Meet a Physician - Dr. Charles Groomes

Dr. Charles Groomes started volunteering for The Addis Clinic in the fall of 2017 as a pediatric specialist. As a physician and U.S. Navy officer who is stationed overseas, he has a unique perspective on telemedicine, as he often uses technology to obtain specialty consults for his own patients. We are grateful for people like Dr. Groomes who see the need for and invest their time in The Addis Clinic.

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As a physician and U.S. Navy officer stationed overseas, you have a verbusy schedule and many responsibilities. What motivates you to spend extra time to consult other health care workers far away?

Currently, I serve as the "town pediatrician" for the approximately 500 children living on U.S. Naval Station Guantanamo Bay, at the very southeastern tip of Cuba. Specialty and critical care pediatric services are a 700 mile flight away in Miami, so I know firsthand what it's like to be far away from subject matter experts. Fortunately, Navy Medicine has a rich history of successfully navigating the inherent challenges of providing medical care in isolated and austere settings. Remote military clinicians use a telemedicine network called the Health Experts onLine Portal (HELP) to receive timely specialty consults from experts all throughout the Military Health System. I use HELP regularly, and am always sincerely grateful to receive expert guidance from my colleagues all over the world. Volunteering for The Addis Clinic allows me to pay that gratitude forward to frontline healthcare workers in places far more remote and austere than here.

How have you used your specialty so far in your work for The Addis Clinic?

The funny thing is, common things are common! Whether the patient is living in a large U.S. city or a small village in Haiti, kids get sick in many of the same ways. Most of The Addis Clinic cases on which I have consulted are for diagnoses I see a couple times per week in my regular pediatric practice. Of course, there are the more challenging cases that require geographic consideration, but I am finding the foundational elements of pediatric medicine are unchanged.

Why do you think an organization such as The Addis Clinic is needed?

Technology is making the world a smaller place. Being able to instantly communicate with people in the furthest reaches of our planet is incredibly exciting for sure, but it also brings us face-to-face with the profound, widespread need in less developed countries. I think The Addis Clinic realized something could be done about that, and I'm proud to be a small part of the solution.

What have you gained for your professional AND personal life so far by volunteering for The Addis Clinic?

I absolutely love my day job. Serving the very deserving children of the Guantanamo Bay community is truly a treasured responsibility.  When I get an email notification that an Addis Clinic case has been assigned to me, however, it is just as special! I cherish the opportunity to expand my "community" to Haiti (about 120 miles east of here), Ethopia, and beyond. In many cases, I can recommend a very simple treatment that will dramatically change a child's life, and that of her family and community. I imagine the frontline health worker feeling empowered to make a difference in the same way that I do when a subject matter expert answers my consult request in the HELP network. It's cool to know that I can have that same bolstering effect as "just" a general pediatrician. Finally, I have a 4 and 2 year-old. After I complete consult for The Addis Clinic, we go look on the map to locate where the child lives. It makes them really excited and proud of their dad; I'm glad I can model an "others first" priority to them.

Is there one case you remember that was particularly impactful?

Each individual case is impactful in its own way, really, from the simple to the more complex. However, while it's certainly nice to help one kid with his condition, each case also provides a convenient context in which to give a little education to the frontline health worker. That happened recently on a case in Haiti where I explained the slightly different ways that scabies can present in very young kids. The frontline worker later told me that because she had just dealt with that case, she was quick to identify scabies in an entire family she encountered a few days later. Educating people that are "in the trenches" is a cool way clinicians like me can make a difference for years to come.

What would you tell other physicians considering volunteering with The Addis Clinic?

Do it! If you're worried about the time commitment, don't be. In the grand scheme, it's a drop in the bucket. But also, the time investment doesn't feel like a net negative. In fact, it is just the opposite! Also, don't feel like you have nothing to offer because you are "just" a generalist. The cases aren't intimidating challenges from deep in the annals of tropical medicine, they are largely the bread-and-butter things you do in your practice every day. Take the leap!

Thank You, Dr. Groomes!


Case Spotlight

The Addis Clinic connects physicians to frontline health workers, allowing for specialty care in the most remote and underserved areas.

An American family medicine physician on a medical rotation in South America encountered an elderly woman with progressive skin thickening over the past 1-2 years.  Family members also reported progressive limitations in mobility, to the point that she has been unable to walk for the past two months.  In addition, she has lost weight and recently suffered a fractured hip.

The patient's physical examination showed dried, scaling plaques across her entire body, most pronounced on the legs. The case required a dermatology consult, not available at this South American hospital. Using the physician-to-physician template in The Addis Clinic telemedicine platform, the family medicine physician submitted the results of his thorough history and physical exam, along with photos, and the case was immediately allocated to a volunteer dermatologist at a major U.S. university.  Only a few hours later this volunteer responded with an initial diagnosis of pellagra.  Pellagra is a disease that results from a niacin deficiency and is often seen in areas of widespread poverty and malnutrition. The dermatologist recommended the immediate addition of meat, along with multivitamins and other nutritional elements that can enhance niacin intake. 

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The two physicians were able to communicate quickly and securely across thousands of miles as they worked together on this patient’s case.  This diagnosis had not been entertained prior to the consultation with the volunteer dermatologist, and his recommendations augmented the local medical team’s treatment plan for this patient.  After 1-2 weeks of improved nutrition and vitamin supplements, the patient’s skin condition began to improve.   We are grateful to this volunteer for taking time out of his busy schedule and responding quickly and thoroughly to this case! 

Melissa Smith in Ethiopia.

Melissa Smith, advisory committee member for The Addis Clinic, visited Ethiopia and met with our partner Ethiopia Act in November.

Ethiopia captured my heart several years ago.  The people and the culture stood out to me immediately.  The country is so full of kindness, love, and gratitude.  I have come to call many of the people my dear friends and expect some of them to be in my life for many years to come.  The intention of the culture first drew me in with the simple coffee ceremonies.  Coffee “to go” is a nonexistent concept in Ethiopia.   Coffee ceremonies happen several times a day and provide the opportunity to build community and friendships. I’m so humbled by what this country has to offer and how quickly they have accepted me as one of their own, family. 

I initially started going to Ethiopia working with a nonprofit that focuses on orphan prevention.   This was my first trip for The Addis Clinic and focusing on the healthcare side.  In the States, I work for a healthcare company, specifically in the EMR (Electronic Medical Record) space.   Through previous visits, I had seen the vast need for expansion of healthcare in Ethiopia.  Both the city and the countryside have considerable room for advancement in devices, knowledge, and medicines.   The Addis Clinic is an extremely exciting organization that provides the opportunity for physicians and healthcare workers in third world countries to partner with providers in the States to consult on cases.  The exciting part about the consult is the assessment/treatment is based on the specific elements in that country.   They provide feedback based on the labs and medicines that are available in that specific area. 


While in Ethiopia, I spent some time with one of The Addis Clinic’s partners Ethiopia Act.  Act is an incredible ministry that focuses on the family as a whole:  food, medical, rent, education, etc.   Hiwot is the healthcare professional working with Act and was able to spend some time walking me through the partnership with The Addis Clinic and some of the hardships of treating patients in a third world country.   For me, the length of the process to determine treatment was one of the most fascinating parts of her work.   The majority of Act’s patients are HIV positive and live in an extremely impoverished area.  Hiwot is working hard daily to help treat each of the patients and help them manage their medications.  Recently she has seen the type of medical needs expand past the HIV and medication management.  


While there, Hiwot began with walking me through the length of time it can take to determine an assessment for a patient, which can sometimes take several weeks.   In the States, we are adapted to instant answers and results, but not everyone has that same opportunity.   One of the things Hiwot struggles with is the ability to quickly connect with a patient.   If Hiwot needs to ask the patients additional questions or have the patient go to the clinic for tests, she has to go and find the patient in person.  Those in the community typically do not have cell phones and do not live in an easy place to visit.   Hiwot must first get transportation that can get her as close as possible to the village and then walk to find the patient house.  If they are not home or in the area, she will have to plan another trip back to speak with that particular patient.  It may take several attempts to connect with a patient if additional information is required before providing an assessment.  I was wowed by the time and effort that it can at times take to diagnose a patient. 

The Addis Clinic has not only partnered with Act and Hiwot to help treat patients, but they are also working hard to help decrease the time it takes to determine an assessment.  With various new processes in place to help collect all necessary information up front, The Addis Clinic is a valuable partner to Ethiopia Act.  I am so honored to have the opportunity to work with The Addis Clinic and continue to help increase their partners, optimize workflows, and support the organization in any way.  Healthcare is such an exciting industry and provides so many opportunities to those in need.  I am on the edge of my seat waiting until the next time I can head across the pond. 

Case Spotlight

The Addis Clinic connects physicians to frontline health workers, allowing for specialty care in the most remote and underserved areas.

Water is a resource that most of us take for granted.  However, for many of the patients and clinicians The Addis Clinic supports, it is a luxury not easily obtained.  This is one of many restrictions taken into account when The Addis Clinic coordinates case consultations between our global partners and physician volunteers.

The Addis Clinic partners with an organization, Living Hope Haiti, that serves the people of Northern Haiti through educational, medical, and spiritual services.  This Haitian population faces extreme poverty and hunger alongside a lack of resources and education. The local health workers of Living Hope Haiti bring medical care to people in their homes and communities and must find creative ways to promote healing in such a challenging environment.  One such way is to access The Addis Clinic and its large network of physician volunteers through our telemedicine platform.

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This month a local health worker in Haiti encountered a 5-year-old girl with a worsening rash.  She had been previously treated for a presumed skin infection with antifungal and antibiotic medication.  All of the girl’s previously open wounds were healed, yet the number of thick dry patches had spread over her trunk, extremities, and even ears.  The health worker took a number of pictures along with a detailed physical exam and health history and submitted the case to The Addis Clinic for assistance.  The Addis Clinic allocated the case to a volunteer dermatologist who promptly responded with a diagnosis of psoriasis.  Initial recommendations included use of an immunosuppressant along with topical steroid creams. However, after the dermatologist and field health worker exchanged messages about the lack of availability of many traditional medications and treatments, they agreed on an alternate plan.  

The volunteer dermatologist recommended application of hydrocortisone cream twice daily to the affected area with wet dressings, vinegar soaks for the feet three times a week, as well as natural sunlight exposure to all affected areas for 20 minutes per day.  The field health worker immediately implemented the plan. The patient’s neighborhood has no easy access to water, and the health worker knew the chances of the family’s ability to do the soaks were slim unless everything was provided to make it easier. The field health worker had to pre-mix enough vinegar solution in water bottles to last a number of weeks. She even improvised a soak basin using a zip lock bag – because it would simultaneously maximize coverage of the skin while conserving water.

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Despite the immense and immediate challenges faced by this little girl, her family and the health workers in her community, The Addis Clinic provided access to a world-class dermatologist who will continue to be involved in her care as long as required. The health worker will follow-up with the patient in a few weeks, and we look forward to tracking her progress!



2017 Year in Review

As we are entering a new year, we want to look back at a very busy 2017. All of our endeavors wouldn't be possible without the help of our partners, physicians, volunteers, board, and staff. 

Join us in reviewing what we all accomplished this year!

In February, we were featured by eBay Charity to buyers around the world.

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At the end of March, our board member Caroline Gikuru traveled to the Mufindi area of Tanzania to meet new partner organizations and provide training to frontline health workers. If your are interested in her report you can read it here. We are so glad to be able to consult on cases of these little patients and this month Case Spotlight is one of them.



In May, members of our team geared up to train for the Pittsburgh and Vancouver Marathon - others ran their favorite route - all to raise funds and awareness for The Addis Clinic.

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This year brought several new partner organizations implementing our telemedicine, including Hillside Health Care International in the Toledo District of Belize. Their main focus includes primary medical care, community outreach, health education, and disease prevention. They are doing great work and we're glad to help!

One of the biggest goals we had for this year was met in the Spring. The foundation of The Addis Clinic is the telemedicine platform with which our partners communicate with us and our volunteer physicians. The system has to work with limited access to the internet, has to be simple, easy to use, and completely reliable and safe. We moved to Collegium Telemedicus, which is also used by Doctors Without Borders, and we have received a very positive response from both our partners and volunteer physicians. 

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The Addis Clinic had our first in person event in NYC this November. We were were able to connect with current supporters and volunteers as well as educate new friends on our work and why it's so important.

In December, our advisory committee member Melissa traveled to Ethiopia. She spent time with current and new partner organizations in Addis Ababa and is working to help us improve our strategies to make our work more accessible to frontline health workers.  You will read more about that trip in the newsletter for next month - it's going to be really interesting so look out for that as well. 


Looking back makes us even more excited for all the project, initiatives, and plans 2018 has in store for us! Become member of our various communities online: facebook, instagram, and sign up for our newsletter to make sure you don't miss out on any of it! Last, but not least, you can sustain our work by becoming a monthly donor

We hope you have a wonderful new year!

Case Spotlight

The Addis Clinic connects physicians to frontline health workers, allowing for specialty care in the most remote and underserved areas.

Whenever a child is not meeting their developmental milestones it is cause for concern, yet even more so in areas of the world where access to care is severely limited due to location and lack of resources.  In most developed nations, there are early intervention programs to assist babies and toddlers with developmental and physical delays learn skills and catch up to their peers.  These programs are not available to the global partner organizations and patients we serve, making The Addis Clinic pediatric consultations so important to the children and their caregivers. 

In Tanzania, a one-month-old boy came to live at a children’s home for vulnerable children.  In the ensuing months, his caregivers and medical team found that he was not gaining weight on schedule, was often sick, and not meeting his milestones.  When he reached nine months, the local clinic serving the children’s village sent a consult to The Addis Clin including details of the patient’s past medical history and their concerns. After reviewing the case, Addis Clinic staff reached out to a volunteer pediatrician in our network with global health experience, allocating the case to her through our telemedicine platform. The ensuing conversation between the referring clinicians and consulting specialist included exchange of the patient’s monthly weight records, feeding schedules, medication regimen, and recommendations for testing and treatment.  The pediatric specialist also reinforced the developmental milestones for the clinic to consider and encourage.

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This initial consult was four months ago, and since that time the child has improved tremendously!  The most recent reports from our partner say that the patient has gained sufficient weight, and is developing extremely well. He can crawl, stand with support, and hold objects with his fingers.  He is eating solid foods, and many of the medical complaints that accompanied his initial consultation have resolved. The expertise and recommendations of our pediatric specialist resulted in a child’s development being placed back on track, allowing him to thrive and grow in an environment in which he is understood and loved. Furthermore, the staff at his home has improved knowledge that will benefit all of the children they house and care for. 


Case Spotlight

The Addis Clinic connects physicians to frontline health workers, allowing for specialty care in the most remote and underserved areas.

Ask any parent about their highest priority, and they are bound to tell you it is the well-being of their child.  Doctor office waiting rooms everywhere are filled with concerned parents seeking reassurance, guidance, and treatment regarding their child’s health.  For many families, these concerns are either addressed promptly or referred for more specialized consultation. Yet if you happen to live in an area of the world where care is not so readily accessed, an initial complaint can become a chronic complaint that is never adequately investigated or treated. 

An 18-year-old girl presented to one of our partners in Ethiopia reporting white discharge draining from both of her ears, as well as hearing loss, headache, and a persistent ringing sound.  The patient’s parents recounted that the discharge, accompanied by ear pain, had been occurring on and off since early in her childhood.  The hearing loss has been gradual over time, but recently she has also been complaining of headaches, and this change caused them to seek care. The local nurse, unfamiliar with this type of complaint, turned to The Addis Clinic.  She submitted the case for consultation using our telemedicine platform asking for guidance in the evaluation and treatment of her patient.

An Ear, Nose & Throat (ENT) specialist in our volunteer network reviewed the case, communicated with the Ethiopian nurse, and recommended the patient be referred for a CT of her temporal bones to look for a cholesteatoma. A cholesteatoma is a collection of debris in the middle ear that is related to chronic ear infections. While benign, a cholesteatoma can erode the surrounding bone, causing hearing loss and allowing an infection to spread into the inner ear or further.  While waiting for the CT results, the ENT also recommended antibiotic ear drops to treat the current infection.

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The local nurse referred the patient for imaging and forwarded the results to our volunteer ENT. After consulting a radiology colleague, the ENT confirmed that the patient had a bilateral cholesteatoma, the result of long-standing chronic ear infections.  Because of its destructive nature, the ENT advised that the patient would need to be seen by a surgeon to remove the cholesteatomas, or risk permanent hearing loss, nerve damage and spread of infection. 

In this story, the diagnosis is not the end of the journey, but simply another beginning.  Finding a surgeon in Ethiopia to perform this procedure will be very difficult.  Yet despite these challenges, this Addis Clinic interaction educated and empowered a patient, her family, and her local care team to understand and seek the most appropriate treatment for a long-standing and worsening complaint.  This type of high-level collaboration is what The Addis Clinic constantly seeks to promote within the global communities we serve and would be impossible without the passion and dedication of our local partners and volunteer network of physicians.