Medical Treatment By the Internet in Tanzania


Hospitals in rural Tanzania have designed ways to communicate with doctors in referral hospitals using the Internet. The Bugando Referral Hospital in Mwanza has a telemedicine unit that connects Rubya and Kibondo hospitals. The remote hospitals are supplied with a computer, a scanner and a digital camera.

Although this equipment is relatively simple, the teams at the hospitals have still made giant strides towards making healthcare more accessible. Ms Halima Nyindo, a nurse at Bugando hospital, said telemedicine is changing how people receive medical attention.

"There are no boundaries now; doctors can access expert opinions from the region and beyond. Medical challenges can be shared the world over, and responses can come with the click of a button," Ms Nyindo said.

Dr Adam Jonathan from Kibondo hospital mentions one case where a patient had a problem with his finger and could not use his hand for two years. "After initial diagnosis, the medication given did not help, the patient was still in pain and unable to work. His finger would not straighten up and we were all puzzled," Dr Jonathan said.

With the equipment at the hospital, Dr Jonathan took a picture of the patient, wrote the patient's medical history and sent it all to Ms Nyindo at the referral hospital. Ms Nyindo, who has been a nurse at Bugando since 1973, consulted a specialist doctor at the referral hospital and sent an e-mail reply with a detailed diagnosis that helped the doctors at Kibondo operate on the patient and correct the problem.

What started as a simple finger discomfort for the patient had deepened to a medical challenge for local doctors in Kibondo. With rising poverty levels, many people in rural areas fail to seek medical attention because of the costs involved.

For example; given the distance to Bugando Hospital from Rubya Hospital in Bukoba region, transport and accommodation costs would amount to Tsh70,000 ($50), which is unaffordable for people living on less than a dollar a day. This means that many patients are unable to seek specialised treatment; but now telemedicine can help them access this treatment.

Ms Nyindo says that the telemedicine project, supported by Africa Medical Research Foundation (Amref) and Computer Aid is helping the poor access health care and specialised treatment, which they would have struggled to access or failed to get in ordinary circumstances. "It may not be sophisticated telemedicine and video conferencing, but we are getting there. These are the first steps and we will continue reaching out," she said.

According to Gladys Muhunyo, Africa programme officer at Computer Aid, connectivity and training remain the biggest challenges to successful telemedicine in Africa. In more remote areas, she said, residents have had to be more innovative to overcome the many challenges to using information technology, including intermittent power supplies, unreliable phone lines and maintenance.

Muhunyo gave the example of Rubya Hospital, which has had to open a cyber café to supplement the high costs of connectivity. The cyber café is the only one in Rubya, and is used by residents for a fee.

While Computer Aid specialises in providing computers, Muhunyo said the charity has had to diversify and offer training to healthcare workers in remote areas in how to follow simple photographic and email procedures.

In case where the doctors at Bugando are unable to give proper diagnosis from the X-ray or photograph, it is usually sent to the Amref office in Nairobi or to a doctor abroad. This means that a patient at Rubya can access medical opinion from a doctor at a hospital in, say, Chicago.

Apart from telemedicine, the computers and Internet are used to deliver e-learning to doctors in remote areas. According to Frank Odhiambo, an officer at Amref, many doctors decline posting to remote areas because the chances of accessing continuous learning are not as good as in urban areas.

"Workers in rural health care, who serve most of the population, are isolated from specialist support and up to date information by poor roads, scarce and expensive telephones and a lack of library facilities. Information technology can offer solutions," Odhiambo said. With Internet connectivity, doctors and nurses in rural hospitals can access free online resources including journals, research databases, and training courses.

The East African