Intended for healthcare professionals


Email health support service is already operating in Africa

BMJ 2001; 322 doi: (Published 06 January 2001) Cite this as: BMJ 2001;322:51
  1. F J Cooke, specialist registrar (fionacooke{at},
  2. A Holmes, senior lecturer
  1. Infectious Diseases and Microbiology, Hammersmith Hospital, Imperial College, London W12 OHS
  2. Public Health Laboratory Service Microbiology, St George's Hospital, London SW17 OQT

    EDITOR—We agree with Fraser and McGrath that email is an effective and practical medium for healthcare support in remote regions1 and that many patients in rural areas may soon benefit from telemedicine projects.2 In Britain we have been providing an international email health support service since April 1998,3 which has been accessed frequently in sub-Saharan Africa. Our service is successful and highly valued,4 and it is constantly being improved and expanded. It was initially developed for the overseas training programme of Voluntary Service Overseas, which is the largest independent agency in the world to send volunteers. Trainees in this programme (age 18-25) are placed in community based projects overseas for up to 12 months. Many placements are in extremely remote areas, but in spite of this, email is a medium that can be readily used. In many cases it is easier to email the overseas training programme doctor in the United Kingdom than contact the local doctor. A large proportion of trainees are in sub-Saharan Africa, and so far the email service has been accessed in Cameroon, Benin, Zimbabwe, Botswana, Tanzania, Kenya, Mozambique, Togo, Lesotho, Niger, Uganda, Zambia, South Africa, and Madagascar (figure).


    Countries in Africa where overseas training programme email service has been successfully used

    We have developed a health support service that incorporates the use of email. Our service includes advice before departure, medical support while in the field, and follow up on return to the United Kingdom. The success of our email consultation service hinges on personal knowledge of the individual, their medical history, their placement, and their local doctor and healthcare facilities, which may be some distance away and not easily contacted by email or telephone. Our email response is within 24 hours, and we can communicate with doctors in the country when required. Various medical and psychological conditions have been successfully identified and managed, aided by appropriate background knowledge and liaison with local services. In addition to expanding the current service we intend to develop it further to support also local doctors participating in these development projects.


    • Both authors run the health support service for the Overseas Training Programme of Voluntary Service Overseas, 317 Putney Bridge Road, London SW15 0HS.


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