Amazon Swim (Martin Strel)
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Telemedicine in Tabatinga, Brazil

February 22, 2007

Tabatinga is on the Columbian Peruvian Brazilian border. It was the first Brazilian city we visited on the journey down the Amazon.

Tabatinga’s mayor, Mr. Joel Lima, held a great reception for Martin and the whole team.

I expressed an interest to see the local hospitals when we arrived and the mayor called the local Minister for Health, Sebastião Aldevio Soares de Almeida, Secretario Municipal de Saúde de Tabatinga, and the Head of both local hospitals, the neurosurgeon, Dr. Renildo Sergio Batista dos Anjos who is also a Major in the Brazilian Army.

Dr. Renildo is the head of the Regional Municipal hospital as well as the Director of the Military Hospital, Hospital de Guarnicao de Tabatinga.

Mr. de Almeida showed me the Municipal Hospital and talked about the patient statistics. The hospital sees about 100 patients every day, most of whom come from Columbia and Peru. They normally get treated even though they are not Brazilian. He said that they learned their lesson when an epidemic of cholera broke out across the border in Peru in 1991. Since the Brazilian authorities did not have the medications, the epidemic spread to Tabatinga and Columbia as well. Mr. de Almeida said that since then he provides medications to the Peruvians on a regular basis not just at his clinic but he sends them across the border to different clinics.

He also said that they had attempted to implement Telemedicine, Telecardiology in this facility several years ago. They would connect with a private clinic in Rio de Jeneiro. The project did not work mainly because the cardiologists were not interested in Telemedicine consults. I was able to see some of the left over old equipment for the project.

The military hospital is quite different, it is a brand new facility with 200 beds. Dr. Renildo gave me a personal tour and spoke mainly about the problems. This is the only bigger hospital in a 1000km radius, yet he only has one ventilator in the Intensive Care unit. The facility looked barren while we were touring and talking. He has problems attracting doctors to this area as well. When we were at the hospital a trauma patient with a C4-5 neck fx was admitted and had to be flown to a hospital in Manaus because the ventilator was being used on another patient. Dr. Renildo also let me assisst on a consult for a patient with Guillaume Barré syndrome.

The next morning, Dr. Renildo, Mr. de Almeida, and 8 doctors from the Military Hospital came to tour the Telemedicine equipment which we have set up on board of our boat. I gave them demonstrations of the Rosseta-to-go mobile unit as well as the Second Opinion’s units.

Both, the doctors and the Minister were very impressed and wanted to discuss possibilities on setting up Telemedicine in their hospitals. In addition, Prof.Dr. David Lopes Neto from the Universidade Federal do Amazonas was present who expressed the interested in collaborating as well. He has several students in computer technology who are interested in practical experience which such projects might offer.

I saw the first case of rabies in my life at the Military hospital in Tabatinga, which unlike Veteran Affairs hospitals in the USA caters mainly to the civil population of the upper Amazonas region and caters to the population of 350,000 inhabitants.