Teleradiology in Mali (IKON) - Mali

Telemedicine is a relatively new development in the health sector whereby modern communication technology enables doctors in rural areas to call in the help of specialized doctors in larger, academic hospitals to give the right diagnose and to decide upon the right course of treatment. In Mali IICD assisted SOMIM (Société Malienne d’Imagerie Médicale) with setting up internet connection between three rural hospitals in the rural areas of Timbuktu, Mopti and Sikasso and expert radiologists in Mali’s capital Bamako.

IKON wants to address the structural problem of the lack of specialist radiologists in Mali by using the benefits of Internet technology. As statistics show that in general half of the generalist doctors make mistakes in interpreting an x-ray, compared to only 5% of the radiologists, it can be concluded that due to the project, the quality of health care in the three rural hospitals improved significantly.

Read more about IICD's Mali Country Programme.

The very first real-life exchange of radio scans took place in April 2005 between the regional hospital of Mopti and the national hospital Point G in Bamako, and immediately revealed its potential. An initial diagnosis by local staff in Mopti of a radio of a patient’s hand - potential bone cancer in one of the fingers - was dismissed by the experts in Bamako as a default error on the radio film, thus saving the patient from the premature amputation he himself had requested for!

During the first year of implementation, the project had several setbacks – especially on the technical and organisational level : scanners proved more expensive than budgeted, software for the scanners was not supplied, connectivity and server problems at the level of Keneya Blow’n forced IKON to migrate to a Canada based server. On the organisational side, it became clear that the project lacked dedicated staff for the execution part. Most of the work was done by the consultants of IDC and Reonet, two training partners of IICD.

Nevertheless in 2004, approximately 150 hospital staff of the four involved hospitals were informed about the project during seminars, and 35 hospital staff in the four hospitals received basic training.

Specific training on scanner and software use for dedicated hospital teams took place in April 2005 in Bamako and Mopti, and the first successful exchange of a radio via the Internet was performed during that same training workshop.

In 2006, the project owner dr. Touré travelled to Tanzania to present the IKON project to the participants of the IICD Roundtable workshop for the Health sector.

The objectives for the project are:

• To create awareness on new information and communication technologies (ICT) for Health
• To build capacity of hospital staff

• To reduce costs for hospitals and patients

The direct beneficiaries of the project are the related hospital staff and patients whose radios need to be submitted to expert diagnosis by a radiologist. The expected economic benefits are significant reductions on travel costs for patients, and improved use of local hospital facilities (less pressure on – more expensive - hospital facilities in the capital. The project also will contribute to the understanding of the possibilities of ICT for Health by hospital staff and to the development of general ICT-skills and/or specific ICT4Health skills.

Read more about IICD's approach towards Health.

The capital costs per site remain a problem, and in particular the purchase of the X-ray scanner which costs at least 7500 Euros. It would be interesting to try out other solutions, for example the use of a CD-ROM or a DVD allowing the direct digitalization of the x-rays. This solution would allow the hospitals in addition to save partially on the expenses of films, chemical supplies etc, and thus to minimize the additional costs of the teleconsultation.

The Malian telemedicine project is one of the first  (if not the first) on the African continent to have carried out the teleradiology in practice for a prolonged period of time. In spite of the technical difficulties, the project showed that teleradiology is practicable, and probably with some improvements at the technical and organisational level, sustainable. Other countries in more or less the same circumstances as Mali on the level of the medical such as Madagascar and Togo, already showed a lively interest in replicating the project.

The Société Malienne d’Imagerie Médicale (The Malian Society of Medical Imaging) is a non-governmental organisation which specialises in digital imaging for health in Mali.