Two-month-old Edward September (not his real name), crying inconsolably, was rushed to Clanwilliam Hospital on Monday afternoon.
Edward had been refusing to eat and his abdomen was distended. The doctor who examined him was unsure what to diagnose and there was no paediatrician to consult at the hospital.
So the doctor sent Edward's X-rays and case history all the way to Tygerberg Hospital - on the Internet - for paediatrician Etienne Nel to examine. It seemed at first that there was a blockage in Edward's digestive system, which would have required surgery.
A closer examination showed that he had pneumonia.
Nel recommended that Edward continue taking antibiotics and the next day, much healthier, he was discharged from hospital.
This system of digital consultation, the first of its kind in South Africa, is one of many that have taken place between Tygerberg and outlying hospitals.
Two years ago the link between Tygerberg and Worcester Hospital was made, through the health department's intranet system. Clanwilliam, linked to Tygerberg through the conventional Internet, joined at the end of last year.
By the end of this week Hermanus Hospital will also be linked up, and it is hoped that soon Paarl, Stellenbosch, Strand and the Red Cross Children's Hospital - another tertiary institution where the diagnoses will be made will also join soon through the department's intranet system.
X-rays, ECGs and laboratory results and case histories are scanned at outlying hospitals, in the tele-medicine system, as the computer consultation system has been dubbed, then sent on to Tygerberg.
We spend quite a bit of time consulting with outlying hospitals by phone as it is, said Nel, who does most of the tele-medicine work at Tygerberg. This system definitely increases our workload, because it takes more time for a diagnosis. But hopefully it improves the level of care.
It's not sophisticated technology. Essentially it consists of just a PC on a desk.
Tygerberg Hospital's paediatrics professor Robert Gie said that the tele-medicine system cost at Tygerberg around R40 000 to set up.
The system is one solution to the problems facing paediatric care at tertiary hospitals, he said. These include budget cuts, and fewer beds and lack of facilities.
Primary healthcare, and the paediatric service in outlying hospitals are simultaneously improving, he said, but paediatricians in remote areas needed senior specialists' advice.
The incidence of tuberculosis was escalating dramatically, Gie said, as HIV/AIDS increased. Most of the paediatric cases seen at Tygerberg from outlying hospitals had tuberculosis or pneumonia.
Yesterday Rotary International president Bhichai Rattakul, from Thailand, visited Tygerberg to see the tele-medicine project and others set up by Rotary.
There are so many good Rotary projects in South Africa, Rattakul said. I am here to see what Rotarians have done, and to encourage them to do even more. (Source: The Cape Times, 26 February 2003)