My first connection to the need for telemedicine in East Africa dates back to when Stephen Chan, the eventual founder of the Addis Clinic, returned from his second medical mission trip to Ethiopia in the fall of 2007. My husband Jon and I were good friends with Stephen and went to the same church small group. Stephen returned from those travels describing the frustration he felt not being able to follow up with the patients he treated in Addis Ababa and how he was certain there was a better solution.
When he talked to us about his idea to form a non-profit organization which could enable him to utilize telemedicine to help patients, my husband, Jonathan, and I agreed that this was worth putting more effort into.
So, we did. Jon dug deep into the complicated world of founding a 501c3 non-profit, researched bylaws to put the organization on solid ground and helped to recruit a strong board.
I wanted to be part of the effort to offer my expertise as an Internist with a subspecialty in Allergy and Immunology. I could make a difference through utilizing my training to serve patients half-way across the world.
In 2011, we had our first official board meeting as I was 9 months pregnant with our first child. I took on my first case while I was on maternity leave. I remembered that I was surprised by the complexity of the first cases which motivated me to go back to my medical books to read and remind myself of a few things. In my clinical work, I’ve gotten so used to the resource-rich settings in a western clinic where I had unlimited access to other medical professionals, labs, imaging studies, and a wealth of therapeutic options. I had to adjust my approach to the situation in Ethiopia where they didn’t have those resources.
I have now consulted on more than 20 cases and am more comfortable in handling cases where I don’t always feel like an expert. I realize that I might be the physician with the most knowledgeable and resources our beneficiaries will ever encounter. My work with The Addis Clinic had broadened my medical knowledge about health problems rarely encountered in the U.S. It forced me to consider cost and to think outside the box. I remember one case where a patient had rheumatoid arthritis managed with steroids alone. Long-term steroid use which would be needed to treat rheumatoid arthritis has major side-effects that would lead to more problems in the future. In the US I would have prescribed any number of available antibody-based therapies, but those are very expensive and not available to the population we serve in East Africa. So, I found a non-steroid drug that was not only available in Ethiopia but also inexpensive. This change in therapy gives this patient the best chance for maintaining the function of her hands and feet with less risk for long-term side-effects.
I find that the most important factor to the success of the work of The Addis Clinic is the communication between our partners in Ethiopia, Kenya, and Tanzania. Up until now, we have been using a largely in-house built app to enable communication with our patients and their medical professionals in our partner clinics. As the volume of our work has increased, the ability of the healthcare professionals on the ground to follow up quickly is too labor intensive and could run smoother. That’s why we are so fortunate to partner with Collegium to use their well-established telemedicine application used by a number of organizations such as Doctors Without Borders. It excels in facilitating the communication stream between medical professionals across the globe. With a large case volume, it’s important to have a fast and accurate description of the medical situation. The switch of technology service will increase the quality and quantity of information for physicians to make recommendations.
It’s been deeply gratifying to see how far The Addis Clinic has come in the last years. We are working together to overcome barriers to make a difference in people’s lives in Africa. It keeps me grounded. The access to medical care we enjoy in the US is not the norm. What a privilege it is to invest our time as physicians to care for patients across the globe.