Description
Introduction with Aims &Objectives: Eastern Sub-Himalayan Region of Nepal has complex climatic and physiographic terrain that make it ecologically more fragile. Providing healthcare services in this region is challenging because of difficult geography. Patients need to travel outside their community for seeking medical care. Telemedicine seems most appropriate for the delivery of healthcare in this region. B.P.Koirala Institute of Health Sciences (BPKIHS), a university teaching hospital in Nepal conducts the rural-telemedicine program in this region. Recently the agenda of carbon foot prints of health care has gained importance because of its relationship with climate change in this ecologically fragile region. A carbon footprint, expressed as carbon dioxide (CO2) equivalent is the total Green-House gas (GHG) emissions released into the atmosphere as a result of the human activities. It acts as a risk multiplier and affects health through interdependent pathways. Within this background and magnitude of the existing problem, we conducted this study with aims of exploring the adjunctive utility of Telemedicine in Reducing Carbon Footprint of Healthcare in Ecologically Fragile Sub-Himalayan Region of Nepal. Methodology: We employed exploratory and socio-ecological study design to conduct this study. The data of patients availing the telemedicine service from our sites during one year from January 2021- to December 2022 were examined along with the estimated distance they would have travelled had each of them availed medical consultation by visiting our hospital physically. Google Maps with the option "fastest route” was used for calculating the distance travelled. A Simple Environmental Protection Agency (EPA) emission calculator was used for to estimate carbon emissions. Since 95 % Public bus in our study area use diesel, for the purpose of this study and for the reason of practicality and logistics, we considered 2.6 kg of CO2 emitted as the result of per liter of diesel used by the bus. Simple descriptive and inferential statistics was used for data analysis and to explore the utility of Telemedicine Service in Reducing Carbon Footprint of Health Care. Results: During the study period 337 patients availed the telemedicine service from our centers located on an average 100 Kilometer of distance from our referral center. Delivery of telemedicine service resulted in the saving of 23, 534 passenger kilometers and avoided emissions in the range of 40,516 Kg of carbon dioxide equivalent (CO2e) amounting to reduction of approximately 40 tons of Carbon Footprints in one year. This was translated to equivalence of 1200 mature trees saved which could have absorbed 180,000 kg of CO2 and 4500,000 liters of rainfall in one year. Discussions & Conclusions: Telemedicine is a high value, low cost intervention that has a high adjunctive utility in reducing carbon foot prints of healthcare directly by decreasing transport-associated carbon emissions as well as speeding up carbon sequestration indirectly by conserving trees which are recognized as the ‘lungs of the world’. It should be scaled up in ecologically fragile regions of the world to deliver an eco-friendly healthcare care services and to protect the communities from the health impacts of climate change.
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