I am now taking care of several pregnancies via e-mail and text messaging. These women live far from a hospital (or don't have access to a safe hospital) and while they plan to come to Kijabe to deliver, I'm trying to provide their prenatal care from a distance. Sometimes the questions are easy: can I take this medication? Sometimes harder: is this pain normal? Medicine typically involves a physical exam and testing, but the first thing you learn in medical school "How to take a patient history" has become the most critical in caring for these women. It also allows these families to stay on the mission field while expecting.
The care via communication-only reached a new level 2 weeks ago when I provided management for an obstructed labor via radio. The nurse caring for the patient lives in a remote area of Kenya and as she described the patient I was worried because they were more than 2 hours from a hospital (a hospital which may or may not have a doctor available to assist). Thankfully, the mother and baby did well, but knowing the situation and being aware of all that could go wrong, it was hard to know in the end there was little I could do... but we did pray together for the patient.
There are still many places in Kenya, on the continent of Africa and in the world where access to healthcare remains poor. In the end, radio, e-mail and text messaging can't substitute for an available doctor.