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International Telehealth CollaborationsDuring and prior to the COVID-19 pandemic, physicians used telehealth technologies to share knowledge, experience and provide technical assistance. International telehealth collaborations have proved particularly beneficial to low-income countries where healthcare workers often lack the resources of their peers in higher-income nations. One recent example of a telehealth collaboration took place when British physicians offered up virtual services to assist India’s overworked healthcare staff. Elsewhere, international telehealth collaborations have increased the quality of care in low-income countries.

Collaboration During COVID-19

Presently, international telehealth collaboration is underway between British and Indian physicians. On May 6, 2021, India reported the highest daily average of COVID-19 cases in the world. As the country’s doctors work tirelessly to care for patients, the British Association of Physicians of Indian Origin (BAPIO) has sought to lend a helping hand. Yet, instead of traveling to the afflicted country, the BAPIO has reached out to Indian peers via the internet.

More than 250 physicians partnered with BAPIO are providing assistance to junior doctors in India by way of video calls. BAPIO’s physicians tackled a surge of cases earlier on in the pandemic and are using the experience to advise Indian doctors during this time of increased strain. Virtual conferencing tools provide a quick way to share information in the chaotic environment of India’s ongoing health crisis. Indian physicians have also been taking advantage of BAPIO’s resources by sending digital medical documents for medical professionals in Britain to review. In this case, telehealth is used to facilitate on-the-spot medical assistance during immediate health crises, but examples of international telehealth collaboration between high- and low-income nations can be found well before the COVID-19 pandemic started.

Collaboration Before the Pandemic

By creating links between medical professionals in high- and low-income nations, telehealth has proven an invaluable tool for strengthening healthcare institutions lacking access to adequate resources. One of the early successes in fully digitized cooperation between high- and low-income healthcare institutions is that of the Swinfen Charitable Trust. In 1998, the United Kingdom-based trust was established in order to fund a communications network that would link healthcare professionals across the globe.

The network, which is still in operation, allows medical professionals in resource-scarce healthcare systems to email questions to affiliated physicians in better-equipped healthcare systems. The physician best qualified to respond will then do so within 48 hours. Though not particularly high-tech, this rudimentary telehealth network has nevertheless been a valuable resource for medical professionals in low-income parts of the world. Since the establishment of the Swinfen Charitable Trust, the scope and quality of such international collaboration programs have only increased.

The University of Virginia (UVA) maintains numerous collaborative telehealth programs with healthcare systems in low-income countries across the globe. One program connects medical experts at UVA with teams at both the National University of Rwanda and Ethiopia’s Jimma University Hospital. As part of the program, participants discuss surgical and anesthesiological cases over the internet. The programs do far more than answer a few questions though. For underdeveloped healthcare systems, connections with resource-rich nations can improve the overall quality of care.

The Value of Collaboration

Healthcare quality suffers in low-income countries, such as those in sub-Saharan Africa, where per-person spending on healthcare is only a fraction of that in higher-income nations. Polling in the region shows that sub-Saharan Africa’s population has the lowest rate of satisfaction with healthcare out of any global region. Only 43% of those surveyed were satisfied with the healthcare in their area. Furthermore, the region suffers from numerous health crises including maternal mortality and the HIV/AIDS epidemic.

In areas where financial limitations clearly impact healthcare resources, international telehealth collaborations can provide a low-cost solution to some of the deficiencies of underfunded healthcare systems. In many cases, international telehealth collaborations have facilitated technical training for healthcare professionals, provided logistical support for the expansion of healthcare infrastructure and created research opportunities.

University Collaboration

International telehealth collaboration programs such as that undertaken by the UVA in Tanzania have successfully changed the way that healthcare is administered to low-income communities. The UVA connected a gyne-oncological expert with teams at Tanzania’s Kilimanjaro Christian Medical Center in an effort that educated local medical personnel on women’s health and led to the development of breast cancer testing infrastructure. The UVA is not the only university working on collaborative telehealth projects. A survey of four African universities identified a total of 129 inter-institutional healthcare programs in the universities alone. The sheer number of these programs suggests the value to both the participating medical professionals and the supported communities.

With the increased availability of advanced communication technologies, the ability to establish and maintain international telehealth collaboration is more possible now than ever before. Virtual spaces have provided medical professionals with platforms that can be used for immediate consultation or long-term development. No matter how the technology is used, it is undoubtedly creating connections that are beneficial to communities around the globe.

Joseph Cavanagh
Photo: Flickr

Healthcare for Disabled PopulationsWorldwide, estimates have determined that more than 1 billion individuals live with some form of disability. In developing countries, access to healthcare is difficult enough with rural areas being far from main health centers and low socioeconomic status preventing optimal diagnosis and treatment. For disabled populations, low mobility leads to transportation difficulty, creating an additional barrier that compromises health and access to the nearest healthcare providers. Established in 1998, the Swinfen Charitable Trust (SCT) is a United Kingdom-based nonprofit organization that focuses on providing healthcare for disabled patients in developing countries through increased access to telehealth.

Disability as a Public Health Issue

Although 15% of the world lives with a form of disability, every person experiences varying limitations and healthcare needs. Article 25 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) states that those living with disabilities must receive the highest former of care without discrimination. Despite some countries upholding Article 25, many developing countries cannot provide the proper care for disabled individuals.

Beyond discrimination experienced in the health sector, individuals with disabilities face various barriers to healthcare. To begin, they typically encounter prohibitive costs for health services and transportation since a disability can create the need for a specially adapted vehicle in order to travel to the nearest healthcare professional. Estimates have stated that more than half of people experiencing a disability are unable to cover the costs they incur in healthcare, compared to approximately a third of people for those who are able-bodied. Also, physical barriers prevent disabled people from being able to access certain buildings and essential medical appointments. Inaccessible medical equipment, poor signage and inadequate bathroom facilities all comprise potential barriers. For example, medical professionals can often deny disabled women breast and cervical screening since the tables are not adjustable to one’s height and mammography equipment cannot accommodate women who are unable to stand.

The Swinfen Charitable Trust’s Mission

The Swinfen Charitable Trust (SCT) focuses on the disabled population of the developing world. SCT creates telemedicine links between healthcare centers in the developing world and medical professionals globally, who provide complementary diagnosis and treatment services. SCT represents the longest operating telemedicine nonprofit in existence. To date, there are 366 referring hospitals and more than 700 specialists providing their expertise to disabled people in developing countries free of charge. People can download the app called SCT Telemedicine on mobile phones and SCT has established telemedical links in 78 countries.

SCT raises money that goes toward improving the telemedicine experience and accessibility for disabled patients in developing countries. To begin, financial contributions provide round-the-clock system operators who have the task of analyzing and allocating new cases to specialists. Also, the money raised grants on-site support to partners for telemedical coverage implementation in local communities. This is especially crucial in remote areas of the developing world. Finally, any additional funds are allocated to expanding care to new countries or villages that are struggling to deliver adequate healthcare for disabled populations.

Improving the Lives of the Vulnerable

With a rising technologically dependent world, the Swinfen Charitable Trust is attempting to bridge the gap between poverty and healthcare access in developing countries, particularly for vulnerable populations. By establishing the means for disabled populations to access telemedicine, the disabled population can overcome healthcare barriers and improve their quality of life and life expectancy significantly.

– Sarah Frances
Photo: Flickr