Satellite Internet connection enables telemedicine aid to isolated Cambodian villagers

Robib 13 February 2001Linking one of the poorest, most remote villages in Asia to expert medical attention at a leading medical centre has occurred last February between Robib in northern Cambodia, whose per capita annual income is just $37 a year, and Massachusetts General Hospital's telemedicine department in Boston with the co-operation of the charity Sihanouk Hospital Center of Hope in Phnom Penh.


A trained Cambodian nurse from the Sihanouk Hospital, furnished with testing equipment and a digital camera, has undertaken the first of a monthly nine hour journey by jeep from Phnom Penh to Robib in Preah Vihear, isolated for more than a decade by Khmer Rouge troops. Last year, a satellite Internet link was set up in the village, which has no piped water, electricity nor telephone systems, to demonstrate how the new digital technology enjoyed by millions in the industrialised world, can benefit the world's impoverished rural areas in obtaining medical assistance from the best medical institutions.

The nurse from the Sihanouk Hospital Center of Hope has examined some thirty patients in Robib, much as in a triage situation of an outpatient clinic of a hospital. She has entered the information collected after examining the patients, while an assistant took digital photos of the symptoms. In the future, x-ray and other equipment will be provided to the village clinic for such examinations. At the completion of the examination, the nurse has transmitted the data and digital photos to the charity Sihanouk Hospital Center of Hope in Phnom Penh, operated by a staff of some 300 medical workers and led by a team of ten American, British, Filipino, and Japanese physicians and to Telepartners, a telemedicine expert, staffed by specialists from Massachusetts General Hospital and Harvard Medical School in Boston. Doctors at both institutions studied the data sent by the nurse and responded with instructions to provide to each patient within the same day.

While at Robib, the nurse held sessions with the villagers to instruct them in general preventive health care, treating common ailments and also collected questions about medical problems from the villagers which she relayed to the specialists at both hospitals for a response to be placed on the village Web page both in English and the Khmer language. This formed the first step of a learning process in how villages in developing countries can benefit through the Internet from medical specialists when neither the villagers are able to move to visit these physicians at their facilities nor can the specialist come to the village.

"Charity hospitals such as ours", noted Dr. Graham Gumley, director of the Sihanouk Hospital Center of Hope in Phnom Penh, "are unable to reach the remote villages where most people do not have the opportunity to obtain the type of medical attention everyone deserves. More than half of our outpatients come to us by foot, bicycle or motorcycle from hundreds of miles because there are no medical facilities near where they live. Often their condition deteriorates because of the long, strenuous trip. Telemedicine is at a very early stage but this gives us the opportunity to study how we can effectively contribute our knowledge to save lives through long distance medicine to people who never dreamed we could find ways to reach them."

The Internet access to the Wakako Hironaka School in Robib, which includes a satellite dish linking to a satellite, is provided by Shin Satellite of Thailand. The project is operated by American Assistance for Cambodia/Japan Relief for Cambodia non profit organisations. The telemedicine project is organised by Dr. Graham Gumley, director of the Sihanouk Hospital Center of Hope in Phnom Penh and Dr. Joseph Kvedar, vice chair of dermatology at the Harvard Medical School, and director of Partners Telemedicine, which offers the consultative services of physicians at the Brigham and Womens Hospital, and the Massachusetts General Hospital.

Leslie Versweyveld

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