Dr Basil consulting a patient

Dr Basil Leodoro (far right) consulting a patient at the medical ward on Maewo

On the remote island of Maewo, Nurse Steven Leo was working in the Kerembei Health Centre when a 59-year-old male came to see him.

He was in distress: he had been in pain for three days. He was constipated, unable to urinate, and had lower abdominal distension. Maewo Island has no doctors and no hospitals. Nurse Steven was his only hope.

Nurse Leo put in a catheter, per protocol, however; no urine came out of the bladder, even though he was sure the catheter was in the bladder. When he palpated the bladder it felt full, but still no urine came out through the catheter. Nurse Steven removed the catheter and immediately blood began to flow out.

For nurses working in remote areas, with no access to telecommunications and no doctors on site, this scenario and many, many even more difficult scenarios often arise.

Luckily, Nurse Steven is part of a telemedicine initiative that has connected his clinic to the internet. He knows who to contact for help: using his smart phone he reaches out to the VITAL team doctors. VITAL is the Vanuatu Inter-Island Telemedicine and Learning Network and it utilizes an internet connection provided by Kacific Broadband Satellites. Nurse Leo, from his remote, outer island, is able to instantly ping a team of four doctors from the urban hospitals.

Immediately he received a response from Dr. Basil Leodoro, Senior Consultant General Surgeon at Northern Provincial Hospital (NPH), who asks him a series of questions. After answers from the nurse, Dr. Leodoro was able to assess that the patient was stable enough to stay in the clinic overnight and began working on a life flight to evacuate the patient to the nearest hospital the next morning.

Through Dr. Basil’s immediate advice, Nurse Steven was able to take measures to ease the patient’s pain and make him comfortable while he waited to be evacuated. This instant access to lifesaving advice is a huge comfort to the staff at the health centre, the patient, and his family.

The next day the patient was escorted safely to the Northern Provincial Hospital and transferred to the care of the treating surgeon. He was admitted for surgical treatment and made a stable and good recovery. The patient will be followed up by the specialist urology team in 2020.

According to Dr. Leodoro, “Acute blood loss in peripheral health facilities such as Kerembei on Maewo can become life threatening very quickly. With Kacific’s support, VITAL network is able to identify serious or potentially serious complications early, and ensure that patients, like this one, get the expert help they need in a timely manner.”

Nurse Leo added, “Telemedicine is very helpful, and it’s a very important tool for all remote areas. Thank you everyone for your help to make sure lives are saved.”

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