Telemedicine and e-health.

Introduction The challenges facing Africa in delivering high-quality paediatric surgical care during the next century are great. Overcoming poverty, difficult access to medical care, governmental instability, lack of trained physicians, and a large burden of existing and emerging diseases all appear at times insurmountable. In September 2000, the largest gathering of heads of state ever held, including leaders from 189 countries, adopted the Millennium Declaration with eight Millennium Development Goals (MDGs) as a blueprint to accomplish by the year 2015.1 These include progress in ending poverty and hunger; addressing universal education, gender equality, child health, and maternal health; combatting HIV/ AIDS; and working toward environmental sustainability and global partnership. The MDG update report for 2008 shows that Africa continues to have the largest need of any continent in the world, and is making only minimal progress in meeting its goals.2 Medical diagnostics and therapeutics are becoming more advanced daily, creating a larger gap between services possible in the industrialised world and those available to most Africans. The physician in Africa is forced to work between two worlds: one of technologic advancement and voluminous medical information and one of limited resources and profound medical need. How can the modern African surgeon bridge this gap? Appropriately applied technology can provide part of the solution. Information and communication technologies continue to undergo a revolution, making instant access to remote locations easier and less expensive. Telemedicine utilises these technologies to bring medical information and services to geographically or physically isolated people who would not otherwise be able to reach a physician. Perhaps the greatest utility of these technologies is in the developing world, where the disparity between access and need is the largest. The World Health Organization (WHO) has recognised the capacity of telemedicine to increase health care information and delivery. WHO recommends that all their member states should: applications of telemedicine is of great importance for the African surgeon. This chapter is written as an introduction to that knowledge.