1915Published on December 5, 2020
When most of the hospitals suspended non-emergency services and doctors shut their private chambers during the initial bout of the coronavirus pandemic, telemedicine services emerged as a saviour to the patients.
And Jatiya Shasthaya Batayan or National Health Call Centre, has led the way in advising patients remotely, helping millions stay at home and reduce the risk of infections by avoiding hospital visits.
This also helped ease pressure on the hospitals overwhelmed by the worst public health crisis in a century.
Besides supporting other patients, those involved with the national health helpline - 16263 - dialled back to advise those who tested positive for COVID-19.
The doctors and other staff members of the call centre continued to attend office in-person risking their lives to provide information and services. Nonstop.
The figures related to the calls they received substantiate public trust in the helpline. More than 15 million people sought help through the national telemedicine services after its initiation in September 2015.
After Bangladesh reported its first novel coronavirus cases on Mar 8, the helpline received more than 10 million calls in eight months until Nov 28. On an average, nearly 40,000 calls were made daily.
They included 8.3 million calls related to the novel coronavirus illness, while about 134,000 were made by people showing the symptoms of the virus infection, according to the Directorate General of Health Services or DGHS.
At least 3,623 among 9,058 calls made in the 24 hours on Nov 28 were related to the coronavirus. They included 511 high risk or extremely emergency calls.
Doctors in the Shasthaya Batayan made over 253,000 calls to make a query about people suffering from COVID-19.
Health Minister Zahid Maleque thanked everyone related to the hotline. "We're providing services tirelessly through the Jatiya Shasthaya Batayan. We're doing our best, trying to ensure that people receive telemedicine service beside the regular hospital service. This (telemedicine) service is available 24 hours (a day)."
They are considering expanding the national health helpline services further, said ABM Khurshid Alam, director general of DGHS.
“Fewer number of people will visit hospitals if we can provide a part of non-COVID treatment here (telemedicine) and reduce the risk of infection,” he said.
The Medical Information Service or MIS wing of the DGHS is running the Shasthaya Batayan with the support of Synesis Health, a health sector IT company.
Initially, the national telemedicine service used to prescribe medication, provide suggestions, health information, ambulance information, and booking and emergency information needed for any accident. As the novel coronavirus pandemic hit the country, it included medical treatment services related to the infection.
During a visit to the place from where the services are provided, doctors appeared extremely busy taking calls one after another and giving the patients advices over the phone.
Nizam Uddin Ahmed, CEO of Synesis Health, showed how the callers receive the services they seek in a few minutes.
Whenever someone calls and seeks advice on health issues, they are connected directly to a doctor. The doctor then diagnoses the problem based on the information provided by the patient, gives advices, and if necessary, prescribes medication.
An e-prescription is sent to the patient’s mobile phone soon. The entire process takes three to five minutes.
One of the physicians working there, Dr Rehnuma, has been providing telemedicine services at Shasthaya Batayan since the novel coronavirus pandemic broke out. She continued working from her office even during the lockdown.
“It doesn’t mean that a doctor has no risk (of contracting the disease). One of my family members died from COVID-19 at the beginning of the pandemic. I feel the pain people suffer when a close one passes away. That’s why I continue to work taking precautions in order to serve people,” she said.
Dr Muhammad Rizvi Islam finds it a bit challenging to treat patients by listening to the symptoms over the phone. Initially the doctors were having a little trouble diagnosing the diseases but later got used to it, he said.
“When a patient visits the doctor, they can be examined well before being provided with treatment. Here we need to depend on the patient’s words. We have to listen to the case history and then provide treatment.”
Many people have recovered from illnesses using the telemedicine services. Some of them also call again to thank the doctors.
A 74-year-old woman contracted COVID-19 and suffered from respiratory distress. Her son called the helpline where the doctor suggested administering oxygen to the patient at home and hospitalise her in case her condition deteriorated.
“Later he called to thank us. The information and medicine he received from us helped his mother to recover. Our suggestion was useful,” said Dr Sushmita Aich.
Among those who have called since the inception of the helpline until now, 73 percent received treatment and advices while 14 percent received other health services and 1 percent ambulance services. Around 10 percent called to know about the helpline while 2 percent complained about the services.
The highest number of patients, 13 percent, sought remedies for common cold. Next were callers who received services for COVID-19 - 11 percent. Among the other callers, 9 percent sought treatment for fever, 8 percent for weaknesses, 5 percent for dry cough, 2 percent for sore throat, 2 percent for acidity, 1 percent for a runny nose, 1 percent for asthma and 1 percent for mental illness.
WHAT BENEFICIARIES SAY
After he tested positive for COVID-19, Kamrul Hasan of Mohammadpur in Dhaka dialled 16263. Later, he regularly received calls from doctors at the Shasthaya Batayan.
“I liked this initiative,” he said. “They called me and suggested medication. They also gave me a diet plan and a daily routine. This new platform of seeing a doctor is actually not bad.”
When the 11-year-old daughter of Iqbal Hossain in Narayanganj caught a cough, their regular physician was not available in his chamber.
“Suddenly I remembered about 16263 and called them. A doctor asked for the details of my daughter’s physical condition and prescribed medicine by SMS. My daughter is much better now.”
Shahidul Islam of Gazipur has been using the telemedicine service regularly after the pandemic broke out as it became hard and risky to go to a doctor or hospital. He always had a good response from the Shasthaya Batayan.
“Even if you go to a hospital or a doctor, they will examine you from 10-15 yards away. How would they diagnose your problem? So, it's better to consult Shasthaya Batayan for common illnesses,” he said.
“Also, most of the times doctors ask you to do tests worth thousands of takas. Doctors in telemedicine service do not ask for tests. They just send the prescription via SMS,” said Shahidul.
Public health experts also encourage telemedicine services in an organised way for more efficacy.
The national helpline is useful for treating some common illnesses, said Dr Be-Nazir Ahmed, an advisor to the World Health Organisation.
The former director of the disease control wing of the DGHS had once called the health helpline to know about their services.
“They may not be able to treat all diseases but can at least address some problems. Sometimes we don’t even know where to seek health services. They are providing the information as well,” he pointed out.
“Shasthaya Batayan should be widened, just like 999 (national helpline),” he added.