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Hardware costs for telecommunications circuits can account for a maj or portion of total costs in Third World telem1icine progranis based on voice comunications. This is due to the relatively high cost associated with developing voice based coirimunications links to remote and isolated areas which are not already equipped with them. Iveloping satellite links specifically for telemedicine can be particularly expensive . However, more arid more remote and isolated areas in the Third World are already being sewed today by modern thin-route telecommunications systems . This is being done by exbending line of sight radio systems into remote areas using the so called point-to-multipoint microwave radio tecbnology. Point-to--multipoint radio systems have already been installed in several African and South American countries through a variety of financing arrangements such as funding by international agencies as well as funding by the countries theitselves. These systems reach into areas where health care seivices are often marginal. Health care workers — es, nurses , mid—wives and doctors , many, if not the majority of whom are women - often lack the support system that would provide for skills upgrading to allow them to benefit from the latest medical knowledge and advances. They also often lack the means to keep in touch with what is going on in the health field in other parts of their own country. By capitalizing on existing telecommunications links into such areas, telemedicine programs can be inlemented at costs far below those requiring the building of new networks for the purpose. This paper explores the possibilities of using existing telephone networks for implementing telemedicine projects in remote areas of the third world.
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