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Growing up in South Africa at the turn of the century, Emma Gibson saw the rise of the HIV/AIDS epidemic and its devastating impact on her home country, where many people lacked life-saving health care. At the time, Gibson was too young to understand what a sexually transmitted infection was, but she knew that HIV was infecting millions of South Africans and AIDS was taking hundreds of thousands of lives. “As a child I was terrified of this monster that was HIV and felt so powerless to do something about it,” she says.

Now, as an adult, her childhood fear of the HIV epidemic has turned into a desire to fight it. Gibson seeks to improve health care for HIV and other diseases in regions with limited resources, including South Africa. She wants to help healthcare facilities in these areas use their resources more effectively so that patients can receive care more easily.

To achieve her goal, Gibson sought mathematics and logistics training through higher education in South Africa. She first earned her bachelor’s degree in mathematical sciences at the University of the Witwatersrand, and then her master’s in operations research at Stellenbosch University. There she learned to approach complex decision-making problems with mathematics, statistics and computer simulations.

During her master’s, Gibson studied the operational challenges faced in rural South African health facilities by working with staff at Zithulele Hospital in the Eastern Cape, one of the poorest provinces in the country. Her research focuses on ways to reduce hours-long wait times for patients seeking same-day care. In the end, she developed a software tool to model patient congestion throughout the day and optimize staffing schedules accordingly, so the hospital could care for its patients more efficiently.

After completing her master’s, Gibson wanted to continue her education outside of South Africa and left to pursue a doctorate in operations research at MIT. Upon arrival, she immersed herself in her research and worked on a project to improve breast cancer treatment in US health care, a very different environment than what she was used to.

Two years later, Gibson had the opportunity to return to health care research in resource-limited settings and began working with Jónas Jónasson, an associate professor at the MIT Sloan School of Management, on a new project to diagnose To improve services in sub-Saharan Africa. . For the past four years, she has worked diligently on this project in collaboration with researchers from the Indian School of Business and Northwestern University. “My love language is time,” she says. “When I invest a lot of time in something, I really appreciate it.”

Diagnostic testing is an essential tool that allows medical professionals to identify new diagnoses in patients and monitor patients’ conditions as they undergo treatment. For example, people living with HIV require regular blood tests to ensure that their prescribed treatments are working effectively and to provide an early warning of potential treatment failures.

For Gibson’s current project, she is trying to improve diagnostic services in Malawi, a land-locked country in Southeast Africa. “We have the tools” to diagnose and treat diseases like HIV, she says. “But in resource-limited settings, we often lack the money, staff and infrastructure to reach every patient who needs it.”

When diagnostic tests are needed, clinicians collect samples from patients and send the samples to be tested in a laboratory, which then returns the results to the facility where the patient is being treated. To move these items between facilities and laboratories, Malawi has developed a national sample transport network. The transport system plays an important role in linking remote, rural facilities with laboratory services and ensuring that patients in these areas have access to diagnostic tests through community clinics. Samples collected in these clinics are first transported to nearby district hubs, and then forwarded to laboratories in urban areas. Because most facilities do not have computers or communication infrastructure, laboratories print copies of test results and send them back to the facilities through the same transportation process.

The sample transport cycle is difficult, but it is a practical solution to a difficult problem. “During the Covid pandemic, we saw how difficult it was to build diagnostic infrastructure,” says Gibson. Diagnostic services in sub-Saharan Africa face “similar challenges, but in a much poorer setting.”

In Malawi sample transport is managed by a  non-governmental organization called Riders 4 Health. The organization has approximately 80 couriers on motorcycles that transport samples and test results between facilities. “When we started working with [Rider], couriers operated on fixed weekly schedules, visiting each site once or twice a week,” says Gibson. But that led to “a lot of unnecessary travel and delays.”

To make sample transport more efficient, Gibson has developed a dynamic scheduling system that adapts to the current demand for diagnostic tests. The system consists of two main parts: an information exchange platform that aggregates sample transport data, and an algorithm that uses the data to generate optimized routes and schedules for sample transport couriers.

In 2019, Gibson conducted a four-month pilot test for this system in three of Malawi’s 27 districts. During the pilot study, six couriers transported over 20,000 samples and results across 51 healthcare facilities, and 150 healthcare workers participated in data sharing.

The pilot was a success. Gibson’s dynamic scheduling system eliminated about half of unnecessary trips and reduced transportation delays by 25 percent—a delay that used to be four days was reduced to three. Now, Riders 4 Health is developing their own version of the Gibson System to operate nationally in Malawi. During this project, “we focused on making sure this was something that could grow with the organization,” she says. “It’s gratifying to see that actually happen.”

Gibson will complete his MIT degree this September, but will continue to work to improve health care in Africa. After graduation, she will join the technology and analytics healthcare practice of an established company in South Africa. Her initial focus will be on public health care institutions, including Chris Hani Baragwanath Academic Hospital in Johannesburg, the third largest hospital in the world.

In this role, Gibson will work to fill gaps in African patient data for medical operations research and develop ways to use these data more effectively to improve health care in resource-limited areas. For example, better data systems can help monitor the prevalence and impact of various diseases, guiding where health workers and researchers put their efforts to help the most people. “You can’t make good decisions if you don’t have all the information,” says Gibson.

To best leverage patient data to improve health care, Gibson plans to reevaluate how data systems are structured and used in the hospital. For ideas on upgrading the current system, she will look to existing data systems in other countries to see what works and what doesn’t, while also drawing on her past research experience in US health care. Finally, she will tailor the new hospital data system to South African needs to accurately inform future directions in health care.

Gibson’s new job – her “dream job” – will be based in the UK, but she expects to spend a significant amount of time in Johannesburg. “I have so many opportunities in the wide world, but those who call me are always back at the place I came from,” she says.

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