Doxy.me (“Doc see me”) Will Change Telemedicine in Rural & Remote PNG.

Telemedicine platform Doxy.me stand to make a huge impact in increasing access to doctors in rural PNG.

I have been writing and researching about telemedicine on my blog since 2007 and just today I Googled around looking for a free telemedicine platform and came across Doxy.me. (www.doxy.me). Its so easy to use and has a free version that even doctors in countries like PNG can use at very minimal cost. I believe that this platform will make a huge impact, in fact a giant leap in improving access to doctors in the developing world.

It is is only a matter of time before it takes off in countries like PNG where there are so few doctors and a very large rural population that is unable to have access to a doctor.

I predict once in use, community health workers, nurses or HEOs will use this service to schedule doctors consultation clinics and they will be able to manage patients without referring patients to major district hospitals where it can be expensive for rural patients.

Thank you creators of Doxy.me. I am already using it and enjoying it. This is what I was looking for!

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PNG Media Need To Get Facts About Cancer In PNG Dissected Accurately.

I feel compelled to write this post after seeing the editorial in The National newspaper. This blog has been an advocate for improvement in cancer diagnosis and treatment in all its forms. After seeing the editorial, I feel the need to write this. See editorial at the end of this post.

The newspapers in PNG have a duty to educate the PNG public on different aspects of cancer. There are different forms of cancer. Don’t they know this basic fact! Radiotherapy is not the single best treatment for cancer, a combination of treatment modalities including cancer drugs are used. And you need to know the biological characteristics of the form of cancer (tissue or blood) before planning treatment. And for that you need a well equipped pathology laboratory and pathologists to characterise for you.  The journalists and editors need to educate themselves on these basic facts about cancer treatment planning before talking about cancer treatment in Lae. If you don’t know and don’t have the time, please ask the experts.

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Investment In Preventive Public Health Programs In Local Communities Will Reduce PNG’S Disease Burden By More Than 50%!

I don’t think buying more sophisticated diagnostic equipment or the availability of very strong antibiotics will reduce our disease burden. Having more doctors or nurses will not help directly either. Sure, these things may but it’s like catching overflowing water in a bucket by having more dishes on the side to capture the over flow. What we need to do is fix the tap that’s running freely!

What has happened to Preventive health activities in our communities and villages? Things like general cleanliness, proper latrines, access to clean drinking water, oral hygiene, enforcing our public health laws in towns and suburbs, creating health Programs for the ever growing squatter settlements and you can think of some more.

I find PNG people to be generally  unaware of of health issues when it comes cleanliness in Communities. Or are they just ignorant. They want to be paid for doing an activity. Why can’t people just do it for the benefit of the local community?

People have been brain washed by the cash economy. Middle class craving for lifestyles they can’t afford. Village people want to make a fast Kina, legally or illegally. All at the expense of their health or the communities’.

So what will it take to change this self destructive behavior?

The answer is obvious. Public Health Programs embedded into our hospital services, school curriculum, work place health Programs, in villages and communities. And these activities require money and trained people.

Now comes issue of health funding and management. I will leave that issue for a different post.

A greater challenge that only require sweat and time is community mobilization to promote and sustain good Public Health behavior. Leave a comment on how you think this can be done.

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Leukemia & Lymphoma classification at PMGH: what do we do when we can’t reach global standards?

I failed my specialist training in 2016 and decided to take a year off in 2017 to write and publish some of my work in medical journals. My interest is in Pathology, the science of studying diseases and I have a special interest in hematopathology, a subspecialty that concentrate in diseases of the blood (leukemia and lymphoma).

Supported by my supervisors at PMGH I was fortunate to secure a training fellowship for 8 weeks at Maryland Medical Center, Baltimore, USA. I have been here for 5 weeks and got 3 more weeks before I return. I am supported by the American Society for Hematopathology (ASH).

All leukemias and lymphomas are classified after diagnosis. The classification systems have changed over the years, the current global system is the WHO system. But PMGH is still using outdated classification systems which are regarded in most settings to be obsolete. But we have no choice really! We can not classify these diseases without doing very specialized testing​, which I might add are very expensive. So where does that leave us?

WHO system of classification of blood cancers it seems assumes that all hospitals providing Hematopathology services have these tests or plan to have these tests. But the reality is far from the truth.

So that leaves PMGH to continue with using outdated systems? I guess we must. This is probably the same situation in most low to middle income counties.

So what do we do? I think we should strive to reach the standards​ set before us. We might not get there in 5 or 10 or maybe 20 years. We may not even reach there in my lifetime. But we must make a start.

 

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Primary Health Care Remains and Should Be Priority for PNG.

A friend of mine recently asked me why Cancer services are non existent in PNG. He had to know because his mother-in-law was diagnosed with stage 4 cervical cancer and the family decided to try services in the Philippines. He was paying a good amount of money out from his pocket.

So I did a bit of research and showed him that cancer accounts for less than 10% of the total disease burden in PNG.

What constitutes the other 90%?

Infections diseases constitutes about 60% and trauma takes about 20% of the pie. The rest is divided between other life style diseases.

So given the adhoc cash flow within PNG NDOH, most of the funding is for communicable diseases.

So I explained that in terms​ of funding and prioritising, cancer services is at the bottom of priorities. He kind of got the picture but was still very unhappy. And we went into the usual conversation about corruption, kick-backs, bribery, nepotism and the list goes on, things we are all too familiar in PNG.

So he asked, “what do ordinary Pngeans do now if one of our loved ones is diagnosed with cancer?” I told him, my honest opinion is nothing. All we can do is not to think cure but quality of life and end of life care. Dying is part of being born and living.

I think doctors caring for cancer patients in PNG should see the big picture and train in palliative and end of life care. We will continue to see increase in disease burden but resources will remain limited. Our focus should be now on preventing and use every opportunity at the primary health care level to spread this message to help change behavior and promote healthy lifestyle.

 

 

 

 

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