In the desperate days soon after the earthquake in Haiti last month, foreign medical volunteers relied on improvised, low-tech devices for consultations and coordination. But American doctors are switching to more sophisticated technology to help improve public health in Haiti, one of the world’s poorest nations.
“We are in this for the long haul,” said Scott C. Simmons, whose title at the University of Miami Miller School of Medicine is director of telehealth.
Telehealth, better known as telemedicine, is an offshoot of the space program; it was developed by National Aeronautics and Space Administration in the 1960s to serve the astronauts. In the live, real-time version, it involves a video hookup between a patient on the scene and a doctor or other health professional in a hospital or office. Sometimes a doctor or nurse on the scene will consult via telemedicine with a specialist elsewhere.
At the University of Miami’s 240-bed tent hospital near the airport in Port-au-Prince, Haiti, where volunteer surgeons from the United States have performed 1,000 operations since the Jan. 12 earthquake, doctors should soon be able to consult via satellite with specialists in Miami and other medical centers, said Mr. Simmons, an engineer who helped develop portable telemedicine for NASA’s space shuttles.
The satellite connection should provide sufficient bandwidth for telemedicine consultations; meanwhile, the Haiti field hospital is making do with high-speed Internet connections donated by a Miami philanthropist and connections through Access Haiti, a wireless regional network linked through the neighboring Dominican Republic.
It is also getting help from a network of volunteer ham radio operators like Jack Satterfield, a fisherman from St. Petersburg, Fla., who helped get an imperiled day-old infant from Haiti to the Navy hospital ship Comfort offshore. “Their doctor talked to our doctor” via the military’s radio system for amateurs, Mr. Satterfield said.
The Comfort, part of the United States military’s Southern Command, has 82 physicians and 136 nurses. Capt. Miguel Cubano, surgeon general of the command, said he was in “discussions to set up a long-term presence in Haiti.” Among other things, Captain Cubano said, it could provide telemedicine consultations with the Center for the Intrepid, a military rehabilitation hospital in San Antonio.
The ship is no stranger to Haiti. The Comfort provided assistance after the hurricane last year. “Haiti was a priority for us before the earthquake,” said Captain Cubano, who is also a surgeon.
Southcom, short for Southern Command, has a partnership in advanced technology with the University of Miami.
Dr. Anne E. Burdick, associate dean of telehealth and clinical outreach at the Miller school, said the university’s program could be “a hub for connecting Haitian patients with health care providers in several U.S. telemedicine programs around the country.”
In a test with the Southern Command, Dr. Burdick said, the school used live teleconferencing to link kidney transplant patients in Guyana with a surgical team at Walter Reed Army Medical Center in Washington.
John Linkous, chief executive of the American Telemedicine Association, a trade and advocacy group in Washington, said it was often hard to persuade busy physicians to stay for long in developing countries. After a visit, however, they are often ready to help out with telemedicine consultations.
The video sessions are often prepared in advance with secure Internet messaging, including pictures, X-rays and pathology reports. More often, the exchange is entirely by Internet, with a response sent back within hours.
Dr. S. Ward Casscells, a Houston cardiologist who was assistant secretary of defense for health affairs under President George W. Bush, noted that telemedicine had become simpler and less expensive in the era of the Internet and advanced cellphones.
Dr. Casscells urged the military to leave telemedicine equipment behind when the disaster eases in Haiti and train local medical people to use it.
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