What is the Guyana Telemedicine Network project ?

Guyana is a large French overseas department. It covers some 86.000 km², 80% of which are covered by equatorial forest. Most of its population lives close to the shore and in three towns: Cayenne, Kourou and Saint-Laurent du Maroni, where the three hospitals of the department are located, as well as most of its health resources. The ‘health centres and stations’ (CPS in French) spread on the whole territory are in charge of the remaining healthcare issues. They are the only access to healthcare for those 20% of people living inland. These CPS are operated by paramedical staffs. The largest ones can also rely on a general practitioner. Telehealth is mandatory to ensure a proper healthcare all over the Guyana territory. To ensure that goal, the ‘health centres and stations’ are linked to a regional hospital centre (the ‘Centre Hospitalier André Rosemond’ – CHAR) which is in turn linked to the ‘external world’ through an Internet website making it possible to interact with a server dedicated to telehealth issues. The ‘Guyana Telemedicine network’ started with an experimental phase at the very beginning of the 2000’s. It addressed three specialities (parasitology, dermatology, cardiology) and four health centres. Then, starting in 2004, a operational development phase took place, leading to an integrated system which includes now other disciplines (ophthalmology, obstetrical gynaecology, paediatrics, image processing (neurology), diabetology, cancerology, traumatology) and 16 sites (including the ‘SAMU’ - a French acronym for ‘Emergency Medical Support Service’ and the Website). It can now be considered as fully operational while growing on. Cardiology is a perfect example of telehealth application, in particular by adding a digital electrocardiogram to the medical record. The hospital specialists and local healthcare staff can decide whether patients can be safely treated on site or if they have to be evacuated, and with which emergency level. Several parasitic (malaria, intestinal parasites) and dermatologic (leishmaniosis, others) diseases do exist in Guyana. In most cases, they can be remotely diagnosed with efficiency, hence the interest of telehealth systems in these domains. This was the leading application domain in the beginning of the 2000’s. It is now strongly decreasing, since tests for quick diagnosis have been successfully developed and allow local healthcare staff to avoid using observations through microscopes.