Ahuge poster of John Abraham is not what you?d expect to see on the wall of your doctor?s clinic. But then this clinic at Chakrajmal, almost 65 km from Bijnor in Uttar Pradesh, is unique in other ways too. For one, there?s no doctor here! Correction, not one who?d hold your pulse to diagnose your problem. Nishi Devi, a regular at the clinic, knows it. She takes off her slippers at the entrance of the clinic and promptly seats herself on a chair infront of the computer, facing the webcamera. A few minutes and several login attempts later she is talking to Dr Abenla Long. Dr Long checks her temperature and BP, asks a few more questions and recommends a few medicines. Nishi Devi collects the prescription from the printer and proceeds to pay the fee (Rs 50) to Jagdish Singh, Co-ordinator of the telemedicine centre (TLC). She promises to return for a repeat consultation in five days?knowing well that the paid amount covers her for a full week.
Singh, a pharmacist, invested Rs 25,000 to set up the TLC with an additional Rs 75,000 as loan from the NGO World Health Partners (WHP), payable from year three. Though Singh declines to comment on how soon the TLC will break even in terms of investment, he does share that the flow of patients has steadily increased over a period of time. He got 63 patients last month ?helping him earn about Rs 2,000 in fees alone, not including the cost of the medicine. ?It?s difficult for the villagers to go the city for treatment. And it also costs them a lot more,? says Singh adding that ?people also tend to avoid the two government primary healthcentres in the vicinity because they do not trust the quality of their medicines.? Singh has his own challenges though. He has to rely on the generator for most of the time to run the clinic from 9 am to 6 pm, thanks to ?the power supply that lasts for not more than four to five hours a day.?
However, the potential of telemedicine in India continues to be huge. Experts estimate India?s telemedicine market to be pegged at $3.4 million, growing at 21.6%. And that?s precisely what WHP is trying to tap. It launched an 18-month pilot project in 2008 to service 1,000 villages in Meerut, Bijnor and MuzaffarNagar. Though the primary focus of WHP remains reproductive healthcare, it is also addressing other health issues. As per rough estimates the project reaches an estimated 3.6 million people, including two million living in rural India. ?The unmet need for family planning in this area is close to 30% ? that is couples in the reproductive age do not want to either space or limit their families but are not using a method of contraception. Also, the incidence of gynaecological problems among women is high?close to 80%,? says Gopi Gopalkrishnan, President, WHP. Presently, WHP does close to 120 consultations each day.
Right from day one Gopalakrishnan wanted it to be an economically sustainable model. Each TLC caters to around 10-12 villages and usually it is the rural health providers in each village that refer patients to the former. The TLC Co-ordinator keeps Rs 30 as his share and divides the rest equally between WHP and the rural healthcare provider. ?People value the services more when they pay for it. And it?s also a way to tackle the problem of phantom morbitidities,? reasons Gopalakrishnan. And rightly. Many like Harvendra Kumar Gehlot see it as a viable enterprise. Gehlot quit his job in a diagnostic lab in Dhampur to open a TLC in his house in Bhagwanwala village. Now he assists his wife at the Centre and sounds extremely positive about the future: ?looking forward to provide ultra-sound facilities to his patients, as also opening a general store with assistance from WHP .?
But for now, the pilot seems to be going smoothly ? thepanel of 12 doctors in Delhi is set to grow and the number of villages in the network will be scaled up to 2,000.