Tristan da Cunha, one of the world's most remote inhabited islands, sits 1,665 miles west of Cape Town, South Africa, which means islanders can reach the mainland only after a weeklong trip on a fishing boat across the South Atlantic Ocean.

But the island's 274 British citizens now have access to free expert medical care through IBM and the University of Pittsburgh Medical Center.

In a pro bono effort known as Project Tristan, IBM has linked the communication center at UPMC Presbyterian to the volcanic island so the island doctor can transmit X-rays, electrocardiograms and other readings to UPMC for medical backup.

Dr. Carel Van der Merwe, the island physician, said the IBM connection established weeks ago will provide needed support for residents on an island that has Internet access but neither an airfield nor heliport.

His patients, ranging in age from 6 months to 97 years, suffer from high blood pressure, diabetes, asthma, other ailments and occasional emergencies.

"Being able to make contact with the outside world is brilliant," he said. "This does mean I can at least consult in cases where I'm not certain of treatment. It makes quite a difference to have that capability."

Dr. Scott Harrington, the communication center's medical director, said UPMC already handles medical calls from major airlines with inflight emergencies, along with other remote services. The center receives 10,000 calls a year, with about 3,000 requiring a consulting physician.

"We're certainly prepared to talk with people in remote locations," Dr. Harrington said. "This certainly is novel in the location they are in and their remoteness, as well."

Dr. Paul Grundy, IBM's director of health care technology who is from Africa, said he created Project Tristan to prove that IBM technology can work worldwide. He used a blog to search out a willing partner and UPMC responded.

IBM sent a South African technician on a fishing boat to Tristan to set up the link inside the island's Camogli Hospital. Test runs confirmed that Dr. Van der Merwe now can download test results to UPMC physicians, who can help decide whether a patient's condition warrants the weeklong trip to the African mainland.

Dr. Van der Merwe said that's the big fear of his patients, given the precarious trip on a fishing boat.

"It's two weeks to get out and back, so it's a big deal," he said. "UPMC and IBM eliminate the chances that someone will be evacuated if the situation doesn't warrant it. That's the most amazing thing -- that we have access to the finest medical experts in the world."

Tristan sits almost midway between Cape Town and Buenos Aires, Argentina. Residents there live in bungalows and raise livestock, grow vegetables and potatoes in a community patch, and earn their living from fishing. The island town, Edinburgh, sits on a flat lip of land on the round island that is 10 kilometers in diameter. It has a school, store, museum, church and a crayfish processing factory.

In summer months, as many as six cruise ships visit the island, where tourists can purchase woolen products. Islanders can get two television stations via the British armed forces: "So we'll soon be watching 'Desperate Housewives,' " Dr. Van der Merwe said.

The island has no crime and a strong social network of proud people who "cherish their independence." Dr. Van der Merwe said the big monthly event occurs when a ship arrives with supplies.

"They have a nice life," said Dr. Grundy, who served a brief stint as island doctor. "They've been there for multiple generations."

"My hat is off to Dr. Van der Merwe to function as he does and practice with the constraints he does," Dr. Harrington said. "We're just happy to provide assistance and backup."