Labor pains had persisted too long. By 10:30 in the morning Dr. George Wolfe knew he couldn’t deliver 20-year-old Sandra Cheechoo’s baby without expert help. But there wasn’t any, not in Moose Factory, an isolated outpost 12 miles from James Bay. Within minutes, however, Wolfe had the help he needed. He simply switched on the TV and contacted Dr. Earl Russell, a skilled anesthetist 700 miles away in London, Ontario. Together, with Russell watching and giving instructions over closed-circuit TV, they performed a cesarean birth. By 11:23 a.m. they had delivered a healthy nine-pound, 10-ounce girl—Canada’s first satellite baby.
Until recently, Sandra Cheechoo’s fate would have depended on a quick flight south. Moose Factory’s main contact with the world had been by shortwave radio, a fragile link easily broken by bad weather. Health care in emergencies was something northerners took their chances on. But in 1977 Moose Factory became part of an experiment in space technology: tele-
medicine, the marriage of medical science and telecommunication by Hermes, the world’s most powerful communications satellite. Designed and built in Canada,
Hermes suddenly made dependable communication possible in any weather. Complex medical data (ultrasound probes to monitor pregnancies, electrocardiograms, blood smears could be transmitted thousands of miles in a few seconds to inexpensive portable receivers as small as 3/5 metre in antenna size.
Moose Factory was lucky. Back in 1970 Dr. Earl Russell and Dr. Lewis Carey had traveled 24 hours by train from London to reach patients in Moose Factory. They found themselves snowed in. For four days they could do little except talk, so they debated the problem that had stranded them in the first place: health care delivery in isolated communities. The solution, they decided, lay in solid communications links with medical experts in the south. Hermes.
Last December, the pioneers in telemedicine presented for the first time the promising results of their pet theory. They met in Ottawa with other Canadian and American researchers to discuss the outcome of the first five telemedicine experiments using Hermes. Two of those experiments originated in Canada—one with Russell and Carey at the University Western Ontario in London, the other at Memorial University in Newfoundland, The $600,000 Western experiment linked the university to a base hospital in Moose Factory, with an added audio link to a nursing station farther north in Kashechewan. Both outposts had access to 64 Lon-
don physicians participating in the project. Sitting 700 miles away, doctors could zoom in on an injured knee or abscessed mouth and, with the medical data transmitted almost simultaneously through other channels, provide sophisticated diagnoses. They assisted a total of 228 patients during the 19-week experiment.
On the first day of telemedicine transmissions, Heather Laughlin, a nurse at Kashechewan, had been trying to reach Moose Factory for a plane to transport a child with chicken pox. A few seconds after the satellite link became operational, Laughlin could talk to the base hospital doctor, who decided the child shouldn’t risk the cold plane ride. Treatment was relayed and the child recovered. In addition, patients flown south for treatment could now speak with relatives back home in their village. Before Hermes, one health aide said, when a patient was transferred relatives often didn’t know if the patient “was dead, still in hospital, or what.” Tomassie Augia, an elderly Cree hospitalized in London and unable to speak English, told his wife Mina, through the satellite orbiting 22,300 miles away, that he wasn’t being fed enough meat or tea. She soon straightened it out with the hospital.
The Newfoundland experiment used telemedicine as a teaching tool rather than as a diagnostic one. Isolated doctors and nurses spread out along the rocky coasts of Newfoundland and Labrador updated their medical skills through dialogue with medical experts at Memorial University. In each experiment, while audio links were two-way, the video capacity was one-way only. The next step, two-way video communication, may follow sooner than doctors had anticipated. In January, the federal government approved a “bonus” third
year of Hermes experiments, and further telemedicine experiments are now being considered. As well, the first of a new series of satellites now under construction, Anik-B,is due for launch late this year. Still in its embryonic stages, telemedicine won’t be fully operational until the 1980s. Though its feasibility is no longer doubted, its cost remains to be calculated and defended. At the Ottawa conference, the Memorial University delegation attacked the attitude that telemedicine, though incredibly effective at solving northern health care problems, is an expensive toy and peripheral to crucial issues in medicine. Until the northern telemedicine network is established, they said, inadequate medical services across the barren Arctic tundra will remain the standard. And northerners who would fare well down south will continue to suffer and die.JULIANNE LABRECHE
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