Basra University Medical College in Southern Iraq is part of the Swinfen Charitable Trust (SCT) e-health network featured in our last story (Technology links remote regions of the world with the finest medical minds).

STC Director and Systems Operator, Pat Swinfen, said the Medical College has enjoyed wide international support from medical specialists since the e-health link was set up in 2004.

“One case that stays in my mind is that of a seven-year old boy, who presented at the hospital with a headache,” Pat said.

“A scan revealed a bullet in his head, just above his left eye. The local doctor was able to immediately seek international expertise on this rather unusual case, despite the country being at war.”

The email received at the SCT included an x-ray and the following request:

This unlucky and lucky at the same time. Child exposed to a bullet from above and of unknown origin, to the left upper part of the frontal bone, passing through the frontal lobe as we see in the CT scan, to the left orbit behind the globe. Conscious, oriented and fully active - only complaint is heaviness in the left orbit.

“In conjunction with the Centre for Online Health (www.uq.edu.au) in Brisbane, we were able to quickly forward the referral to an appropriate specialist,” Pat said.

“Surgery was recommended and specialist advice on the procedure was provided to the local surgical team on stand-by.

“We have since learnt the bullet was the result of a wedding celebration. It’s customary for gunshots to be fired into the air after the ceremony. Without anyone realising, one of the bullets had come down to lodge in the child’s head."

Technology enables global specialist medical knowledge to be shared speedily with developing countries. To establish a satisfactory link, referring hospitals require a computer with Internet access. The SCT supports new referring hospitals with a digital camera and basic user training. Where there are no telephone lines, some hospitals have relied on solar powered, satellite telephone links to send emails to the SCT.

“Most hospitals are in remote locations and often fairly inaccessible, making the provision of the link an essential service,” Pat said.