| Joy and sadness of telemedicine |
|
 |
| Written by Levi Obijiofor | |||||||||||||||||||||||||
| Friday, 09 May 2008 | |||||||||||||||||||||||||
|
Joy and sadness of telemedicine By Levi Obijiofor Friday, 9 May 2008 For the first time in many months, I found a news story that made me feel temporarily upbeat about federal attempts to uplift medical services in Nigeria. The headline of the news story, published in The Guardian of Tuesday, May 6, 2008, was: “Govt set to begin telemedicine nationwide”. According to Robert Borofice, a professor and director-general of the National Space Research and Development Agency (NARSDA), the telemedicine project is an online health service “between two or more remote centres and the medical consultants at the university teaching hospitals or federal medical centres”. Borofice said at a ceremony to mark the handing over of the first telemedicine bus that the scheme was “… being initiated in collaboration with the Federal Ministry of Health to rapidly expand the healthcare facilities to cover the remote areas without the physical presence of medical consultants”. Telehealth, as it is known and practised in remote communities in some parts of the world, involves linking patients in isolated and rural communities to medical specialists and consultants in cities and other centres with better medical facilities for assessment of their medical condition through video (videoconference). Based on information released to journalists on Tuesday this week, the Nigerian brand of telehealth will start from nine federal medical facilities such as those located in Gombe, Owo, Makurdi, Yenegoa, Birnin Kebbi and Owerri. These centres will be supported by a transportable (mobile) unit. Public optimism about telemedicine practice in Nigeria is justified. Any scheme that would bring advanced medical service to the doorsteps of impoverished rural dwellers must be commended. Different countries in the developed world have trialled “telehealth” or telemedicine and found it to be a useful means of extending medicare to people in remote locations. Thanks to the magic of new communication technologies, telemedicine is now operating in many isolated, rural and regional centres in developed countries. Based on research evidence and my personal experience in an Indigenous Canadian community, there are numerous advantages associated with telemedicine. In this regard, it is important for us to aspire for innovative ways of improving healthcare systems, particularly services aimed at delivering healthcare at little or no cost to the less privileged members of our society who have no access to medical consultants and specialists in city-based hospitals. These are the people to whom telemedicine should be directed. In terms of advantages, telehealth, as practised in Canada, has saved huge amounts of money for the government, as well as travel time for patients and medical personnel. Another benefit generally associated with telehealth is greater access to specialist medical services by rural dwellers. But that’s in Canada. What about Nigeria? What advantages do we expect to derive from the introduction of telemedicine? What obstacles are likely to confront this splendid initiative by the government? There are many barriers. But they are not insurmountable if the government is faithfully committed to telemedicine practice. In the Nigerian context, telemedicine could be beneficial to local communities, as well as the Federal Ministry of Health, provided the senior officials don’t conspire to share the money saved through telemedicine, in a fraudulent manner. Telemedicine would also facilitate early diagnosis and treatment of life-threatening ailments among members of local communities. Beyond these advantages, the critical question for the Federal Government is: would telemedicine operate successfully in a country where electricity supply has become a luxury and where rural communities have continued to suffer the indignity of remaining in the dark in the age of modernity? In medical practice, electricity serves as the oxygen bag that keeps alive many patients, particularly patients on life-support system. If we can crack the riddle that has strangulated the power sector in the country, we would have taken one major step to putting the telemedicine bus on the right track. Solving the electricity problem is a good beginning but it will not overcome another important problem that threatens the effective implementation of telemedicine. Telemedicine practice is propelled by modern technologies. Without new technologies, telemedicine remains a pipe dream. Erratic supply of electricity and lack of modern technologies constitute the two main barriers that must be overcome before the government can effectively jump onto the telemedicine bandwagon. Telemedicine is certainly an excellent idea but government needs to provide the basic framework and infrastructure on which it would operate successfully. Based on a study I conducted in the Canadian Aboriginal community of Fort Severn -- on the edge of Hudson Bay in Northern Ontario – in 2004, it was obvious that, for telehealth to succeed, the community has to have access to state-of-the-art modern technology. That is the missing link in the telemedicine plan rolled out by the government in Abuja. Even with the use of mobile buses equipped with modern technologies, as envisaged in the government’s plan for telemedicine, it would be difficult to connect patients in rural communities through video or satellite technology to medical centres where medical specialists will be waiting to assess the conditions of patients. The absence of new technologies in rural communities and the electricity hiccup that has gripped urban and rural communities may yet undermine the effective implementation of telemedicine. In many parts of the world, new technologies are perceived as the basic tools for survival in the 21st century. But while the rest of the world is doing something to promote the uptake of new technologies in urban and rural areas, we continue to engage in talk shops that raise expectations based on preposterous assumptions. Across the country, the institutions and infrastructure that should facilitate access to and use of new technologies are weak or non-existent. In an article published in The Guardian of Monday, October 8, 2007, Philip Emeagwali underlined the role of new technologies in the transformation of modern societies. He wrote: “Africa’s inability to realise its potential and embrace technology has left it at the mercy of the West.” At the national level, we are confronted with a major problem. How can adoption of new technologies take place in an environment in which the basic raw material required to boost public use of new technologies is simply unavailable? How can you operate a meaningful business that relies on public power supply without being frustrated by ceaseless power outages? Across the country, the private sector is the main conveyor belt that is taking new technologies to the people. But it has been a slow and painful and costly experience. Many businesses have invested in electric generators simply to keep their enterprises operating, sometimes at minimum capacity. While one must commend the spirit behind the telemedicine project, one must express scepticism about the effective implementation of the scheme. For telemedicine to work effectively, two things are necessary. In the first place, the project would require medical quality videoconference equipment. As rural villages do not have the quality infrastructure with the right capacity to support telemedicine, the government’s idea of taking healthcare directly to the people could be endangered. Relying on electric generators might help to overcome the power problem in the interim but for how long would telemedicine depend on electric generators? I am thrilled by the idea of telemedicine in Nigeria but I am saddened by the absence of the infrastructure that is required to implement the project. In other parts of the world, the implementation of telemedicine was preceded by research and consultations with local communities to identify possible obstacles and areas of special need. In our case, research and consultations did not take place. The government has proceeded to roll out the telemedicine project without a clear idea of what it would take to set it up, without a clear idea of what it would take to sustain and service the project, and without any idea of how the target population would respond to the project. Research and community consultation ought to precede the introduction of telemedicine. Grand ideas are great but the government must move to make their implementation also grand. Effective telemedicine requires reciprocal access to modern technologies and electricity by patients in rural villages, as well as by medical consultants stationed in buses and medical centres set up to provide telemedicine services.
|
|||||||||||||||||||||||||
| < Prev | Next > |
|---|
Services : E-mail news | 
RSS Feeds | Podcasts
Links: About the NVS | Contact Us | Terms of Use | Privacy & Cookies | Advertise With Us
All Rights Reserved. NigeriaVillageSquare.com
Posted by Robot| 08.05.2008 23:12