are checked by telemedicine
each year (AFP Photo/DAVID ESNAULT)

Bouaké (Ivory Coast) (AFP) - Every time Catherine Coulibaly's 19-year-old son had to make a routine appointment with the cardiologist for his heart condition, she gritted her teeth as she silently counted the financial cost.

It wasn't just the hospital fee -- there was the transport, food and accommodation, too, all of it amounting to a hefty burden for an Ivorian family on a modest income.

But thanks to telemedicine -- consultations that doctors conduct through the internet or by phone -- this cost is now a fading memory.

Her son can book an appointment at a telemedicine facility in a nearby town in northern Ivory Coast.

There, he is attached to monitoring machines which send the data sent to Bouake University Hospital in the centre of the country, where it is scrutinised by a heart doctor.

The fledgling technology has long been championed by health advocates for poor rural economies.

Ivory Coast has become an African testbed for it, thanks to a project linking the Bouake hospital's cardiac department with health centres in several northern towns, some of which are a four-hour drive away.

Telemedicine "caused a sigh of relief for the population of Bouake, Boundiali, Korhogo, everyone," says Auguste Dosso, president of the "Little Heart" association, which helps families with cardiac health issues.

Some 45 percent of the Ivorian population live below the poverty line, according to the World Bank's latest estimate in 2017. And the minimum monthly wage -- not always respected -- is only around $100, or 90 euros.

Heart disease surging

The pioneer behind the scheme is cardiologist Florent Diby, who set up an association called Wake Up Africa.

In Ivory Coast, heart disease, diabetes and other "lifestyle" ailments are surging, Diby explained.

Cardiac specialists are rare in Ivory Coast -- patients can spend much of their

income in transport and accommodation when they need a consultation 

(AFP Photo/DAVID ESNAULT)

"Urbanisation is making people more sedentary, and there's the rise in tobacco consumption, changes in diet, stress," Diby said.

Three decades ago, only around one in eight of the Ivorian population had high blood pressure -- now the figure is one in four, on a par with parts of Western Europe.

But in Ivory Coast -- and across Africa -- well-equipped cardiology units are rare.

"Ninety percent of heart attacks can be diagnosed by telemedicine, so for us cardiologists it's a revolutionary technology," said Diby.

The beauty of the telemedicine scheme is that neither the doctor nor the patient has to travel far.

The cardiac patient is hooked up to the electrocardiogram (ECG) and other diagnostic machines with the help of a technician in a local health centre, which is connected to a computer in Bouake's University Hospital.

The cardiologist there can then see the results in real time, provide a diagnosis and prescribe treatment.

The five-year-old project has already linked 10 health centres to the seven cardiologists at Bouake, enabling 4,800 patients in other towns to receive consultations by telemedicine each year. The goal is to expand this to 20 sites, doubling the intake.

Expertise France, the French public agency for international technical assistance, subsidises up to 185,000 euros of the network, which pays for equipment such as computers, artificial intelligence software and internet connections.

Diby is now calling for telemedicine to be expanded in other medical fields such as neurology and psychiatry, not just in the Ivory Coast, but across West Africa too.

That opinion is shared by other experts. Sixty percent of Africans live in rural areas, where shortages of doctors are usually acute.

But numerous hurdles need to be overcome, especially investment in computers and access to the internet, according to a 2013 analysis published by the US National Library of Medicine.