1 an effort towards bridging the digital divide... going the last kilometer in the peruvian jungle...
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An effort towards bridging the An effort towards bridging the digital divide...digital divide...
Going the last kilometer in the Going the last kilometer in the Peruvian Jungle –Peruvian Jungle –
for HEALTH CAREfor HEALTH CARE
ENLACE HISPANO AMERICANO ENLACE HISPANO AMERICANO DE SALUD – EHAS*DE SALUD – EHAS*
*Hispano American Health Link
Four institutions collaborate working for the EHAS program in Perú:
TWO are from Spain: Universidad Politécnica de Madrid (UPM) with the
Grupo de BioIngeniería y Telemedicina (GBT)Asociación Madrileña Ingeniería sin Fronteras (IFS)TWO are Peruvian:Pontificia Universidad Católica del Perú (PUCP), with
the Laboratorio de Comunicaciones de Bajo Coste (LCBC)
Universidad Peruana Cayetano Heredia (UPCH), with the Centro de Coordinación Nacional (CCN)
Funded by:
Actors:
PUCPPUCPISFISF UPCHUPCH
AECIAECI CYTEDCYTED CONCYTECCONCYTEC
GBT-UPMGBT-UPM
Other support Entities
“Enlace Hispano Americano de Salud” EHAS Program in Perú
Microsoft
UNIVERSIDAD PERUANA
CAYETANO HEREDIA
(Antiviral program) (Software Licences)
44
The EHAS program has established a pilot in 40
communities in Alto Amazonas, Dept. of Loreto, working with the
Ministry of Health...
One of them is Sucush-Yacu, a riverine community on the Huallaga river.
The river is almost the only way of reaching this small town...
Shucush - YacuShucush - Yacu
Seen
from
above
Travel conditions in the Peruvian JungleHealth personnel travel away from their Posts some 30-50
times a year, because of service needs
EHAS-PERÚEHAS-PERÚ
EHAS ProgramEHAS Program
Keys of the EHAS program: Communication and health information services
Targeted to the health personnel in rural areas of developing countries
Appropriate low cost technologies
Spanish language services
General Objective
Contribute to the improvement of
the public health system in rural
areas of Latin American countries
EHAS ProgramEHAS Program
Specific Objectives
Improve the working conditions of rural sanitary personnel by acting on:
The telecomunication infraestructure of the more remote and isolated rural health establishments, specially those without telephone lines and services
Provide health information services, so as to give:Remote access to specialized health information
Access to distance learning coursesRemote access to consultation with expert health
personnelImprovement of the epidemiologic surveillance system
EHAS Program
And... What is the communications And... What is the communications tool going to be?... the COMPUTERtool going to be?... the COMPUTER
There’s NO telephone in most of the Health Posts... and there’s NO hope of having one in those communities, for many years
Therefore RADIO has to be used for both VOICE and DATA communications
And TRAINING the personnel for proper use of the new tools is paramount...
Remember:
The Alto Amazonas Province
EHAS-PERÚ
Health Establishments involved in the EHAS Alto Amazonas Pilot
In June 2001, OSIPTEL/FITEL placed telephones in 7 establishments:
* Saramiriza, * Santa Cruz, * Pampa Hermosa,* San Lorenzo, * Shucush-Yacu, * Jeberos and * San Gabriel de Varadero
EHAS-Alto AmazonasEHAS-Alto Amazonas
From: "Puesto de Salud Munichis" <[email protected]>
To: <[email protected]>
Sent: Tuesday, November 06, 2001 7:28 PM
Subject: ofidismo (SNAKE BITE)
hola Señor Carlitos como esta me da mucho alegría que alguien tenga un tiempito para dedicarnos a nosotros apesar que estamos tan distante pero mediante este sistema fácilmente se comunica, quería pedirle una lección te cuento que en este mes he tenido 02 casos de mordedura de serpiente (jergón nombre común) yo quiero que me envíes el tratamiento correcto de un paciente con este Dx, Ud., sabe que nosotros somos técnicos a mucha honrra ¡verdad! yo trato así coloco una vía de cloruro de sodio 9%, suero antibotropico polivalente, dexametazona, metamizol 1gramo,PG sódica 1000,000UI, y después de las 24 horas ya empiezo con vía oral es decir según casos si el paciente ha mejorado y dime siempre en necesario para prueba de sensibilidad, bueno señor carlitos espero su respuesta ya que estoy tratando un caso de esto. chau hasta otro momente.
(The punch line: " I expect your answer because I’m treating a case ")
AN AUTHENTIC MESSAGE FROM THE FIELD
Some of the didactic material prepared specifically for Loreto
By the
Primary Health Care – Loreto
Project
And the “Sanicho” newsletter – Which has its own trajectory!
Primary Health Care – Loreto Project
NOW, there’s an electronic version...
Costs of the EHAS system (per establishment)Costs of the EHAS system (per establishment)
Infrastructure costs: US$ 4195
Energy supply: US$ 1450 (two 75Wp solar panels; a
225 Ah battery bank; a photovoltaic regulator; a 75 W
inverter; two 13W lights; supports, battery box, etc.
Communications system: US$ 685 (a VHF
transceptor; a radio MODEM; box, etc. Antenna &
accessories: US$ 800 (a 15 m robust mast; a VHF antenna;
a grounded lightning rod; coaxial cable, etc.)
Workstation: US$ 1260 (a laptop computer; a matrix
printer; a worktable-enclosure)
Communications Costs :
Local voice and data communications – most
(~ 80%) of these are FREE
Access to external addresses: ONE local call
every 3 hours, shared throughout the network
Maintenance Costs:
Paid, so far, by the EHAS project as part of
the funded activities
Initial Evaluation (at 9 months operation) :
Most communication occurs locally, and is on patients while they are seen - better care!
Health personnel travel is reduced – savings! Patient evacuations are avoided or simplified and
streamlined – further savings! Out of 237 urgent evacuations, in 60 cases the EHAS
system is credited with saving lives Time for report making is reduced and less data
errors are likely to be made - no rewriting! Health personnel appreciate e-mail consultation and
training – Courses satisfied 70% of expectations! Satisfaction and confidence of the Health personnel
in the new tools is high – 95%!
Initial Evaluation (at 9 months operation) :
Taking initial investment, maintenance and repair costs, avoided travel “pays back” in 32 months
If tangible indirect savings (avoided productivity and time losses of Health personnel) are factored in, the system is amortized in 13 months!
Calculations of economic benefits for the reduction of lost workdays by the patients, less deaths or discapacities, etc., would result in even less time to amortization.
And then, there are the intangibles… better health, greater equity, improved community life, citizen pride, etc…
But…we have to think of all the rural areas of Perú......
And
There’s a greater challenge…:
The map shows the distribution of the 36 native mother-languages spoken in Perú
Within the Universidad Peruana Cayetano Heredia, the EHAS project is housed at the Instituto de Medicina Tropical Alexander von Humboldt
Director:Dr. Eduardo [email protected]
EHAS Coordinator :Dr. Humberto [email protected]
Mailing Address: A.P. 4314, Lima 100, PerúPhone: (511) 4823903 Fax: (511) 4823404Website: http://www.upch.edu.pe/tropicales/upch.htm
Instituto de Medicina Tropical Alexander von Humboldtof the UNIVERSIDAD PERUANA CAYETANO HEREDIA
Within the Hospital Nacional Cayetano Heredia, Lima 31, Perú