Medical convoy in Khemisset region in northern Morocco. Source: sada.lmaghrib Facebook page, used with permission.

By Khalid Bencherif

While playing in her village in southeastern Morocco, little Idia suffered a fall. Her family rushed her to the nearest hospital, only to find it lacked a crucial medical scanner. Desperate, they took her 100 kilometers away for scans, but the diagnosis was inaccurate. They then embarked on a 330-kilometer journey to Fez, where Idia passed away. 

This tragic incident is one of many that are caused by the severe healthcare disparities in Morocco.

The rural areas in the country face significant healthcare challenges. Over half the doctors are concentrated in urban areas, leaving vast rural regions underserved. Nearly half the population must travel over 10 kilometers for healthcare, often hindered by rugged terrain, scarce transportation, and economic hardship. Morocco also suffers from a shortage of doctors, with only 7.8 per 10,000 people in 2018, far below the WHO's recommended 23.

‘Shortage of medical personnel in Morocco.’ Illustration by Khalid Bencherif, used with permission.

To bridge this gap, Morocco has embraced mobile medicine and telemedicine which makes use of new communication technologies to provide healthcare for people at a distance. 

Such mobile medical units and telemedicine platforms bring healthcare services to remote villages, reducing the need for long journeys and ensuring access to specialized care. The COVID-19 pandemic further emphasized the importance of telemedicine, making it a vital tool for delivering healthcare to isolated communities.

Mobile healthcare in Morocco takes several forms, including medical convoys organized by civil society groups, government-backed mobile units, and telemedicine stations that connect remote patients with specialists via video. 

Telemedicine units are already operating in places like Chefchaouen in Morocco’s northwestern Rif Mountains, with 19 civilian campaigns and over 900 mobile medical visits in 2023 alone according to Jawad Dib, an official health services provider. 

Since its pilot in 2015, Morocco’s telemedicine program has expanded to reach 40 rural communities and is expected to serve 120 by 2025.

Health relief

During my field visit to Bab Berd in Chefchaouen, I met several residents who had benefited from one of the mobile medical campaigns. Among them was 63-year-old Mohammed, who suffered from multiple health issues, including high blood pressure and stomach pain. 

“I couldn’t afford to travel to the city for treatment because of the cost and distance,” he explains, “but when the medical campaign came to our village, I was able to receive the necessary tests and treatment at no cost. Now, thank god, I feel much better, and this has brought immense relief to my poor family.”

I also encountered Maryam, a young girl who had been struggling with a persistent dental problem. With no dentist in the area, Maryam had endured months of pain. When the mobile medical team arrived, they were able to treat her condition and finally bring her relief.

“Maryam was in so much pain at night, and we didn’t know what to do,” her mother recalls. “The medical campaign came at just the right time, and we are deeply grateful to the doctors who helped her.”

More needed

My journey then took me to the town of Rich, in southeastern Morocco, a region that has long suffered from neglect. In early September, a medical campaign was organized for the local residents and surrounding villages, hosted by the town’s poorly equipped hospital.

Several villagers shared their positive experiences, including Fatima, a woman in her fifties who explained the significant impact the campaign had on her community: “It helped us enormously, but we still need a permanent, fully equipped hospital here in town,” she said. 

Fatima emphasized how the campaign had been a lifeline for many people who previously had no access to healthcare. “These convoys sometimes only come once a year, and we need far more than that,” she added.

Medicine for the poor

Actually, mobile medicine — whether through mobile medical units or telemedicine — has proven not only effective in improving healthcare but also as a tool for promoting rural development. 

When villagers have reliable access to healthcare, they are better able to participate in economic and educational activities, which enhances their quality of life and helps them break the cycle of poverty.

Moreover, mobile medicine provides a valuable opportunity to reduce the healthcare gap between rural and urban areas and promote health equity. 

Tayeb Hamdi, a Moroccan doctor and researcher in health policies and systems, explains, “Telemedicine units are vital when specialized doctors are not on-site. Thanks to digital diagnostic tools and advanced communication technology, medical services can now be provided remotely. This helps ensure equal access to treatment and contributes to the democratization of healthcare.” 

He further points out, “We often assume telemedicine is for wealthy countries, but in reality, it serves poorer nations even more. It’s like the transition from landline telephones to mobile phones — if we had remained reliant on landlines, the poor would not have been able to afford them.”

Tayeb is optimistic about the potential of telemedicine. “The future of medicine lies outside of hospitals, not inside,” he explains. “Even in cities, it’s becoming possible to receive treatment at home, especially for conditions that don’t require hospitalization.” He stresses the need for the private sector to be involved, for investment in this area, and for changes to legislation to ensure quality and promote health coverage linked to telemedicine.

Map of areas benefiting from civil medical campaigns in the first half of 2024. Data collected and map designed by Khalid Bencherif, and used with permission.

Real challenges

While mobile medicine offers significant benefits in rural Morocco, it faces several challenges. From a logistical perspective, one major challenge is the rugged terrain, which makes accessing some remote areas extremely difficult. “The rough landscape and isolation of certain regions are major obstacles to providing healthcare services,” says Habib Kroum, representative of the Moroccan Nursing Association. 

He also highlights the shortage of human, logistical, and financial resources, which further complicates efforts to meet the healthcare needs of these populations.

Jawad Dib, an official health services coordinator, notes that some individuals or groups run campaigns without properly coordinating with local health authorities, leading to duplicated efforts or services that don’t match the community’s actual needs. “Some exploit these campaigns for profit, which is unacceptable in this field,” Dib says.

Researchers also warn of potential risks. Telemedicine could be misused as a cost-cutting tool by some countries, particularly in rural areas, where healthcare budgets are already stretched. 

Experts insist that telemedicine should not become a substitute for proper in-person healthcare; instead, it should be used to complement existing services, ensuring clinicians can provide the best care for their patients.

This was visible during my field visits, where people criticized medical campaigns as being, in some cases, merely an attempt to compensate for the lack of well-equipped hospitals in rural areas. Many residents expressed their desire for permanent hospitals with reliable medical staff. 

The European Journalism Centre‘s Solutions Journalism Accelerator programme funded this research project and article with support from the Bill & Melinda Gates Foundation.