Telemedicine: A Lifeline For Patients In Garissa’s Remote Village

It is around midday in Daadab, Garissa County and despite the scorching sun, patients are trooping into Daadab Sub- County Hospital seeking treatment for their various ailments. Among those queuing to see the doctor is Hawo Hassan, rocking her convulsing baby whose unrelenting cry attracts the attention of a nurse. Mother and baby are allowed to jump the queue and ushered into a consultation room. The baby, Farhan Abdi, is 18 months old and has been unwell for a week now; his condition is deteriorating. Upon examining the baby, Kevin Amudavi the attending clinician, realises the seriousness of the multiple conditions that Farhan is suffering from. While he has managed many severely sick children before, Kevin is uncertain that he can give the delicate treatment that Farhan needs. He immediately makes a decision to seek specialist clinical advice from a paediatrician at Gertrude’s Children’s Hospital located in Nairobi, almost 500 kilometres away. Thanks to advanced telemedicine technology, Kevin is able to consult specialists whose advice make it easier for him to make the right clinical decision for the management of difficult medical cases, like Farhan’s.

With support from the DFID-funded County Innovation Challenge Fund (CICF), Gertrude’s Children’s Hospital established the telemedicine platform that enables mothers and their newborns to receive quality care, when their medical needs are beyond the capacity of staff at the Daadab Hospital. The platform is among the most advanced care-at-a-distance technology that incorporates high-definition video, clear audio and connected diagnostic devices.

“This technology is making it possible for patients in very remote areas to receive specialist care that is mostly only available in the urban areas. It saves patients and their families the cost and risks associated with long distance referrals for higher level care. The platform also enables health workers to receive virtual mentorship and clinical decision support from senior medical experts,” explains Dr Renson Mukhwana, a paediatrician at Gertrude’s Hospital who provides telemedicine consultations from Nairobi.

Stakeholders in Garissa County agree that telemedicine can help improve maternal and child health by addressing access gaps and shortage of medical personnel. The county is among the 15 out of Kenya’s 47 counties that accounts for the highest burden of maternal deaths. Neonatal outcomes are equally poor with a neonatal mortality rate estimated at 33 per 1,000 live births, much higher than the national average of 22 per 1,000 live births. Since early 2017 when the telemedicine platform was launched at Daadab Hospital, over 60 remote consultations have been conducted assisting patients who would otherwise have been referred to higher facilities, often more than a day’s travel.

Despite some challenges such as poor Internet connectivity and unreliable electricity, the futuristic telemedicine solution has literally been a lifeline for patients such as Farhan whose medical conditions require specialist management. The initiative has demonstrated that through an effective public-private partnership model, telemedicine can solve some of the complex barriers Kenya faces on the path to reaching universal health coverage.