The contribution of telemedicine to humanitarian surgery.

Telemedicine enables us to push back the geographical and interactive boundaries of medicine. With a role in humanitarian missions, it is particularly pertinent at two key stages: the preparation phase, and at postoperative follow-up after the mission. It is our intention to describe our experience of telemedicine within a humanitarian context. Four teleconsultations were organized between departments of maxillofacial surgery in Caen (France) and in Bamako (Mali). 21 patients were assessed regarding their care. The preparation phase, taking place several weeks before the mission, allowed us to meet the patients preselected by Prof Traore. We were also able to review imaging, such as previous X-rays or preoperative CT scans. After discussion between the two teams, a decision on the coordination of patient care was reached, namely surgery performed by Prof Traore and the local team in Bamako, or surgery during the next mission to Ouagadougou. Several weeks after the mission, patients attended postoperative consultation by means of teleconsultation. This covered wound assessment, management of complications, and scheduling of follow-up surgery. The benefits of telemedicine in humanitarian projects are manifold: real-time exchange of specialist skills with Malian colleagues, collective therapeutic decisions, academic value, and anticipation of anesthetic and surgical needs before missions.