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Democratising healthcare in Kenya , and the first live birth on Proximie

Democratising healthcare in Kenya , and the first live birth on Proximie

Eddy Haddad is Proximie’s Sales and Support Engineer based in Lebanon, from where he works closely with Proximie’s sales team to understand customer requirements and create solutions, enabling surgeons to make optimal use of the Proximie platform whatever their requirements. He is also key to implementing the Obstetric Safe Surgery Programme in Kenya; installing Proximie in a number of Kenyan hospitals to better facilitate optimal outcomes in childbirth.

As a sales and support engineer at Proximie, my role is to work jointly with the sales team to understand customer requirements and facilitate their use of the Proximie platform. A large part of my job is training surgeons and doctors on how to use Proximie and its key features, learning what they need from the platform and translating this into a technical solution for them.

There are two elements to setting up the Proximie platform, one being installing the hardware on the ground — so, for example, in a hospital — and the other being the training of doctors and surgeons. The former involves sending over the kits that include laptops, cameras and wires, guiding them in the installation to ensure that all the cameras and medical devices are working correctly with the Proximie platform, and checking that it’s possible to connect to the local site from a remote location. Then there is the implementation of our security and data protection measures, which involves liaising with the hospital’s IT departments to ensure that all security standards are met.

Parallel to overseeing the installation, I will be training the medical team on the ground in how to use the Proximie platform, and — additionally — any surgeon anywhere in the world that might be required to remotely assist in performing a local procedure. Through speaking to a large number and variety of medical professionals while working for Proximie, I’ve gained a lot of insight into those technical features of the platform that are most important and useful to them; I have to put myself in their shoes and consider how they look at and implement the platform’s features, in order to anticipate the information they need and explain it to them medically rather than technically.

Firstly, there is the four-camera stream, which is crucial because it provides a 360 degree view of everything inside the OR; if the surgeon providing remote assistance wants to see the echo machine, the patient’s vital signs, everything is connected to Proximie so it can be easily seen on the screen. Then there is the annotation capability, allowing the remote surgeon to annotate on the screen of the local surgeon — or vice versa — so that they can communicate very precisely regarding the specifics of the procedure.

Uninterrupted two-way communication is another crucial element — both audio and video — but the fact that Proximie is able to augment this (beyond annotation) with 2D or 3D models and image overlay is a really exciting function from a medical perspective. A surgeon can overlay an image on the live feed of the patient and change the level of transparency to show, for example, exactly where a bone is on the patient’s body. It’s even possible to add PowerPoint presentations to the live stream, which help with teaching students while carrying out live surgery. The library feature is also useful for teaching and training, enabling surgeons to record procedures to watch at a later date, or schedule a session with another surgeon to go over what happened during a procedure. In this sense it can almost function as a social network, allowing doctors to share and jointly evaluate techniques or performance.

“Any training I do is then tailored to the specific surgeon or doctor I’m training, based on which features are most important to them and how they’re aiming to use the Proximie platform.”

Any training I do is then tailored to the specific surgeon or doctor I’m training, based on which features are most important to them and how they’re aiming to use the Proximie platform. One of the most exciting projects I have worked on is heading up the Obstetric Safe Surgery Programme in Kenya, with the aim of implementing Proximie to democratise healthcare and save lives in a region that needs additional resources in order to provide optimal healthcare. Proximie, by enabling surgeons and doctors from outside Kenya to virtually scrub in and assist during surgeries, provides access to much-needed global expertise that facilitates better outcomes during pregnancy and childbirth — as well as recording procedures so that doctors and nurses can share experiences, making it possible others to train through the Proximie platform and significantly increase the learning curve.

Proximie is currently set up in the Makueni Mother and Child Hospital, Makindu Sub County Hospital and Mbooni Sub County Hospital, but will ultimately be installed in five hospitals across Kenya. Our installer on the ground is called James, an extremely tech-savvy guy who takes the hardware into the hospitals and installs the Proximie platform, shows the nurses and surgeons how to dial in and provides them with hands-on experience with Proximie. His presence on the ground is very important as he is constantly visiting new ORs and visualising everything inside; where the camera should be placed, how they should be placed and finally verifying that Proximie is ready to go on with a live case. After that, I dial in to check that everything is working correctly, testing the internet connectivity and making sure it’s possible to access the stream and all the devices remotely. But what’s truly amazing is how the surgeons and nurses on the ground take this technology and their training and they run with it, because the platform is so incredibly intuitive, and they have such an urgent need for this technology.

“…what’s truly amazing is how the surgeons and nurses on the ground take this technology and their training and they run with it, because the platform is so incredibly intuitive, and they have such an urgent need for this technology.”

We set Proximie up in the Makueni Mother and Child Hospital around five months ago, and on the first day James goes and installs everything and shows them how Proximie works. The next day I found out they had already built up a whole library of test runs; the surgeons and nurses had already started testing the platform, and you could see them exploring the best camera angles, asking each other questions about which should be the primary and secondary feeds. You could really see that they were immediately committed to learning and mastering this new tool, getting to grips with it so they could share it with other hospitals.

The next thing that happened was truly amazing. A week or two after we had first installed Proximie in Makueni, I received a call from a nurse named Mary. It was on a Sunday, but I asked if there was anything I could do to help and she said “Can you view the stream please Eddy? We need you.” So I entered the session where there was a live surgery taking place, and I can see all the feeds, and just after joining the session I see a baby being born — not just the first baby born live on Proximie in Kenya, but in the world! This was after just one or two weeks of initially installing Proximie, and they’ve trained themselves to use the platform perfectly, to set up and control the camera feeds, to schedule a session and go live and record the case. And two weeks later I’m watching them deliver a baby live, and they’ve mastered the technology almost entirely by themselves. Every time I think about it I tear up and get goosebumps.

“I entered the session where there was a live surgery taking place, and I can see all the feeds, and just after joining the session I see a baby being born — not just the first baby born live on Proximie in Kenya, but in the world!”

Since then, we’ve seen the stats for Proximie usage in these hospitals going up; new surgeons entering the platform and training themselves on how to use it, scheduling sessions on their laptops from home, tapping into surgical expertise from around the world. This is why I love my job, because every day I can see Proximie’s vision being realised; surgeons and nurses training themselves, sharing their knowledge, and guiding each other using Proxime — and I can also see the number of people using Proximie in Kenya is increasing all the time. I can see that we’re making a difference.

“Every day I can see Proximie’s vision being realised; surgeons and nurses training themselves, sharing their knowledge, and guiding each other using Proxime — and I can also see the number of people using Proximie in Kenya is increasing all the time. I can see that we’re making a difference.”
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