The power of telemedicine: How tech saved life of child with hole in the heart

When her daughter was born in 2011, Samson Locherno from Lodeng’o village in the far-flung Tiaty West and his wife were elated as they welcomed the new member who ushered them into parenthood.

However, their joy was short-lived as two years later, the infant became sick, with regular fever, nose bleeding and general body weakness. Little Joyce also had delayed milestones.

Coming from a remote area where health facilities are scarce, Mr Locherna decided to walk for tens of kilometres to AIC Lodeng’o health center, where he sought medical services for little Joyce. However, her situation did not improve.

“My child never used to play like other children and most of the time you could find her sleeping. She also had delayed milestones and to worsen the situation, her nose bled frequently. I took her to a local health facility but her situation continued to worsen,” said Mr Locherna.

At one point, he resorted to taking her to a health facility in Lomut in the neighbouring West Pokot County.

“I remember one afternoon she became so frail she couldn’t even walk. I rushed her to the local health facility, where we were given painkillers and referred to Chemolingot Sub-County Hospital, dozens of kilometers away.

On returning home, Mr Locherna’s wife advised him that they seek the help of a herbalist.

“Chemolingot Hospital is very far away and owing to our scarce resources and the rugged terrain down to the facility, we resorted to herbal medicine, which did not help either. The child’s condition kept deteriorating by the day. I also started panicking because my brother had earlier lost his child to the same condition,” he told Healthy Nation.

Last year, after numerous visits to the local facility, he decided to take the ailing Joyce to the sub-county hospital, where she was admitted for three days. It is at the facility that the 13-year-old girl was diagnosed with Patent Ductus Arteriosus, a hole in the heart that is supposed to close immediately after birth; but for the young girl, it never happened.

“After being discharged from the hospital, the Grade Five pupil was given drugs and told to go back for regular check-ups,” says the father.

“When we went back to Chemolingot for check-up, doctors directed that the child be taken to Nakuru Provincial General Hospital for X-ray. We took back the results, which were relayed to doctors at Getrudes Hospital in Nairobi through a technology dubbed Daktari Smart, which was launched at Chemolingot Hospital by the M-PESA Foundation in 2021, in partnership with Gertrude’s Hospital Foundation.
 
The technology seeks to reduce referrals, increase the number of patients treated and address delays in treatment in remote areas.

 In January this year, the child was booked for a heart surgery. A month later, she underwent a successful operation at Gertrudes Hospital and the hospital bill was cleared by the Safaricom Foundation.

“I really thank God because through this technology, my child got a diagnosis and even managed to undergo the surgery.  I come from a very remote area where getting health services, let alone specialised care, is a nightmare. If not for this technology at Chemolingot Hospital, I don’t know if this girl could be alive today,” said Mr Locherna.

The girl’s tribulations are a replica of the challenges thousands of residents in the far-flung villages in Tiaty Sub-County are enduring while seekinghealth services, with some, especially young children, expectant women and the elderly, dying of treatable diseases due to lack of services.

Many people have died in the vast region while being referred to far-off health facilities for specialised treatment, but more lives are now being saved, thanks to telemedicine, which involves remote diagnosis and treatment of patients using telecommunications technology.

The Daktari Smart kit includes electronic medical devices such as an electronic stethoscope, vital signs monitor, derma scope camera, ultrasound machine, otoscope (for examining the condition of the ear canal and eardrum) and an electrocardiogram (ECG), used to check the heart's rhythm and electrical activity.

Unlike conventional video conferencing, Daktari Smart allows a healthcare worker at local partner health facilities to place the electronic medical devices on the patient.

A specialist at Gertrude Hospital is then able to see the patient and hear the sounds in real-time without the intervention of the health worker at the local facility.

The telemedicine technology connects the hospital with medical specialists from Gertrude Hospital via video link, who will thereafter diagnose and prescribe medication for the patient. If the patient, in the opinion of an expert, needs more specialised treatment, referrals can be advised.

The bandwidth required for the equipment is low, ranging from 512 kilobits per second (Kbps) to 2 megabits per second (Mbps).

This means that the platform can be installed in rural and underserved areas that do not have fiber connectivity.

Dr Elizabeth Chebet, a medic at Chemolingot Sub-County Hospital, said the technology has come in handy, especially in Baringo County, which is still grappling with a shortage of health workers, especially in the far-flung villages where patients walk for long distances to access medical services.

“This technology has helped a great deal because many people in Tiaty are illiterate and when you refer a patient, for instance from Chemolingot to Kabarnet hospital, he or she will have to be accompanied by a translator, increasing the cost. When we offer the specialised services through telemedicine, we are cutting these costs and the patient can also be managed in a locality where they feel familiar. They don’t have to incur any cost,” said Dr Chebet.

According to the doctor, since the technology was commissioned in the facility three years ago, it has helped more than 3,600 patients. Further, four children have undergone heart surgeries at Gertrude Hospital.

“We do not have paediatric specialists in this facility, so when we are guided by a specialist at Gertrude, through the technology, we help the patients in need. It has also helped us to strengthen the skills of our staff through the same because we interact with the specialists. This is a system that we really advocate for the government to adopt because it will reduce the number of referrals,” said the Doctor.

During the launch at the time, MPesa Foundation Director Les Baillie said the technology - initiated in three other pilot counties-  Samburu, Homa Bay and Lamu - aimed to use telemedicine to link and provide treatment to 32,400 children in six hard-to-reach counties in Kenya.

The participating counties in this programme have only one or no paediatrician to treat children in these counties.

According to the Kenya Medical Practitioners and Dentists Board, the doctor-to-patient ratio in Kenya stands at about one for 6,355 people, limiting access to a qualified medical professional.

“Our mission is to transform communities by improving access to quality healthcare services to needy and disadvantaged children in the country. This involves embracing innovation and technology as well as research,” Mr Baillie said, adding: “The Daktari Smart programme will enable us to provide the much-needed specialist care to children in far-flung areas as well as develop appropriate data and information to support paediatric healthcare in the country.”

M-Pesa Foundation committed over Sh168 million to the initiative while Gertrude’s Hospital Foundation invested over Sh35 million in the three-year programme that seeks to leverage telemedicine to provide specialist care to more than 32,000 children in Baringo, Homa Bay, Lamu and Samburu counties.

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