Our East African Telehealth Journey – Story of a Kenyan and a Ugandan Therapist

Telehealth in Kenya and Uganda

The COVID 19 pandemic made occupational therapists around the world to make some changes in how they work. With the need for social distancing and working from home directive. Many therapists embraced Telehealth, a mode of service delivery that enables a therapist to offer their services remotely by use of telecommunication devices.

African occupational therapists were not left behind. In this article we get to read the Telehealth experience of two therapists from East Africa. As we read along, we shall get to know their joys, their disappointments, and how they feel about Telehealth.

The Kenyan Telehealth Experience

When the first case of the COVID 19 was reported in Kenya on March 13th 2020, I was disappointed, scared, and confused. Why confused? As a School-Based Occupational Therapist, I was dealing with a new dilemma of all schools being closed indefinitely.

My downtime was limited for just a few days. My optimism kicked in and I told myself “COVID-19 will be in Kenya for just a few weeks; we just need to Stay Safe and Work from home then we are good to go back to normal”.

Immediately after this comment, a question popped in my head “How can a School-Based Occupational Therapist work from home?” I dashed to my computer and started my journey of discovering how. I spent hours reading research papers, I joined several Facebook groups, and spoke with practitioners and clients. By the end of the second week, I had a Eureka moment, I discovered I can work from home through Telehealth, a mode of service delivery that allows a therapist to offer services from a distance via technology devices. I went a step further and took a course on Telehealth to further understand this new model of service delivery.

After this I started another wonderful journey, conducting Telehealth sessions with my wonderful clients. Telehealth has such great benefits and here below are some I have experienced;

  • Convenience: I just need to be at my working space at a particular time, no staying in traffic, etc.
  • Further reach: I can reach clients from different parts of the country and even different countries. It also gives me the joy of reaching clients in the very remote areas of our Country. This would not have been possible with the onsite sessions.
  • Safety: I can Stay Safe and ensure I keep my clients safe. Through this, we flatten the curve.

Well, there are pros and cons as well. Here are the challenges I have experienced while offering Telehealth;

  • Technology challenges: On some days the internet and or the technological devices fail to work. Though with time I have gotten ways around this.
  • Stakeholders Buy-In: Since it is a new form of service delivery, much more investment is put in awareness to encourage stakeholder buy-in.

I have come to enjoy this journey. I have experienced great and fulfilling moments as a therapist. I feel much more valuable as an Occupational therapist and from what I’m seeing, I’m not stopping any time soon.

Perpetua Omondi
Managing Director, Dynamic Occupational Therapy LTD
OTWB Africa Regional Director

The Ugandan Telehealth Experience

“The eyes of a Ugandan are in their hands; They only believe after seeing or practically touching or being touched.” (Ugandan Proverb). A challenge to telehealth services

As an occupational therapist working with people living with long term neurological conditions, I have had to change the way that I engage with my clients during the coronavirus. Some tell me that their life has not changed apart from the common difficulties of getting out and engaging in everyday tasks and things that are important to them.

Others tell me on the phone that they are “fine”, but I feel limited, I can’t see their eyes, or faces on the telephone. I have to find other ways to know if they are fine or not. I experienced one sad case, a client of mine, who was ill for two weeks during the total lockdown period in Uganda said she was fine on the phone. She did this so as not to worry her son, sadly, she passed away four days later.

As an OT, I love engaging with people in a meaningful way which is a key role. When I speak with my colleagues and friends, they say that they are liking the new ways of working and using telehealth. They mentioned it has been convenient, instead of the lengthy, inconvenient, and time-consuming trips to the hospital, they can offer the service from home. This has enabled to remove the barrier of distance and one can remotely deliver therapy interventions and enhance clinical support in the local communities. This from their perspective has improved access to specialized services, opened opportunity to learn, reduced the feeling of isolation for clinicians in the rural settings and last but not least helped maintain progress in their clients.

For some, they miss the personal touch that comes with physical therapy sessions, they say this cannot be achieved by a phone call or video conferencing. The eyes of a Ugandan are in their hands; They only believe after seeing or practically touching or being touched. (Ugandan Proverb). I have at many times called a client and what they tell me is “okay, we shall see when you come or when the lockdown is lifted.” They don’t believe that through a phone call, a service is being rendered.

Also, some say they encounter difficulties while using technological devices.

In conclusion, the use of Telehealth is expanding quickly in Uganda and it carries great benefits. It is a helpful and safe model of service delivery for many healthcare providers; however, it comes with its fair share of challenges such as cost, practitioner competence, and reimbursement.

Victor Alochi,
Director, Ebenezer Rehabilitation Clinic
OTWB, Uganda Founder