Photographs one does not usually smile for

From the outside, a room at Mater Dei Hospital looks exactly like all the others, with blue clinical-looking doors, but inside rather than medical equipment are state-of-the-art cameras and lights.

Opened earlier this year, the Medical Illustration Department is Malta's only such unit where images, and videos, of various medical problems are taken and stored.

Clinical photographer Brian Cassar, who runs the department, explains that the aim of the unit is three-pronged.

First and foremost the images are kept as visual records forming part of the patient's medical file but they are also used for teaching purposes. This, he continues as he walks through the rooms that make up the department, is extremely important in a teaching hospital like Mater Dei, especially since risks of infection mean that as few students as possible go into operating theatres.

Moreover, photos and videos can be used for consultation with doctors abroad, reducing the need to bring specialists to Malta or fly patients to hospitals abroad.

Work is in progress to set up a video-conferencing unit within the department, enabling consultations with specialists abroad.

In the near future, images will be collected on a database that will be made available to doctors, nurses and paramedics in a similar manner as medical files.

Mr Cassar, a physiotherapist who later specialised in medical illustrations, emphasises that patients need to consent to having their photos taken and used, especially if they are to be published in medical journals. "It is no longer acceptable to cover a patient's eyes, they will still be recognisable."

While most of the work takes place in the subterranean department, Mr Cassar is often called to operating theatres to record images during surgery and the crude and at times gory photos saved on his computer are proof to this.

But does he ever get queasy seeing severe rashes, gangrened flesh and hearts visible in clamped-open chests?

Mr Cassar smiles. "You have to have some guts to do this. Many people freak out when they see some of the things that we take photos of. It is surely not a glorified photography job".