Phones are saving lives in rural Peru

Doctors, nurses punch in data, receive answers

By Drew Benson
Associated Press
Published: Sunday, March 14, 2004 8:00 p.m. MST
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PACARAN, Peru — Beyond the reach of the Internet and paved roads, this quiet town in the rocky Andean foothills is typical of much of rural Peru, where isolation can hinder timely medical reporting and health officials' ability to respond.

But when villagers from the hamlet of Picamaran — a five-hour hike away — started showing up in Pacaran with symptoms of sometimes-deadly bartonellosis three years ago, nurse Malena Rivas turned to her new "computer" — a cell phone.

Using a pilot program set up by Voxiva Inc., Rivas dialed a toll-free number and, through a several-step menu system, punched in the data on her patients.

Within minutes, the Health Ministry had the data. And only days later, university physicians arrived to contain an epidemic of bartonellosis, also named La Oroya Fever after the Peruvian smelter town where an 1871 outbreak killed more than 7,000 people. The disease, which is transmitted by sand fly bites and develops rapidly, can cause fever, chills, aches, seizures — and in severe cases — death.

Since most of rural Peru lacks Internet connections, isolated health workers are often left to rely on paper medical reports that can take weeks to get back to Lima — giving epidemics a head start on the Health Ministry.

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But after Peru privatized its telephone system in the early 1990s, virtually every town now has at least one reliable public pay phone.

That simple link helped Voxiva set up a computer system, known here as "Alerta," that lets doctors and nurses in Peruvian villages use public telephones to send medical reports and also ask questions and get answers using voice mail boxes.

Health workers were given laminated cards with codes for certain illnesses, which they can punch into the phone keypad along with information about the number and severity of the cases they encounter.

On the other end of the information chain, doctors and health officials in Lima, the capital, are linked into the system by desktop computers and cell phones when they're out of the office. As a result, timely decisions about, say, a cholera outbreak deep in the Amazon could now be made on a Saturday afternoon from a beach house outside Lima.

Impressed with the results, Peru's Navy started to use the system for medical outposts in the Amazon jungle and along Peru's northern desert coast. Voxiva placed its computers within a high-security Peruvian military complex.

"It isn't rocket science," said Guillermo Delgado, who heads Voxiva's work in Peru. "But it is a very effective way to bridge the technology gap."

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