COOL! VR Pain Relief A First in Uganda

Torin Lucas, Firsthand Advisor (UK)
May, 2017

Read: Howard’s Comments (LinkedIn)

The invitation to collaborate with an African University really came out of the blue. Like most us in the West, Africa paints a picture for me. It conjures up a leafy jungle imagery interrupted by fantastic hopscotch steps over crocodile heads bobbing like foot stones across a lagoon. I have a collection of family photographs taken during the Ugandan civil war when my parents were doctors attached to a Canadian Aid mission.  I have one favourite photo with me and my mum and a few African friends. I was a baby.  There was a war. This was Africa. Parents did that sort of thing back then. It was the 70s!

I received a late night email from my Father around Christmas to say that he’s going back to Uganda. With all the jungle adventure imagery floating in my mind I replied to the email to say, “I’m coming”.

I was put in touch with Jones Murangira, head of IT at the University.  Jones and I quickly saw the potential of my bringing the bag of skills that I’ve assembled over the years in technology management and developing university curriculum. We drafted a quick agreement and arranged with the Chancellor to sponsor my collaborative visit. It was set. I was going and I was very nervous. My main concern was the potential of becoming swamped by the sheer magnitude of the challenges I was likely to face. The leafy jungle imagery was fast being replaced by dreams of out-stretched hands.

But together Jones and I had developed a solid plan. I was being asked to provide technical consultation for the development and training of computer assisted teaching, use of e-learning and the development of computer literacy curriculum for the University’s graduate Communication program. But my other mission was to introduce Firsthand Technology and VR pain relief. My Father’s work in the anaesthesia department and my work with IT made a really perfect storm – you might call it a VR storm.

I landed late at night in Rwanda in a prop plane with a backpack full of computer equipment. You might be thinking, not my idea of a safe holiday. I found Milton the taxi driver waiting outside waving a cardboard sign with the words ‘Torin Lucas’. This was a very good sign. If anyone were to ask now whether I’d recommend Milton to trust with their life to drive over the Virunga Volcanic Mountain range in the dead of night I’d say, “Yes sure. Why not? Milton is trustworthy, helpful, speaks Rwandan, Rukiga and passable English, and definitely drives straighter on the left-hand side of the road (on the Ugandan side of the border).

In the light of day, Uganda was full of color, very welcoming, and yes has lots of need and want. But somehow what I was able to accomplish made a difference. I quickly came to learn that while there is suffering and want, challenges that make simple tasks difficult, actually making a contribution is quite easy. This is the wonderful thing. And technologies such as the Firsthand approach to pain will have a way of leapfrogging the people of Africa forward quite quickly. It’s exciting. And it was obvious to me that the members of the IT department were delighted by the experience of exploring the VR environment. They were quick to see its potential and both willing and keen to see it introduced to the doctors on the Medical side of the University.

The current health care situation in Uganda and throughout Central Africa remains rudimentary and physician anaesthetists are scarce and simply not available at first referral level health facilities. In fact, according to the World Health Organization Dr. Henry Bukwira is one of only thirteen anaesthetists (excluding expatriates) in the country of 27 million people. In comparison, in the United Kingdom of Great Britain and Northern Ireland there are 12,000 physician anaesthetists for a population of 64 million. These are stark numbers making any alternatives to traditional medical solutions essential. One approach to meeting the overwhelming need is training anaesthetic nurses. A focussed vocational approach to training nurses has achieved good success through Dr. Bukwira’s work, first during his time in Rwanda, and now through the new anaesthetics nurses program at Kabale University.

In this context, any serious non-drug approach to pain remediation like the Firsthand ‘Cool’ intervention holds a very promising alternative to acute pain management. The needs are  obvious and despite the many logistical challenges, the potential here for creating a positive lasting contribution through this technology is very exciting.

Torin gives Dr. Jones Murangira his first VR experience – and his first experience of snow!

While the positive potentials presented by the Firsthand solution are clear, the logistical and cultural challenges remain. This would include reliable access to power outlets and perennial power outages – especially problematic during the rains. Power outages are a problem throughout Uganda, but are minimized in some cases with the use of battery-bank backups. Computer literacy is also a real challenge making the administration of a multimedia equipped computer and VR technologies a technical support challenge. On the cultural side, the representation of snow within the ‘Cool’ simulation, while indicative of coolness to many of us, is not necessarily familiar to a Central African –  yes, many will simply never has seen or felt snow. This seems obvious to me now, but I have my own entrenched Western perspective. It’s great when Africa knocks your assumptions like that! The rendering of a 3D environment is also a novelty for many Africans whose exposure to mediated computer environments may not extend beyond their mobile handsets. Neither of these cultural aspects necessarily minimize the effect of the VR experience and its potential from a clinical point of view, but the cultural divide certainly made for an amusing challenge that everyone could laugh about.

There’s a sense of movement forward. There’s an accelerating growth in Uganda and you can feel it. The growth of mobile technologies in particular will allow this country to leapfrog infrastructure what took the West many decades to develop. Opportunities are growing and there’s a vast well of optimism, among the youthful population especially. Life is not mediated here through a device or a technical support call.  That was a strong, lasting impression for me. People talk to one another. Solutions are found through collaboration. They reach out to involve those who are ready to help. The needs are so great, it’s hard not to make a positive impact. We will bring Firsthand technologies to Africa, because we can. And the Ugandans themselves are ready for it with open arms.

– Torin