[Announcer:] On GLOBAL CHALLENGES, is there a doctor in the house? Yes and no. Top surgeons assist with and even perform operations from hundreds of kilometers away. Doctors are scarce here as well, so these Kenyan women are taking matters into their own hands to clear up an old problem. And message in a bottle. A husband and wife team with a conscience return home to develop vaccines at an affordable price.
[Guillermo Arduino, Cnn:] Welcome to GLOBAL CHALLENGES. I'm Guillermo Arduino. Have you ever wished to be in two places at the same time? It sounds impossible, but it is becoming a reality now by using some groundbreaking technology. A surgeon performing or assisting an operation from hundreds of kilometers away.
[Unidentified Male:] Stay on the inside of that white line. Inside would be on the left side? Yes. Right here? Yes.
[Arduino:] World-renown surgeon Mehlan Anvari is going to remotely watch over Dr. Trudeau's shoulder during a complicated procedure. It is called telementoring.
[Dr. Mehlan Anvari, Surgeon:] Telementoring is where the expert surgeon can actually watch them operate in their own operating room and give them guidance and advice as they are performing the surgery, to make sure they can gain experience in a safe manner.
[Arduino:] In this case, the patient's stomach has moved up behind the heart and between the lungs.
[Anvari:] The patient is being repaired because potentially he can have very massive blood loss. This is a very big operation. Patrick?
[Dr. Patrick Trudeau, Surgeon:] Yes?
[Trudeau:] Is it usual to have this much lesions
[Anvari:] Yes, at the round part
[Trudeau:] You put the sutures from down going up? Is that right?
[Anvari:] No, I go from up coming down.
[Trudeau:] Oh.
[Arduino:] In the end, after nearly four hours, the operation is successful. Would Dr. Trudeau have chosen to do this surgery without Dr. Anvari's telementoring?
[Trudeau:] No, I would not. There are cases that we see less often or are more complicated that need some special skills.
[Anvari:] Telementoring is a much more readily available form of disseminating knowledge across distances, where an expert surgeon can help a relatively inexperienced surgeon perform some of these more complex surgeries by watching live on video and being able to communicate by video and with a telestrator to the local surgeon what to do. That's perfect.
[Arduino:] And this is not the only technological advance in medicine this Iranian-born Canadian citizen has pioneered. In 2003 he was to perform minimal access laparoscopic surgery, as he had done countless times before, but the patient was in remote northern Canada, 400 kilometers away. His partner in the operation, a three-armed surgical robot that allowed Dr. Anvari to execute the intervention.
[Anvari:] This is a laparoscopic robot, a minimal access robot, so you can see the surgery is done through long instruments which have entered the abdomen through small ports or trochars.
[Arduino:] The surgeon and the robot are linked by a secure high-speed fiberoptic cable.
[Anvari:] These buttons allow me to move the instruments as if there is a full wrist. This opens and closes the instruments and this moves the instrument around, inside and out, up and down, left and right.
[Arduino:] Dr. Anvari invited me to give it a try. [on camera]: So I'm going to go up, forward
[Anvari:] Go on and pick up that suture, if you can.
[Arduino:] You mean the needle?
[Anvari:] Or just the suture. Rotate your wrist. That's it. Now you have done it. Excellent.
[Arduino:] When can I start? [voice-over]: But what are the chances that a computer glitch or a communication malfunction could end in tragedy?
[Anvari:] Less than a one in a million chance, because of redundancy and duplication of the system. Then the issue is, what if the robot fails, and, certainly, again, we have developed prototypes with spares that can easily be changed very quickly.
[Arduino:] Since the country has an advanced fiberoptic infrastructure, remote areas now have access to experts like Dr. Anvari.
[Dr. Kevin Smith, St. Joseph's:] Telerobotics is a tremendously exciting technology and the technology is evolving literally as we speak. And again, it allows us to do more with technology while never forgetting at the root of our mission is the treatment of an individual.
[Arduino:] Telementoring and telerobotics go beyond the OR. Dr. Anvari is shown here guiding astronauts on Nemo 7, part of NASA's extreme environment program. By using telecommunication lines from Canada, Dr. Anvari gives surgical instruction to astronauts located in an underwater habitat similar in size to the space shuttle.
[Anvari:] My hope is by sometime in the next year we already have a new prototype robot ready for the next Nemo mission, the robot SRI, which is a very portable robot, which is going to go inside the habitat. So we have there are some robotic platforms around the corner.
[Arduino:] It started as the world's first hospital-to-hospital telerobotics assisted surgery. Now experts like Dr. Anvari hope to take it to the next level.
[Anvari:] Yes it is, and you want to be away from that. I hope that these programs will really help us to reach out to communities all over the world and provide better quality of health care and surgical care whenever people live.
[Arduino:] We are going to take a break now and then look at some very simple measures that can transform lives in Africa. That's next. Welcome back. Water is, of course, the key to life, but it can be deadly. In many developing nations, the water table is contaminated. People have no other choice but to drink it, spreading disease and shortening lives. But there is a simple solution.
[Gary Strieker, Cnn Correspondent:] For many living in poverty in developing nations, more than 1 billion people, access to clean, disease-free water like this is still a dream. Yet there are places where simple measures, just a little technology -
[Unidentified Female:] Ensure that you have removed all of that that was there.
[Strieker:] and basic habits are making safe water a reality for those who need it most. Here in the hills of western Kenya, it's changing lives. These women are victims of HIVAIDS, all of them infected with the virus. Most of their husbands died from it, leaving them facing a bleak future. But now they celebrate because of what has happened to them after adopting a new system of treating their water for drinking and household use. Two years ago Jemima Odo was weak and bed-ridden, covered in skin rashes and weighing 10 kilos less than today. She says, "I used to have a lot of diarrheal diseases affecting me and my family, but since I started treating our water, there's been a big change." Jemima started this support group in her home area. It's one of many in a network sponsored by SWAK, the Society for Women and AIDS in Kenya. BERYL AUDI,
[Cdc:] We try to tell them that it's very important for them to use water that is safe, especially the water that they are drinking, so that they don't get infections from water-related diseases, especially for those who are already on antiretroviral therapy. It really doesn't help them much when they are on ARV drugs and they are taking water that is contaminated.
[Strieker:] For those with immune systems weakened by HIVAIDS, there is an even greater risk from exposure to cholera, typhoid, dysentery and other water-borne diseases. A safe water supply is absolutely critical to their survival. [voice-over]: A high percentage of young children here die from diarrheal diseases. Jemima has already lost two, but she still has 15 children living hereAIDS. These members of Jemima's group tell the same story. Less diarrhea, disappearing skin rashes, gaining weight, healthier families, because of safe water. Ezikia Akenu's wife died from HIVAIDS, but using the safe water system now helps him cope with his infection. He says, "When I first heard about it, I thought it was a fake and I didn't take it seriously." It's easy to understand why people might not believe there is a simple, cheap method that takes only a few minutes to transform dirty, contaminated river water into clean drinkable water like this. But it does work, starting with a packet of powder, a product called Pure developed by the Proctor & Gamble Company for the safe water system.
[Unidentified Female:] You pour the contents inside the water. And then you stir vigorously for five minutes. It has iron sulfate and
[Strieker:] In a process called flocculation, stirring in the powder causes suspended particles to clump together.
[Unidentified Female:] So the dirt and the microorganisms will setting down and then leave the clear water on top.
[Strieker:] The water is also purified by chlorine in the powder, and in 20 minutes, after filtering with a clean cloth, it's safe to drink.
[Unidentified Female:] You can see here the difference between this water
[Strieker:] This looks like an almost magical solution for those who lack safe water, but it's only one element in a three part safe water system devised mainly by the U.S. Centers for Disease Control and Prevention. The second part is safe storage, to prevent clean water from being recontaminated by dirty hands or utensils. Each household is encouraged to use a new redesigned clay water pot with a narrow opening, lid and spigot that reduce the risk of recontamination. To satisfy demands from the new pots, SWAK has its own project that generates income for dozens of women who make them. And the third element in the safe water system is behavioral change, adopting sanitary habits in the household, especially proper handwashing, to prevent the spread of infection. In community meetings and seminars, and going door-to-door, SWAK's health workers promote the safe water system as a better alternative to boiling water, the method that had always been recommended by the government.
[Unidentified Female:] So for women, at least they don't need to go and look for firewood, boil the water, which is very time consuming and also expensive. So this is a very easy and cheap method they can manage themselves at their homes.
[Strieker:] But there is a drawback to this safe water system. Packages of Pure and other chlorine disinfectant and other health care products are distributed and sold by support groups, earning small profits to help care for orphans. It costs only a few cents a month to treat all the water a family needs, but it's still too expensive for the poorest of the poor. That's the greatest challenge facing the women who lead this movement. But they see how they've changed the lives of people they are able to reach.
[Unidentified Female:] When they confess that safe water system is really working for them, you know, I feel such excitement and I feel I am really doing some good for the people I am working with.
[Strieker:] In this overwhelming health crisis, simple solutions, real progress and cause for hope. Gary Strieker for GLOBAL CHALLENGES in western Kenya.
[Arduino:] There are many causes for change, but not all of them are as simple as the one you have just seen. After the break, an amazing turnaround. That's next. Welcome back. Certain parts of India are fast emerging as technology centers, but others are still toiling in poverty. We profile a man who straddles both worlds.
[Ram Ramgopal, Cnn Correspondent:] Hyderabad, an ancient city that is now at the heart of the new India, an emerging scientific and technical power. Companies from far off have come here to take advantage of the well-educated work force and an improving investment climate. It's a place where research and development cost a fraction of what it would in the west and companies here are helping create cutting edge computer software, hardware and biotech products. Along with the multinationals are native sons, some of whom have spent time in the best global research labs and have now returned home to chart a new course. Krishna Ella is it co-founder of Barat Biotech, a company that specializes in developing and manufacturing vaccines and gene therapy products. His business partner is his wife, Suchitra. The Ellas spent more than a decade in the United States where he worked in genetic science labs and she got a degree in business. After years of personal success they say they felt they were ready for a new challenge. In 1996, they bought land on the outskirts of Hyderabad. The aim, to build a biotech company that would focus on making vaccines and cures for diseases that claim millions of lives in developing countries such as their own. Today, theirs is a $10 million company, small even by standards in India, where the major pharmaceutical companies have their eyes set on selling large volumes of medicines to big markets like the United States. Krishna Ella says his company is driven by two guiding principals: to be seen as a global innovator and also to resolve some of the most pressing public health challenges in his country. KRISHNA ELLA,
[Pharmaceutical Company Owner:] Because in India, there is still a lack of public health consciousness and infections are a major problem in most of the rural areas. Can we work globally for innovation? Can we be identified as a totally different company
[Ramgopal:] It was not easy. There were battles with bad infrastructure and bureaucracy. SUCHITRA ELLA,
[Pharmaceutical Company Owner:] There were times and telling on us whether we could actually maybe do it or not. At some point in time I must have either felt I should admit that maybe, you know, we made a mistake. We needed to go back or restart all over. But we persisted. We stayed.
[Ramgopal:] The investment did pay off, especially with a vaccine that Barat Biotech has developed a high yield process for. It's a vaccine for hepatitis B. Unlike other processes that use
[K. Ella:] Out of 600,000 children's deaths in the world, 160,000 children die in India. 160,000 children is not a small number. So just to save 160,000 children, to bring them wellness.
[Ramgopal:] The Ella's say they have set safety and manufacturing standards matching the best in the world. [on camera]: Vaccines are manufactured here under the most stringency of sterility standards. Because the products made here are meant to cure disease, contamination is totally unacceptable. [voice-over]: Krishna Ella says he hopes his rotavirus vaccine will be ready for rollout within three years. The malarial vaccines could be ready even earlier, he says.
[K. Ella:] We want to create excellence and innovation, and also multi-billion dollar satisfaction. Thanks to Bill Gates, he has contributed billions of dollars in the vaccine research and vaccine procurement program, and I don't have billions to contribute, but certainly what I can contribute to the society is some sort of excellence in this public health program.
[Ramgopal:] Ram Ramgopal for GLOBAL CHALLENGES, Hyderabad, India.
[Arduino:] And that's all the time that we have for this edition of GLOBAL CHALLENGES. Thank you for being with us. I'm Guillermo Arduino. See you next time. END TO ORDER VIDEOTAPES AND TRANSCRIPTS OF CNN INTERNATIONAL PROGRAMMING, PLEASE CALL 800-CNN-NEWS OR USE THE SECURE ONLINE ORDER FROM LOCATED AT www.fdch.com