Dr. Reza Bin Zaid, a dermatology consultant at BIRDEM hospital, Dhaka, is a doctor with a difference. While the vast majority of medical professionals in Bangladesh are skeptical technology that facilitate remote diagnosis, Dr. Zaid has been successfully running the first instance of telemedicine services in Bangladesh since 2000. As the chairman of the Telemedicine Working Group of Bangladesh, he is currently operating in 16 unions across Bangladesh.
Dr. Zaid truly is a rare breed of doctors, deeply passionate about technology. ”My love for technology started with my first computing course at BUET. I was actually the second person to get an internet connection in Bangladesh,” he said.
At the Telemedicine Working Group Office in Dhanmondi, we had the opportunity to see the telemedicine device known as DICOT created by Dr. Zaid and his brother, Dara Bin Zaid. Standing 6 feet tall, the basic contraption is a carefully crafted composition of a computer, a high definition webcam mounted on an adjustable arm, a lighting system to normalize images, and a printer. In addition, there was also an X-ray light box attached to the device for remote X-ray readings. The CPU was also connected to a digital BP machine and a modified stethoscope. The DICOT is currently being used across 21 telemedicine centers sponsored by Grameen Telephone as part of their CSR initiative. At his office, we were fortunate enough to witness a live tele-dermatology session. It started with a phone call from one of his remote centers, informing Dr. Zaid that a patient was waiting. Dr. Zaid agreed to take the call. The caller, known as the telemedicine assistant, essentially fulfilled the role of the doctor’s assistant- he was responsible for handling the DICOT to take pictures and blood pressure measurements and entering all relevant information regarding the patient and complaint into a patented software known as the TIMES also invented by Dr. Zaid.
Since all the information had already been entered by the telemedicine assistant, including a high definition picture of the patient’s affected area (in this case, the feet), Dr. Zaid did not spend much time asking questions but jumped right to the discussing the problem. Over a Skype call he informed the patient that he had athlete’s foot and he advised the patient on what to do and what to avoid. He then selected the diagnosis from an extensive drop down list in the TIMES which automatically generated a prescription. After making some modifications to this prescription, he hit the print button. Over Skype, we saw the telemedicine assistant handing the prescription over to the patient on the other end. The entire session took about 3 minutes.
And the system is not just limited to tele-dermatology. Currently, it supports pediatrics, gynecology and general practice. Telemedicine is a wondrous tool, especially in the case of Bangladesh, where the medical infrastructure is inadequate (1 doctor for 3000 patients according to the World Bank) and disproportionately concentrated in urban hubs, but the large majority of the people reside in rural settings. The vast majority of these rural residents fall in the bottom quintile in terms of income. For them, the expense associated with travelling long distances and revenue lost in missed day(s) of work due to the travel, add up to prohibitive costs of seeking healthcare. The result is that most health problems are left unattended until serious complications arise – complications that could have been avoided with proper care at the right time. Telemedicine allows rural patients easy access to doctors and at scale, such technology can ensure that medical services to be made available across the country with relatively small investments. Pioneers like Dr. Zaid take us one step closer to realizing that vision.
Ahmed Abu Bakr