An evaluation of the first year's experience with a low-cost telemedicine link in Bangladesh

J Telemed Telecare. 2001;7(3):125-38. doi: 10.1258/1357633011936273.


In July 1999, the Swinfen Charitable Trust in the UK established a telemedicine link in Bangladesh, between the Centre for the Rehabilitation of the Paralysed (CRP) in Dhaka and medical consultants abroad. This low-cost telemedicine system used a digital camera to capture still images, which were then transmitted by email. During the first 12 months, 27 telemedicine referrals were made. The following specialties were consulted: neurology (44%), orthopaedics (40%), rheumatology (8%), nephrology (4%) and paediatrics (4%). Initial email replies were received at the CRP within a day of referral in 70% of cases and within thee days in 100%, which shows that store-and-forward telemedicine can be both fast and reliable. Telemedicine consultation was complete within three days in 14 cases (52%) and within three weeks in 24 cases (89%). Referral was judged to be beneficial in 24 cases (89%), the benefits including establishment of the diagnosis, the provision of reassurance to the patient and referring doctor, and a change of management. Four patients (15% of the total) and their families were spared the considerable expense and unnecessary stress of travelling abroad for a second opinion, and the savings from this alone outweighed the set-up and running costs in Bangladesh. The latter are limited to an email account with an Internet service provider and the local-rate telephone call charges from the CRP. This successful telemedicine system is a model for further telemedicine projects in the developing world.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Bangladesh
  • Child, Preschool
  • Computer Communication Networks* / economics
  • Computer Communication Networks* / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Paralysis / diagnosis
  • Program Evaluation
  • Referral and Consultation
  • Remote Consultation / economics
  • Remote Consultation / methods
  • Remote Consultation / statistics & numerical data
  • Spinal Cord Diseases / diagnosis*
  • Telemedicine / economics
  • Telemedicine / methods*
  • Telemedicine / statistics & numerical data