Miracle! Hamida is able to walk again!

Hamida Mustafa*, a 35-year old female, from Haidarabad, Bamyan was ill since June 2018. She was suffering from body pain, headaches, weakness and convulsions and was unable to do routine activities at home. Because of her convulsions, her family begin to think she was possessed and took her to a shrine for spiritual treatment. Hamida’s condition did not improve. She then visited Mhadi Hospital, a private hospital in Bamyan located 30 minutes from her home, to seek medical treatment. She was put on a treatment regimen, but unfortunately, Hamida was unable to recover. When she lost her ability to walk and was confined to a wheelchair, her worried family took her to Bamyan Provincial Hospital in hopes of finding a cure.

Due to a lack of Neurologist at the Bamyan Provincial Hospital, staff referred her to the AKDN Digital Health Programme for teleconsultation with a neurologist at the French Medical Institute for Children (FMIC).

Dr Esmatullah Hamed, Neurologist at FMIC, reviewed Hamida’s case and diagnosed her with epilepsy. He prescribed medication regular follow-up teleconsultations. After a one month treatment, Hamida was able to make a complete recovery – Hamida was miraculously able to walk again!

Hamida and her family were able to save time and money as a result of availing teleconsultation services from the AKDN Digital Health Programme. Through one initial and two follow-up visits, Hamida and her family saved approximately USD 400.00 along with the inconvenience of travelling to and fro Kabul for the three visits with a patient confined to a wheelchair.

*The name of the patient has been changed to protect patient privacy.

Teleconsultations helped ease Azoom’s misery of Leishmaniasis

Azoom Khan*, a 36-year old man from Shaiwa in the Badakhshan Province, had been suffering a skin condition on different parts of his body for the past two years. Azoom had visited multiple physicians and paid for numerous diagnostic tests in Badakhshan, but was not able to receive a proper diagnosis. He visited the Faizabad Provincial Hospital with some skin lesions, mainly ulcers, on his right ear. They were painless with redness and discharge. Hospital staff referred Azoom to digital health services and a teleconsultation was arranged with a dermatologist at the French Medical Institute for Children (FMIC).

Dermatologist at FMIC, diagnosed him with Leishmaniasis, caused by leishmania, a parasite and transmitted by the bite of sandflies. He was prescribed medication for treatment. After the treatment was complete, all his symptoms on the skin disappeared completely. Azoom was impressed as he had been suffering from the disease for the past two years and had taken numerous medications, yet there was no improvement.

In the absence of teleconsultation services at the Faizabad Provincial Hospital, Azoom would have had to visit Kabul in search of quality medical treatment, which would have cost him an estimated USD 300.00 for travel, food and accommodation for one night and doctor fee. He was able to save time and money and prevent further complications due to delayed treatment. Azoom expressed his wishes to expand the services to the clinics in his area. He mentioned that at one point he suspected he had cancer, but was relieved to receive a proper diagnosis through teleconsultation services.

*The name of the patient has been changed to protect patient privacy.

Bakhtiyar finds specialized treatment 7000 kms away

In October 2018, when the Ak-Talaa village, a remote village in Naryn region, was experiencing a harsh winter, Bakhtiyar Masumbaev* was suffering from a rare form of Arthritis.

Bakhtiyar, a 41-year-old man, begin experiencing excruciating pain and inflammation in the left knee. The tenderness and inflammation loitered for a few days and settled on its own shortly. After a month, when he completely forgot what had happened, he started experiencing pain and discomfort in his right ankle. The pain was so severe that it was limiting Bakhtiyar’s movement. He was unable to walk and perform routine tasks. A round, painful cyst appeared in his left elbow and he began to experience tender inflammation in the left knee. Shortly after, Bakhtiyar’s ankle swell up and became extremely painful to touch. He also developed high fever with disturbed sleeping patterns.

To seek some relief, he consulted a family physician in the Ak-Talaa village, who diagnosed him with Polyarthritis and referred him to the At-Bashy Territorial Hospital, 20 kilometres away from his home, for further treatment. There, he was treated for the Unspecified Polyarthritis, with NSAIDs. At the time of discharge, his symptoms were not resolved.

When the cyst in his elbow joint ruptured, excreting blood and pus-filled discharge, Bakhtiyar visited the territorial hospital again. This time, due to lack of specialist care available at the hospital, doctors recommended a teleconsultation with a rheumatologist in Geneva, Switzerland, through the AKDN Digital Health Programme. The rheumatologist at the Geneva University Hospitals, 7,000 kms away, diagnosed him with Acute Gout Arthritis, where uric acid crystals accumulate in your joint, causing inflammation and intense pains of a gout attack. He was prescribed medication.

About a month and a half later, during the follow-up teleconsultation, Bakhtiyar explained how the prescribed treatment helped relief his Gout symptoms. Bakhtiyar was grateful to the AKDN Digital Health Programme, which made it possible for him to receive quality, specialist services from an expert in Geneva, thousands of miles away from his home. He just had to travel 20 kilometers from his home to consult the specialist.

In the absence of the AKDN Digital Health Programme, Bakhtiyar would have had to travel in the cold, harsh weather to a higher level health facility in Bishkek, 380km away from home, in hopes of finding medical relief, which would have been very painful considering the amount of pain he was experiencing. Furthermore, the teleconsultation services helped Bakhtiyar save almost 8-10 days of travel time and other waiting times and associated costs of approximately USD 90.00 for meals and accommodation.

*The name of the patient has been changed to protect patient privacy.

Teenage girl brought back to life from depression

Eighteen-year old Zeba Gula* from Shuhada District in Badakhshan, Afghanistan, had been experiencing psychological problems since August 2017. Headaches, sensitivity to light, social anxiety, severe pain in the upper abdomen region and discomfort constantly plagued her. Overcome with feelings of hopelessness and helplessness, Zeba was unable to find joy in any of the activities she had previously enjoyed.

Doctors at the Baharak District Hospital, three hours away from her home, were not able to diagnose Zeba’s condition - no conclusions could be drawn from her assessment or medical history. Her worsening condition made Zeba’s family anxious to reach a proper diagnosis.

The AKDN Digital Health Programme connects the Baharak District Hospital with the Faiziabad Provincial Hospital for teleconsultation services. The primary physician at Baharak District Hospital decided to consult an Internal Medicine physician at the Faizabad Provincial Hospital (FPH) through teleconsultation. The doctor recommended a few diagnostic tests to obtain a better understanding of her complains. Fortunately, the tests recommended were available at the district health facility near Zeba’s home. When the results came back clear, a teleconsultation was conducted with Dr. Majabeen Sarahat, a Psychiatrist at the Faizabad Provincial Hospital on 2nd January 2018. Dr. Sarahat diagnosed Zeba with migraine and prescribed medication with regular follow-up teleconsultations for six months. Additionally, Zeba also received health education for the management of her migraines and related symptoms. Slowly, Zeba was able to recover with the help of teleconsultations and manage her condition better.

The physicians at the Baharak District Hospital had a difficult time diagnosing Zeba’s condition, even though she had a very basic health problem. Through teleconsultations, Zeba was able to consult a specialist, Dr. Sarahat, 25 miles away at the Faizabad Provincial Hospital. The AKDN Digital Health Programme helped Zeba and her family save AFN 10,000 and 96 hours of travel time to and from Faizabad. Zeba received the quality healthcare services she needed through the live teleconsultation services, resulting in an accurate diagnosis and treatment.

*The name of the patient has been changed to protect patient privacy.

Technology saves newborn Farzana’s life

In March 2018, Farzana Ahmed* brought her 20-day old baby girl for a visit to the Faizabad Provincial Hospital, one and a half hours away from her home in Qushqulagh. The baby girl was delivered through a normal home delivery. Shortly after delivery, the parents noticed a huge, mass full of fluid, the size of a big apple, at the back of her head. They brought the newborn to the Faizabad Provincial Hospital to see a general surgeon, however, she was referred for teleconsultation services by hospital staff with a preliminary diagnosis of a cyst as there was no CT scan machine available at the Faizabad Provincial Hospital. A teleconsultation was scheduled with Dr Tariq Rahimi, Head of the Surgery Department at the French Medical Institute for Children, eight and a half hours away by road.

During the teleconsultation, Dr Rahimi and his team recommended an operation, so the family travelled to FMIC. After a CT scan with other investigation, the baby was diagnosed with a cyst in the occipital region, which required to be operated. After undergoing a surgery, the cyst was removed and the problem was corrected successfully and in a timely manner.

Follow-ups were conducted through live teleconsultations, saving the family enormous amounts of money. Farzana and her family were grateful to the AKDN Digital Health Progamme, quoting how it helped save their newborn’s life and saved them from an excessive financial burden.

*The name of the patient has been changed to protect patient privacy.

Malika earns additional income through the Nighedaasht mobile app

Malika Zohra, a 35-year old community midwife (CMW) from Danyore, a village 15 kms away from Gilgit city, is the breadwinner for her family - her husband has no regular source of income. Malika lives with her husband, four sons and her mother-in-law. To support her growing family’s needs, she depends on agriculture and livestock for additional income. Malika’s daily work consists of her duties as a midwife, household chores and tending to the crops and livestock.

In 2018, Malika was provided with the Nighedaasht mobile application on a smartphone to record maternal, newborn and child health (MNCH) activities she conducts in the field. The application, developed by the AKDN Digital Health Resource Centre in collaboration with the Aga Khan Health Service, Pakistan, aims to improve the quality, coverage and access of MNCH services.

The application digitises the processes of antenatal care, delivery and postnatal care; strengthens the referral system between CMWs and gynaecologists; and builds capacity of CMWs through educational videos. Since then, Malikha has been using the app during her field visits in communities to record data about the health of pregnant women, mothers and newborns and report data. The application also helps Malaika track antenatal and postnatal visits and to communicate with physicians for expert advice from the field for complicated cases or emergencies.

With the help of the Nighedaasht application, Malika has been able to improve her income through the charging mechanism introduced by the social franchising model. She earns an additional income of approximately PKR 12,000 per month by selling medicines and supplies, for family planning, Antenatal Care (ANC), Postnatal Care (PNC) and general care.

Malika underwent intensive trainings under the social franchising model. She has received training on Healthy Timing and Spacing of Pregnancy (HTSP), essential maternal and neonatal care, reproductive health care, interpersonal communication and business management. The Nighedaasht mobile application and trainings Malika has received are part of the Access to Quality Care through Extending and Strengthening Health Systems project (AQCESS) project, funded by Global Affairs Canada.