TELEMEDICINE:

‘The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities.’

TELEHEALTH:

‘The delivery and facilitation of health and health-related services including medical care, provider and patient education, health information services, and self-care via telecommunications and digital communication technologies.’

SOURCE: Board of Governors, Medical Council of India. Telemedicine Practice Guidelines, 25 March 2020

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Telemedicine and abortion: India says yes or no?

Hidden Pockets, by Nishitha Aysha Ashraf, 17 April 2020

“While ‘stay home, stay safe’ is indeed the need of the hour to ‘break the chain’, many are pushing for telemedicine to address the health issues of the population such that neither the doctor nor the patient has a risk of getting exposed to the virus.Recently the Ministry of Health and Family Welfare, Government of India, issuedguidelinesfor telemedicine practice which has solidified the acceptability of this new mode of medical intervention. These guidelines have nowmade it legalto practise telemedicine in a professional setting. The scope of telemedicine for sexual and reproductive health and rights, especially for abortion, holds a lot of promise. However, there seems to be no specificity whatsoever about abortions, a much-needed service, in the existing guidelines.

“The Medical Council of India released guidelines specifying what telemedicine entails in India, who can practice it and how e-prescriptions can be provided to clients. They explained that at present, the Government of India allows only over-the-counter medicines to be e-prescribed, apart from a few exceptions. They firmly think that in any circumstances, medical abortion pills cannot be prescribed via telemedicine in India, not even during an epidemic…. Dr Ashok Kumar Devoor, Senior Gynaecologist and Advisor to Hidden Pockets Collective said: “Two important prerequisites of abortion are (1) clinical examination (2) confirmation by scanning…”

“…The Careline Counsellor at Hidden Pockets Collective is the first point of contact for clients who are in distress. Aisha said, ‘More than the fear of contracting the virus, the youth have the fear of finding out that they are pregnant and they are already panicking about safe abortion during this lockdown’. She explained that most people who reach out to Hidden Pockets have no access to pregnancy test kits as they are staying with their parents during the lockdown. When their otherwise regular periods are now unusually delayed, it sets forth a whole chain of doubt and fear that they are pregnant. To worsen their woes, they do not have the approachability to request their parents for a pregnancy test kit nor can they step out to get one on their own. Immense stress, anxiety and fear constantly swing these young people between gloom and doom.

“With the lockdown extended recently, their worries too have grown that if lockdown gets stretched further in the future, they will not be able to hide their pregnancy (if they are pregnant) as the tell-tale signs of pregnancy will start to show and family will realize what is happening.

“…Telemedicine guidelines, in their current form, are not addressing many challenges on the ground when it comes to access to safe abortion. Aisha said, “Most scanning centres are non-functional during the lockdown and if they are functional the question of access during the lockdown remains….

“We are trying to understand how feasible it is to have a medical abortion through telemedicine in India.”

PHOTO:Hidden Pockets website