An app especially for Ukrainian refugees in Tilburg should ensure that busy GPs in that city are not overloaded. “If a Ukrainian refugee doesn’t feel well, he immediately calls an ambulance,” says Robert Ellenbroek, who supports the GPs. The refugees can ask a question in their own language in the app, a nurse who receives the question then determines the seriousness of the situation and sees whether, for example, an appointment with the doctor is necessary.The users like the app, but also have criticisms.
After the war in Ukraine, a thousand refugees came to the Tilburg region. ‘Ordinary’ refugees are taken care of by the COA and that organization also arranges the care. But the Ukrainians were taken care of by the municipality and ended up at the GP.
“A GP from Tilburg had Ukrainian patients from Eindhoven at the door.”
That immediately caused problems. Because many practices are full. “The need is very great,” says general practitioner Anniek Masman. “So you set the bar high. Because if you, as a GP, say ‘yes’ to one refugee, 250 people from a reception center know where to find you.”
“That really happened,” says Ellenbroek. “A GP from Tilburg even had Ukrainian patients from Eindhoven at the door.”
An additional problem is that the refugee does not fit into a standard ten-minute consultation, because you have language and cultural problems. Masman: “They are used to something different. Here the GP is a gatekeeper. You go there first. In Ukraine, they go straight to the specialist in the hospital.”
Something really had to be done, the municipality of Tilburg and Primacura, the umbrella club for general practitioner care in Central Brabant, knew. They contacted Medicinfo in Tilburg. They have a medical team that specializes in remote care. In the province of Zeeland, they support GPs via an app. Holidaymakers who are ill can ask a question in their own language via the app.
“We can help more than half through the app.”
Mariëlle van de Ven of Medicinfo directs the nurses who answer the questions via the app. “Ukrainians download the app in their own language. They send a message in their own language, possibly with a photo. Skin rashes, for example, or a child with impetigo. The nurse receives the question, translated into Dutch and determines the seriousness of the situation. If we believe that the GP should assess, we will make an appointment with a practice. One of twenty who participate in rotation. We can help half to sixty percent directly via the app and do not come for a consultation.”
Every day patients come in via the app. “I really think it’s a success story,” says Masman. “The pressure on the doctor’s assistant is off. The appointment has already been made and the doctor knows what the patient is coming for.”
“Only call 112 when life-threatening? Real?!”
And the Ukrainian refugee? It needs to switch. That is why they receive an information meeting before they install the app on their phone. Ellenbroek: “If we then say: you are really only allowed to call 112 if it is life-threatening, rumbling and hassle will arise in the room. Don’t they get it. “Really alone then?!” We spend half the time explaining the Dutch healthcare system. But once they get used to it, we never hear back that they don’t like it.”
The Ukrainian Anastasia Ostapchuk calls the app easy and pleasant to use. But she also criticizes. She speaks good English and regularly helps other refugees as an interpreter in her shelter. “We can’t always go to the same practice. And our information is not transferred either. I don’t understand that, because it is a lot of work to tell your story over and over again. But I understand that this is a problem of the system. You have fewer doctors.”
The app has recently been used throughout Tilburg, near the three major reception locations. The municipality of Oisterwijk will also start using the app soon.
