telemedicine 20 June 2012. On 14 June ESPI was the host of an evening dedicated to Humanitarian Telemedicine. The keynote was given by Dr. Krishnaswamy Kasturirangan, a member of the Planning Commission of India, and former Chairman of the Indian Space Agency, ISRO. Further presentations were made by Dr Yasushi Horikawa, Dr Adigun Ade Abiodun, John Riehl, Andreas Papp and Prof. Antoine Geissbuhler. 

 

Humanitarian telemedicine enables medical care in many fields to be provided from industrialised countries to regions of the world with severe undersupply of medical expertise. Telemedicine makes distance irrelevant and is thus a potentially powerful tool to overcome the North/South divide in health care, whilst also enabling effective South/South cooperation.

As a kick-off for a wider initiative on humanitarian telemedicine, ESPI had invited for an evening event on 14 June dedicated to this topic.

After a welcome by the ESPI director, Peter Hulsroj, an opening statement was made by the current chairman of the UN Committee on the Peaceful Uses of Outer Space (COPUOS), Dr Yasushi Horikawa, who put the initiative into the broader context of the UN’s efforts to make space of real use to global citizens.

The keynote speech was given by Dr. Krishnaswamy Kasturirangan, a member of the Planning Commission of India and former Chairman of ISRO. Dr. Kasturirangan conveyed vividly the extensive experiences of India with telemedicine, and how telemedicine plays a crucial role in India’s efforts to bring good healthcare also to rural and remote areas of the vast country. Dr. Kasturirangan showed how the cost of telemedicine had gone down very significantly over time and how the quality had gone up – tendencies that can be expected to continue in the future as well. Dr. Kasturirangan finally mooted the possibility of creating a Global Fund for Humanitarian Telemedicine as a means for the global community to tap the tremendous potential of telemedicine for the benefit of the ones most disadvantaged.

The keynote was followed by a presentation by Dr. Adigun Ade Abiodun, former chairman of COPUOS and an applications specialist of the highest standing. Dr. Abiodun highlighted the prevailing belief of many decision makers in developing countries that the grass is greener at the other side of the fence, particularly as it relates to their own personal healthcare. Thus, instead of investing in the best healthcare services money can buy in their own countries, their personal distrust of such care, locally, often results in their private reliance on overseas medical services, to the detriment of any progressive health-care services  for all in their home countries. Such an approach is an obstacle to introducing real progress in health care for the general population; it denies them of basic first-rate healthcare services in their own country and impacts their life-expectancy. Telemedicine can overcome some of the structural impediments in developing countries, yet, as many examples show, real progress requires support of the local political  system and its leaders, so this should not be forgotten when discussing the potential of telemedicine in undersupplied regions of the world. Technical challenges can surely be overcome but hearts and minds must be won as well.

 

The president of the American NGO Medical Missions for Children, John Riehl, thereafter discussed the reality ‘on the ground’ of using telemedicine to assist in needy areas. Medical Missions for Children has a more than decade long experience in providing specialist paediatric advice in, currently, 108 countries through its network of 27 specialist hospitals. Competition for telecoms capacity often exists and humanitarian organisations are sometimes outbid, meaning that needy areas will go unassisted in these cases. Mr. Riehl also drew attention to Medical Missions for Children’s tele-education programmes for medical professionals, and how Medical Missions for Children seeks to educate also the patient side in order to make for more effective patient-doctor interaction. Such educational programmes are essential for building sustainable health structures in underserved regions.


Operational Support Director Andreas Papp of Doctors without Borders - Austria continued the focus on field experience. Mr. Papp explained how in Somalia Doctors without Borders some time ago had had to withdraw its foreign staff due to insecurity in some of their project locations . Doctors without Borders then set up a telemedicine link with an end-point in Nairobi, in order to assist their local medical staff and to ensure quality in their health care. With the help of local staff in Somalia 222 telemedicine consultations took place. 105 of these 222 patients would likely have died if it had not been supported with telemedicine consultations. An example which clearly resonated strongly with the audience at the event and a demonstration of the potential of telemedicine even in very difficult circumstances.


Professor Antoine Geissbuhler of Geneva University Hospitals rounded out the evening by giving both a broad overview of the state-of-play of telemedicine and medical tele-education and concrete examples of how telemedicine has worked both in regions of Africa and Latin-America. Professor Geissbuhler explained how telemedicine allows moving expertise rather than people, and how important this is particularly in rural areas in developing countries where the distance to a hospital and the effort to get there might be a significant challenge and in itself often poses significant health risks. Professor Geissbuhler also mentioned the importance of ‘teaching the teachers’, thereby creating self-reinforcing virtuous circles of knowledge dissemination. In that respect one should also not underestimate the learning effect for the health care professionals at both ends of concrete tele-consultations.


The evening ended with Mr. Hulsroj thanking the speakers for their excellent contributions and explaining that the event was intended as a first step of a wider initiative to make humanitarian telemedicine a reality to a far higher degree than currently. A report will be issued by ESPI in the next months where the results of the evening will be captured and analysed. In six months time an in-depth conference will then be held, giving an opportunity to drill down in the topics and providing a more interactive way of addressing issues.





Copy_of_telemedicine
From left: Dr Adigun Ade Abiodun, ESPI Director Peter Hulsroj, John Riehl, Prof. Antoine Geissbuhler, Dr Krishnaswamy Kasturirangan, ESPI Resident Fellow Lionel Poncelet, Dr Yasushi Horikawa, Andreas Papp.

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