:00:00. > :00:00.a telemedicine scheme which is saving lives in war zones
:00:00. > :00:28.Afghanistan. A country racked by seemingly interminable war. Here,
:00:29. > :00:32.there are always casualties. In hospitals they fight their own daily
:00:33. > :00:40.battle against injury and disease, armed with the most basic
:00:41. > :00:46.facilities. On the outskirts of the capital, Kabul, laser refugee camp
:00:47. > :00:55.for around 1000 Afghan families displaced by war and poverty. --
:00:56. > :00:57.lies a. Today they have a visitor, a man who knows how it is to live in
:00:58. > :01:19.the most basic of conditions. It is very sad to see this. It
:01:20. > :01:52.brings all my memories back. In his kitchen, in Chester, Dr
:01:53. > :01:57.Waheed Arian is taking yet another call from Afghanistan. Hospital in
:01:58. > :02:03.Kabul has a problem and needs expert help. Those hot -- hospitals are
:02:04. > :02:06.happy is not on speed dial. Over the past two years he has established a
:02:07. > :02:14.network of around 100 volunteer doctors and consultants in the West
:02:15. > :02:22.to give free advice to hospitals in war zones. It is all done by text,
:02:23. > :02:26.WhatsApp, Skype and e-mail. This is telemedicine at its simplest and
:02:27. > :02:29.most effective. They don't have the up-to-date technologies, they don't
:02:30. > :02:35.have the cutting edge expertise, they don't have advanced evidence
:02:36. > :02:41.-based medicine. So they need any expertise or any advice that's more
:02:42. > :02:48.world class here, that's very useful for them. Just to make sure the
:02:49. > :02:52.child as well. The child is stable. They send us the cases immediately
:02:53. > :03:01.on the phone and our specialist then look at those cases and then give
:03:02. > :03:08.them advice. What do we have here? What images? For the last three
:03:09. > :03:12.years Dr Arian has been based at a hospital in Liverpool but his life
:03:13. > :03:21.is still dominated by Afghanistan. Born in Kabul 34 years ago, he grew
:03:22. > :03:27.up knowing only war. The Afghan conflict in the 1980s made child
:03:28. > :03:31.refugee. The ensuing civil war of the 1990s shaped his destiny. His
:03:32. > :03:36.parents sent him to England to give him a chance of a future. They could
:03:37. > :03:40.never have imagined how he would seize that opportunity and create
:03:41. > :03:47.new hope for those casualties of war in his homeland and beyond. I've
:03:48. > :03:51.seen so much suffering in my childhood and that suffering is
:03:52. > :03:55.still very vivid in my memory and I wanted to see if I could help in any
:03:56. > :03:59.way alleviate that suffering for many people who were in a similar
:04:00. > :04:04.position to my as a child. And when I went back to Afghanistan I kept
:04:05. > :04:09.making regular trips, I could see the people were still suffering and
:04:10. > :04:13.I thought, I have to make a difference. Along with other
:04:14. > :04:31.colleagues go and try to do as much as we can. He and his wife have
:04:32. > :04:38.lived in Chester since 2014. Their son Zane was born two years later.
:04:39. > :04:42.Waheed is a specialist registrar in radiology based at Aintree
:04:43. > :04:45.University Hospital but just two years from qualifying as a
:04:46. > :04:54.consultant he has taken a career break to develop his new project,
:04:55. > :04:58.Arian Teleheal. He had spoken to me before he made the decision to
:04:59. > :05:02.concentrate on the charity but I honestly believe that if you've got
:05:03. > :05:05.a passion and you've got an idea you must fulfil it, otherwise you may
:05:06. > :05:09.have regrets in later life and the fact that his passion and his idea
:05:10. > :05:13.was to save millions of lives, especially in poorer countries that
:05:14. > :05:17.don't have such a great facility that we have in the NHS, and because
:05:18. > :05:24.the idea was so brilliant it was one of those risks that you couldn't not
:05:25. > :05:32.take. So, yes, I just said, go for it. But with the charity is still in
:05:33. > :05:38.its infancy, he doesn't have funding to pay himself a salary. So either
:05:39. > :05:43.lie on working Friday, Saturday and Sunday is in emergency departments
:05:44. > :05:46.as a senior emergency doctor and that actually provides me the
:05:47. > :05:51.expenses to be able to support my family, to be able to support myself
:05:52. > :05:59.as well as to cater for all the trips that I do. I'm off to Kabul,
:06:00. > :06:03.Afghanistan, from Manchester airport. I've had an invitation from
:06:04. > :06:09.the minister of health in order to review our work with telemedicine in
:06:10. > :06:13.hospitals and the expanded throughout Afghanistan in the near
:06:14. > :06:22.future. Unhappy that I will be able to see my family again tomorrow. --
:06:23. > :06:26.I am very happy. When he was born in 1983 the Soviet Afghan war was
:06:27. > :06:33.already in its fourth year. By the time he was five, his family decided
:06:34. > :06:38.to escape to Pakistan. They subsequently spent three years in a
:06:39. > :06:44.refugee camp near Peshawar. Today, back at the family home in Kabul,
:06:45. > :06:47.Waheed and his parents reminisce about their terrifying journey on
:06:48. > :06:54.foot and on donkeys through the mountains near the past. Most
:06:55. > :07:00.frightening of all was when they were almost killed by a Russian
:07:01. > :07:05.helicopter gunships. TRANSLATION: We thought that we would all be killed
:07:06. > :07:10.and this would be our last breath. All I was thinking was finding a way
:07:11. > :07:14.to save you. The plane fired a rocket which destroyed the house
:07:15. > :07:16.where we were hiding. I told you, if I am killed, go back to Kabul. Don't
:07:17. > :07:33.go anywhere else. On most trips home, Waheed takes
:07:34. > :07:37.close to distribute at the refugee camp in Kabul. The memories of his
:07:38. > :07:41.childhood years in Pakistan are always with him. The living
:07:42. > :07:47.conditions in a refugee camp are not humane. As a family of ten we were
:07:48. > :07:54.living in one mighty brew with just one carpet -- muddy room. If you
:07:55. > :07:58.clothes, no mattresses. The temperatures would rise up to 45
:07:59. > :08:03.degrees. We suffered malaria many times, like many other refugees in
:08:04. > :08:06.the camp. And I contracted tuberculosis which lasted for about
:08:07. > :08:09.two years. I was being treated by one of the doctors in the refugee
:08:10. > :08:15.camp and that's when I became inspired to become a doctor. So that
:08:16. > :08:21.I could help myself, my family and many other people like myself who
:08:22. > :08:27.were suffering. After three years in the camp, the family returned to
:08:28. > :08:34.Kabul. The Russians had gone, but civil war now breached through the
:08:35. > :08:39.country. This is where I used to live between the age of eight and
:08:40. > :08:45.15. All this area used to be all flat and destroyed by the war. We
:08:46. > :08:50.had to move from our house to another area near the mountains over
:08:51. > :08:55.their and from there we have to move behind the mountains over there.
:08:56. > :09:01.Because of the war. Then we have to move from there all the way to the
:09:02. > :09:05.other side of Kabul, just to hide from the shillings and bombing that
:09:06. > :09:11.were happening on a daily basis. -- shillings. Eventually his parents
:09:12. > :09:18.would take the decision to send him abroad and his life would never be
:09:19. > :09:23.the same again. But in 2017 he no longer runs from war, he confronts
:09:24. > :09:28.it and today in Afghanistan there's war on two fronts. The Taliban never
:09:29. > :09:35.went away and now the situation is further complicated by new
:09:36. > :09:39.insurgents. More than 30 people have been killed and dozens wounded in an
:09:40. > :09:43.attack by so-called Islamic State militance of a hospital near the
:09:44. > :09:48.Afghan capital. Local officials say the three gunmen were dressed as
:09:49. > :09:53.doctors... Waheed was actually in this hospital just 24 hours before
:09:54. > :09:56.the Isis attack. His younger brother, a junior doctor, was
:09:57. > :10:01.moments from death. Everybody was running to save their lives and we
:10:02. > :10:08.couldn't find a way to help. We found a door. We smashed the door
:10:09. > :10:17.and after that we all were running. Unfortunately, I lost my two friends
:10:18. > :10:23.who were my class fellows and I lost those friends in the hospital. We
:10:24. > :10:27.will all upper house waiting to hear the bad news. My parents were
:10:28. > :10:32.distraught. My mother was crying non-stop. We were in a shock
:10:33. > :10:39.situation, just waiting near the phone, complete shock, utter shock,
:10:40. > :10:44.how something like that unexpectedly could happen at any moment and
:10:45. > :10:47.that's why it is so dangerous. The attack was a stark reminder of what
:10:48. > :10:52.hospitals in Afghanistan are up against. But it's not just the
:10:53. > :10:58.direct results of terror attacks that need attention. With poor
:10:59. > :11:02.sanitation, scarce resources and a low standard of medical training,
:11:03. > :11:08.there are numerous problems which just don't occur in the developed
:11:09. > :11:14.world. On Waheed's latest trip he visits a number of hospitals to
:11:15. > :11:15.check on the progress of his telemedicines scheme and inevitably
:11:16. > :12:29.encounters new cases. Waheed's telemedicines scheme is
:12:30. > :12:33.deliberately nonpolitical and nonreligious and when it unreliable
:12:34. > :12:39.Afghan telephone system allows it gets results.
:12:40. > :12:44.TRANSLATION: Although our hospitals receive complicated cases, almost
:12:45. > :12:48.all maternity hospitals have emergencies. Two of our cases in
:12:49. > :12:51.particular were covered very well and we received very good
:12:52. > :12:58.information. With one of our patients, we weren't sure what the
:12:59. > :13:04.problems were. We sent the symptoms and after discussing with
:13:05. > :13:10.international doctors we started the procedure and the patient recovered
:13:11. > :13:15.well and was discharged. The green and white matter differentiation is
:13:16. > :13:21.maintained. As you can see there is no high density to indicate that
:13:22. > :13:41.there is any leads in the end of cranial or extracranial bleeds.
:13:42. > :13:46.Waheed also met with the head of emergency and intensive care
:13:47. > :13:50.services for the whole of Afghanistan. She has a direct line
:13:51. > :14:11.to the health minister, so she's a vital contact.
:14:12. > :14:34.All of this became possible because of Waheed's parents decision to send
:14:35. > :14:38.him to London in 1999. TRANSLATION: He was 15 years old when the
:14:39. > :14:42.fighting got worse. This time it was due to the Taliban. I had a
:14:43. > :14:48.discussion with my friend and told him that my son is very clever and
:14:49. > :14:51.very intelligent. And my friends helped me and told me they would
:14:52. > :14:57.tending to a foreign country. They took into Pakistan and their he went
:14:58. > :15:02.abroad. TRANSLATION: My son was very smart and he wanted to study. But I
:15:03. > :15:07.did not want to send him anywhere. We had a house which we sold, so we
:15:08. > :15:21.could send him to London. I became very depressed.
:15:22. > :15:29.So, the 15-year-old Waheed arrived in a new land and asylum seeker, not
:15:30. > :15:33.knowing what the future would hold. We had one contact in London and
:15:34. > :15:39.that was a family friend, and that was on Portobello, and then after a
:15:40. > :15:44.week I found a job for myself, and that turned into three jobs, but
:15:45. > :15:47.that was my primary mission to be able to support my family members.
:15:48. > :15:51.Always thinking that I had to educate myself as well, now that I
:15:52. > :15:54.have got the opportunities. The education began in earnest, he
:15:55. > :15:59.taught himself English and science and was soon studying for five
:16:00. > :16:03.A-levels at night school. By now he was also looking after his younger
:16:04. > :16:14.brother who had come to join him in London. But nothing was going to
:16:15. > :16:22.deter him. Five a grades were good enough to get him an interview to a
:16:23. > :16:28.place at Trinity Hall Cambridge. When I came for my interview I did
:16:29. > :16:31.not even know how to do my tie. So one of the parents for another
:16:32. > :16:36.student who was there for the interview, I asked them, if he could
:16:37. > :16:43.help me with the tie, so he helped me with my tie. After a few days I
:16:44. > :16:48.received a letter and the letter said "We are very delighted to offer
:16:49. > :16:51.you a place to study medicine at Cambridge University." I think that
:16:52. > :17:05.was one of the happiest days of my life, certainly. Hello, I am... Nice
:17:06. > :17:09.to meet you. Do you have a case to discuss today? Yeah, we have an
:17:10. > :17:15.important case that I want to discuss. Today they had a challenge
:17:16. > :17:23.for us, they discussed a very unusual case, some kind of... This
:17:24. > :17:29.is where we learn from outside as well, because such cases, we discuss
:17:30. > :17:33.them among our group of specialists here, we go back and we look at our
:17:34. > :17:39.literature, and then we give them the best advice that we can. They
:17:40. > :17:46.are also competent clinicians, the problem lies often in lack of
:17:47. > :17:53.resources, and sometimes in lack of experience, in some cases that are
:17:54. > :17:58.not straightforward. Waheed's network of volunteer consultants and
:17:59. > :18:03.doctors has grown to around 100. He is clearly very persuasive. He is
:18:04. > :18:10.particular good at engaging people's attention. So what he does, he tells
:18:11. > :18:15.people about the plight of war-torn countries and the lack of medical
:18:16. > :18:20.facilities. And he is very enthusiastic about getting people
:18:21. > :18:26.involved, to the point that he has spread his neck quite widely. --
:18:27. > :18:31.net. He has identified a little need, radiology is very important to
:18:32. > :18:35.nearly all cases that come into a hospital, particularly in an area
:18:36. > :18:39.where there is poverty or a war zone. And it is really collocated
:18:40. > :18:48.stuff. -- complicated stuff. We'll need some help and we are working in
:18:49. > :18:52.these hospitals, so it no -- comes as no surprise to me that people in
:18:53. > :18:55.these countries are looking around for help when it gets collocated.
:18:56. > :19:05.There are some places where tele- medicine is the only line of support
:19:06. > :19:10.for beleaguered doctors. Kunduz in Afghanistan represents the frontline
:19:11. > :19:14.of the battle the Taliban. Here in 2015 trauma centre was destroyed in
:19:15. > :19:21.error by a US bomb psych which killed 42 people. -- strike. In
:19:22. > :19:25.Kunduz, normal rules don't apply. TRANSLATION: Sometimes we get a
:19:26. > :19:29.patient who comes in with 20 or more guards, and they threaten the
:19:30. > :19:37.doctors. The dock is not safe. -- doctors. What we require is
:19:38. > :19:42.emergency help. We receive help from Doctor Arian's tele- medicine team,
:19:43. > :19:47.they help us diagnose cases we are not able to solve due to lack of the
:19:48. > :19:51.right equipment. We send our examinations to them and they give
:19:52. > :19:54.us advice. We thank them from the bottom of our hearts because they
:19:55. > :20:07.help selflessly and they have helped war-torn Kunduz.
:20:08. > :20:13.Waheed is back in London for an important meeting tomorrow morning.
:20:14. > :20:58.But overnight the calls keep coming in.
:20:59. > :21:06.The next day, he meets the most senior doctor in the UK, Sir Bruce
:21:07. > :21:09.Keogh, the medical director of the National Health Service. He wants to
:21:10. > :21:20.hear more about Waheed's work, and what the NHS can learn from it. Grab
:21:21. > :21:23.a seat. He brings an enormous sympathy to the approach, and I
:21:24. > :21:27.think there is a lot we can learn from that -- simplicity. And I hope
:21:28. > :21:32.that by bringing together the experiences of other people that
:21:33. > :21:39.have tried similar things around the NHS, along with Waheed, that we can
:21:40. > :21:43.catalyse the uptake of this technology. Port of our patients. We
:21:44. > :21:47.are getting a glimpse of the future here, and I think what he is doing
:21:48. > :21:53.represents something that is very special. Healthcare systems around
:21:54. > :21:57.the world are all constrained by their national boundaries. But the
:21:58. > :22:02.art, the science, the values of medicine no no national boundaries.
:22:03. > :22:08.And if anybody exhibits that, it's Waheed and his work. It connects on
:22:09. > :22:13.the top there, they scan the room, it is inside out... This simple
:22:14. > :22:17.everyday mitigation methods that so impressed Sir Bruce is the mainstay
:22:18. > :22:21.of Waheed's work, but he is also keen to push the boundaries. He
:22:22. > :22:26.wanted to try and augmented reality telemedicine call to Afghanistan,
:22:27. > :22:31.something that had not been done before. So we teamed up with a BBC
:22:32. > :22:36.technology unit, to explore its potential. What they are seeing is
:22:37. > :22:43.what you're seeing. So they will be able to see that as well on Skype?
:22:44. > :22:46.Fantastic. In a training theatre at Aintree Hospital, Waheed wares and
:22:47. > :22:51.augmented reality headset, and uses a mannequin to help illustrate
:22:52. > :22:55.details of a medical procedure. In the headset, he can see the doctors
:22:56. > :23:01.in couple, while almost for thousands of why -- in Afghanistan,
:23:02. > :23:05.while almost 4000 miles away they can see the augmented reality he is
:23:06. > :23:09.conjuring up in his headset. I will take the arrow and place it along
:23:10. > :23:20.the mouth on this mannequin, and then we have to make sure that the
:23:21. > :23:24.next vertebrate... We check the patient from head to to make sure
:23:25. > :23:28.there are no visible injuries or broken legs, any open fractures that
:23:29. > :23:33.we need to reduce before we move on, and we also check the temperature of
:23:34. > :23:36.the patient. It went very well. We discussed the medical case, we solve
:23:37. > :23:44.the problem, it was alive medical case in one of the hospitals in
:23:45. > :23:51.carpal Afghanistan, -- couple, Afghanistan, and we talked about the
:23:52. > :23:58.ways we can use this technology to advise and also educate. Waheed is
:23:59. > :24:05.already working with hospitals in Syria, and has plans to expand into
:24:06. > :24:10.Kashmir, Iraq and parts of Africa. He is also working with some sectors
:24:11. > :24:17.of the NHS to help enhance patient care and medical training gear in
:24:18. > :24:23.the UK. One penalty is any semblance of a normal family life. Now I'm
:24:24. > :24:30.doing this charity work from my living room, and I'm on the Move
:24:31. > :24:33.24/7, I mobile phone is with me, I co-ordinate all the activities in
:24:34. > :24:38.Afghanistan, and almost all activities in Syria. Yes, he is away
:24:39. > :24:43.a lot, and it can be hard and can be lonely at times, when you are on
:24:44. > :24:47.your own, missing -- when you see the other families out and think it
:24:48. > :24:51.would be nice to have my husband home. But on the other side, I know
:24:52. > :24:56.that he is doing amazing things for humanity, he is going to be saving
:24:57. > :25:01.thousands of lives, so I look at the positive and think, I have a great
:25:02. > :25:07.life and what about the people who would love to have something that
:25:08. > :25:12.that we have got. Shortly after Waheed's visit to Afghanistan, is
:25:13. > :25:19.BBC driver was killed in a massive explosion which claimed over 150
:25:20. > :25:23.lives. And injured hundreds more. Waheed and his team were once again
:25:24. > :25:29.called into action. Their work providing yet another glimpse of the
:25:30. > :25:34.medical future, brought to Afghanistan by a survivor of its
:25:35. > :25:42.troubled past. When I see the war-torn areas in Kabul, it brings
:25:43. > :25:46.back the memories of my childhood, and I'm happy that I am able to go
:25:47. > :25:52.back and help. So that is my therapy. One person can't do all
:25:53. > :25:57.this. What we need now is urgent support with it technology. We have
:25:58. > :26:02.come a long way in two years, and we are helping places that have no
:26:03. > :26:10.other support. And this is so important. Lives are at stake. And
:26:11. > :26:53.we can help save those lives. But we cannot do it on our own.
:26:54. > :26:59.The weekend is by no means a write-off, but right from the word
:27:00. > :27:00.go we have showers and thunderstorms rolling in across Wales