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

Rural South Africa faces many challenges. The prevalence of HIV/AIDs is partnered with high rates of other diseases, both infectious and non-communicable.

Limpopo Province is among the poorest of South African communities, with a 34 percent poverty rate. In addition, Limpopo also has one of the lowest rates of accessible drinking water. Only 44 percent of the population has regular access to potable water. The Mukondeni Filter Factory located in Ha-Mashamba is addressing limited water access with a new kind of water filter that could be a game-changer for communities where access to clean water is a challenge.

Pure Madi is a nonprofit run by the University of Virginia in partnership with the University of Venda in Thohoyandou, South Africa. Pure Madi designed the ceramic water filter of the same name to provide a sustainable solution to the world’s growing water problems. Pure Madi, named after the Tshivenda word for water, is cheap to make, simple to use and long-lasting.

The ceramic filters are flowerpot-shaped clay pots that can treat between one and three litres of water in an hour. Local clay is mixed with sawdust and shaped into a pot, then fired in a kiln. As the ceramic hardens, the sawdust burns away, leaving a porous matrix that will filter particulates out of the water. It is then treated with a dilute solution of silver nanoparticles inside and out. These nanoparticles lodge in the pores of the filter and kill pathogens like Eschericia coli and Vibrio cholera.

The filters are designed to fit into five gallon buckets that rural families commonly use to haul water. By the time water has passed through the filter, a reported 99.9 percent of all pathogens have been killed and filtered out. The filters last for about five years and are inexpensive, as a result, there is almost no access barrier.

Access to clean water is crucial to the development of communities. Without clean water, hygiene and health are almost impossible to maintain and agriculture suffers from low yields and substandard product. One could say that development grows from the groundwater up. Without access to clean water, communities lack functional sanitation services, experience constant illness and unproductive farms. Such hindrances keep a population from exploring the business and education opportunities required for further development.

Every year, between three and four million people die from waterborne diseases easily preventable with modern technology. Cholera and E. coli, rare in the developed world, are a major threat in areas without water filtration services.

The Mukondeni Filter Factoy will eventually be able to produce over 500 filters a month. Pure Madi’s 10-year plan is to build sister factories all over rural South Africa and eventually other countries as well. Pure Madi has stated that its ultimate goal is to serve 500,000 people with new filters every year.

Marina Middleton

Sources: How Stuff Works, Azo Materials, Tree Hugger, Gizmag, UVA Today
Photo: Flickr