In early 2015, billionaire philanthropist and Microsoft founder Bill Gates aroused the global media’s curiosity when he coolly sipped water made from human faeces. He said tests were ongoing to begin poop processing plants around the world.
Three years later, on November 2018, Mr Gates hit the stage at the Shanghai Reinvented Toilet Expo event. In his hand was a glass jar of poop, human faeces.
In his speech with the jar beside him, Mr Gates said the faeces therein could contain as many as 200 trillion rotavirus, 20 billion shigella bacteria and 100,000 parasitic worm eggs.
Rotavirus is a contagious virus and the most common cause of diarrhoea in infants and children worldwide, with an estimated over 200,000 deaths annually. Shigella is a family of bacteria which is passed through stool, contaminated food, drinking or swimming in contaminated water. They cause an intestinal disease in children leading to bloody diarrhoea. Parasitic or intestinal worms are nasty; they feed on human beings, commonly as tapeworms and hookworms. They cause stomach upsets, nausea, abdominal pain and many other ailments.
All the above have one thing in common, poor sanitation. But what, pray, is the connection with a tech billionaire?
“Any problem… I will look at how technical innovation can help solve that problem. It’s the one thing I know and the one thing I’m good at.”
Ever since retiring as chairman of tech giant Microsoft, Mr Gates has been seeking to change the world through the Bill & Melinda Gates Foundation. In a 2019 Netflix documentary, Inside Bill’s Brain: Decoding Bill Gates, Mr Gates expresses his shock by a 1995 article that shows that children are still dying of diarrhoea in most areas of developing countries. He sets out to find a solution to change this. The solution, says Mr Gates, lies in technology and innovation, as he believes that it is the answer to 21st Century problems, from sanitation, nuclear energy to climate change.
He then sets out in 2011 to fund universities, scientists and organisations to the tune of US$200 million (about Ksh20 billion), challenging them to design an affordable toilet that can solve the world’s sewage menace. This is based in his belief that it will be more expensive to build sewers and toilets for emerging cities and slums already in existence but which lack sanitation facilities such as flushing basins.
Thus the Shanghai expo, which showcased 20 bacteria-fighting innovations. Mr Gates also worked with Peter Janicki of Janicki Industries, an engineering and manufacturing company, whom he challenged to come up with an innovation that could solve the world’s death-causing poop problem. Mr Janicki developed the Omni Processor, which turned human waste to clean drinking water, and which Mr Gates coolly drunk in full glare of the cameras.
In the Netflix documentary, Mr Janicki explains how the Omni Processor, which took him and a team of engineers 18 months to develop, works.
“You empty all the pit latrines, and instead of dumping the waste in the rivers (before this is a graphic display of how the sewage is emptied from pit latrines around the developing nations, dumped in sewers and rivers in slums where people live and actually fetch water for drinking and cooking), you put it in a central place”. The processor has a centralised location, which evaporates the water.
The dirty water is put through a cleaning system to produce drinking water.
The remaining solids are burned in a fire, generating steam is used to generate electricity, and which in turn runs the Omni Processor. The by-product of the human waste is clean water, electricity and ash. The process doesn’t use outside energy. It generates its own energy – clean, green energy, which saves the planet from the effects of warming as a result of greenhouse gases.
“The water tasted as good as any I’ve had out of a bottle,” wrote Mr Gates in his blog, “and having studied the engineering behind it, I would happily drink it every day. It’s that safe,” he added.
The Omni Processor has been in use in Dakar, Senegal, since May 2015, reaching about a third of the population.
So what’s this to do with Universal Health Coverage?
Though what has been described above is more of a technical innovation, the world is moving fast to digital technology and innovations that will change the future of all human experience, including in medicine and health.
Indeed, we are moving fast into the fourth revolution. The third revolution used electronics and information technology as described above. The second revolution used electric power which led to mass production, while the first harnessed water and steam to mechanise production.
According to an article by the World Economic Forum, the fourth industrial revolution is building on the third. It is the digital revolution that has been occurring since the middle of the last century. It is characterised by a fusion of technologies and is blurring the lines between the physical, digital and biological spheres.
At its centre is knowledge shared in real time, since the digital revolution is fuelled by fast Internet connectivity and mobile phone networks. This technological revolution has been defined as disruptive, that is, it starts slowly, like a simple application, and then integrates in the market to push off established systems, habits and brands with superior alternatives.
Examples include taxi-hailing mobile apps like Uber or Bolt. Another example is Airbnb, where homestays have been taken online, threatening the existence of traditional hotels as we know them.
The fourth revolution will be built, nay, is being built, around IoT, that is the Internet of Things, where digital and mechanical devices are increasingly connected and send data without human-to-human interactions, It includes innovations like autonomous or self-driven cars, nanotechnology, biotechnology, artificial intelligence (AI) and robotics.
Indeed, today, robots are already in use in hospitals, where they assist in surgery through non-invasive tiny incisions instead of inches-long incisions common with traditional surgery. Robots and AI are said to be more accurate than human beings. A recent study by researchers from Google Health and Imperial College, London found that a computer algorithm outperformed six radiologists in reading mammograms. They had designed and trained a computer model on X-rays from nearly 29,000 women. Traditionally, it takes two radiologists to analyse each woman’s X-rays. The human experts also know the woman’s history to help them in diagnosis, but the AI model was not given such privilege. Regardless, it was as good as the double readings of the radiologists.
Robots are already being used to relieve medical personnel of some routine duties, like monitoring patients’ vitals and alerting medical personnel in case there is need for human interaction.
In countries like Japan, the government invested in robots as early as 2013, allowing the health ministry to roll out a programme designed to meet workforce shortages and help prevent injuries by promoting the use of nursing care robots that assist with lifting and moving patients. This is according to Louise Aronson in an opinion piece for the New York Times.
Aronson noted that, “A consortium of European companies, universities and research institutions collaborated on Mobiserv, a project that developed a touch-screen-toting, humanoid-looking “social companion” robot that offers reminders about appointments and medications and encourages social activity, healthy eating and exercise. In Sweden, researchers have developed GiraffPlus, a robot that looks like a standing mirror-cum-vacuum cleaner, which monitors health metrics like blood pressure and has a screen for virtual doctor and family visits.”
This is a demonstration that the world is geared towards digital revolution. It is a wake-up call for Kenya to invest in the same if the country is to achieve the Universal Health Coverage vision. This is in addition to improving the economic livelihoods of citizens, especially the youth, who stand to lose a lot if they are not re-educated with 21st Century digital skills.
But there is hope. Already there are many government-led, or public-private partnerships, and civil society, NGO-led investments which are taking advantage of technology to achieve healthcare in Kenya.