Tuesday, November 11, 2008


My father before his death in 1996 served almost all of his adult life as a physician and surgeon in the public health service. While many of his medical contemporaries chose to practice their profession in the cities where the monetary rewards were great and where professional advancement was assured, he decided to go home to Mindanao where health services in the rural countryside was either pitifully inadequate or actually non-existent.

There he would spend the rest of his life being a healer to the poorest of the poor and performing major surgeries in makeshift operating rooms with the most rudimentary of equipment. He eventually became a pivotal figure in the establishment of the first government district hospital in Lianga which he help ran until his retirement.

All his life he would lament at how woefully inadequate are the health and medical services available to Filipinos in the remote, provincial areas like Lianga. During his time and even more so today, local medical professionals had to contend with the lack of proper diagnostic and treatment facilities as well as the dearth of qualified medical workers needed to attend to the health problems of the rural folk. Thus the latter have higher morbidity and mortality rates for many diseases whose incidence in the more urban areas are lower and whose victims are more easily diagnosed and treated when they do occur.

To avail of more specialized medical care and treatment procedures not available in primary and secondary level hospitals, seriously ill patients in the rural areas have to be transported to the cities over long distances and often with great difficulty and expense. This fact alone accounts for majority of these patients' inability to secure the proper medical attention they desperately need.

The College of Engineering of the University of the Philippines together with Philippine General Hospital is pioneering in this country the use of computer and Internet software to make available to far flung and remote areas of the country the specialized and sophisticated medical expertise and diagnostic tools that ordinarily can be availed of only in urban centers like Manila.

From a small office located in UP Manila, two nurses man a computer center to which doctors in the rural areas can log into and send queries via the Internet. Such requests are then referred to medical specialists at the UP-PGH via computer link. Video and voice calls using free Internet software like Skype enable the specialists to confer with the doctor seeking advice and assistance when needed.

Patient data can be uploaded to Manila via e-mail for evaluation. The center can then recommend a diagnosis, an initial course of treatment or with the use of an information database currently being developed, the specialist in Manila can access information about the location of the patient and give advice as to the location of the nearest hospital or medical facility to which the patient can be brought for treatment.

In areas where no Internet access is possible, referrals and queries via SMS or text messages through cellular phones may be made and the center in Manila has logged in queries and referrals from Abra, both Ilocos provinces, Pangasinan, Cagayan, Quezon, Ifugao, Bohol, Aklan, Romblon, Palawan, Negros Occidental, Cebu, Masbate, Iloilo, Sibugay, Lanao del Norte, Lanao del Sur, Cotabato, Bukidnon, Surigao del Norte, Zamboanga del Norte, Tawi-Tawi and, of course, Surigao del Sur.

The potential for such a service to help make more, accessible, efficient and affordable the delivery of more expert and sophisticated health care services to the rural and remote areas of the country like Lianga cannot be underestimated. Doctors and health workers in the provinces and remote areas of the country can now avail of the best in diagnostic and treatment advice wherever they may be assigned. The system can also be invaluable in gathering data to monitor health care services all over the country and help insure prompt government response in cases of health emergencies like disease outbreaks and epidemics particularly in an country composed of so many islands spread over a vast area of ocean.

The UP's National Telehealth Center is just another innovative way in which the power of the Internet which ordinarily is just being used for social networking, entertainment and research is now being harnessed to serve the public welfare. But this telemedicine program is still in its infancy and will require a lot of government and public support to really take off.

In areas where rural doctors can go online, many still lack the needed computer equipment to do so. There is also a need for training programs for ordinary health workers, which in the absence of a qualified physician, which will enable them to benefit from access to program. A national government broadband system would also provide the necessary communication infrastructure for such a telemedicine scheme to have the widest coverage and impact all over the country.

When I first heard about the telehealth center, I was instantly reminded of the Australia's legendary Royal Flying Doctor Service, that unique Aussie institution which, with the use of airplanes and a dedicated group of air-mobile physicians and health personnel, provide round the clock health care and emergency medical services to isolated communities in the vast Australian outback. Only in the case of the Philippines, the doctors fly not on metal birds but virtually on the gossamer tendrils of the World Wide Web.

Still in both cases, the results are still gratifyingly the same. The doctor is, for all intents and purposes, always IN.

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