Bismillahir Rahmanir Rahim

May The Almighty shower us all with His infinite blessings

Telemedicine in Bangladesh
Background, Implementation & Experiences

Dr. Kazi Saifuddin Bennoor

Assistant Professor (Respiratory Medicine) National Institute of Diseases of Chest & Hospital, Dhaka, Bangladesh

General Secretary Bangladesh Telemedicine Association bennoor@gmail.com

From Dhaka, Bangladesh

To Cochin, Kerala

Bangladesh
Area 150,000 sq-kms population 145 million M:F = 104:100 below 15 years >40% Per Capita GDP <300 US$
INDIA

INDIA INDIA
MYANMAR

Bay of Bengal

mainly plane lands extremely networked by numerous rivers heavy monsoon and torrential flood

Flood affected areas of Bangladesh, April 2004

We need medical help

qualified physicians <30,000. 10% of them hold a specialist degree or diploma Population per physician is around 5,000 Number of hospital beds is about 40,000 population per bed 3750 (ideal figure 500)

sp ec ial ist

distribution of specialists is lop-sided more specialists in the capital city Dhaka tertiary care hospitals are also concentrated in Dhaka

Applicable Fields of TM in Bangladesh

Emergency Medical Care. Physician to Physician Second Opinion Teleconsultation. Follow-through medical consultation for patients receiving treatment abroad. Rural Telehealth care. Post-disaster (flood) medical management.
Cont.

Applicable Fields of TM in Bangladesh

Home Tele-monitoring. Healthcare Professional Training Program for remote isolated doctors Medical Education, Continuing Medical Education (CME) and Patient education. Military and Prison Healthcare System.

Current Status of Telemedicine

Telemedicine Associations:
Bangladesh Telemedicine Association

Telemedicine Services:
Medinova Telemedicine Center for Rehabilitation of the Paralyzed Bangladesh Institute for Research of Diabetic, Endocrine & Metabolic disorders (BIRDEM) Bangladesh Telemedicine Services DNS Telemedicine

Bangladesh Telemedicine Association (BTA) is the nationalmember of International Society for Telemedicine (ISfT)

Priorities of BTA

To Promote Development of Telemedicine Network in Bangladesh. Establishment of a Virtual Medical Library. Computer Literacy Programs for Medical Professionals. To lobby for establishment of the regional office of ISfTeH in Dhaka. To explore the possibilities of developing South Asian Association of Telehealth Initiatives (SAATHI) in collaboration with SAARC.

Medinova Telemedicine Bangladesh Telemedicine Services DNS Telemedicine

- providing commercial services - digital data store & forward - medical video-conferencing - follow up cares

Center for Rehabilitation of the Paralyzed

- non-profit NGO providing second opinion services from British Navy

Bangladesh Institute for Research of Diabetic, Endocrine & Metabolic disorders (BIRDEM)
- networked between central institute in Dhaka & peripheral center on a limited basis

Benefits Obtained

Cost effective
Travel & accommodation Investigation & Consultancy

Family care & environment retained for the patient Prompt specialized opinion served to the remote & isolated areas Remote physician does not feel helpless Faculty development of the physicians

The Problems
Security & Confidentiality of information Reliability issues of the patients Lack of record keeping attitude & facilities Computer illiteracy, reluctance & phobia Scarcity of TM-supported imaging equipments

The Problems
Unavailability of data transfer connectivity High cost of band-width Inexistence of government initiative & policy

Future Programs

Server-based telemedicine network connecting GPs of five divisional districts with Dhaka. Country-wide tele-home monitoring of Cardiac, Respiratory and Diabetic patients. 24 hours / 7 days a week emergency call center. (Using Cell phones)

Future Programs

Interactive CME and training programs. Robotic telepathology network connecting different districts with Pathologists in Dhaka. Expansion of International Teleconsultation network for follow-up of patients receiving treatment abroad & to countries needing specialized medical support.

Towards a new discipline:

global e-health

Medical Knowledge & Know-how should not be constrained by geographical borders

Lets make GEOGRAPHY, a HISTORY in Medical Science

Thank you very much for your kind attention