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17 January 2010

eHealth: Necessity in Nepal

SANJIB GHIMIRE
One evening last summer, I watched a social affair-related TV program showing the agonizing story of an 18-year-old girl from a remote village of Nuwakot district. She was in the Teaching Hospital in Kathmandu, and near death. The reason was she had a heart problem from her birth, but the staff of the local health post in her village treated her for normal complaints.

Obviously, she didn’t get well. She also didn’t have access to good hospitals and doctors. Born in a poor uneducated family, her father consulted the shamans, the dhami jhankri, for remedies. That also didn’t work. After living like this for 18 years, she was finally brought to the Teaching Hospital. Doctors said her case was complicated because her illness had become too matured.

This is just one of the scenarios of the medical situation in Nepal, and there are many.

Worldwide data shows that one out of seven children born will not survive to age five. Poverty and poor medical facilities are the causes. Around 31% of the people in Nepal live under poverty level.

Therefore, in a country like Nepal, with its difficult and intricate geographical structure, limited transportation facility, and poor access to medical information and hospitals and qualified doctors, eHealth – also called telemedicine – would be the right approach to medical deficiencies. eHealth is a way of providing medical-related services through the use of information technology. These services include access to national and international hospitals and doctors, access to medical information, answers to medical queries, and so on.

There are, however, opportunities as well as challenges for us to implement and execute this method.

In eHealth practices, it establishes communication links through IT tools between patients and doctors or hospitals which are geographically far apart. The two parties communicate with each other through tools like videoconferencing, Internet, and telecommunication, and so on. Patients describe their problems and doctors provide information and prescribe remedies. For this, trained medical doctors don’t need to be in the patient’s location.

The medical histories of such patients can also be saved for future references and decisions. Similarly, people will have access to medical information and services from any place at anytime. Such tele-treatments will free patients from travel, costs, and other hassles, such as visas. This is the beauty of the technology which also doesn’t discriminate against one’s caste, color, creed, culture or religion. It treats all people equally.

However, implementing eHealth is not easy in Nepal. Infrastructure development is the utmost challenge. eHealth service providing center should be well equipped with IT tools like computers, Internet, telecommunications, video conferencing, communication channels and networks. In a country which only has less than 1% Internet and computer users and 15% mobile users, the solution is not easy. Out of the 3,916 VDCs (village development committees) across Nepal, 3,400 of them have telephone services. Not all the villages and districts have access to Internet. Internet and telecommunications, however, can be provided through wireless technology like Wi-Fi and Wi-Max, but it can add to the costs of services. Difficulties in connectivity and bandwidth are other factors.

Another challenge is the availability of electricity with 12-18 hours of power cut occurring everyday. So operating electronic devices would be impossible. Even if electricity is supplied regularly, only around 15% of Nepalis have access to it. Therefore, solar energy can be the alternative to this situation, though it calls for heavy financial and technical investment.

Similarly, eHealth service providers also have to expand the capacity to use this great facilitator. Institutions must empower their human and institutional capacity to increase eHealth service productivity. In many developing countries, Nepal included, health projects are funded by I/NGOs, posing questions about the sustainability and longevity of such eHealth projects with regards to professionalism and dynamism.

Health services are the basic needs and rights of global citizens. That is why 3 out of the 8 points in the UN Millennium Development Goal (MDG) are concerned with health issues. Developing countries have deadlines to guarantee these health concerns to their citizens.

After visualizing the power of eHealth, WHO, in 2005, published a general report on the issue of e-health for drawing the attention of decision makers to the need for the rapid development of strategies in this area. This initiative led to the approval by the World Health Assembly, meeting in Geneva in May 2005, of a resolution on e-health, which invites each state to define its national strategy, develop regional mutual aid and PPPs.

Experts also take the DOHA Declaration as a useful WTO statement because it clarifies the scope of TRIPS. And one of the TRIPS calls is “Medicine for all.” Hence this is high time for the authorities concerned to be positive about eHealth for the obvious reasons, as highlighted above, so that we may not have to see Nepalis facing the same problems as that 18-year-old young girl of Nuwakot went through.

Published on 2010-01-15 13:42:09

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