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of “electronic health” or eHealth, defined as the use of information and communication technology in the health sector, including digital data transmission, storage and retrieval, for clinical, educational and administrative purposes (WHO, 2002; Dzenowagis, 2004). The discipline of eHealth can be of use in the most precise area of medicine as well as help solve medical problems and boost training in remote areas of Africa. In the UK, for example, young surgeons simply don’t have time to attend training courses or leave their hospitals to observe new surgical techniques or investigate new technologies. Within hospitals, shift rotas prevent most trainee surgeons from attending regularly-scheduled instruction sessions, making flexible training programmes absolutely essential. A pilot project called Telematic Training for Surgeons (TETRASUR), initially a collaboration between the University of Plymouth and the European Space Agency (ESA), funded by regional medical research grants and industry sponsorship, was established in 1997 to investigate telematics applications with respect to surgeon training, initially in local hospitals (Kingsnorth et al., 1999). The TETRASUR project metamorphosed into the Satellite Network Telematics Training for Surgeons (SANTTSUR), following receipt of a £300,000 research grant from the ESA, as a distance learning package integrating live digital TV, video conferencing and the internet, with a service being provided to 26 nationwide locations. SANTTSUR delivered high-quality, live, interactive TV programmes to hospitals and medical centres broadcast from a studio in Plymouth via a TDS4b uplink provided by the ESA and received by sites throughout the UK and Ireland. The course material was modular, built on a syllabus devised by the Royal College of Surgeons (RCS). Telematic-based training enabled tutors and trainees to remain in their local hospitals and conduct training in close proximity to their patients. Trainees could interact with tutors, presenters and contributing experts via real-time phone, text-messaging, e-mail, fax and ISDN (Integrated Services Digital Network) video conferencing. Many hospitals, clinics and medical facilities already have considerable infrastructure in video conferencing and telecommunications, and reception merely required an additional small, cheap antenna, 1.2 m in diameter. Three sets of 10 lectures, were transmitted weekly via a single 90-minute lunchtime session. Each transmission comprised formal presentations, studio discussion, live ISDN6 video feeds from teaching hospitals and trainee question-and-answer sessions via ISDN2, telephone or on-line chat. A noteworthy “Case of the Week” was also included. Broadcasts could also be videotaped, and then made available at any time for the trainees. In several institutions, a consultant would assign a task based on the broadcast, with a written response required within a set time. A general review and open forum Corresponding author: Andy Crump, Visiting Professor Kitasato University, 5-9-1 Shirokane Minato-Ku, Tokyo 108-8642, Japan E-mail: crumpa@easynet.co.uk Satellite teleHealth: good for the cutting edge and in the bush?