BELFAST, Northern Ireland — In a remote area of Niger, where medical resources are limited, a local doctor can be sitting with his patient, describing their symptoms of chest pain into a smartphone. Thousands of miles away, connected through a telemedicine platform, a cardiologist can access images and videos shared by the doctor and provide a specialist opinion.
Telemedicine — the remote diagnosis and treatment of patients — isn’t a new concept. But as health workers come under increasing risk — whether from hostile groups, working in conflict situations, or from COVID-19 — it could prove a key tool for ensuring their safety, as well as for providing patient care, said Dr. Chibuzo Okonta, president of Médecins Sans Frontières in West and Central Africa.
In places where the safety of MSF staff and volunteers can’t be guaranteed — either because of conflict, the targeting of certain groups, or insufficient personal protective equipment to go around — MSF has to consider whether it can deploy its teams, explained the Abidjan-based doctor. If it isn’t safe, a community could miss out on emergency medical assistance.
“There's been instances where, due to the level of insecurity, we’ve been forced to work differently,” Okonta said. For example, due to insecurity in Somalia, MSF has operated from neighboring Kenya.
Still, “with telemedicine, we can provide assistance to the population in need, especially with health consultations,” and offer general practitioners and nurses in the field access to specialists as they diagnose and treat patients, Okonta said.
According to the Safeguarding Health in Conflict Coalition, at least 151 health workers were killed in 2019, and 502 were injured in incidents of violence. MSF itself lost two staff members in May — one in a shooting at a hospital in Kabul, Afghanistan, and another during fighting in Jonglei, South Sudan — while an MSF-supported health center in the Drodro region of the Democratic Republic of the Congo was also looted.
Such threats to health worker safety impact the number of volunteers that MSF receives. If it cannot find the right people to go or cannot guarantee their security, it doesn’t send them, Okonta said, adding that the global shortage of masks during the coronavirus pandemic has been another factor to consider.
“It has been quite challenging to ensure that all our medical personnel in over 80 countries have the right equipment during this time. That in itself will push MSF to make certain decisions on which places they can go to respond to the crises,” Okonta said, adding that travel restrictions have also contributed to some programs in West Africa being put on hold, such as its pediatric surgical program in Monrovia, Liberia.
Although telemedicine requires an initial investment in terms of providing equipment and an internet connection to participating health workers, Okonta said it is worth it, considering the added value it can bring.
The only limitations are technical, he said. For example, the current system MSF has in place only allows medical professionals to connect and consult with each other. Okonta believes that allowing patients to have direct virtual consultations with a doctor via telemedicine would be one way to improve.
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