Shortly after lunch, three top European hepatologists sat in a transmission studio at Munich’s University Clinic II, fiddling with their microphones and tensely waiting for the start. At the same moment, over 5,300 miles away, students at Aga Khan University (AKU), Karachi, Pakistan filed quietly into an auditorium.

Suddenly, the rapidly filling seats at AKU, slanted with afternoon sunshine, appeared on the video screen in Munich. At the same moment, the three waiting panelists in Germany popped up on a screen in front of the Pakistani audience.

“Good afternoon, Karachi”, came the greeting from panelist Peter Ferenci MD of Vienna’s Clinic IV for Internal Medicine. “Hello, Munich”, came the immediate reply from Dr. Mohammad Khurshid, medical director at Aga Khan University Hospital. “Please start with your presentations.”

That exchange kicked off a sober, practice-oriented session on hepatitis B and C that spanned three time zones. Held on May 6, 2003, the 150-minute lecture link-up showed two globalized centers of medical teaching determinedly testing the growing potential of distance learning. Technology has developed impressively: when the ISDN line held, picture and sound were excellent. Almost as important, all concerned saved valuable time. Said Dr. Ferenci: “Instead of week’s worth of travel from Vienna to Karachi and back, all I took is one day for the trip to Munich. This is the way to go.”

The presentations from Munich and Karachi covered patient evaluation, epidemiology, diagnosis and management. The European lecturers were fully prepared for questions – and they came, along with extended contributions from the Pakistani side. “How do I treat …?” was a recurrent question. Discussions were case-based and health economics a major underlying theme.

“A regime of hepatitis medication that we can afford in rich countries is out of reach for most Pakistanis”, said Prof. Rainer Zachoval, another Munich panelist. “Clearly, a strong option for poorer countries is prevention. Multiplying video lectures like this is a great way of sharing advice and information.”

The Munich-Karachi learning session was conceived by OMGE Past President Meinhard Classen MD and Professor S.M. Wasim Jafri, chief of gastroenterology and chairman of AKU’s department of medicine, as the first in a series planned for OMGE training centres. Evaluation will improve the process. Prof. Jafri’s verdict on May 6: “Despite the technical hiccups, we enjoyed it.”

While videoconferencing remains costly, industry experts are looking to the internet to assume more and more of the heavy data transmission currently performed by ‘private’ digital lines. This should push down costs -- and help open a treasure of intercontinental learning.

Photo by T. Nater

(From left) European professors Zachoval, Ferenci and Schulte-Frohlinde highlight prevention

Photo by T. Nater

As seen in Munich, Aga Khan University audience studies the show from distant Germany