========================================================================= RED CIENTIFICA PERUANA SATELLIFE ========================================================================= The five following documents detail information about SatelLife. They are: 1) Backgrounder 2) Update 3) SatelLife Fact Sheet 4) Becoming a Partner in HealthNet 5) What is HealthNet ---------------------------------- BACKGROUND INFORMATION WHAT IS SATELLIFE? SatelLife is an international not-for-profit organization which uses micro-satellite technology to serve the health communication and information needs of countries in the developing world. SatelLife's mission is to improve communications and the exchange of information in the fields of public health, medicine and the environment. A special emphasis is placed on areas of the world where access is limited by poor communications, economic conditions, or disasters. SatelLife is an initiative of the International Physicians for the Prevention of Nuclear War (IPPNW), recipient of the 1985 Nobel Peace Prize. IPPNW realized that the voices of medical colleagues in the southern hemisphere were often missing in the global forum on issues of peace and health. As East-West tensions diminished, North-South disparities loomed larger than ever. Although an inexpensive, reliable communication system would not solve all problems, it could give physicians and healthcare workers in both hemispheres a means by which they could problem-solve together. SatelLife came into being in 1989, when an international board of directors was formed, an executive director was appointed, and offices opened in Cambridge, Massachusetts. With fax machines and telephones in such abundance today, why is SatelLife necessary? Affordable and reliable communication is a significant problem for health professionals in many countries of the developing world. Communication dependent on the telephone system is costly in terms of time and money. - It costs a professor in Lusaka, Zambia, $7/minute to call a colleague at the London School of Hygiene and Tropical Medicine. - A medical researcher in Nairobi, Kenya, can pay up to $7 to fax a single page of laboratory results to World Health Organization headquarters in Geneva. - The minimum charge to send a telex from the University of Dar es Salaam in Tanzania to the Center for Disease Control in Atlanta, Georgia, is $25. - It is often impossible to call, fax, or send a telex from a country in East Africa to one in West Africa - from Uganda to Nigeria, for example. - Getting a dial tone does not necessarily mean a successful connection. Actual connection rates vary from a 12% success rate on international calls from Ghana to a 45% success rate for local calls in Tanzania. These are not worst case scenarios. What does a lack of information mean for health professionals? "Information poverty" can often mean planning without facts, making decisions based upon information that is several years out of date, and undertaking research that is irrelevant or redundant. In the fields of medicine and public health, isolation from current developments may be one of the more serious consequences of "information poverty." The medical library of Makerere University in Kampala, Uganda, for example, reports a decade-long gap in its periodical collection. Only those faculty who have the means to travel abroad can formulate research, since a review of the literature is a prerequisite to formulating a problem statement. Dr. Ramnik Xavier, now a physician at the Massachusetts General Hospital in Boston, attended medical school at the University of Zimbabwe. He explains: "The references in our most current textbooks of medicine are from the early 1960s, simply because none has been republished since the 1970s. As a senior medical student, I was co-author of a paper describing research on the prevalence and treatment of goiter in central Africa. That was 1988. That same study was repeated in Zambia last year. Upon inquiry, I was told by the researchers there was no knowledge of our study. Further investigation revealed there was no way for them to have discovered it. The British journal in which it was published was not available in the national medical library. There is no search capacity available in Zambia that can produce bibliographies or abstracts. In brief, our patients are not even able to benefit from the research done by and for our own people. Our isolation forces us to re-invent the wheel." Is lack of information as great a medical problem in the developing world as difficulties of communication? They are complementary issues. Health professionals in Africa are not only facing the continuing erosion of basic information resources - books, journals, and other materials - but also isolation from new technologies that make comprehensive information services available in industrialized nations. Because there are few packet-switched circuits in developing world countries, access to international databases is virtually impossible. Even where there is access, line charges and user fees are beyond the means of most institutions. The average American medical school has 3,000 subscriptions in its periodical collection. Surveys have shown medical schools in developing world countries may have between 30 and 300 titles. Under pressure from International Monetary Fund structural adjustments, many African medical libraries were forced to cancel all subscriptions to medical literature requiring foreign currency. For example, at the University of Ghana medical school library, periodical subscriptions fell from 435 in 1972 to 51 in 1983. A 1989 survey by the American Association for the Advancement of Science revealed that few medical libraries of Africa had recovered from those cutbacks. WHAT IS HEALTHNET? SatelLife administers HealthNet, a telecommunications system designed to facilitate the exchange of information among health professionals in developing world countries and to link them with their colleagues abroad. HealthNet is envisioned primarily as a decentralized network which joins provider and user institutions in relation to specific interests, problems, or requests. SatelLife's initial efforts have focused on a pilot project with seven nations in Africa. SatelLife ground stations, which send and receive messages have been installed and made operational in Zambia, Uganda, Tanzania, Kenya, Mozambique, the Congo, and Zimbabwe. HealthNet provides an information service that is cooperative and interactive, driven by the needs and resources of its users. The system's flexibility in handling small or large amounts of data makes many applications possible. For example, the Users Council in Zambia wants to engage the system for the following purposes: - Electronic mail and conferencing (local and international); - Distribution of international and local publications; - Distance learning; - Publicizing health news; - Epidemiological data transmission; - Data collection and distribution of statistics; - Referrals and consultations; - Management of information. THE HEALTHNET INFORMATION SERVICE INCLUDES: - Library partnership program: In this program, medical libraries in developing world countries and those in industrial countries create partnerships for the purpose of requesting and exchanging health information. This "sister library" concept encourages collegial relationships for the two-way exchange of information to the benefit of all participants. Regina Shakakata, Medical Librarian at the University of Zambia Medical School, and Lenny Rhine at the Health Science Center Library at the University of Florida have begun a demonstration of this program. - HealthNet News: Published by SatelLife in consultation with an international editorial board, this electronic publication contains full text articles, journal article summaries, and commissioned articles. HealthNet News is being designed as an interactive publication; its content will be shaped in collaboration with users and internationally known research institutes. HealthNet News was inaugurated on March 20, 1992, by the Queen of England. The first issue contained articles from The New England Journal of Medicine and summaries from Journal Watch. The Massachusetts Medical Society has given SatelLife permission to distribute archival and current articles from these publications free of charge. The publishers of Annals of Internal Medicine granted permission for the use of Predictors of Mortality among HIV-infected Women in Kigali, Rwanda and have expressed interest in making additional contributions. Five physicians from the Massachusetts General Hospital and the Harvard School of Public Health also contributed articles. HealthNet News will be distributed for the most part by electronic means. For example, the School of Medicine at the University of Zambia is proposing that all District Hospitals be connected on an electronic mail system to the University. This system will give HealthNet News an audience within the Medical School as well as around the country through Provincial and District Hospitals. It will also provide physcians from more remote districts with a means of participating in future editions of HealthNet News. - Consultation: HealthNet provides physicians and health-care workers in developing world countries with on-call access to organizations and institutions. Initial participating organizations include the Harvard School of Public Health, Liverpool School of Tropical Medicine, and the Oswaldo Cruz Institute in Brazil. In Africa, medical doctors working in Maputo Central Hospital in Mozambique treating patients with rare forms of sickness will be using the system to share clinical reports and data with doctors in Zambia to determine if they have seen similar cases. - Research Capabilities: CD-ROM readers are being installed in conjunction with ground stations to allow initial research on MEDLINE and archival retrieval of abstracts to be performed on site. On this component of HealthNet, SatelLife is collaborating with the Health Foundation in New York City which is supplying a CD-ROM setup to the Medical Library at the University of Zambia which serves as a national focal point for medical information. The Health Foundation's CD-ROM project includes a number of the countries in which SatelLife has or will have ground stations. Additionally, CD-ROM readers and disks are included as part of the recent grant SatelLife received from the International Development Research Centre. How does HealthNet deal with the problems of poor telecommunications infrastructure and costs that are unaffordable? The technical foundation of HealthNet is a "store and forward" satellite called HealthSat. As this technology relies on radio waves to transmit messages to and from the satellite, there are no transmission costs. Because HealthNet does not depend on international telecommunication links, it is not affected by congested circuits, unaffordable service charges, or frequently disrupted service. The ground station required to send and receive messages from HealthSat comprises a personal computer, a radio which is similar to a ham radio and an antenna. A complete ground station costs $7,500, making this technology affordable, sustainable, and appropriate for any country in the developing world. HealthSat itself cost approximately $1 million to manufacture in contrast to the average cost of $250 million for a geostationary satellite used to transmit telephone or television signals. HOW DOES HEALTHSAT WORK? HealthSat was built by Surrey Satellite Technology Ltd. in the U.K. Packet-satellite is a new application of three proven technologies -- personal computer, packet radio, and "store and forward" satellite. HealthSat has a 500 mile, low-earth orbit, continually passing over the North and South poles. As the satellite travels in a north/south plane, the earth rotates east to west; each orbit takes approximately 100 minutes. Every place in the world is within the satellite's signal, or "footprint", at least twice a day. A HealthNet user sends a message composed at the ground station's computer via a radio to a computer in the satellite. The satellite's computer "stores" the message. When the satellite passes over the ground station for which the message is destined, it "forwards" the message to that station. HealthSat receives messages by sending a signal to a ground station as it passes over, inquiring if there are out-going messages. If there are, the radio attached to the computer uplinks the messages to the satellite. If there are incoming messages, the satellite downloads them to the computer on the ground. Equipped with software which compresses the text of the messages, the ground station can transmit or receive approximately a page each second. Every ground station is in the "footprint" of the satellite twice a day for a minimum of 10 minutes per satellite pass. Some locations may have six or eight passes each day with equatorial locations having the least access and polar locations the most. At Memorial University in St. John's, Newfoundland, a "gateway" station has been set up to handle messages to and from the satellite for the U.S. and Canada. A similar gateway for the U.K. and Europe is at Surrey Satellite Technology Ltd. in Guildford, Surrey. HOW MUCH "TRAFFIC" CAN HEALTHSAT SUPPORT? HealthSat has an on-board memory capacity of approximately 10 Mbytes. It can support a network of 500 ground stations with each transmitting or receiving 100 pages of electronic mail per day. Anticipating significant need, SatelLife's board of directors has already authorized the manufacture and launch of a second satellite in 1993-94. This will double the total communication capacity and halve the maximum time between passes for equatorial locations from 12 hours to 6 hours. The HealthNet system, to be expanded in response to user demand, has been designed to accommodate several satellites. WHY DID SATELLIFE CHOOSE AFRICA FOR ITS PILOT PROJECT? Dr. Gottlieb Monekosso, Director of the World Health Organization's Regional Office for Africa, believes that: "Establishing reliable communications may be one of the most important priorities for improving health in Africa." The first transmission of medical information on HealthNet confirmed this need. It was an article from The New England Journal of Medicine, published in the summer of 1990, entitled A Randomized, Controlled Trial of Vitamin A in Children with Severe Measles. Measles is a deadly disease for children in developing world countries, even though Vitamin A is readily available. Despite the fact that the research for this article was conducted in Africa, it had not been widely read there months after publication. This may be because subscriptions to leading medical journals are extremely costly for libraries in developing world countries. When a library is able to purchase journals, they often arrive by mail months after publication, if they arrive at all. After they are placed in the library's collection, users often rip out pages, so desperate is the need for information. On top of all of this, the climate plays a significant role in the deterioration of paper copies. For these reasons, SatelLife's initial efforts have been focused on the 7-nation pilot project in Africa. ARE OTHER INTERNATIONAL AGENCIES INTERESTED IN USING HEALTHNET? A ground station was recently installed in the WHO/African regional office in Brazzaville. Of the forty- four countries in that region, one-third of them cannot communicate with Brazzaville; it is also extremely difficult for people in the Brazzaville and Geneva offices to communicate with each other. Dr. Monekosso wants to expand SatelLife's initial pilot project in Africa to include all the countries of that region. WHO Eastern Mediterranean region has approached SatelLife with a similar proposal. Additional international agencies who have expressed interest in using HealthNet to facilitate their communication with developing world countries include: - United Nations Development Programme; - International Development Research Centre; - World Health Organization's Tropical Disease Research Program; - Expanded Program on Immunization; - Rockefeller Foundation's International Clinical Epidemiology Network; - Pan American Health Organization; - UNICEF; - Swedish Agency for Research Cooperation with Developing Countries; - International Program against Micronutrient Malnutrition. WHO FUNDS SATELLIFE? SatelLife is supported by contributions from individual donors, foundation grants, and corporate sponsorships. NEC Corporation of Japan is a founding corporate sponsor. Additional support has come from the International Physicians for the Prevention of Nuclear War and Soyuzmedinform in the Soviet Union. The International Development Research Centre of Canada is also collaborating with SatelLife through a lease of HealthSat capacity for a range of health research communication and information exchange services in developing countries. The pilot project in East Africa has been funded by grants from the John D. and Catherine T. MacArthur Foundation, the Rockefeller Foundation, and the Lippincott Foundation. SatelLife has also received major support from the Ted Turner Foundation, the Alfred Jurzykowski Foundation, the John Merck Fund, Microspace Communication Corporation, and the New Land Foundation. -------------------------------------------------- #2 UPDATE 8/17/92 AFRICA PILOT PROJECT INITIATED: - SatelLife ground stations have now been licensed and/or installed in eight countries in Africa - Zambia, Uganda, Tanzania, Kenya, Zimbabwe, Mozambique, Ghana and the Congo. - The installation in Ghana will be SatelLife's first station in West Africa. Once this station is operational, it will be the first time countries in East and West Africa are able to communicate with each other in the field of health. - At Memorial University in Newfoundland, Canada, we have a "gateway" station serving North America which handles messages to and from our satellite, HealthSat. We have a similar station for the U.K. and Europe at Surrey Satellite Technology Ltd. in Surrey, U.K. HEALTHNET INFORMATION SERVICES: ENTHUSIASTIC PARTICIPATION FROM PRESTIGIOUS SOURCES: - The Massachusetts Medical Society has agreed to make available current and back issues of The New England Journal of Medicine, Journal Watch, and AIDS Clinical Care for electronic distribution by HealthSat in Africa. The American College of Physicians has given SatelLife permission to distribute Annals of Internal Medicine and ACP Journal Club. Times Mirror is permitting distribution of Mosby-Year Book. - The Massachusetts General Hospital and Harvard School of Public Health are interested in establishing "on call" services for our users. - We have formed active groups of medical librarians/institutions in Africa, the U.S., U.K./Europe, and Canada who are participating in our library partnership program. Regina Shakakata, Medical Librarian at the University of Zambia Medical School, and Lenny Rhine at the Health Science Center Library at the University of Florida are making history as SatelLife's first "sister" libraries. - The AIDS and Hepatitis CD-ROMs by Macmillan New Media (formerly Maxwell Electronic Publishing) will be featured in our HealthNet Bulletin Board pilot project in Nairobi. We expect that the bulletin board will be used by physicians and researchers engaged in AIDS and hepatitis research and clinical care throughout Kenya. HEALTHNET INFORMATION SERVICE INAUGURATED: - SatelLife's HealthNet Information Service was launched in March by the Queen of England from our U.K./European gateway station. At the same time, our colleagues in Zambia officially opened their ground station which had been receiving and transmitting messages to and from HealthSat for the previous year. President Chiluba of Zambia exchanged greetings with Queen Elizabeth. - As a part of this celebration, HealthNet News was sent to all countries participating in the pilot project. HealthNet News is an electronic newsletter which contains full text journal articles, journal article summaries, and commissioned articles. Designed as an interactive publication, the content of HealthNet News is shaped in collaboration with users and internationally known research institutes. DRAMATIC INCREASE IN DEMAND: - The World Health Organization's Africa Region and SatelLife have established a demonstration project with WHO's Brazzaville office and African pilot countries. Eventually, WHO wants to use SatelLife's HealthNet system to connect the regional office in Brazzaville with forty-four country offices -- one-third of which the regional office can't communicate with at all. While visiting SatelLife offices, Professor Gottlieb Monekosso, Director of the WHO Regional Office for Africa, told us: "Establishing reliable communications may be one of the most important priorities for improving health in Africa." - The Expanded Program on Immunization (EPI) of the World Health Organization believes SatelLife can play a critical role in achieving their goal -- to eliminate polio by the year 2000. HealthSat's ability to collect data for 50,000 rural and isolated sites around the world will greatly enhance their efforts to eliminate both polio and measles. - Tropical Disease Research (TDR) program, an initiative of WHO, UNDP, and the World Bank, is interested in using HealthSat to link laboratories specializing in tropical disease research in the North and South. The work stations for southern laboratories will contain specialized discs for tropical medicine which will include textbooks, databases, and journals. AIDS and viral hepatitis information will also be available. - International Development Research Centre (IDRC) of Canada has approved a grant of CA$700,000.00 to SatelLife. These funds will make it possible for fifteen designated countries in the developing world to join SatelLife's HealthNet system. SATELLIFE ON THE MOVE - NEC recently sponsored SatelLife's participation in INET'92, an international networking conference held in Kobe, Japan. Approximately 80 participants from the developing world attended the conference where Julia Royall, Deputy Director; Dieter Klein, Technical Director; and Jon Metzger, Associate Director for Operations presented HealthNet and conducted almost non-stop demonstrations of the system. While in Japan, SatelLife staff were received at NEC headquarters in Tokyo. - Charlie Clements, Executive Director, presented SatelLife at the International Society of Infectious Diseases conference in Nairobi, Kenya in June. The presentation generated much enthusiasm and meetings were held with people interested in HealthNet from around the world. CORPORATE SPONSORSHIP PROGRAM INAUGURATED: - SatelLife's Corporate Sponsorship Program enables corporations to be part of a humanitarian effort which also affords significant opportunities in marketing and public relations. - NEC Corporation of Japan was presented as a Founding Corporate Sponsor at our first press roundtable held at the National Press Club in Washington. The roundtable was introduced by Dr. Bernard Lown, Nobel laureate and SatelLife founder/chair, and moderated by John Kenneth Galbraith. ------------------------------------------------- #3 SATELLIFE FACT SHEET WHAT IS SATELLIFE? - SatelLife is an international not-for-profit organization which uses micro-satellite technology to serve global health communication and information needs. SatelLife's mission is to improve communications and the exchange of information in the fields of public health, medicine and the environment. A special emphasis is placed on areas of the world where access is limited by poor communications infrastructures, economic conditions, or disasters. HOW DOES SATELLIFE IMPROVE COMMUNICATIONS AND THE EXCHANGE OF INFORMATION? - SatelLife administers HealthNet, a telecommunications system designed to facilitate the exchange of information among health professionals in developing world countries and to link them with their colleagues abroad. The HealthNet Information Services provided by SatelLife include: - Library Partnership Program: In this program, medical libraries in developing world countries and those in industrial countries create partnerships for the purpose of requesting and exchanging health information. - HealthNet News: This electronic publication is transmitted over HealthNet, and contains full text articles, journal article summaries, and commissioned articles. - Consultation: HealthNet provides physicians and healthcare workers in developing world countries with on-call access to organizations and institutions. Initial participating organizations include the Harvard School of Public Health, Liverpool School of Tropical Medicine, and the Oswaldo Cruz Institute in Brazil. - Research Capabilities: CD-ROM players associated with ground stations allow initial research on MEDLINE and archival retrieval of abstracts to be performed on site. HOW DOES HEALTHNET WORK? - HealthNet uses a "store and forward" satellite called HealthSat to pick up and deliver electronic mail messages. Because HealthSat doesn't depend on international telecommunication links, it is not effected by congested circuits, unaffordable service charges or frequently disrupted service. - The ground station required to send and receive messages from HealthSat comprises a personal computer, a radio and an antenna. This technology is affordable, and sustainable for any country in the developing world. Ground stations may be solar powered. WHO USES HEALTHNET? - HealthNet is intended for use by medical libraries, medical schools, research institutions, health ministries, nongovernmental health agencies, grassroots organizations, and other health care related institutions. - SatelLife's initial efforts are focused on a pilot project in East Africa. Ground stations now have been licensed and/or installed in Zambia, Uganda, Tanzania, Kenya, Mozambique, Ghana, the Congo and Zimbabwe. WHO FUNDS SATELLIFE? - SatelLife is supported by contributions from individual donors, corporate sponsors, and foundations. Major support for SatelLife's operations and programs have come from the NEC Corporation of Japan, the Ted Turner Foundation and the International Development Research Centre of Canada. The MacArthur Foundation and the Rockefeller Foundation have contributed toward SatelLife's pilot project in East Africa. ------------------------------------------------- #4 BECOMING A PARTNER IN HEALTHNET SatelLife is committed to creating partnerships in health communication. An important step in this process is the installation and licensing of ground stations as a resource for the medical community. USERS COUNCIL The first step in partnership is the formation of a Users Council which includes representatives from the university, the medical school, the medical library, non- governmental health agencies, grassroots organizations, and the ministry of health. The Council will determine the site of the ground station, staffing, and policy issues (such as access to the ground station.) A member of the Council will serve as liaison with the SatelLife office. GROUND STATION SITE AND STAFFING The User Council should consider as host an institution which can provide staff to operate the station and technical expertise as backup. (Location of a ground station at one institution does not prohibit access by other institutions and organizations. Access to this "hub" station can be obtained via the telephone system using almost any computer/modem combination and special software.) The host institution contributes the time of a staff person (ground station operator) to manage and operate the ground station. Depending on the amount of information being transmitted, this person could spend up to three hours per day preparing, uploading/downloading and distributing messages. This ground station operator should be computer literate; SatelLife can train him/her quickly in the basics of the system. In the event of any problems, the operator will need access to computer/radio expertise. University computer centers can often provide back up when the ground station site is at a medical school. Local amateur radio society operators, or "hams," have been valuable sources of radio expertise in many countries. IN ADDITION, THE SITE MUST: - Have roof access within 100 feet (30 meters) of the ground station for antenna location, - Be secure against theft/vandalism, and - Be protected against environmental factors, such as dust and moisture. LICENSING THE GROUND STATION An academic or research institution, such as a university, is most likely to obtain licensing for the ground station. The institution must apply to the national telecommunications authorities for a license to operate the ground station. STEPS TO BECOMING A HEALTHNET MEMBER: - Please submit the following information to SatelLife: 1. The name and address of the institution applying for the ground station license. 2. Name, address, and telephone numbers of principal contact person responsible for facilitating the steps outlined above. 3. Names and affiliations of members of Users Council. 4. Description of resources available -- i.e. proposed site, technical support, local amateur radio operators/clubs, computer equipment, etc. - SatelLife and the Users Council will negotiate a Memorandum of Understanding in order to clarify all expectations. - The host institution next petitions the national telecommunications authorities for the ground station license. (Technical and legal consultation is available from SatelLife to help with this.) - Once the ground station is licensed, SatelLife will order equipment and present an installation and training plan and timetable to the Users Council for approval. SatelLife encourages partnerships in which we provide basic equipment, installation, and training, and the ground station host contributes printer and supplies. For more information, contact: Jon Metzger Associate Director of Operations SatelLife-U.S.A., 126 Rogers Street Cambridge, MA 02142 U.S.A. Telephone (617) 868-8522 Fax (617) 868-6647 ------------------------------------------------- #5 WHAT IS HEALTHNET? HealthNet is a not-for-profit telecommunications service created to facilitate communication amongst health professionals in developing world countries and to link them with their colleagues abroad. Its satellite- based network allows any user to send electronic mail messages daily to any other participating institution. HealthNet will also provide access to medical literature, abstracts and summaries of journal articles, and current research. Because HealthNet's satellite uses radio waves for transmission and reception, delivery of information is possible even in the most isolated or difficult of circumstances. A network can be constituted anywhere, regardless of the quality or quantity of telecommunications services available in the region. How does HealthNet work? HealthNet is made possible by an innovative application of tested technologies _ amateur radio, personal computer, and a "store and forward" satellite. A HealthNet ground station consists of a computer attached to an amateur radio by an advanced modem. The radio sends and receives information via an antenna. The satellite orbits the earth at 17,000 miles per hour. As it passes overhead, it signals the ground station to transmit (upload) outgoing messages. Any messages addressed to that destination are then downloaded from the satellite to the ground station. The satellite, circling the earth in a low altitude orbit, checks every station for outgoing and/or incoming messages at least twice each day. If the radio in the ground station is left in the receive/transmit mode, the messages are transferred automatically. What will HealthNet cost? The user community in developing countries will not be charged for the basic monthly service of HealthNet. As there will probably be a need in the future for institutions to assume a portion of the costs, we envision "shadow billing" from the beginning. Shadow billing allows the user to see what the actual costs are while not being charged. SatelLife encourages partnerships in which we provide the basic ground station equipment, and the ground station host contributes printer and supplies. SatelLife will assist institutions in obtaining funding for ground stations. SatelLife staff or HealthNet users will provide installation assistance and training to new members. WHO CAN PARTICIPATE? HealthNet is intended for use by national medical libraries, medical school libraries, research institutes, health ministries, medical schools, non-governmental health agencies and grassroots organizations, and other health care related institutions. The host institution for the ground station must agree to: 1. Obtain the necessary licenses and permits from the appropriate national telecommunications authority, such as the Ministry of Communications or the Postal, Telephone, and Telegraph (PTT). 2. Insure broad access for as many users as is practical in the local medical community. 3. Staff the ground station. 4. Guarantee the security of the ground station. 5. Provide for maintenance of the ground station. 6. Participate in the technology transfer to other host institutions as the network expands. HealthNet will eventually have "gateways" to other international electronic mail networks, so that HealthNet users in developing world countries can send messages to institutions on other networks. WHO ADMINISTERS HEALTHNET? HealthNet is administered by SatelLife, a non-profit organization, headquartered in Cambridge, Massachusetts, and governed by an international board of directors. SatelLife is an initiative of the International Physicians for the Prevention of Nuclear War (IPPNW), recipient of the Nobel Peace Prize in 1985. SatelLife reflects the belief of IPPNW that the greatest threat to our common humanity is the gap that exists between health conditions in the developing world and those in industrialized countries. For more information, contact: Jon Metzger Associate Director of Operations SatelLife-U.S.A., 126 Rogers Street Cambridge, MA 02142 U.S.A. Telephone (617) 868-8522 Fax (617) 868-6647 .