A year ago plans to connect Rwandan hospitals through telemedicine – the use of telecommunication and information technologies to provide distant clinical healthcare - were announced.According to the plan, district hospitals across the country would start using the technology to treat patients without doctors necessarily meeting them physically. The technology, which helps improve access to medical services that would otherwise not be available especially in rural areas, was expected to link the health facilities across the country, with the national referral hospitals.A study, a copy of which was availed to The New Times last year, was conducted in Butare between October 31 and November 14, 2011 and focused on technical and organisational feasibility of the project.Following the study which proved that the project can be practicable, a pilot study was set to be conducted for a period of three months starting on February 1, 2012 after which it was set to be extended to other district hospitals.But almost 12 months after the project was announced, it is yet to start operating.The project, Dr Richard Gakuba, the coordinator of E-Health in the Ministry of Health, says was delayed by the lack of the entire required infrastructure to support it."The fibre-optic network was not working properly in some districts,” Dr Gakuba told The New Times in an interview.High-speed broadband network is needed for a stable internet connection which is necessary for the project to take place.But, Gakuba then hastened to add that now that the issue of internet seems to be resolved after the fibre-optic network became operational in some parts of the country, the project is set to start ‘soon’ in some district hospitals."We have installed all required infrastructure in some hospitals and they are inter- connected,” he stated.According to Gakuba, the first hospitals to benefit from the project will be district hospitals offering practical training to students pursuing medical studies at higher learning institutions.He cited the hospitals of Rwamagana (East), Kabgayi (South), Byumba (North), Kibungo (East) and Nyagatare (East) as those that have already been equipped with necessary instruments to start practicing telemedicine. The main focus in the beginning, will be to train students rather than full-scale treatment."We have already done the testing and the system is working properly,” he said. "We shall start using it soon.” He, however, doesn’t know when the system will become operational. "It can start anytime from now,” he laboured.According to the official, the target is to have all district hospitals practicing telemedicine ‘in the near future’."We have a larger project to connect all district hospitals to video conference,” he said.However, this would be possible only if all the hospitals are connected to the national fibre-optic network.So far, only 22 hospitals-which is about a half of all district hospitals across the country- have access to the high-speed internet connectivity, Gakuba said.EmpowermentAccording to the Ministry of Health, Rwanda has one doctor for every 18,000 citizens and one nurse for every 1,690 patients.According to the same figures published on the ministry’s website, 78 per cent of those nurses are in rural areas as per a 2010 study where internet and even electricity are scarce.This means that there is still a big gap between the number of patients and available human resources to attend to them.But the official is optimistic that telemedicine is the solution to close the gap."With the technology, patients will not even have to be referred to other specialised hospitals,” Gakuba says.According to the official, the technology gives an opportunity for doctors in various parts of the country to discuss any case and find appropriate and suitable solution on time without having to move the patient.This is already happening between the University teaching hospitals of Butare and Kigali (CHUB &CHUK) and the King Faisal  Hospital, Gakuba said."When a doctor faces a complicated case, he or she discusses it with others in other hospitals to get another opinion from other specialists,” he said.When fully operational, telemedicine will, according to the Director of CHUB, Dr André Musemakweli, offer alot of opportunity in the medical field."It is beneficial to both patients and medical staff,” he said.Musemakweli, however, noted the need to equip hospitals with enough infrastructure and boost the internet bandwidth in district hospitals for the effectiveness of the programmeApart from treating patients from their home district without referring them, the technology is also expected to provide an opportunity for medical students across the country to learn from each other and improve their skills.According to Gakuba, it will be an opportunity to provide continued medical education to students.Medical staff at districts level will also be empowered through the exchange with their colleagues at advanced levels.