By Donald Thompson MD, MPH & TM
In many international ministry settings, you as the ex-pat are seen as the medical expert, whether you are medically trained or not. While you might be a highly accomplished doctor, nurse, pharmacist, or community health worker, often pastors, church planters, evangelists, or project managers are sought out as “the medical experts.” In spite of the fact that there may be a good national medical infrastructure available, you can count on being asked “to consult” on your national partner’s aunt, or the son of the village elder, or the brother of the local Imam, just because of your western perspective!
I have a friend whom I will call ‘Pete’ who had served as a church planter in the Philippines for about a decade. Approximately 25 years ago he stayed in my home while he attended a two week tropical medicine intensive at Tulane University. This two week course colloquially known as the “Missionary Doctor Course” was stuffed with all the tropical medicine training that medical personnel needed for their third world setting. This two week course has been replaced with a one semester certificate level course that is now available at other universities. Though designed for physicians, nurses, and those with medical training, ‘Pete’ just devoured everything in it because he had been ’doctoring’ for the previous 10 years!
You might be another ‘Pete’ or perhaps even as a skilled family practice physician, nurse practitioner, or physician assistant, you are regularly stumped by various skin conditions, fevers of unknown origin, or chronic abdominal pain with weight loss and cough. You may work alongside a very competent national counterpart but there will often be cases where the diagnosis and management options are not clear. Who are you going to call?
There was a time not long ago when you may not have had access to a computer with video capability or a strong enough internet signal to support video. Not having a dependable electrical supply from local grid may also have created issues if you did not have redundancies in the form of a generator or solar power system to keep you functional when the power goes out. Technology now permits, for the most part, almost everyone to have access to a smart phone and data network that will support real-time consultation. ‘Pete’ did not have internet access. ‘Pete’ did not have a smart phone. YOU do! In most settings, your national counterpart does as well! That being said it still begs the question: who are you going to call?
The good news is that even a smart phone will connect you to that person. Need a Dermatologist? Need a Pediatrician? Need an OB/GYN? What is the typical need where you work? Telemedicine can address that need! Do you or your national colleagues need to speak with an experienced medical specialist while you have a patient in front of you? Telemedicine can do that! Does your hematology analyzer need to be re-calibrated? Telemedicine can access a bio-lab technician who can walk you through this process! Does your medical staff need training but can’t afford the cost or time away? Does your office staff need support developing a spreadsheet for budget? Iterations of telemedicine can and will address these needs.
If you’ve asked if there’s a way to use a telemedicine network to build capacity within the national healthcare delivery system where you serve, I believe that you now have the answer. Call the Doctor!
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Margie Stevens