Over the past 10 years, telemedicine has been used for treating diseases over the internet in third world countries. Dr. Ellen M. Einterz, of Cameroon, Africa, says it is a wonderful idea, but, she cautions that the "glitter of satellites could divert attention and funds from the grittier problems of health and health care on this continent." Basic necessities, like clean water, transportation, communication lines and education are still high on the list of needs.

Telemedicine will not help diseases such as AIDS, malaria, neonatal tetanus, and tuberculosis since the means to prevent them are already known, but the supplies and services are lacking, says Dr. Einterz.

Computers are great if the electricity is working and the workers are educated and equipped to run them. Much is still needed in order for telemedicine to work here she says. Needed more is basic medicinal supplies and better nutrition for all residents.

On the other hand, in Bangladesh, telemedicine may be more useful in identifying disease in the early stages. The country, "spends $1 Billion dollars on healthcare but patients are not getting the expected care," says Dr Sikder Zakir of the Bangladesh Telemedicine Services (BTS). With telemedicine, doctors can send an electrocardiogram image to Dhaka for expert interpretation and perhaps save a life.

With telemedicine, 20 people can be treated with the same money used to evacuate two patients to other hospitals. Case files and queries can be sent to Dhaka over the internet and with pharmacies in place, business will be more lucrative.

By the year 1999 the Swinfen Charitable Trust (SCT) was using digital cameras and email to help doctors in developing countries. Hospitals in Bangladesh, Nepal and the Soloman Islands were benefitting from these technologies.

The Centre for Rehabilitation of the Paralysed (CPR) in Bangladesh has been helped by the (SCT). Both have a policy to get the patients as independent as possible and the CPR even trains patients to be able to work and make an income when they are discharged.

With no welfare system in Bangladesh and a shortage of consulting doctors, telemedicine helps bridge the gap in healthcare. The SCT runs out of the home of two authors. Medical consultants who are located in Europe, Australia and the US give their advice without charge. They keep up with the emails so that if a specialist does not respond, they can look for another immediately. "There is comfort in knowing that help is only an email away," says the Director of Gizo Hospital upon leaving for Tasmania.