Telemedicine gets mobile

An innovative mobile pathology laboratory is set to be a bold step forward for telemedicine in South Africa ñ and the MRC's Telemedicine Lead Programme is in on the act.

The South African National Defence Force could boast the country's first mobile telemedicine laboratory by mid-year if the Surgeon General approves a prototype that Armscor's Defence Institute, in close cooperation with the MRC's Telemedicine Lead Programme, has successfully developed and tested.

Medical technologist, Captain Gerrie van Niekerk of 2 Military Hospital, Wynberg tests out the mobile laboratory.

Officially launched at Wynberg's 2 Military Hospital in Cape Town in December, the R2.5 million fully equipped pathology laboratory is set in a modified shipping container with ample room for three medical technologists to work inside.

Mounted on the roof is a satellite dish that provides instant access to expertise wherever it exists (including videoconferencing). Internal equipment, much of it computer-linked, is designed for transmitting and receiving data relating to pathology, dermatology and some allergies.

Close cooperation between members of the MRC's Telemedicine Lead Programme and specialists in the various institutions of the SANDF's Medical Services resulted in the selection of appropriate equipment and its positioning within the container laboratory.

The entire set-up operates autonomously, weighs 4.7 tons and can be flown into remote areas by heavy transporter plane. According to Brigadier General (retired) Lee le Crerar of the Defence Institute, the laboratory can be fully operational within 45 minutes of deployment. The container shell has a built-in generator, hot and cold water supply, air conditioning suited to tropical locations, grey water disposal tank and back-up batteries, plus a priority power management system. Laboratory specimens are bar-coded before being loaded into a Disa data information system to facilitate accurate tracking.

The mobile laboratory will be able to address many problems arising from the use of the disciplines of pathology, dermatology, and allergies. Currently installed single discipline equipment is centred around histopathology, dermatology, chemical pathology, haematology and microbiology. Shared interdisciplinary equipment and services include a centrifuge, two microscopes (with magnification from 10x to 100x), variable focus-enabling illumination, a refrigerator, a freezer, transportation and cooler chests, stainless steel sinks and waste disposal and holding systems for both contaminated and non-contaminated waste storage.

The laboratory would boost SANDF health care capacity in peace missions (including health support of local populations), disaster relief operations and combat deployments. If required, it can include a R900 000 remotecontrolled Zeiss microscope and IMX automated immunoassay analyser, the former manipulated via satellite or landline, by any suitably equipped outside consultant with whom the technologist is in contact via an appropriate telemedicine link.

Its civilian applications for handling cholera or other epidemics plus basic primary health care support make it a very attractive proposition well beyond the original intentions when the SANDF first commissioned the development.

A short description of the unit was presented by Dr Moretlo Molefi (Director of the MRC's Telemedicine Lead Programme), at a recent Telemedicine Conference organised by the University of the Transkei.

"This laboratory and its associated telemedicine have the potential to improve health care greatly, for both remote rural populations and SANDF members, and also to provide much support to their health care givers," Dr Molefi said.