From the October 8th Earthquake, to the Dengue Fever outbreak, to the recent bombing in Islamabad and Peshawar, people all over Pakistan have found �disaster’ headlines staring them in the face. It has become quite obvious in the past few years that a Disaster – Natural or Manmade – can take place almost any where and at any time. There is really nothing anyone can do to stop these disasters from occurring; however, we can engage in a plan that will better equip us to cope with future emergency situations; a plan that will help our nation and its people to recover at a much faster pace when disaster does strike again.
One such solution proves to be Telemedicine. Advances in technology have made it possible for Telemedicine to be used in multiple areas of medicine, including trauma care. During the last few years many countries have developed Telemedicine applications to deal with disaster emergencies in their respective countries. These Telemedicine applications aim to provide quality healthcare services to geographically and environmentally inaccessible people.
Telemedicine was first adopted in disaster situations during the mid 1980’s by the National Aeronautical and Space Administration (NASA) to provide disaster aid following the devastating earthquake in Mexico City. Since that time there have been many other examples where Telemedicine has been used and has had remarkable success.
In the case of any natural disaster the availability of health care is just as crucial as food, shelter and water to the affected areas. Telemedicine increases health care accessibility and decreases the burden on tertiary care hospitals. Telemedicine also upgrades remote hospitals during an emergency. To understand this better I use the example of the October 8th, 2005 earthquake in Pakistan that left widespread destruction in its wake. It was at this time that Telemedicine was most needed. Over 1,02,600 patients needed treatment during this time, however the 70 hospitals in the earthquake neighboring areas were not equipped to deal with the massive number of patients in terms of beds or medical supplies. Today, in the aftermath of the earthquake people still suffer, could this be because they were not given the care they needed at the most crucial stage? I think the answer is yes.
Natural disasters as we know are of a unique nature in a sense that not only do they cause damage to human life and social infrastructure but also leave a huge population in need of long term follow-up sessions. This long-term care is usually never possible at the larger hospitals that are overwhelmed during the days of a disaster. However, with the use of Telemedicine, assistant doctors can help in managing trauma patients at remote health centers after their initial check up.
To further illustrate I include a study that was carried out by Doctor Faisal Murad, a member of the TelmedPak team and a senior surgeon at the Holy Family Hospital, to test the success of Telemedicine during the Oct 8th earthquake days. The study included patients that were initially treated at the Rawalpindi Medical College (RMC) and then brought to a step down hospital (District Headquarter hospital DHQ Attock); step down hospitals are usually ill equipped and lack qualified doctors. However, in this case it was due to Telemedicine that the shifted patients received the same treatment as in a fully equipped hospital and were also monitored by the same doctors that had initially treated them at RMC. This was done through the help of an IT person connecting the senior doctor with the junior doctor telemedically.
The objectives of the study were to evaluate the role of Telemedicine in
Follow up of trauma patients using remote technology without the need to travel to main center
Consultation and reevaluation of distant patients
Assessment of undetected/missed injuries during first check up
Freeing up beds at major hospitals for new incoming patients
The total hospital stay for these patients ranged from 10 to 57 days, with an average of 36 days, during which the patients were kept at the tertiary care hospital for only 6 days and the rest of the 30 days were spent at the Telemedicine center. During their stay at the Telemedicine center injuries were found in patients that had not been detected before. In this way, Doctor Faisal Murad proves that without telemedicine this would not have been possible and the patients would have had nowhere to recover or heal. Thus, we understand how crucial it becomes to plan Telemedicine centers in the wake of future emergency situations.