Doctors at Fletcher Allen Health Care and the University of Vermont routinely use two-way television links to reach rural parts of Vermont so patients don't have to travel hours to Burlington.

Early Friday morning, those doctors reached across 12,000 miles in the first telemedicine link with Vietnam.

"Vermont, like Vietnam, is a rural environment that is highly dependent on an agricultural economy," John Evans, executive dean of the UVM College of Medicine, said to physicians in Hanoi, in Washington, D.C., and in Burlington. "This is where telemedicine can help provide care for remote regions."

The UVM and Fletcher Allen telemedicine program has been recognized nationally as it pioneers uses of the technology. The nation's three telemedicine trade journals routinely name the program as one of the best in the country. The December issue of Telehealth Magazine nominates the program for the editors' 1999 "Hall of Fame" as one of four telemedicine programs that consistently ranks tops in the nation.

Friday's demonstration was the first step in a developing collaboration among Uplift International, a humanitarian medical assistance organization; UVM; George Washington University Medical Center; and several hospitals in Hanoi. Eventually, telemedicine will help expand medical education in the two countries, and medical students will travel between the two countries.

For four Vietnamese-American UVM medical students who watched from Burlington, Friday's link was an emotional journey to the land of their birth, a place they know mostly from their parents.

"My father is a veteran; he has a distrust of the government (in Vietnam). He would say for them, this is all politics," said Thanh Nguyen, 25, of San Jose, Calif., "but as medical students, we are trying to separate the politics from the medical issues."

Thanh Bui, 27, hopes she'll be able to go to Vietnam as a medical student in the exchange to learn from physicians in her native country. Bui grew up in San Dimas, Calif.

Jonathan Mai, 34, from South Burlington said he and other Vietnamese medical students went to talk to Burlington's Vietnamese community leaders as the collaboration developed.

"Once they understand that this is a humanitarian effort, and not just a way to treat sick North Vietnamese people, they support it," Mai said, "but it is a tough thing. There is a level of animosity (toward the Vietnamese government) many people have seen their friends and relatives killed in the war."

Friday's demonstration included a consultation between Fletcher Allen physician Michael Ricci, who was in Hanoi to demonstrate the technology, and his surgical patient, Janice Gonyeau in Canton, N.Y.

Gonyeau, a diabetic for 34 years, has had several toes amputated, and telemedicine allows Ricci to monitor her recovery from surgery without her driving 300 miles to see him in his Burlington office.

"In the old days, she would travel that distance, and I might see her for five minutes, say, 'Everything's OK, and have a nice drive home,''' Ricci said to his colleagues in Hanoi. "Now I see her more on TV than I do in person."

Participants also watched an endoscopy, in which a patient's esophagus was viewed using a tiny camera to look for possible signs of cancer, and open-heart surgery.

Sen. Patrick Leahy, D-Vt., who helped make the link between UVM and Uplift International, watched as doctors pointed out inflamed esophageal tissue, and the coronary arteries in a patient's beating heart on a Burlington operating table.

"As you see these close-up pictures, are they good enough for you to do diagnostics?" Leahy asked Ricci in Hanoi, who also watched the procedures via the television link.

"There is no doubt that telemedicine can assist with these kinds of procedures," Ricci said, "but it is not a substitute entirely."