Telemedicine refers to the use of various telecommunications by physicians and the institutions that provide health care to their patients through electronic or digital means. Telemedicine employs technology that makes it possible for health care providers to care for their patients in the patients' homes or in other remote areas. It is just a confluence of communication technology, information technology, biomedical engineering and medical science, telemedicine helps patients in distant and remote areas to avail timely consultations from specialist doctors without going through long hours of travel across distances, incurring huge expenses.
Telemedicine consists of customized medical software integrated with computer hardware along with diagnostic equipment like ECG, X-ray, pathology and microscope etc, connected through satellite-based communications means like the VSAT (Very Small Aperture Terminal) system at each location. The facility transmits patient’s medical images and medical history to the specialist doctors, either in advance, or in real-time, who studies it, diagnoses and advises the local doctor or the paramedic at the patient’s end during the two-way audio and videoconference. Apart from providing timely medical assistance, telemedicine is also cost-effective.
Background of the project
This project is responsible to provide health care facilities through Telemedicine and also encourage other income generating activities to boost up poverty reduction process directly and indirectly. We think investment in health sector highly related with productivity and play a vital role to reduce poverty. The economic gains to the poor from improved health are significant, since they bear a disproportionate burden of disease. Moreover, the income of the poor typically depends on physical labor, and thus illness robs them of a greater portion of their income. Since the poor usually do not have much savings they find it difficult to recover from ill health without depleting their human and physical capital. As mentioned previously sickness is a major cause of financial loses among the poor. Thus a vicious cycle of low capital low income and poor health prevail. Investing in the health of the poor increases their productivity and helps to accumulate assets they need to lift themselves from poverty. In goal four and five of MDG Child and Maternal health is the main issue respectively. Our proposed project will play a vital role to reduce child and maternal mortality especially in rural area and this project will also help to government initiatives of attaining MDGs target become successful. Other goals, such as women empowerment, poverty reduction, prevention of HYV/AIDS will indirectly support by the other program (income generating work, advocacy, training, awareness) of SAMAMA, which is highly related with this project. The United Nations Development Program in its ‘Human Development Index’ (HDI) also encourages investments in health. Such investment reduces deprivation and provides the poor with the immediate welfare gain of relief from physical suffering.
In rural area percentage of patients who do not get any treatment have increased during the period 2004- 1999 (in 2004 18.7 for male, 18.9 for female and in 1999 5.5 and 9.5 respectively). Because of high consultation fees of private doctor, in one hand treatment recipient by private doctor has reduced to 17.3 per cent for male patient and 19.2 per cent for female patient in 2004 from 30.6 percent and 31.7 per cent for the respective category in 1999, on the other hand treatment recipient by quack has increased to 40.7 per cent for male patient and 41.3 per cent for female patient from 38 and 38.8 per cent for the respective category during the same period. Treatment by quack, kabiraji or hakemi is the great threat for health; because of unscientific treatment people suffer for a long time, which cause of low productivity, low income and then poverty. So it is necessary to provide health care services in such a way, which will be affordable to our targeted population.
Qualified doctor is very rare in rural area although some of them are provide treatment once or twice in a month at any particular area, poor people have to pay Tk 200 to 250 for per time prescription fees, which is beyond of capacity most of our rural poor. But be a member of SAMAMA one can get treatment by a registered MBBS doctor for all the member of his/her family how many times s/he need in a year by providing only Tk 500 payable in four consecutive installment.
Medical science is at its best today. However, its benefits are available to privileged few in the urban areas. Even though the majority of population lives in the rural backyard, only a negligible quantity of qualified doctors practice in the countryside. Since qualified doctor are not interested to go to village, to take treatment from registered doctor become impossible in rural area. As a result very often poor people are bound to take treatment from quack and suffer for a long time because of wrong treatment. What’s needed is a system that facilitates medical aid from a distance. Now a day, as a result of technological development it is very easy to communicate with doctor and patient although both parties are far away from each other. It is possible to provide treatment properly by examine all the organ of the body through digital camera, although it is expensive, by considering the well-being of distress people by this project we want to provide a unique health care service program. This program contributes to the well-being of the under privileged, landless peasants, marginalized farmers, destitute men, woman, disable and aged people, drug addicted and community people and their families by promoting access of unique health care program.
Affordability of healthcare services and health status in project areas
Nationwide targeted to implement the project. In targeted area more than 85 percent peoples’ livelihood depends on agriculture and a major portion of them are day labour. More than 60 per cent people live below the poverty line. As most of them are day labour physical capital is the main source of income. According to our field survey in the project area on average at least 25 working days of each labour are spoiled because of illness in every year. During this illness period earning source become closed, all the member of the family suffer from hunger, children deprived from education and engaged in work which is a cause of increase child labour in this area, and because of proper treatment productivity also deteriorated. Average distance of local hospital from the targeted area is 7 km. Here doctor patient ratio is 1:7500. On average each family have to expend Tk 1950 to get treatment from various sources. Most of the poor get treatment from quack, hakimi and kabiraji. To get treatment from MBBS/Reg. doctor on average cost is Tk 1250 for one time, which is equivalent to three days income of a day labour.
How this project will work
Four employees of SAMAMA for each unit are trained up to make available the benefit of telemedicine system among the local population, make awareness and motivate to bring them under the coverage of HSTRD, and hence provides various types of treatment including pathological support. One manager will supervise entire process regularly. This project will cover 1500 households for each unit region. An emergency unit will be opened for 14 hours in all the day of the week to give primary treatment. One MBBS/Regt doctor for each unit will also trained up to operate the telemedicine equipment’s and also check up the patients and prescribe by consulting with specialist through video conference. One nurse will support him to check up women and ensure quality services. Doctor patient ratio will be 1:3750 which is almost half than existing ratio. To ensure services of reproductive health and child health at least one doctor will be female. The program also seeks to reduce drug addiction and implement awareness program of STD and HIV/AIDS through various campaign and to ensure qualitative and less expensive pathological test. After one year successful completion coverage area will be expanded and number of physician be increased and an emergency to provide primary treatment will be opened for 24 hours.
Facilities
HATRED is closely working with SAMAMA’s existing health program. Rural distress people can therefore get access to health care services in SAMAMA’s 5 units of health care center.
S/he will get the following facilities
Special facilities provided to development Program’s Members