Graph of the Month

In October, 15% of cases received by The Addis Clinic required an Emergency Medicine consultation.  Our Emergency Medicine volunteers are always willing to assist with urgent cases and need for this quick attention is growing as we expand to areas where patients do not travel to seek medical attention until they are quite ill. 

To meet this demand The Addis Clinic is putting together an “Urgent Care” team of physician volunteers across all specialties who are willing to take more cases with faster turnaround times and ensure our partner health care providers receive the support they need.

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Expanding our reach with Mr. Sylvester Gero, Telemedicine Coordinator,  IHOPE Foundation

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As you may know, The Addis Clinic had the opportunity this past July to visit many of our partners in East Africa.  As part of these visits, we spent ample time brainstorming ways to better serve not only existing partners but all providers and patients throughout these communities.  One byproduct of these sessions was the decision to advertise the position of a telemedicine coordinator to work with one of our longest standing partners, the IHOPE Foundation, based out of Migori County, Kenya.  The use of telemedicine in this region has expanded at a very fast rate, and IHOPE and The Addis Clinic recognized the need for a dedicated individual on the ground to bring on new partner clinics, train new referrers, and assist in troubleshooting when issues arise.  

In September, after extensive interviews, Mr. Sylvester Gero was hired in this position, and he has already made an extraordinary impact in his new role.  Mr. Gero holds a Diploma in Clinical Medicine & Surgery, has worked in a DigiMedicine program and has a wide knowledge of health facilities and the handling of patients on a day to day basis.  In his first month on the job, Mr. Gero has already connected The Addis Clinic with two new clinics and trained them in such a way that they are already submitting cases.  This is an exciting development and we are very happy to have him as part of our team!

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Case Spotlight

Read about how one of our partners used asynchronous telemedicine this month:

In early October, The Addis Clinic received a referral from East Africa describing a gentleman who had been attacked with gasoline and suffered burn injuries to his face and abdomen.  He was being attended to in a local hospital, and the physician managing his care needed additional guidance on how to proceed with such a complex case.  

In high resource areas with access to advanced medical care, this patient would have been immediately transported to a regional burn center staffed with physicians and nurses specially trained in the management of burn patients. However, due to the constraints of his location, this was not an option and the local physician treating this patient turned to The Addis Clinic to fill this specialized need.  

While we do not have a burn specialist on our team of volunteers, we do have a very experienced emergency medicine physician who agreed to take the case.  Over the course of 3 days, this volunteer physician in Pennsylvania and our partner physician in Kenya "discussed" this patient's management, status, and progress over our asynchronous telemedicine platform.  

The emergency physician requested very detailed additional information and pictures of the patient, and based on the response he received he was able to provide specific recommendations on wound management, pain control, antibiotics, hydration, and nutrition.  The patient is currently healing well, and in the next week or so the volunteer and referring physicians will discuss his progress and any further management that is needed. 

We are thankful for the referral of this case, and to be involved in this patient's care! 

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Graph of the Month

In September, 88% of our cases came from rural Kenya, where word has spread throughout the region about the clinic's ability to connect with specialist physicians.  Additionally, we received cases from Haiti, Cameroon, and Egypt. The cases we receive come from rural counties, impoverished urban neighborhoods, and established hospitals. This graph highlights the diverse needs of each of these partners, and we are grateful to be able to connect each of them with the specialists they need.

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Case Spotlight

Earlier in September, The Addis Clinic received a case from a clinical officer in rural Kenya describing a young woman who was bitten by an unknown snake.  The referrer needed assistance from The Addis Clinic for two things - identifying the snake which had bitten the woman, as well as guidance on how to care for the bite. This was the first snake-bite case that we ever received and we immediately turned to our large network of physicians and supporters for assistance.

It was important to first identify the snake, as that would guide the care and treatment of the patient.  We shared the picture with our supporters on social media and were immediately flooded with connections to experts who quickly identified the snake as an East African Garter Snake. This request for help had over 5500 views on Facebook! We were happy to learn that while venomous, a bite from this snake has never been known to be fatal, and there is no anti-venom prepared or required for this type of injury.   After identifying the snake, we quickly allocated the case to a physician with experience working in the East African region, and she gave the local clinician expert advice on how to care for the bite wound as well as what to look for as possible complications and how to care for those complications.  Furthermore, she provided access to a great reference for practicing medicine in low-resource settings that this clinician will no-doubt find a useful resource not only for this case but many future cases as well. 

According to the snake experts we were connected with, bites of this kind are very rare and not well documented. The experts have remained actively involved in the case over the last two weeks, interested to follow up on the woman’s condition - which we are excited to report is excellent. Even a few days after suffering the bite she was only experiencing mild swelling and minimal pain.

This case truly showed the ability of asynchronous telemedicine to quickly provide assistance and feedback to clinicians, and it was truly a team effort as we worked to get this young woman the answers and care she needed.

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Graph of the Month

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We have recently noticed an increase in the number of urgent cases we receive.  The patients served by our partners do not usually seek out care until they are very ill due to the long distances they must travel.  By the time they encounter our partner clinicians, a telemedicine consultation is needed quickly, and we are thankful to have a dedicated team of volunteers who work hard to meet that need. 

In August, 30% of our cases required Family Medicine expertise, 25% required Pediatric volunteers, and 20% required guidance from Internal Medicine physicians.  Additionally, Infectious Disease, Dermatology, and Emergency Medicine physicians offered their thoughts on a variety of cases from Kenya, Haiti, Cameroon, and Ethiopia. 
 

Referrer of the Month - Eli Chacha Thomas, Chang Medical Clinic

The Addis Clinic receives referrals every day from community health workers, nurses, and physicians serving their communities across the globe. 

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This month we are happy to introduce you to Eli Chacha Thomas, the founder of Chang Medical Clinic.  Chang Clinic opened its doors in November 2017 and is located in a rural locality of Opapo which is in Ringo, a sub-county of Migori County, Kenya.  

Mr. Thomas is a clinical officer with a Diploma in Clinical Medicine and Surgery, and also holds a diploma in Medical Laboratory Technology.  When asked why he opened Chang Medical Clinic, he replied, "Well, I decided to start up this facility for I saw the need the people had. Opapo is a remote place and the nearest public health facility is over 15km away.  Children and mothers now have a place to run to for medical attention."

In discussing the incorporation of The Addis Clinic & asynchronous telemedicine into his patient care, Chacha says, "I can't mention enough, but The Addis Clinic telemedicine works for me perfectly.  Our patients now get the services of specialized doctors without having to go to these big facilities which are expensive.  I have seen my clients responding well to the treatments recommended by The Addis Clinic doctors.  We also have learned a lot from the doctors as well."

The Addis Clinic is excited about our partnership with Chang Medical Clinic, and looks forward to expanding our relationship in the coming months! 

Case Spotlight

For two days, an 8-year-old boy complained of fever, shortness of breath, fatigue and joint pain.  When he showed no signs of improvement, his family traveled an extreme distance to have him seen at the nearest clinic in their region of rural Kenya.  The clinical officer assigned to his case completed some initial assessments and found him to have an elevated heart rate, as well as a lower than normal hemoglobin level.  Knowing that this young boy needed more advanced care, he reached out to The Addis Clinic through our asynchronous telemedicine platform for a connection to a pediatrician.  The clinical officer also personally messaged us and asked for the case to be assigned quickly, as he knew this boy needed urgent intervention.

The Addis Clinic is lucky to have approximately one dozen pediatric-trained physician volunteers on our team, and we knew exactly who would be great for this case.  This volunteer responded within just a few hours, and his initial belief was that the child was suffering from acute chest syndrome, a very serious pulmonary complication of sickle cell disease.  Even in places with vast medical resources, this condition can be very difficult to treat.  Knowing that, and understanding the restrictions posed by care in a small rural clinic, the physician volunteer provided basic recommendations as well as details on how to vary care based on the child’s progress during the course of his illness.

The patient was admitted to the clinic for close observation and provided with rehydration, adequate pain control, respiratory support, and antibiotics.  Testing did show that the boy was positive for sickle cell disease, and throughout the week the clinical officer and pediatrician exchanged messages discussing the patient’s condition and care. Not only did these messages include information on how to manage the current situation, but also how to prevent or decrease the risk of future complications due to his chronic condition. 

The immediate attention of his local clinician and the detailed guidance provided by our physician volunteer resulted in a complete recovery from this acute illness. This very sick child never required an expensive or logistically challenging transfer to another facility because the pediatrician assigned to his case was able to successfully guide the clinical officer through a difficult scenario. Empowering local clinicians to provide appropriate care is why The Addis Clinic exists - every day our consultations bring hope, healing, and equality to those who need it most.

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Graph of the Month

July brought The Addis Clinic cases from Ethiopia, Kenya, and Cameroon. Many were submitted by long-established partners, while we also received several referrals as a result of new partner relationships cultivated during our Executive Director's visits to Addis Ababa in Ethiopia and Nairobi and Migori County in Kenya earlier this month.  While we continue to find that the many of our cases require primary care specialties such as family medicine (25% this month); and pediatrics (17% this month), we also had increased need for specialty consultations from physicians in fields such as pediatric urology and nephrology which you can read about in this month's case spotlight.  

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Case Spotlight

Sometimes, as the saying goes, “It’s all about who you know.”  That sentiment proved true this month for one girl in Ethiopia whose referral to The Addis Clinic started with an email from a woman in Tennessee to our founding physician in Pittsburgh.  This woman and her husband support an organization in rural Ethiopia serving impoverished children and she heard about The Addis Clinic through a mutual contact working with our longest standing partner, Ethiopia ACT.

Once the case made its way from our founder to our clinical team, we learned more about this girl in great need of specialized medical care.  In their email to us, these concerned supporters told us how during a routine medical exam, the eight-year-old was found to be suffering not only from malnutrition but many other medical problems.  Further testing revealed that she was born with only one kidney and that it was failing.  Unsure of where to turn next, they hoped that The Addis Clinic could facilitate guidance and advice from specialists most suited to her case.    

It became clear that this young girl would need the expertise of a nephrologist and we did not have one on our team of volunteer physicians.   We immediately put out the call through our supporters and volunteers, and they delivered! Within hours we had three nephrologists contact us with a willingness to assist.  Simultaneously, we worked with this girl’s caregivers to officially bring their organization on as a partner of The Addis Clinic and trained their staff on how to submit an asynchronous telemedicine case.  It took many emails and conversations, but by the next morning, we had this new partner set up in our telemedicine system, while our new volunteer nephrologist was onboard and prepared to receive her first case. 

As timing would have it, most of this transpired while our Executive Director, Michelle Turner, prepared to fly to Ethiopia and conduct site visits. Within the first few days of her arrival she assisted in referring the case and even more wonderfully, she was able to meet the sweet girl who we are so grateful to help.  In the U.S., our Clinical Operations Manager, Meghan Moretti, connected the case with our volunteer nephrologist, who immediately responded with her thoughts and recommendations. These included the belief that a pediatric urologist should also add his perspective.  Thankfully, The Addis Clinic is already connected to a pediatric urologist who is happy to lend his expertise when needed, and he was quick to do so on this case.  

 

 
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Now that this girl’s caregivers have the professional opinion and advice of two very specialized physicians, they are much better informed to navigate and consider her medical options.  We and our volunteers will continue to support them during this overwhelming and difficult time.

The ability of The Addis Clinic to connect with a new partner and bring on a new and very specialized physician volunteer all within a matter of hours took the quick work of our entire team.  We are grateful that so many people share in our passionate belief that telemedicine can successfully connect the world’s most underserved individuals with skilled and appropriate medical care.