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Telemedicine transforms healthcare in Dadaab

Evelyn Makena @evemake_g

Rukia Waqo helplessly looks down at her 10-month-old son as he convulses in loud sobs. He is inconsolable and wriggles his fragile frame in discomfort even as the mother gently rocks him. While she is engrossed in calming down the distraught child, a small camera roams above his mouth.

Baby Hassan is in the middle of a medical examination in Dadaab Sub-county Hospital, Garissa where he has been admitted. It is the second admission in the hospital within a month for Rukia’s son since he started experiencing persistent convulsions.

The baby, who was diagnosed with cerebral palsy at birth, due to delayed labour has not shown much improvement despite being put on medication. Rukia eagerly watches the baby undergo the examination carried out by Kevin Amudavi, a clinician at the hospital.

This particular medical examination is special to Rukia for two reasons. First, she is meeting a pediatrician from Nairobi to help treat her son and secondly, she is getting a chance to interact with a technology that is making it possible for patients in Dadaab to consult specialists from Gertrude’s Children’s Hospital, Muthaiga albeit remotely.

She is one of the beneficiaries of a telemedicine platform by Gertrude’s Children’s Hospital, that enables doctors at the hospital attend to patients in rural and underserved locations, at no cost to the patients.

“It involves diagnosis and treatment of patients through electronic links as opposed to meeting on a face-to-face basis,” explains Dr Bretson Mukhwana, a pediatrician at Gertrude’s Hospital involved in the telemedicine programme.

The platform that was introduced in Dadaab in 2017 under Gertrude’s Hospital’s TeleAfya project, is making specialised health services accessible to mothers and children in the far-flung location.

Garissa county is among the 15 counties in Kenya that account for the highest maternal deaths in the country and equally high neonatal deaths. The county has a limited number of medical personnel mostly concentrated in urban areas like Garissa town.

Due to the remote nature of the county, pregnant women have to travel long distances to access antenatal care, have safe hospital deliveries and postnatal care.

The platform is making healthcare easily accessible to mothers and children at Dadaab whose cases are complex and cannot be treated at a local level.

“We only refer difficult cases to the specialists in Nairobi,” explains Amudavi. The enabling technology involves two screens on both the doctor and patients end, that transmits high definition video and clear audio in real time. It also allows for connection of medical devices.

The patient’s booth includes a stethoscope and a vital signs monitor that tests and transmits essential patient information on temperature, blood pressure and pulse rate to the doctor.

There is a clinician at the patient site to help with the tests and relaying that information to the doctor. Just like in face-to-face consultations, patients have to book an appointment with the doctor.

The telemedicine platform is set up at least two times in a week to attend to the patients. After an examination that lasts close to half-an-hour Dr Mukhwana who has been attentively observing baby Hassan from his screen in Nairobi, makes a diagnosis and recommends treatment.

Rukia leaves the consultation room a happy mother. Since its inception, 53 referral cases have benefited from the platform that is funded by County Innovation Challenge Fund.

Despite its effectiveness, the ingenious solution has its limitations. Certain procedures such as surgeries cannot be performed remotely. Also, the entire set-up relies on Internet connection, yet low speed broadband at times leads to poor connection.

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