eHealth Workshop – Dubai, UAE
Booni, Chitral, Pakistan
Improving access to quality health services for underserved, poor communities
Building capacity of health care professionals in remote, rural areas
eHealth Workshop - Istanbul, Turkey
Year in Review
Health Care Professionals Trained
Countries of Operation
Teleconsultation Conducted between the Aga Khan University Hospital and the French Medical Institute for Children
In June 2017, Naymat Ullah Hafizi, a 38-year old man from Wazir Akber Khan, Kabul was at the office busy with usual work when suddenly he caught himself in the aftermath of a bomb explosion nearby. He was rushed to the hospital in a critical state, with excruciating pain and right facial and ear trauma.
Naymat sustained serious injuries during the blast and was admitted to the French Medical Institute for Children in Kabul under supervision of Dr. Syed Sabir, an ENT specialist. He was diagnosed with severe ear and facial trauma and weakness on the right side of his face. He also experienced swelling and slurred speech.
Because of limited treatment options available at the FMIC, Naymat was referred to Dr. Sohail Awan, an ENT specialist at the Aga Khan University Hospital, Karachi, Pakistan - 676 miles away from Kabul. Quality treatment was provided by a team of doctors at AKUH, K and he was discharged from the hospital after a 20-day stay in Karachi. For follow-up treatment, Naymat was expected to visit AKUH, K multiple times. The second visit to AKUH, K was not easy for him; his work required him to stay in the office, so approval of leaves was difficult and he could not afford the visit to Karachi so often. As a result, he ended up missing the third appointment.
Shortly after, his friend referred him to FMIC, where the AKDN eHealth Programme was offering teleconsultation services from the Aga Khan University Hospital, Karachi. Naymat was able to consult his physician from Kabul through eHealth services without wasting travel time and expenses.
The distance from the Kabul to the tertiary hospital in Karachi was 676 miles. The teleconsultation saved Naymat 48 hours of travel time and associated costs of approximately USD 1254.00 for airfare, boarding and lodging, which is considerable as compared to the minimum monthly wage of USD 103.00* in Afghanistan.
See Naymat speak about his like with AKDN eHealth Programme through the above video.
Teleconsultation conducted between the French Medical Institute for Children and the Bamyan Provincial Hospital
Roshan Ali, a 12-year old boy from Khalankash, Follady Valley, Bamyan was admitted to the Bamyan Provincial Hospital with a history of convulsions. The patient had been experiencing convulsions for last five months, but due to strong beliefs, his father was availing faith healing therapy for Roshan, which had prolonged his condition. Also, there was a lack of specialist services at the local health centre in his village.
Upon admission, his family discovered there were no neurosurgeons at the Bamyan Provincial Hospital. Luckily, the AKDN eHealth Programme connects the Bamyan Provincial Hospital with the French Medical Institute for Children in Kabul for teleconsultation services. Roshan was scheduled for a teleconsultation with neurologists, Dr. Ajmal Ghaffar Zai, and Dr. Esmatullah Hamed at the French Medical Institute for Children (FMIC), who diagnosed his condition as Epilepsy.
Roshan was prescribed anticonvulsants (antiepileptic medicines). His condition started to improve significantly within two follow-ups with his physician at the French Medical Institute for Children. Roshan was able to make a full recovery and was symptom free in a year.
The AKDN eHealth Programme allowed Roshan to access the specialist service of a neurosurgeon, otherwise not available in his village, saving him substantial travel, time and cost. Travelling by road to FMIC for treatment would have not only taken 5 hours, but would also have been very risky due to the socio-political disorder within the country. Instead, Roshan and his family only had to travel one-hour from his village to reach the Bamyan Provincial Hospital to avail specialist care. Considering the minimum monthly wage of USD 103.00* in Afghanistan, through the Programme, Roshan and his family were able to save a large sum, approximately USD 550.00 along with considerable time and hassle.
Teleconsultation Conducted Between the Faizabad Provincial Hospitaland the Ishkashim Comprehensive Health Centre+
Qurban Baigum, a 46 year-old female, visited the Ishkashim Comprehensive Health Centre+ (CHC+) with a very visible and painful skin condition on her right cheek. Due to the lack of qualified health professionals at the Ishkashim CHC, a teleconsultation was scheduled with a specialist, Dr Mukhtar Raizkani, at Faizabad Provincial Hospital. He diagnosed her with Rosacea and prescribed topical creams and anti-allergy medication for about a month and offered patient education. After a month, Qurban condition disappeared and she was doing well again. As compared to the minimum monthly wage of USD 103.00*, Qurban was able to save a considerable amount, USD 100.00, by availing teleconsultation services rather than visiting the Faizabad Provincial Hospital for treatment, which is at a 6-hour drive from her village.
Teleconsultation conducted between the French Medical Institute for Children and the Faizabad Provincial Hospital
In March 2017, a newborn of 23 days, Bibi Rana Fareed, who had been diagnosed with ptosis on the right side before birth, needed specialist services of an orthopaedist at the Faizabad Provincial Hospital (FPH). Her parents complained of semi-paralysis of left shoulder along with a dislocation of the left shoulder joint. Due to the lack of specialist services at the FPH, Dr Qutbuddin Fazli, General Physician, FPH, decided to schedule a live teleconsultation with Dr Ezatullah Faiz, Orthopaedic Surgeon, at the French Medical Institute for Children (FMIC) in Kabul. After the first live teleconsultation, Dr Ezatullah invited Bibi Rana to FMIC for further investigation. After her visit to FMIC, Dr Ezatullah diagnosed her with Septic Arthritis. Treatment was provided at FMIC for two days, after which Bibi Khadja returned to her village. Through follow-up teleconsultations over two months with Dr Ezatullah, Bibi Rana recovered. Towards the end of the treatment, Bibi Rana was healthy and there were normal movements in her shoulder and arm. Her family was advised to continue with physiotherapy exercises for further improvements. Bibi Rana’s family expressed their gratitude for the eHealth services, as initially they were advised to travel abroad to seek specialist treatment, which was not possible without a large sum of money.
Through the AKDN eHealth Programme, Bibi Rana was able to access specialist health care services needed for her condition and receive correct diagnosis and appropriate treatment. FPH was only a 10-minute drive from Chabchi, while FMIC is approximately a 15-hour drive by car and is risky due to unstable political conditions of the country. Availing teleconsultation services at FPH saved Bibi Rana an enormous amount of money and considerable time.
Teleconsultation conducted between the Faizabad Provincial Hospital and the Bharak District Hospital
Hasina Ibrahim, a 39-year old woman from the village of Chabchi, was experiencing severe balding. She was losing over 100 strands of hair per day, yet was unable to identify the cause of the problem. She presented to Bharak District Hospital in Afghanistan with depressive symptoms and complains of uncontrollable hair loss. There were visible bald patches in her scalp.
A teleconsultation was scheduled with Dr Qutbuddin Fazli, General Physician at the Faizabad Provincial Hospital in November 2017. He diagnosed her with depression, which was ultimately resulting in the hair loss. Through the teleconsultation, Dr Qutbuddin prescribed her medication and patient education was also carried out via the teleconsultation, providing valuable information on how to handle the condition better, particularly with regard to hygiene and insomnia. Over a period of one month with multiple teleconsultation sessions, Hasina’s condition improved significantly and she was satisfied with results.
Through teleconsultation, as compared to the minimum monthly wage of USD 103.00*, Hasina saved approximately USD 40.00 through teleconsultation services and considerable time and hassle. Travelling to the tertiary care hospital would have taken about three hours by car, as opposed to the one hour walk she undertook to reach Bharak District Hospital. Traveling the long distance for treatment would not only have troubled Hasina, but also would have led to unnecessary expenses, leading to further psychological stress and worsening of her depression. Through the AKDN eHealth Programme, Hasina was able to receive correct diagnosis of her condition, which was depression rather than extreme hair loss, and the treatment she needed.
Hasina conveyed genuine gratitude to the AKDN eHealth Programme and expressed the desire for expansion of telemedicine services in her community.
Teleconsultation conducted between the National Hospital of Kyrgyz Republic and the At-Bashy Territorial Hospital
Aizada Beshenalieva, a 55-year old woman from the village of Kara-su, was admitted in an emergency condition at the At-Bashy Territorial Hospital in June. The patient had sustained serious injuries during a thunderstorm, during which a tree fell on her. She was experiencing excruciating pain in the chest; shortness of breath; difficulty breathing; severe weakness; and dizziness. The patient’s debilitating condition suggested she was in traumatic shock, which required immediate medical attention.
Diagnosis through examination and X-ray reports indicated multiple fractures on both sides of the ribs and accumulation of blood and air in the chest on both sides, called bilateral hemopneumothorax, in medical terminology and traumatic shock.
A teleconsultation was scheduled immediately with the head of the Department of Thoracic Surgery at the National Hospital, Kyrgyz Republic, who recommended that the patient be given immediate treatment remotely, as opposed to travelling to Bishkek. Treatment was administered by a team of doctors, which included Dr. Adranov (Head of Surgery Department), Dr. N. E. Ibraimov (Traumatologist), Dr. S. Satybekov (Head of Intensive Care Unit), and Dr. A. Mirzabekov (ICU clinician). Thoracentesis was carried out on both sides of the chest, to drain out blood and air from the pleural cavities in the chest. The treatment plan also involved infusion therapy to provide symptomatic relief, and antibacterial therapy to prevent post-op infections.
Aizada was able to make a good recovery and was discharged from the hospital in early July, after a month’s stay at the hospital.
The distance from the patient’s village to the tertiary hospital in Bishkek is 400 km, which is about a 5-hour drive from At-Bashy. Traveling the long distance in the traumatic condition may have led to the deterioration of her condition while costs for travel, boarding and lodging for one month’s stay for her and her family would have cost her USD 223.00, which is an enormous amount as compared with minimum monthly wage of USD 17.00* in Kyrgyz Republic. By conducting teleconsultation, Aizada was provided quality treatment in a timely manner, saving her travel time and costs and resulting in better health outcomes and a better prognosis.
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Annual Report 2017