Benefits of Technology in the Age of COVID-19 and Diabetes. . .Mobile Phones From a Rwanda Perspective

We have learned these past few months of the benefits (as well as pitfalls) of technology in the age of coronavirus disease 2019 (COVID-19). Zoom, Microsoft Teams, and WebEx for all those meetings to attend from your new/temporary home office. Seems all the news is always “Breaking now”! Constant updates of the new numbers of cases of COVID-19 in your location”—if you have chosen to have a local TV news station app on your mobile phone. Probably, the one technology that has become the most useful tool/asset in fact is the mobile phone for information, communication, purchasing items, scheduling, and watching Netflix. Telemedicine has now become “virtual” appointments for many individuals, and those mobile phones are assisting in managing diabetes.

We two authors have been discussing how mobile phones have changed the landscape for many around the world regarding diabetes care. Klonoff ¹ wrote in 2009 “Telemedicine promises to become a novel 21st-century tool for diabetes health care providers to communicate with patients to improve the quality and lower the costs of health care.” The pace of telemedicine has clearly quickened during this pandemic.

The Centre for Evidence-Based Medicine (CEBM ² ) has recently (2020) looked at nonresource-intensive interventions to optimize self-management of diabetes not requiring face-to-face contact during COVID-19. These interventions generally fall into four categories: (1) text-message; (2) mobile phone app; (3) web or computer-based; and (4) monitoring of blood glucose. The conclusion for now appears to that text messaging is one of the better approaches for managing blood glucose.

Use of Mobile Phone for Diabetes Management During COVID-19 in Rwanda

So how does this impact a country like Rwanda? Rwanda is one of the Sub-Saharan African countries with the highest mobile phone coverage at 98% ³ and these devices are very useful in everyday life. A mobile phone is more indispensable during the COVID-19 because of the related lockdown. Early this year, the President of Rwanda launched a smart phone access challenge ⁴ in collaboration with an Indian company (Mara Phone Factory) based in Rwanda.

Besides the usual means of communication, telephones are used to spread official announcements and news such as the lockdown and number of COVID-19 cases. They are also used by health officials to spread factual information on the disease.

For youth and children with type 1 diabetes (T1D) in Rwanda, mobile phones are even more important because of the precaution needed to avoid becoming infected with SARS-CoV-2 and making sure they control their blood sugars. People with diabetes need tighter blood sugar control during this pandemic because when someone gets infected with COVID-19 and has a high blood sugar, the complications appear to be more severe. ⁵

Mobile phones are also used for fundraising to support those who are in most need or money exchange and that is important during lockdown when most businesses are closed. They are used for online shopping for home delivery/take away without touching cash, and therefore, contributing to prevention of COVID-19. This has been a source of income to many people without leaving their houses. (Sounds a bit familiar to the United States).

Patients (parents/guardians) use phones to communicate with their health care provider (HCP), such as by booking for appointments or addressing any health concern. Likewise, HCPs also use phones to communicate with their patients. There are also diabetes educational programs available on phones accessible in local languages. ⁶

We believe that mobile phone is a crucial tool in people’s lives, and there should be an effort to increase their access to the general public in prioritizing the chronic diseases, such as T1D, especially during a pandemic like the one we are experiencing.

Case Study

One of us (LS) set up a WhatsApp Group in Rwanda that included nurses in charge of diabetes from all district hospitals (42) and T1D group leaders to gather information, challenges, and solutions around the country. It is also being used as a fundraising tool to assist those who are experiencing more challenges. We have also used this method to pay health insurance also known as mutuelle de sante ⁷ to five individuals and that is helpful because their diabetes care is more affordable. Instead of paying $20 a month, they only need $2 for two vials of insulin. With WhatsApp, we also receive the information on the current status of medical supplies at each hospital and relay the message to senior health officials who then authorize a new delivery.

The true power of the mobile phone is mostly untapped at this point by society. However, events like the COVID-19 pandemic will give rise to more innovative applications not only for people with diabetes but for patients dealing with the range of illnesses around the world.