Bangladesh telemedicine introduction Project
I went to Bangladesh to introduce telemedicine system from 25th February to 1st March 2015.
In Bangladesh a large number of wells were drilled by international organizations after the World War II to ease water shortages. But, as the well water contains natural arsenic, the number of persons who became arsenic poisoning has reached as many as 30 million, and health damage, such as mental retardation, premature birth and respiratory diseases including lung cancer, has become a problem.
However, due to the shortage of domestic doctors and, in addition, biased distribution to the urban areas of the doctors capable of examining chronic arsenic poisoning, the early detection of chronic arsenic poisoning patients in rural areas is stagnant.
In villages around a rural city of Chandpur (population of 465,000) in Bangladesh, a trainee doctor living in the capital Dhaka visited a clinic in a doctorless village about once a month and provided medical care. Due to lack of expertise in chronic arsenic poisoning, however, the trainee doctor had difficulties in diagnosis and treatment. Many rural residents are poor and there is no means of transportation, so the condition is widespread in which it is difficult for them to visit and see a doctor in Chandpur.
As a solution to the above, a Bangladeshi doctor(Dr. Haque) from a suburb of Chandpur, who was studying in Japan, devised an attempt to provide early detection and treatment of chronic arsenic poisoning using telemedicine technology, and in September 2011 he asked Rotary Club of Numata, Gunma Prefecture, to contribute funds for installing telemedicine equipment.
In response to the above request, in May 2013, Rotary Club Numata, Gunma Prefecture, decided to contribute funds as a social contribution project. Then, due to the absence of members with knowledge and experiences of telemedicine, via Japan Telemedicine Society I received a request for assistance, and in February 2014 joined the project team for installing the telemedicine equipment.
I was assigned and conducted the jobs of hearing about the local situation, advising on the method of the remote medical treatment and educating staff of the local clinic and the hospital on how to operate the equipment by visiting the sites.
I decides the method of remote medical care in local area.
1)We install telemedicine equipment at a rural doctorless clinic in Faridgonj district about 40 km apart from Chandpur and at a hospital in Chandpur city, and made connection between them through locally available internet facilities.
2)Local co-medical stuffs carried out screening of patients with chronic arsenic poisoning in the Faridgonj district based on questionnaire.
3)The screened patients visit a clinic in the Faridgonj district for a medical advice.
4)The patient receives remote medical care by a doctor in Chandpur, while receiving on-site support of medical clerks or nurses at the clinic in the Faridgonj district.
5)If medication is needed, a prescription is made up at the clinic in the Faridgonj district.
Next, we selected the telemedicine equipment.
Items required for remote medical care are Interview, stethoscope, visual inspection for skin findings, chest X-ray and electrocardiogram.For interview, video conferencing system is necessary.And remote diagnostic imaging system is necessary to check skin findings, chest X-ray and electrocardiogram.We selected “ViewSend RAD” as a telemedicine system.
ViewSend RAD is remote diagnostic imaging system with real time video conference. ViewSend RAD works on wireless Internet communication network with low communication speed.Unfortunately, we couldn’t connect remote stethoscope control system in Bangladesh.
We dispatched engineers to the local site twice.
At first time, we Installed demonstration equipment, and educated the system to local engineers.At second step, we Installed one set of ViewSend RAD at the clinic and the hospital.In the rural area, wired internet circuit is not available. And 3G mobile network is too expensive to use.So, we selected using a Radio-link system for Internet access. RadioLink can use TCP/IP peer-to-peer connection, and the theoretical communication speed is maximum 20 Mbps.
Video clip of visiting Bangladesh.
This project was aired on local TV.
After setting up
A co-medical is stationed at the clinic in Faridgonj district, and a specialist conducted remote medical care from the hospital in Chandpur city.And I heard that after screening of more than 2000 arsenic poisoning victims, 316 severely suffering patients received telemedicine based health care in a year.
I think, if your country has a problem of lack of doctors and transportations like Bangladesh, telemedicine is waned and you can expect promising outcome using this system.