The publicly funded health infrastructure in India is in a bad shape. However, the private corporate hospitals and super speciality centres catering to the urban rich are having a field day literally. ‘The rural health care sector in India, which has a ratio of one hospital bed for every 1333 citizens has become “nobody’s child”. With most of the medical specialists working in urban areas, villages have virtually no access to super speciality treatment close to their homes.

A recent study conducted by the Indian Institute of Public Opinion reveals that 88.8% of the rural patients in India have to travel 8 kms to access medical treatment of some sort. The remaining 11.1 percent have to travel further. Similarly, a World Bank study indicates that more than 40 percent of the Indians are forced to borrow money or sell assets when they are hospitalised. Strongly advocating the need to strengthen and expand the public health care centres, the World Bank study has recommended allocation of more resources and stepped up activities in the areas of supervisor, monitoring results and increased public accountability. It has also urged a vastly improved investment on disease surveillance, public health monitoring and information system.

Rural health care sector, which has a ratio of one hospital bed for every 1333 citizens has become “nobody’s child


Against this backdrop, the innovative telemedicine initiative launched by the Indian Space Research Organisation (ISRO) with the objective of taking super speciality health to remote rural areas holds the hope of giving a new and meaningful direction to the rural health care in the country. This telemedicine initiative is based on the potentials of India’s fully homegrown INSAT domestic spacecraft. According to G. Madhavan Nair, Chairman, ISRO there is a crying need to lower the cost of treatment to help telemedicine become popular and easily accessible instrument of health care. He also pointed out that ISRO’s role in the telemedicine project was initially envisaged to be  just the connectivity provider. But now, it has taken on the task of providing high quality diagnostic inputs and the software.

Incidentally, Karnataka, which happens to be the hub of the Indian Space activities has become the first Indian state to launch an operational telemedicine project linking all the public health centres at district and sub-district levels. Thanks to the telemedicine project, Narayana Hrudayalaya, a Bangalore based super speciality cardiac care centre is now linked to the Chamarajaynagar government hospital and Swami Vivekananda health care center in the tribal hamlet of Sarguru in Mysore district of the Stae. Not surprisingly then, the Narayana Hrudayalaya has been able to diagnose the cardiac problems afflicting the poor rustics in the remote parts of Karnataka. Obviously, these rustics otherwise don’t have the access to basic health care facilities.


The most advantageous feature of the telemedicine network is that the entire medical record of a patient can be sent to the experts at a super-speciality hospital and get the timely, expert advice. Basically, the telemedicine system consists of customized medical software integrated with computer hardware along with medical diagnostic instruments, connected to the commercial VSAT (Very Small Aperture Terminal) at each location. The Indian telemedicine initiative is an indigenous enterprise with the Indian built spacecraft and computer software engineered by the Indian experts. Efforts are also being made to link up Narayana Hrudayalaya to hospitals in the urban centres of Pakistan through the telemedicine network. This endeavour by ISRO has led to the slow and steady expansion of telemedicine into the remote, rural parts of Sikkim, Ladakh and Northeast, Andaman and Nicobar Islands and Lakshadweep islands. Today more than 14 super speciality hospitals located in various cities of India are linked to many of the rural health care centres in India through the telemedicine network. And when India launches its exclusive health care satellite “Healthsat” by the end of 2005 through the highly successful Polar Satellite Launch Vehicle (PSLV) the telemedicine network would be expanded to most of the remote rural locations in the country

 

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