Telemedicine in Senegal

Senegal : Senegal is situated at the extreme west of the African continent, with a North Atlantic coastline of 531 km; its frontiers with Gambia, Guinea, Guinea-Bissau, Mali and Mauritania extend for 2 640 km. Covering an area of 196 190 km2, Senegal is generally flat and consists mostly of savannah with considerable variation between the north (semi-desert) and the south (semi-wooded). The territory is subdivided into ten regions, each of which is composed of three departments. As of 31 December 1996, Senegal had a population of some 8 446 000, the great majority being young people: 45% of the population are under 15 years of age and only 3% are over 65. The rate of population growth is in the region of 3% per year and 70% of the population live in rural areas. In addition to French, which is the official working language (administration, large companies, international relations, etc.), six (6) national languages are recognized as well as a large number of local dialects. Average life expectancy is 57.16 years: 55.65 for men and 58.71 for women.

Background

The mortality rate associated with birth complications is very high in Senegal. During the period 1979-1992, some two out of every five cases of death in women aged from 15 to 49 years were associated with pregnancy, birth or post-natal complications. In the same period, the maternal mortality rate is estimated to have been 510 deaths per 100 000 (this figure can be as high as 1 000 deaths per 100 000 live births in certain African countries).

Visual conference media make it possible to create a shared visual environment (everybody sees the same images) and a shared aural environment (everybody hears the same sounds) for a number of distant sites. In-service distance training for health professionals is one of the key components of this application.

Training occurs in remote health centres through videoconference systems adapted to the medical environment which are connected by remote links to videocentres, videostation-type terminals or other group or individual terminals located in national or international hospital centres.

The Lille Regional University Hospital (CHRU) and the European Institute of Telemedicine in Toulouse, who have considerable experience of the videoconference applications used, are prepared to assist Senegalese hospitals in the distance training project by placing their equipment (lecture hall and study with a videoconference system, multipoint bridge) and other forms of assistance at our disposal. At the Lille CHRU a medical videostaff specializing in obstetrics has a routine session every Tuesday morning from 10 a.m. to noon, during which pathological pregnancy cases are discussed by a panel of experts. Other medical meetings in gynaecology are planned.

Saint-Louis Hospital and the Clinique du Cap will be connected by a telemedicine link using telecommunication infrastructure. The establishment of such a link may prove beneficial for the clinic, for education and, more generally, as a means of promoting a spirit of collaboration among medical institutions.

The operator in Saint-Louis moves the probe on instructions from the expert in Dakar and the transfer of images occurs in real time. It will also be possible to send a case file from one site to another.

Demonstrations

Two demonstrations are planned between Dakar and France, preparing for future links between Dakar and rural hospitals in Senegal.

A live demonstration with participation of Lille Regional Hospital, will show a distant interpretation of obstetric clinical cases, using echographic image exchange.

Another live demonstration with participation of Toulouse Hospital will be oriented towards continuous education in the field of cardiology.

Partners

• Sonatel

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