Abstract
This paper describes Indonesias telecommunications system and discusses the feasibility of adopting the computer-based system MomCare for extending reproductive health care expertise to remote sites. The paper was presented at a pre-congress seminar entitled Learning Without Walls that was held on October 13-14 1995 in Bali Indonesia in conjunction with the XVth Asian and Oceanic Congress of Obstetrics and Gynecology. A small group of decision makers was given the opportunity to update its knowledge of the information revolution and to explore the possible impact on health care education and training. The MomCare system allows experts at referral centers to work with clinicians at remote sites using real-time transfer of video voice images and computer files. Telemedicine transfers allow for video conferencing still or slow motion image transfer electronic mail text dialogue white boarding and file transfer functions. Indonesias communication system includes a local telephone network; a long-distance network linked by fiber optic cables and coaxial cables microwaves submarine cables and satellites; and an international network of over 3770 circuits. Other facilities include the Packet-Switched Data Network based on digital transmission cellular mobile radio services and radio trunking. State-of-the-art systems can transmit data at rates up to 2400 bps and achieve high-quality nonfading links over short distances and non-line-of-sight paths. Indonesia is continuing to expand links increase transmission speeds and use data compression techniques at lower bandwidths in order to facilitate communication exchanges. The Johns Hopkins University has already demonstrated the utility of a system of inexpensive workstations to provide medical care. MomCare is feasible in Indonesia. The only question is the extent and speed with which to transfer the technology.
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