Piachat: A Spanish-Wayunnaiki app for health services

The Wayuu are an indigenous group that lives in northern Colombia and northwestern Venezuela. Throughout history, this indigenous group has suffered from multiple hardships including colonial persecution, drug trafficking, exploitation of natural resources without their consent, famine, displacement, lack of potable water and basic commodities, and abandonment by both states. All these causes together have put their community members at a disadvantage in accessing health services, which has been exacerbated by the pandemic. Often, many children and elderly people die due to a lack of medical care.  

Although Article 9 of Colombian Law 1381 of 2010 stipulates that indigenous communities must receive medical care in their native language, this is far from reality. Language and cultural barriers are major obstacles for the Wayuu to be understood by Spanish-speaking medical personnel; on the other hand, many older people in the community have difficulty understanding medical instructions in Spanish. In addition to the above, another difficulty in this area is the ignorance or lack of appreciation of Wayuu traditional medicine by medical personnel. All those difficulties lead many community members to stay away from medical centers, feel resentful and, on many occasions, deteriorate their health, causing additional risks in the case of infectious diseases. 

Piachat is an innovative digital platform designed to improve communication between Spanish-speaking medical personnel and monolingual indigenous Wayuunaiki patients. Its functions include translating from Spanish to Wayuunaiki and from Wayuunaiki to Spanish, offering options on vocabulary related to diseases and health problems in both languages, storing and reporting information on medical visits and follow-up, providing recommendations on healthy habits, and providing reminders on medications and healthy habits.  This technological tool contains an interface created with FIGMA and Adobe XD software, which are editing tools for graphics and prototypes that facilitate collaborative and interactive work. These programs allow the generated results to be subjected to validation and testing to improve the interaction process. In addition to the above, the program includes a mobile application created with easy-to-develop technology such as Flutter and the back-end systems written in Python and front-end developed with HTML and Javascript. Overall, this system will be deployed in the cloud using Microsoft Azure.     

The following link shows some photos of the app:

Photos of the app

Describe the target population whose lives you are working to directly and meaningfully improve. Who are they, and in what ways are they currently underserved? How will the solution address their needs?

This project will be very useful for Wayuu speakers who are not fluent in Spanish. Although this technological tool is aimed at the group of Wayuu living in the areas surrounding Barrancas, Colombia, it is hoped that it can later be implemented in other more distant Wayuu populations who currently have very restricted access to technology. The Piachat program will impact the lives of the Wayuu because it will allow them to communicate with medical personnel avoiding the frustration of not being understood and minimizing the risk of being misunderstood.  

In addition to the above, it is expected that its functionality and reminders will help the Wayuu to acquire the prevention of coronary, renal, digestive,  diseases, etc. Along the same lines, this technological tool is expected to promote respect for traditional Wayuu medicine by including some of their most efficient traditions among the recommendations.

Finally, Piachat will have an impact on the appreciation of the Wayuu community by highlighting the importance of their language and knowledge and not the imposition of the Spanish language as a means of communication. The development and use of this tool will highlight the importance for the scientific and medical community to work on more inclusive initiatives in favor of the most ignored groups today. 

Our team is well equipped for the development of this project since it involves experts with experience working with languages and technology, language and society, health sciences, computer science, and graphic design.  

Drs. Heidy Robles (PI), Miguel Jimeno, and Karen Villalba have invaluable experience developing web applications to improve the learning and use of languages in disadvantaged communities such as the deaf, dumb, and visually impaired groups. In previous works, these researchers have successfully implemented strategies and developed applications so that members of  groups can benefit from inclusive education. 

Drs. Rafael and Tania Acosta have participated in health and nutritional projects for vulnerable groups, including the Wayuu communities located in and around Barrancas, La Guajira, Colombia, where this project will be carried out. Their work has focused on identifying and analyzing risk factors for diabetes and malnutrition in rural indigenous communities. Through these initiatives, the researchers have been able to establish a close relationship with members of the Wayuu community. 

In the same line, Dr. De La Rosa and Wendy Valdez have been working on sociolinguistic, descriptive, and bilingualism Wayuunaiki-Spanish projects with diverse Wayuu communities for the past three years. Their research and cultural activities have promoted a good relationship between members of the academic community of Universidad del Norte and the Wayuu people. 

Dr. Paola Harris is also of vital importance to our project due to her experience in the creation of interfaces in cultural and social digital projects. Her knowledge of digital interfaces is very useful for the creation of the application that is part of this project, as it will focus on interactive relations between doctors and patients. 

Our team is characterized by their specialized skills and knowledge, experience in the administration and implementation of projects, and a high degree of commitment to improving the quality of life of marginalized communities. This group is fully coordinated and projected in the realization of this initiative. 

This could include the number of individuals that have visited a center or clinic you run, the number of people who have purchased your product,or the number of users that use your platform.

According to previous inquiries by the medical staff that are part of this group, it is estimated that there are approximately 700 people, over 60 % who come to the health center for chronic diseases. This figure corresponds to approximately 40 families. 

The adaptation pilot implemented in the nearby city of Barranquilla in 2020 showed that about 60% of the patients, who are monolingual speakers of Spanish, agreed to participate voluntarily in the pilot. This participation also included 4 physicians who participated voluntarily and with an optimal degree of commitment. 

We estimate that in the case of the Wayuu indigenous communities there may be a very good participation from their community due to the linguistic difficulties to interact in Spanish, their interest in technology and the closeness of our staff with the community. 

One of the main reason is that Solve provides connections, support, tutoring and follow-up to successfully develop our project. We consider that the strong connections that Solve promotes maybe crucial to enrich the development of this initiative. In addition, Solve may make our project gain visibility and respect to implement it later in other similar fragile contexts. 

Finally, we consider that participating in this call is a good opportunity to make our indigenous communities problems more visible. This type of proposals will lead other researchers to focus their attention on marginalized groups from global south.

Although different digital proposals have been used in other contexts, our technological tool has never been used with the Wayuu community or with any other indigenous group in Colombia. It is an innovative solution that can bring health centers closer to the Wayuu community and reduce the communication gap that exists between them.  

In addition to the usefulness for patient-doctor communication, the functionalities of the application and the platform allow, on one hand, that patients can receive reminders about medical appointments and medications, as well as tips on habits that help improve health. 

On the medical staff's side, the innovative aspect of this application consists of providing information on the patient's adherence to non-pharmacological controls and receiving information that can improve diagnoses. 

We believe that the implementation of this project can change the market in the sense of promoting the emergence of more tools that can improve the quality of medical care for vulnerable populations. The rise of this type of technology can lead to government and foundation investment in this field. In this sense, supply can promote demand from the state and from companies seeking to contribute to the benefit of vulnerable groups. It is hoped that these technologies can be made accessible to the needy and that they do not end up being mere innovations that fail to be widely used for the benefit of society. Therefore, it is important that state and private investment be induced as soon as these tools demonstrate their operability. 

To improve the communication between Wayuu patients and their doctors, the app will provide Spanish-Wayuunaiki and Wayuunaiki-Spanish translations. In addition, it will present vocabulary and symptom-based options for the patient and the doctor to communicate. The app's impact will be measured with surveys and satisfaction scores. 

The adoption of good physical and nutritional habits, the reduction of cardiovascular disease, and control of morbidities will be promoted through daily tips provided in the app. Its impact will be measured with information that the app will collect on improvements in weight, symptoms that appear during the time of the implementation, and information on the adoption or not of the recommended tips. 

Regarding the contribution to the follow-up by physicians, the app and the platform will provide information that doctors may use before the diagnosis. Its impact will be measured by sending surveys to doctors and interviewing them in different phases of the project. 

• Outcome 

  Indicator 

  Improvement in communication between patients and medical personnel 

  • Levels and Rates of patients and physician´s satisfaction 

  • Personal comments about the way that the app and platform improved communication 

  • Number of visits and views to the platform, the app, and the health center. 

  Adoption of dietary and physical habits 

  • Number and percentage of patients reporting the adoption of dietary and physical habits. 

  • Duration of new habits. 

  Reduction of cardiovascular disease 

  • Number and percentage of patients who report cardiovascular problems. 

  Control of morbidities associated with diabetes 

  • Number and percentage of cases with morbidities. 

  Patient´s follow-up by physicians 

  • Reports and comments by medical staff about the quality of data to follow up medical cases. 

  • Numbers and percentages of physicians who continue with the follow-up. 

• Our project focuses on three of the sustainable goals promoted by the UN: 

  
  

  • Promote peaceful and inclusive societies for sustainable development, provide access to justice for all, and build effective, accountable and inclusive institutions at all levels: Helping to improve the relationship between indigenous patients and medical personnel generates social justice since the marginalized indigenous community is valued, accompanied and may be well-served. Medical centers in the zone may gain more stability and prestige as providers of inclusive service to the community. In the long-term path, this project may encourage other members of society to pay more attention to other members of the community who have been marginalized for centuries. 
  • Reduce inequality within and among countries: In this case, this project will contribute to reducing the social gap between indigenous communities and more favored communities in terms of medical service. This type of initiative attracts more investors and leaders who can help generate changes in society. The replicability of projects like these in other countries may be a collateral effect in favor of vulnerable populations throughout the world. 
  • Ensure healthy lives and promote well-being for all at all ages: The adoption of healthy habits in the community may contribute to well-being and health in the indigenous population. In this sense, learning to eat healthy food and exercise continuously will lead to improvement of health and keep a better quality of life. 

If we use technology for the interaction between the Wayuu community and the medical staff, we will improve the relationship between both groups, encourage the adoption of healthy habits in the population and establish more efficient follow-ups by the medical staff. All the above will have an impact on the reduction of health problems such as cardiovascular problems and morbidities associated with diabetes and the generation of trust between medical personnel and patients. In turn, these results will contribute to the creation of a more inclusive and peaceful environment in the region. 

To confirm the achievement of the indicators included in the previous question, data generated by the application and the platform (number of visits, number of visualizations, satisfaction surveys, weight reports and recommended activities), surveys of medical personnel and interviews with people from the community will be used. 

Piachat consists of the use of a platform and an app to improve the interaction between Wayuunaiki-speaking patients and Spanish-speaking medical staff. This will be the first time this type of technology will be used with this population. Its operation is user-friendly and compatible with the Wayuu community's cell phone systems. Its functionality allows not only interaction between both languages but also to receive reminders and tips from patients and follow-ups from doctors. The platform and the app are supported by an interface created with FIGMA and Adobe XD, which allows the interaction to be facilitated. The app and the platform contain an avatar that simulates the process or regression of the patient as he/she advances with his/her treatment. In addition to the above, we complement the functionality of the system through Flutter and back-end, written using Python and developed with HTML and Javascript. The Microsoft Azure cloud is used for its operation. All this technology is user-friendly and efficient. Its operation will allow the necessary data to be collected so that doctors can make a strategic follow-up of their patients. 

In line with the university's statement on promoting an inclusive environment, our group is strongly committed to social inclusion, appreciation of diversity, and the promotion of social equity for the benefit of the community. Our university offers continuous workshops to raise awareness about the importance of appreciating other cultures and the need to work for equity in our society. Our approach is based on participatory research with the inclusion of community members.

Our group of experts is characterized by the commitment to incorporate findings and new technologies in projects focused on vulnerable populations. To do this, we conduct fieldwork and communicate directly with members of the community of study, identify problems, suggest possible solutions together to generate equity and measure the impact of those solutions within the population. In this way, we ensure that the solutions are appropriate to the community and that its members feel that they have been included in the solution, and that we value them as part of diversity. We are committed to share our innovative tools to be used in other vulnerable communities. 

Our model is based on offering a non-profit service that brings benefits to the indigenous Wayuu community and that can be sustained over time with the help of other organizations. In this line, all money raised in the future will be reinvested in the operation, improvement and expansion of the use of the platform and the app.  

Because we focus on a marginalized and economically and socially disadvantaged community, we hope that this project will not only allow a more inclusive treatment of the Wayuu at the medical level but also that the importance of this indigenous group will be recognized by the community. An impact is expected at the level of communication between Wayuu patients and medical staff, in the dietary and physical habits of indigenous people, and individualized support through the app and the platform.  

Despite being a community with scarce resources, the Wayuus are very open and enthusiastic about using technology. We can often see them making use of social networks, online search engines, instant messaging, and cell phone calls. We are confident that the community will be pleased to have an app and platform geared towards them in their own language and culture. It is expected that the implementation of Piachat will generate good acceptance in the community and that it will help to promote Wayuu health. It is very likely that the use of these tools will help them feel more included in society and that their use will help them become aware of the importance of healthy habits and good medical care. 

To achieve long-term sustainability of this project, and to extend it so that other indigenous communities in the region can benefit from the new technology for interaction with medical personnel, we have identified some possible sources of funding, which we mention below. 

On the one hand, we will encourage the medical personnel in the health centers to adopt the maintenance of the system and promote a long-term use of it.  

We will also seek the support of companies in the region interested in financing social projects such as Glencore, which manages the Cerrejón Mine in the Colombian Department of La Guajira and reinvests royalties in favor of the communities.  

Another possibility is to seek financial resources through regional royalties administered by the Colombian Ministry of Science, Technology and Innovation (Minciencias). Once the project has matured in operability, it will be easier for us to apply for national resources. 

The sustainability of this project might be based mainly on one of the first two options or a combination of several of them. 

Our team has extensive experience in fundraising for research and community work. The following are some examples: 

Thanks to EPICS in IEEE (Engineering Projects in Community Service) in 2022, Professor Jimeno, Villalba and Robles won a grant to work on the development of an English learning app for visual impaired students (public school). EPICS  develops effective solutions to transform vulnerable communities. The support received was US $5000. Besides, Professor Robles and Villalba received more funds (US $ 4.900) to extend the development of the application to university students. 

In 2019 Professor Rafael Tuesca and Tania Acosta received a US $ 4.667 grant from Promigas (an energy company in charge of natural gas transportation) to create and implement the pilot software on which this project draws. Previously, Professors Rafael Tuesca and Tania Acosta had received another grant for a different medical project financed by El Cerrejón, Colombia (US $ 67.000). 

In 2020-2021, Professor Johan De La Rosa obtained resources through the research agenda at the Universidad del Norte to carry out research work on bilingualism and contact between Spanish and Wayuunaiki in the Colombian Guajira. The support received was approximately US $ 4,900. Previously, during his doctoral studies, he had secured funding from the journal Language Learning (US $2,000), the Center of Liberal Arts (US $2,500; Penn State) and the Center for Language Science (US $3,500) for other sociolinguistic studies with marginalized communities in San Basilio de Palenque and the Brazil-Argentina Border. 

Another example of successfully funded projects is those run by Dr. Paola Harris. She and her team benefited from grants related to digital entrepreneurship. One of them was funded by The Colombian Ministry of Technologies for Information and Communications in 2016. On that occasion, Professor Harris received advanced training for over 8 weeks to develop her project APPs.co, which started a new phase of Discovery of the Businesses program in 17 Colombian cities. In this project, she created a device to identify objects by using a tablet or a similar appliance. 

This device was later patented at the Spanish Patent and Trademark Office. The above patent can be confirmed via the following link:

Patent