eShango International www.eshango.org
eSHANGO International is an Organization for Standardization of Information and Communication Structures in Africa.
An application of telemedicine in Africa : our experience in Rwanda during July 2003.
Throughout the project Telemedicine and Information and Communication Technology (ICT) and to encourage the teaching of minimal invasive surgery, our group went on a mission to Rwanda. This mission was supported by the high approval of President Paul KAGAME and led by Professor Guy Bernard CADIERE. The association eSHANGO International had the task to work out the feasibility of the visioconferencing between several hospitals, inside and outside the country. The conception, the implementation and the deployment of the system permitting the transmission was realized as follows :
Utilization of audio standards G722 and video standard H320, and IP H323, in the visioconferencing system as a support of Telemedicine in the field of Laparoscopic and Endoscopic Surgery in Africa.
To transmit the sound and the pictures in a synchronized manner, it was necessary to use satellite or ISDN cable, or the more recent IP (internet protocol) broadcast technology. As the broadcasting technology in Kigali (56 Kbit/sec) is too weak, we abandoned the IP and decided to use three ISDN cables of 128 Kbit/sec each. By doing so, we obtained a speed of 384 Kbit/sec, which was considered to be sufficient for telementoring the intervention by specialized surgeons (a high resolution provided by the endoscopic camera).
Our goal was to link the operating room to the auditorium in King Fayçal Hospital in Kigali to other sites further away ( Butare University, Ruengeri hospital and IRCAD in Strasbourg France ).
During this mission, a world premiere was realized. For the first time, a specialized surgeon in Strasbourg performed a cholecystectomy at distance (realized in a third world country).
We have chosen CODEC ( Compressor/Decompressor) Falcon IP from VCON company for reason of its good price and the evolutional possibilities of this system.
Utilization of audio standards G722 and video standard H320, and IP H323, in the visioconferencing system as a support of Telemedicine in the field of Laparoscopic and Endoscopic Surgery in Africa.
To transmit the sound and the pictures in a synchronized manner, it was necessary to use satellite or ISDN cable, or the more recent IP (internet protocol) broadcast technology. As the broadcasting technology in Kigali (56 Kbit/sec) is too weak, we abandoned the IP and decided to use three ISDN cables of 128 Kbit/sec each. By doing so, we obtained a speed of 384 Kbit/sec, which was considered to be sufficient for telementoring the intervention by specialized surgeons (a high resolution provided by the endoscopic camera).
Our goal was to link the operating room to the auditorium in King Fayçal Hospital in Kigali to other sites further away ( Butare University, Ruengeri hospital and IRCAD in Strasbourg France ).
During this mission, a world premiere was realized. For the first time, a specialized surgeon in Strasbourg performed a cholecystectomy at distance (realized in a third world country).
We have chosen CODEC ( Compressor/Decompressor) Falcon IP from VCON company for reason of its good price and the evolutional possibilities of this system.
References :
- G.B. Cadière Interview : Time magazine January 31, 2000 : A Great Leap – « Telemedecine »
- G.B. Cadière, J. Himpens, J. Bruyns Laparoscopic « Surgery and the Third World. Surg Endosc 1996 ; 10 : 957-958
- J.M. Andreu, G.B. Cadière, O.Germay. Chirurgie Laparoscopique en Afrique Noire : « L’appel de Dakar » Le journal de Coelio-chirurgie 1999 ; 31