Botswana-Upenn partnership grows in health care

GOTHATAONE MOENG
Staff Writer | Friday July 8, 2011 00:00

 

In 2001, Mogae told the United Nations (UN) General Assembly that unless the spread of HIV in the country was stemmed the country faced extinction.

'People are dying in chillingly high numbers. It is a crisis of the first magnitude,' quoted Reuters. With almost 40 percent of the adult population infected with HIV, Botswana had, at the time, the highest incidence of the condition in the world.

'It was really bad at the time, people were dying. You would ask, where is so-and-so? And people would say, didn't you hear?' Dr Doreen Ramogola-Masire remembers.

Ramogola-Masire is the country director, and Lead Physician for the Women's Health programme, for the Botswana-UPenn Partnership (BUP) one of the organisations established as a result of Mogae's call for help from the international community.

Established in 2001 by founder and director Dr Harvey Friedman, at the invitation of the government and with the support of African Comprehensive HIV/AIDS Partnerships (ACHAP), the organisation this year marks ten years of working to improve health and healthcare capacity in Botswana.

BUP operates four programmes namely Women's Health, HIV/AIDS care and support, Adult TB and Pediatric TB.Ramogola-Masire says that to examine their successes, as well as challenges, in training healthcare personnel in Botswana, one needs to look at capacity building in a broader sense.

'Are the end-users benefiting from the training?' she asks rhetorically. From the one physician from the University of Pennsylvania's School of Medicine when the partnership started in 2001 with the rollout of the anti-retroviral programme, it has now grown to a staff complement of close to 70 people operating in Gaborone and Francistown. The staff includes 11 specialists and sub-specialists from countries such as USA, South Africa, Germany and Botswana. To deal with the concentration of facilities in one area of the country, BUP also has outreach facilities and extends services to areas such as Bobonong, Ghanzi and Hukuntsi.

The organisation has also, since last year, pioneered, with the support of Orange and the University of Botswana, the local use of telemedicine, in a programme they call the BUP Mobile Telemedicine, in which mobile telephone technology is taken advantage of to extend medical experts to people in rural communities, and take people closer to medical experts. The purpose of the programme is also to improve the delivery of health care and decrease costs in the Botswana public health care system through use of mobile technology.

'Everybody has a cell phone. Things like X-rays, a doctor in a remote village can take a picture of an X-ray and send it to a specialist in the US or the UK, and for a minimal cost the patient can have the next best thing,' she said.

Under the programme, BUP facilitates the Mobile Oral Telemedicine, where patients from district hospitals can send pictures to the only maxillofacial surgeon in the country, saving them money and hours of travel. Camera phones are also used to capture pictures of the cervix for identification of cancerous lesions in the mobile diagnosis and treatment of mobile cervical cancer, one of the top killers of women in the country. Under the programme, BUP specialists are also able to diagnose skin conditions in adults with HIV using phones. A pilot sending radiograph images via email using an internet-enabled camera-phone was conducted between the Princess Marina Hospital and the Deborah Retief Memorial hospital in Mochudi, and another is now underway between the Mochudi hospital and the Seventh Day Adventist Hospital in Kanye.

Ramogola-Masire said that she would love to have Batswana specialists, but admitted that one of their biggest challenges has been attracting personnel. 'It's difficult to have high-skilled personnel because they come with demands of certain amenities otherwise they can have someone else pay them for their skills,' she said. While she did not want to comment on whether Batswana students studying medicine outside the country are returning home, referring such questions to the Ministry of Education, she does admit that as long as people are trained abroad, not everybody is going to come back.

Ramogola-Masire said the recently opened University of Botswana, School of Medicine, to which BUP offers technical assistance, will address the problem of trained specialists not returning to the country.

The School of Medicine, which has admitted its third group of students, may also, under their collaboration with BUP have some of its students spend at least a semester at the University of Penn, so they can experience the medical world in a setting different from the Botswana setting. Under the Global Summer Programme, students from different faculties from the UPenn also come to Botswana to experience practicing medicine here.

'In a year, about a thousand people come here. They become our ambassadors, besides just being doctors, nurses and specialists, so there are also spillover effects.' Dr Zein Kebonang, BUP operations director said.

'We think one of our biggest successes is to have a programme that is mostly local. We see things as they are, and we are able to advise accordingly. We think that is working very well,' said Ramogola-Masire.