Kilimanjaro Hospital Video Linked to Northumbria Healthcare

OR Networks was approached by the charitable link team from Northumbria Healthcare to assist in their development of laparoscopic surgery in Tanzania, the benefits of which are numerous.  To assist in this process we were asked a fairly simple question:  "can we receive high quality video, transmitted from a hospital in kilimanjaro, to our offices in Northumbria, that would be of sufficient quality for us to assist and mentor?" 

Whilst this is a fairly simple question, there are a number of reasons why an immediate response would have been no. Cost prohibits all normal methods of transmitting high quality realtime video, such as ISDN lines or satellite uplinks.  The only affordable medium was the public internet and this is fraught with poor infrastructure, particularly in East Africa: lack of ban

dwidth (the quantity of information that can be sent per second); latency (the time it takes to travel from one destination to another) and congestion (everybody wanting to have what little bandwidth there is).

Last year we proved the principle of transmitting from Africa to England via the internet but there were still significant obstacles to overcome, therefore, the question then was:  is there actually any available equipment that could manage poor infrastructure, low bandwidth, long latency and heavy congestion?

The short answer was again no:  most cheap video conferencing systems were poor quality and fragile (nobody had managed to even use Skype or NetMeeting successfully in Tanzania for any length of time); most expensive high quality video systems would fall over at the limited resources.

The answer was to design and build our own system that utilised varying internet availability, reliability and quality; was stripped down to the basics so that every bit of bandwidth was used to transmit video and to work with TTCL (Tanzanian Telecommunications Company) to advise them on what our requirements would be and how they could improve the service as best they could.

The TTCL company has really done a great job and have improved and are continuing to improve the infrastructure of the country, so much so, that they now plan to run fibre optic cable (more speed and bandwidth) from the outlying towns to the main hubs  and run a marine fibre to South Africa to replace the current satellite link that accounts for 2/3 second delay.

One final problem remained, how can we get personnel in Tanzania to effectively run the equipment with limited IT skills.  The answer was to include a remote control application that allows us from our offices, or staff at Northumbria to take control of the transmission system in Kilimanjaro.  All they need to do is switch it on.

The final days of the trip proved the design to be a total success and we reached our bench marks by transmitting full resolution images to Northumbria into the Surgical Skills institute in Hexham.   The system includes two way audio and return video from Northumbria:  this facilitates live tuition,  nurses forums and operative training in addition to the original design brief to facilitate surgical tele-mentoring.

Kilimanjaro Expeditions and Climbing

I am using the company blog to promote a  fascinating individual that I met during my visit to Tanzania (see blog entries for telementoring from KCMC Hospital and the Mdawi Orphanage).

His name is Faustin Meela, and is from the Chagga tribe that live on the slopes of Mt Kilimanjaro, mainly as farmers.  As is the custom with the Chagga tribe of Kilimanjaro, Faustin's father left the land divided between Faustin and his 2 brothers.  The smaller piece of land was not sufficient to support him and his family and so he went to work in the Tanzanite mines for 7 years, a hard and dangerous job: Faustin lost many friends to rockfalls and suffocation.

His dream was to one day own his own lodge and run expeditions to climb Kilimanjaro (5895m) and safaris to Tarangire, Lake Manyara and Ngorongoro, so he saved as much money as he could and started the foundations of his lodge.  After losing too many friends and fearing for his own safety, he left the mines to work as a National Park Ranger for 5 years until his friend and colleague was shot by poachers, at which point he decided to move back home and start climbing for an expedition company.

After 27 years of hard work, saving and building his lodge in his spare time, Faustin opened for business this year, only to be confronted with the largest downturn in tourism in Tanzania.

I visited his lodge on my last day and he is now in the process of building a road that requires navigating a stream and cutting a swathe through 100 metres of volcanic rock to a height of 10 metres.

His story is totally inspiring and he deserves to succeed which is why I have offered to help him promote his business.  Faustin was my perfect guide during my stay: he took me to the orphanage and helped with the children and then arranged an unforgettable safari to the 3 main parks.  He is quiet and unassuming and is totally reliable and I could not imagine anyone better or safer to take you on safari or to climb kilimanjaro.

So if you fancy an unforgettable "real" safari or hike to Kili, please contact Faustin at 

fntmeela@hotmail.com  or via myself at c.dobbyne@or-tv.net.

Mdawi Orphanage School

Saturday 2nd May 2009:

Before starting work on the KCMC (Kilimanjaro Christian Medical Centre) surgical video link, we visited the Mdawi School for orphaned children.  The school is nestled in the foothills of Mount Kilimanjaro and is a haven for orphaned children, most of whom having lost their parents  to AIDS. The children are looked after by the Pastor Alan Lekey, his wife and a team of teachers.  The first impression you get is that the children are well cared for, loved and genuinely happy despite their tragic start to life.

I hope to work with Alan to raise awareness, child sponsorship and in other ways that he chooses will help him.  There are many children there that do not have sponsors so if you wish to sponsor one, please email me at c.dobbyne@or-tv.net and I will send you the relevant forms and contact details.

At ortv.posterous.net I have posted a series of photographs of our visit.

 

St Mary's Adult Intensive Care Unit

Opening this week is the new Adult Intensive Care Unit at St Mary's Hospital Paddington.

The, never been done before, video communication system integrates visitor management and intra-colleague visual communications, all from the patients bedside, to optimise patient care.

The unique system was designed, built and installed by OR Networks Limited.

other news links: 

 http://www.imperial.nhs.uk/aboutus/news/news_018342

 http://www.healthestatejournal.com/Story.aspx?Story=4978

An integrated Operating Room for a Fraction of the Price

OR Networks Limited have just released a bare bones version of their highly succesful ORTV® Control System on a new computer platform bringing the cost of an integrated OR down to a fraction of the price, including touch screen and surgical monitor.

The system is network enabled and computer based allowing easy integration with other systems e.g. emails, web browser applications (PACS) and Electronic Patient Records.

Removing the unnecessary cost (and consequential "lock in" of a system) of incorporating controls of endo-surgery devices, the ORTV® Live system controls only the devices where it makes sense to centralise them, lights, image selection and video capture.

All of these features are crammed into a single application that runs on one piece of hardware bringing the costs down to a fraction of the normal price (Integrated ORs typically cost between £50,000 and £100,000 each).

"Our customers have realised that there is no point in paying tens of thousands of pounds controlling a device such as an endoscopic camera, which has easily reachable controls on the front panel a few feet away, from another device that is also a few feet away. Especially when it means that the entire theatre will only work with one manufacturer, they are beginning to realise that they will lose their ability to change equipment and consequently their negotiating position with respect to consumables etc.

"Fundamentally, what they want, is to get screens on arms, equipment off floors and be able to inter-operate with other hospital applications, without being tied in to a single provider."

Colin Dobbyne, Managing Director.

Free HD endoscopic camera guide

Endoscopic cameras are now bit of minefield with the introduction of HD television.
Not suprisingly all manufacturers claim that theirs is the best.

OR Networks have published a helpful guide to cut through the marketing hype and help potential customers gain an understanding of the technology to make objective and informed decisions.

First African Live Surgical Video Link from ORTV®

OR Networks, as part of their global corporate responsibility program, have installed one of their ORcast® video link systems for free into the Kilimanjaro Christian Medical Centre operating theatres.

Working with the NUGITS team of laparoscopic surgeons and Northumbria Healthcare, the video link will support the ongoing laparoscopic training by providing surgeons with live video telementoring to their trainers based in the UK.

The video and two way audio is transmitted over secure internet lines and available as a web login, allowing UK surgeons to view the live transmissions from their home or office, or if they have an ORTV® integrated theatre, whilst they work themselves.

The BBC feature the link on BBC Look North. See the news reel.

To view the installation diary - click here.

First permanent HD video endoscopic teaching link in the UK

Stepping Hill Hospital, Stockport is set to be the first hospital in the UK to have a dedicated, permanent HD video teaching link for urological and laparascopic surgery.

OR Networks are installing its ORcast® fibre, digital video teaching link system, to send true HD (1920 x 1024) progressive-scan video from the Storz Image 1 HD endoscope across the hospital WAN to the post graduate centre.

We beleive this is the first live link system that is permanently installed for the highest HD resolution in the UK.

OR Networks are also installing overview cameras and a Maquet in-light camera to offer the delegates three views: overview, surgical site and endoscopic.

The post graduate suite is installed with a projector, an LCD for the surgical team and picture in picture.

Two way audio at broadcast studio quality completes the setup for an unparalleled viewing experience of live surgery.

Galway take delivery of third OR3G® Theatre from ORTV

University College Galway have recently taken delivey of their third ORTV® integrated theatre from OR Networks Limited. This joins the two Cardio-Thoracic theatres currently in use and is used for live operative tuition over digital video links to the post graduate centre.

ORTV® appoints Kuwait Agents for Middle East Region

OR Networks have shipped their first system to Kuwaiti Agents, Central Circle Company. The company is a major distributor for medical equipment and a leading provider of integrated theatres. They have selected OR Networks to provide the OR3G® integrated theatre system since it maintains freedom of choice for clinicians as to which endoscopic system they wish to use.

Central Circle Company will be demonstrating the OR3G® system at numerous medical trade shows in the area.