Arthur Zang split the heart exam in two so a village clinic could borrow a cardiologist

Cameroon's heart patients faced a brutal arithmetic: a country of some 22 million people had a few dozen cardiologists, almost all clustered in Yaoundé and Douala, while half the population lived in rural villages hours from either city. A patient with chest pain in the bush could travel a day to see a specialist, or more likely never see one at all. The official answer was to train more cardiologists, but that pipeline takes the best part of a decade per doctor and deposits its graduates back in the same two cities.

Arthur Zang was still a student at Yaoundé Polytechnic in 2009, writing a thesis on sending heartbeats over wireless networks, when he took the problem personally — he had grown up in a village, and an uncle had died of heart disease. He consulted Samuel Kingué, a cardiologist in Yaoundé, on what an exam actually required, first loaded his software onto an off-the-shelf tablet, then decided to build the hardware himself: a touchscreen device tough enough for humidity, unpaved roads and power cuts. In December 2011 he filed a patent (OAPI No. 16213) and founded Himore Medical to produce it.

Split the exam: a nurse runs the ECG on a tablet, the reading travels by mobile network to a city cardiologist, and the diagnosis returns in 20 minutes.

The exam's mechanical half is easy to learn, so a nurse can do it on site.

The interpretive half needs a cardiologist, but data travels cheaply over existing mobile networks.

One cardiologist can read for many villages, multiplying the reach of a fixed specialist stock.

The 20-minute round trip keeps the reading relevant to the patient in front of the nurse.

When scarce experts can't be everywhere, split the task into a mechanical part a generalist can do and an interpretive part only the expert can, then move only the data.

By 2020 the pad ran in about 100 Cameroonian hospitals and five other countries, with 9,800 remote exams read by twenty cardiologists. Zang was named a Rolex Awards Young Laureate in 2014 and won the Royal Academy of Engineering's Africa Prize for Engineering Innovation in 2016. Himore Medical, founded to make the device, grew to about fifteen employees and exported the pad to Comoros, Gabon, Guinea, Kenya and Nepal — one Cameroonian answer to a shortage that most health systems try to close by training, slowly, more specialists.