The doctor for Tristan da Cunha, perhaps the most remote inhabited island in the world, has just been connected to the University of Pittsburgh Medical Center through a high-speed, Internet service.
The system that several agencies have established allows the island’s only doctor, Carel Van der Merwe, to record and transmit medical data—X-rays, EKGs, examinations—about any of the 274 island residents to specialists at UPMC, one of the outstanding medical centers in the United States. “It’s a pretty unique situation, so having the possibility of backup is actually I think … quite fantastic,” Dr. Van der Merwe told an AP reporter.
The Pittsburgh institution is enthusiastic about the new connection. Dr. Scott Harrington, director of the UPMC Communications Center, said that the hospital system can draw on the vast resources of the medical center for virtually any issue that might come up on the island. He told the reporter that the medical center provides “remote medical arrangements” for various airlines and other distant locations, but this is the first time they have established a dedicated link with a settled, but isolated, community.
The linkup was the brainchild of Dr. Paul Grundy, an official at IBM, and Edward Mullen, chairman of Beacon Equity Partners in Boston. Last year at a conference, they came up with the idea for what they call “Project Tristan.” Grundy had visited Tristan da Cunha a couple times and likes to study remote places. When he saw a news announcement last year that the island finally has a high-speed Internet connection, he wondered about establishing some sort of medical backup for the island’s doctor.
Most other inhabited places on the globe have at least the possibility of emergency medical evacuation, but that is not possible from Tristan, where there is no airfield. Medical evacuation can only take place via ship, so a decision to do so requires the best possible decision making. When Grundy commented about the problem on his blog, a doctor at UPMC responded. Two companies—Medweb and SOAPware—volunteered to provide technical software support. Grundy feels that Tristan is “one of the few places in the world where you have no other route.”
Dr. Van der Merwe, a South African physician, says that there are four islanders who are over 90 and four babies that are not yet one. He encounters a variety of diseases and ailments among the residents, such as diabetes, asthma, and high blood pressure. He plans to use e-mail to familiarize the staff at the UPMC about the islanders, as well as rely on them for professional, back-up service.
Dr. Grundy commented that similar technology is used by military agencies, but the application on Tristan da Cunha is unique. “With that sort of technology, you can really link them up and provide care almost anywhere,” he said.
Dr. Harrington told the Pittsburgh Post Gazette that the UPMC, which is providing the service free of charge, receives 10,000 calls per year for backup medical assistance. About 3,000 of those calls require one of their physicians to become involved. “We’re certainly prepared to talk with people in remote locations. This certainly is novel …”
The Post Gazette also interviewed Dr. Van der Merwe on Tristan. “Being able to make contact with the outside world is brilliant,” he said. Being evacuated on a fishing vessel and taken to South Africa to a hospital is a scary scenario for Tristan Islanders, and this new technology will make the alternatives much more clear before such a decision has to be made. “It’s two weeks to get out and back, so it’s a big deal,” the doctor said.
The Post Gazette also asked Drs. Grundy and Van der Merwe about the remoteness and lifestyle of the Tristan Islanders. They told the paper that the island has no crime, strong social networks, and a lot of pride in their independence. Visits by ships are the major events of the month. “They have a nice life,” Dr. Grundy observed. Dr. Harrington, from UPMC, told the paper he would take his hat off to Dr. Van der Merwe since he is able to “function as he does and practice with the constraints he does. We’re just happy to provide assistance and backup.”