Strengthening Rural Health Through Digital Herd Management: Fighting Brucellosis in South Africa Effectively

Whittlesea is a rural gem just 20 minutes outside Komani, or as the world used to call it, Queenstown, and about 1.5 hours from my home township in Dimbaza. The highlands here revolve around agriculture and livestock, much like where I grew up.

My medical training often led us into rural settings during our community health rotations, and I would often think about home. One experience that stands out is an obstetric grand round where we discussed potential complications in rural obstetrics. Never did I expect the unassuming hillsides of the Ciskei would later influence my medical training.

We had a brilliant OBGYN consultant who was a master at pushing us beyond the textbook medicine. On this particular day, he decided to throw us into the deep end with a pop quiz. The usual answers came quickly: preeclampsia, postpartum haemorrhage, etc.

But I remembered something from life in these rural areas and thought of brucellosis—a zoonotic disease common in communities where livestock and humans closely coexist.

"Brucellosis," I said. There was silence. (city folk don't know these things 😅), then, the consultant nodded, giving me a look of recognition. That moment was a subtle but powerful reminder of how intertwined our lives are with the land and its creatures, sparking my curiosity about the concept of One Health.

That memory is particularly relevant now as I reflect on a study by Cloete et al [1] conducted in Whittlesea, which sheds light on the state of knowledge, attitudes, and practices regarding bovine brucellosis among local cattle keepers. The survey involved 227 cattle keepers and revealed some concerning gaps. Although many respondents had heard of brucellosis, their understanding of the disease was limited.

The knowledge scores told a story of their own: a primary peak at 0/18—essentially no knowledge—and a secondary peak at 5–6/18. This uneven spread highlighted the need for more awareness.

Despite the mixed knowledge levels, there was a strong desire to know more, with the median attitude score at 7/14. However, practices around managing brucellosis were concerning, ranging from consuming raw milk and handling cattle birth materials without proper precautions. These practices increase the risk of brucellosis transmission, not just among cattle but potentially to humans as well.

This circles back to the importance of a One Health approach, which emphasizes the interconnectedness of human, animal, and environmental health. The findings from Whittlesea highlight the need for better education and resources to prevent zoonotic diseases like Brucellosis.

Digital health solutions are an effective and affordable way forward. A mobile app designed specifically for cattle herders could provide relevant and timely information on diseases like brucellosis. Kenya's iCow app, launched in 2011, has been a success, offering farmers a cow gestation calendar and access to vets and livestock markets across Kenya. Yet, there's little evidence of its uptake (or something of similar success) in South Africa—a missed opportunity, if you ask me.

Beyond just education, an app could assist herdsmen through a digital logbook for tracking cattle health status and vaccinations. How about a digital logbook for tracking cattle health and vaccinations? This data, shared with local animal health departments and veterinary services, could act as an early warning system, flagging potential outbreaks - similar to the Electronic Vaccination Data System (EVDS) developed during the COVID-19 pandemic.

The study reminds us that improving health in these areas requires a holistic approach, one that blends education, technology, and community engagement. It’s undoubtedly clear that in rural communities, the health of humans and animals is closely linked. Digital health serves as the bridge through which we close the knowledge gaps and empower rural communities across Africa.

With simple, cost-effective tools, we can provide the education and resources needed to prevent and manage zoonotic diseases like brucellosis. When we uplift these communities, we transform the health landscape of the continent.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6407466/