Forum 2009 Blog

Digital health care in rural India—the costs and benefits of broadband

18 Nov 2009

Posted by: Patrick Adams

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What if a patient in rural Gujarat could see a doctor in downtown New Delhi without waiting in line? Without leaving her village? And what if it only cost her $1.00? According to Al Hammond, Senior Entrepreneur in Residence at Ashoka, that isn’t just the future of health care distribution in remote rural areas. It’s the present. “These things are beginning to be put on the ground right now in rural India,” he said in a plenary session speech on Wednesday. “And they’re all driven by social entrepreneurs.”
Hammond was talking about telemedicine—new technology capable of linking medical professionals with patients in areas plagued by chronic shortages of health care personnel. “It’s not widely understood that within 5 years rural broadband will be available practically everywhere there is cell phone coverage,” he said. “That will allow for video links between a doctor and a patient.” It would also allow for so-called telepharmacy, a potential solution to the lack of licensed pharmacists and the abundance of counterfeit drugs in many rural areas.
“Machines that dispense pills in an automated fashion already exist in many developed world hospitals,” said Hammond. “They’re called ‘Med Stations.’ We need to develop the Internet controlled rural version of these devices that can reliably dispense medicines under the control of the pharmacist from any urban center.”
It’s just the kind of cutting-edge technology that many people associate with the word innovation, a flick-of-the-switch gadget that promises to sweep away the problems of the past. But is it the right innovation for the rural poor?
Claudio Schuftan of the People’s Health Movement in Vietnam doesn’t thinks so. “I want to congratulate Mr. Hammond for bringing high tech equipment to rural areas where there is no electricity, and no way to repair the equipment that has broken down,” he said. “And last but not least for creating a system of dependency in an environment where most of us sitting in this room are trying to resolve the problems of health distribution from a completely different angle.”
Hammond replied that Ashoka is aware of the hostility from some quarters to private sector approaches. “But we want to emphasize that this work is being carried out by social enterprises, which have been launched by NGOs. It uses market techniques, because that’s how you get efficiency in the distribution system.”
Ashoka has carefully surveyed the families participating in the pilot study, Hammond added, “and they like the service. They think it treats them better than the other services available to them, and they consider it very affordable.” Perhaps more important, he said, was the fact that, on the basis of the pilot study to date, the Indian government has requested 600 additional units.
No innovation is a panacea. But if telemedicine is truly able to bridge the urban-rural divide, it would address an issue at the heart of health care in the developing world. Should it be implemented? Is it sustainable? And who should decide?
We invite your comments…

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