Two years ago, the small township of Mthatha in South Africa’s Eastern Cape province was the site of a communications breakthrough due to the telecom industry. An expectant mother had visited a midwife in a local community center with concerns that she was too large to be only seven months pregnant.

Using a satellite link that had been established to highlight the need for better communications infrastructure, a pediatrician in a hospital in the city of East London, more than 200km away, was able to tell the expectant mother that she was going to have twins.

Also in the room, that day was Kyle Whitehill, who recalls a euphoric atmosphere. “I was hugging people I’d never met,” he says. “It was extraordinary.”

From The Financial Times. Story by Nic Fildes.

At the time, Whitehill was chief executive of Africa’s Liquid Telecom and had high hopes that the event would demonstrate the need for infrastructure investment in a part of the country that lacks a fiber backbone for fast internet and mobile services.

Two years later, there has been little progress by telecoms in delivering on the promise of that one successful call.

Whitehill, now running British satellite company Avanti, which beams all over Africa, says the economics for telecoms of rolling out connections to the most rural parts of the continent presents a hefty challenge for the hopes of many in the telemedicine world. “If mobile can’t do it, then you have got a big problem. It is not going to happen based on terrestrial networks,” he says.

Data compiled by M-Lab, an open-source project backed by Google and various universities, shows that Madagascar is the only African country with broadband speeds anywhere close to those available in Europe and Asia, as a submarine cable lands on the island.

Most other African nations rely on 3G and 4G signals, or long-distance WiFi technology Wi-Max. Six of the 40 African countries included in the M-Lab data connect at average speeds of less than 1 Mbps compared with 54 Mbps in the UK.

One of the biggest selling points of 5G networks three years ago was the potential of the new wireless standard to revolutionize the world of medicine.

Ericsson, the Swedish telecom equipment maker, collaborated with King’s College London to describe a world going well beyond the realm of remote diagnosis — as was seen in Mthatha — to one of robotic surgery where doctors could perform operations on patients in the next room or hundreds of miles away over 5G networks.

Read more at The Financial Times.