Telemedicine Bridges the Gap Between the Regions and the Capital
Thanks to the European Union, ‘Voinicel’ Early Intervention Centre provides health care services remotely
‘It was a harsh blow for us to find out that we have a child with elements of autism. Some people think this is a contagious disease and prohibit their children from playing with our child, and it isn't very respectful of us, the parents. Moreover, there is a perception in our society that only in socially vulnerable families can a child with disabilities be born…’.
This is how Maria and Sergiu Lisa, the parents of Iachint, a three-year-old boy from Ungheni, started their story. The specialists of ‘Voinicel’ Early Intervention Centre help him to acquire age-specific skills and behavior, to develop and grow up happily with his parents.
Iachint is the second of three children in the Lisa family. From an early age, he spent a lot of time body rocking, so Maria and Sergiu consulted the pediatrician in late 2021.
‘The pediatrician asked us various questions and referred us to ‘Voinicel’ Centre. He told us that it would be better to have him checked by the professionals there, as he assumed that the boy had some elements of autism’, told us Maria.
The parents were thrilled to find out that ‘Voinicel’ Centre provided physical consultations and online services via telemedicine. These services are precious for families with children in Cahul and Ungheni districts, as parents do not have to wait weeks for an appointment, incur transport costs or miss a whole day of work.
Maria and Sergiu attend consultations as part of the weekly parenting and telemedicine meetings organized by the ‘Voinicel’ Centre
Telemedicine basically means providing remote services. The ‘Voinicel’ center provides online consultations that can be used by the parents of children aged up to three years from Cahul and Ungheni districts who are at risk or who have developmental disorders. The meetings are similar to physical consultations and simplify parents' access to specialized services in areas where there are not enough professionals or where access to certain health services is limited.
‘I learned about online training services from the physiotherapist. So far, I have attended two sessions – it is different when competent people explain things to you. We already know that when Iachint plays, we have to try to enter in his world – we add one toy, or we exclude another, and we see how he reacts’, said Maria.
With the help of modern technologies, doctors can consult and monitor children remotely without compromising healthcare standards.
‘Used appropriately, telemedicine can be an important resource for health systems, but also a connecting link between the public healthcare services that will be reconfigured after the Covid-19 pandemic crisis’, mentioned Igor Codreanu, health program coordinator at UNICEF Moldova.
For example, telemedicine is in the early stage of conceptualizing early intervention services with a physical presence in Cahul and Ungheni, which will be created under the program ‘EU4Moldova: Key Regions’ funded by the European Union and implemented by UNDP and UNICEF.
The pediatric neurologist Mariana Jalba, who has been a member of the team of ‘Voinicel’ Centre since its foundation, provides online consultations with other professionals from Chisinau, Cahul, and Ungheni, thus identifying the health problems in children at early stages.
Although telemedicine cannot replace a classic medical examination, it can play the role of a preliminary consultation as it has many benefits for parents and children.
‘I use interview-type questions to figure out if this is only a false alarm raised by the parents or if the child needs the help of professionals. Sometimes, I interact with children too, and I can ask the parent or the professional to perform some tasks with the child. After that, I can make certain recommendations or, when necessary, suggest the parents come to Chișinău for a complex assessment’, Mariana mentioned.
The professional also noted that the most common reason given by parents requesting services on the telemedicine platform is the lack of language and social skills: ‘the child does not speak or is not interested in interacting with other children’, Mariana said. However, there are also concerns about aggressive behavior, inability to express their wants and needs, poor motor skills, or dependence on gadgets.
During the online consultation, a visit may prove necessary to establish an accurate diagnosis and to choose/draw up an appropriate family support plan.
‘A family who has had a remote consultation and requires a physical examination has priority. Usually, the waiting time for a consultation with physical presence is quite long; it can take up to two months in a normal regime’, mentioned Mariana.
Thus, besides its unique benefits, telemedicine can help reduce the gap between urban and rural areas regarding access to health services. According to studies, people from urban areas seek health services more often than those from rural areas. The share of people from the rural area who made an appointment with the doctor and spent more than 20 minutes outside the doctor’s office waiting for the medical consultation is twice higher than in the urban area.
The number of parents who connect to parental orientation courses is increasing
‘Voinicel’ Early Intervention Centre organizes parental orientation courses for parents from Ungheni and Cahul districts. Ala Benderschi, speech therapist and early communication specialist at ‘Voinicel’ Centre, says that after these courses, families make face-to-face consultations where professionals can assess the children by applying the methods and the instruments that meet international standards.
‘The Early Childhood Intervention Service is a family-centered service, and the involvement and empowerment of parents are determined by their parenting knowledge and skills, which directly influences the child's harmonious development, their integration into the community, and the satisfaction of the family as a whole’, Ala Benderschi said.
‘We take into account the doctors' recommendations, and we try to apply them as much as possible. Iachint is pleasantly surprised with each visit to ‘Voinicel’. He is more cheerful, wants to play, and has started to form sentences. And today, he blew out the candle on the cake for the first time, Iachint's mother added.
‘We must prepare him for life, so he would be accepted by all the people the way he is’
At present, Iachint is attending the kindergarten-crèche ‘Andrieș’ from Ungheni. Besides the play therapy and the therapy for fine motor development provided by the professionals of the Resource Center for Inclusive Education (RCIE), once a week, he has an individual session with a support teacher and a speech therapist at the kindergarten. At the ‘Voinicel’ Centre, Iachint was seen by our professionals four times. During the last two consultations, in July and December, Iachint was assessed according to ADOS testing, one of the most popular and essential tests for the screening and diagnosis of children with autism spectrum disorder, which provides the possibility to obtain highly accurate interpretations and results. Professionals assess his dynamics and provide additional recommendations every six months.
His parents are incredibly proud of his accomplishments:
‘Yes, he is a child with elements of autism, but he is three years old, and he is doing very well for his age. He knows the alphabet better than his five-year-old sister, although we didn’t teach him purposefully. If we observe the recommendations, I believe he will not be different from other children when he reaches school age. We must get him ready for life, so he will be accepted by all the people the way he is, concluded Maria.
So far, 80 families with children with special needs or at risk from Cahul and Ungheni have had consultations with the professionals from the ‘Voinicel’ Centre via the telemedicine platform. Additionally, more than 60 children from other regions of the country were consulted, assessed, and helped to achieve their maximum development potential with their families.
By supporting the early intervention services in Cahul and Ungheni, under the program ‘EU4Moldova: Key Regions’, more children up to the age of three have access to services of early diagnosis of developmental delays while also receiving quality health and social services provided at the place of living by regional teams of professionals.