Setting up a Telemedicine Post in Zambia: Episode #7: Applying to Gates Foundation
by John Bennett MD
The is the 7th post in a series in which we are documenting our attempts to aid a Medical Clinic in Namushakende, south of Mongu, in the western part of Zambia, to obtain Telemedicine services. Not a fundraising effort, but an effort to aid in providing crowdsourced knowledge, and information through networking, and mining the internet, and passing the information on..
Browsing the internet, we found many good programs that seemed to be doing a lot in Zambia.
It became apparent, after talking with Jones, the head nurse, about the clinic in Namushakende, the patients, and what was needed etc., it became apparent to me that they did not know about the many great programs that were being implemented in other parts of Zambia, as shown in this post about the malaria program in Zambia, known as MACEPA.
And, conincidentally, at that time, I had received a post from Chris Stout about applying for a grant from the Gates Foundation, which does a lot of philantropy in Africa. I was skeptical, since I thought that applying for a grant for aid in Africa would be a long, arduous affair, but I was surprised to see that it was a simple, two page submission, the text of which follows.
So, the realization that Jones’ clinic was “out of the loop”, and missing taking advantage of health programs in other areas that are existent, combined with the ease of submission for a grant led me to one conclusion.
Why Not? The worst that can happen is that they say no.
So, herein follows a copy of the submission:
PART 1: IDEA: NEW WAYS OF WORKING TOGETHER
Essence: There are many good healthcare programs, and new mHealth devices and applications in Zambia, but they are not being universally applied in some “hidden clinics”. While writing a diary for my healthcare website, of trying to help a clinic in Zambia obtain a telemedicine service, in the western town of Namushakende, south of Mongu, it became apparent that the head nurse, did not know of the many good healthcare programs that I had found on the internet in Livingstone, Zambia. Programs for malaria, AIDS, TB, etc. were virtually unknown to him and the clinic. And the Namushakende Clinic were not using any of the tools of mHealth, i.e., iPhone apps, for patient care, and as a medical device. I believe this may be present in many other clinics in very inaccessible areas in Zambia, but we will limit this study to 5 clinics.
In addition, there was something which is vital nowadays to reap the benefits of digitalization of healthcare in the 21st Century: a computer. A computer would allow the “hidden clinics” to network and find out about the great programs available in Zambia. In some clinics, they are off the “beaten path”, and do not know these programs even exist. Also, a computer with a good internet connection today can have Google Hangouts for Teleconsults. Fortunately, with wireless service, virtually all areas can have good internet connections.
The computer can also can be used for communication with other healthcare workers, and workers in central offices in Lusada to know of any disease outbreaks, in real time. It also allows the nurse or healthcare workers to send photos of any skin problem they cannot easily diagnose. It can alert a central office if there is a vital need for supplies or service. It can alert the transfer of a very sick patient to a more urban area. In short, it is a lifeline that can and should be used today.
There are clinics, I feel, that are isolated geographically, but do not need to be isolated with today’s technology and internet connections. It can done so with a precise plan to, first, find “hidden” clinics, then outfit them with computers to establish communication, and allow for more efficient allocation of the scarce healthcare manpower of doctors, and specialists.
We propose to find 5 “hidden” clinics in Zambia, and start with Namushakende, and use it as a model for the other clinics to build on
Section 2: How will we Test It?
First we will outfit the clinic in Namushakende and install a good computer with the fastest wireless service from Airtel. Regular doctors will be retained and paid, to screen and treat the more common diseases remotely. Specialists in Lusaka will be obtained to handle any problems not able to be handled by regular doctors. Photos will be sent if needed for medical problems to both the regular doctor and specialists. Teleconsults will be performed, if needed, and seriously ill patients will be triaged to Lusaka or Livingstone. A smartphone will be supplied, and used for its increasingly useful purposes of diagnosing infectious disease and parasites, and, through the computer, educational programs for mHealth will be initiated. .
Once the model is made in Namushakende, the same model will be used in four other “hidden” clinics. To fully outfit the five clinics, and make them operational should take 18 months.
The data generated should be patient satisfaction, and will succeed if the patients, and problems are plugged into the 21 century with the benefits of computers. The next step will be to apply this model of application of Google Hangouts for Telemedicine in Zambia, with an already established network of general doctors and specialist, and well as the effective use of the Smartphones to diagnose infectious disease problems, and to photograph skin lesions, etc.
Costs: Computers for 5 Clinics with upkeep: 18 months=5 x $3000=$15,000
2 Smartphones per Clinic: 10 x $500 = $5000
Connectivity of computers and smartphones: $150/month/clinic x 18 months =$13,500
JEEP= $25,000 Consultation Fees to Doctors/specialists = $20,000 over 18 mo.
Miscellaneous: (Gas, hotels, food on road looking for clinics, outfitting) =$21,500
Okay, that’s it. We will keep you posted on any reply, they said it would be a few months. Keep your fingers crossed!