Unprecedented Times in 2020

Dear Colleagues

The depiction of Australia as  “The Lucky Country “ has probably never been more accurate and poignant. It seems we (the general public and medical staff in particular) have dodged a major bullet in negotiating the worst of this terrible pandemic.

Witnessing the sometimes shocking conditions and consequences that our medical colleagues have endured in advanced economies such as the U.S., UK, Italy etc is sobering.

Now, try to imagine what is on the way for Africa and its medical workers with chronic under-staffing and dismally sparse resources. This will be compounded by enormous economic loss to some of the most fragile economies in the world as a consequence of lockdowns locally and globally.

We have all faced significant economic and other challenges recently and for logistical reasons there will be no formal “Doctor’s Day in May” this year. However, many of your peers have contributed throughout the year and if you feel in a position to make a contribution to support your fellow medical professionals in Africa, you can be confident it will be well utilised and greatly appreciated.

Regards to all and stay safe

Rob Baume

On behalf of the Directors of TTD

We Are In This Together

Dear colleagues,

Lately there have been a few major challenges facing the Australian medical system
including the physical and mental health consequences of the horrendous bushfire season
and the likely upcoming major impact of dealing with a deadly viral pandemic. The latter in
particular has the potential to hugely stretch even our very substantial first world medical
resources. The bushfires, which are widely thought to be at least partly attributable to
climate change and the COVID-19 viral infection have a feature in common; they are both
consequences of actions largely outside our own borders.

To me this is a reminder and a wake-up call that we live in a single biosphere and with the
world being so interconnected we can no longer afford to adopt a myopic view of the
factors that may contribute to our wellbeing.

Dr. Tedros Adhanom Ghebreyesus, the director general of the World Health Organization,
has warned repeatedly of the toll the virus could exact in places with weak health systems.
And these days, more than ever, “what goes around comes around”.

At Twice the Doctor foundation, we have always sought to support programmes that
strengthen the medical resources of some of the most under resourced countries in the
world. I hope you agree that this approach is not only the right thing to do on a
humanitarian basis but is also likely to pay long term dividends in securing our own personal

Regards to all
Rob Baume

On behalf of the Directors of Twice the Doctor Foundation

I was recently in contact with Dr Tamsin Lillie in the UK who advised me of an organisation
called Medic to Medic which seems to have very similar ideals to TTD. In the last 10 years
they have assisted over 100 students graduate to become qualified health workers in Malawi – one of the poorest countries in Africa.

Check out their website: https://www.medictomedic.org.uk/

10 Great Reasons to Contribute to TTD

Dear colleagues,

10 great reasons to contribute to TTD

  1. Support your Australian medical colleagues who have donated about $85,000
    towards this year’s drive (so we are now well over $650,000 raised since inception).
  2. Support your medical colleagues in Africa who desperately need the resources and
  3. Support the patients in countries where health spending is often less than $25 per
    person per annum.
  4. Support your psyche – once you have a modest income, the best use of money to
    promote happiness is to give it to someone in need.
  5. Support your wellbeing and help prevent burnout by knowing you are contributing
    to lifesaving medical work.
  6. Support incredibly efficient and effective programmes. One of our initiatives can
    avert a DALY (disability adjusted life year) for about $25. In Australia we often pay
  7. Recall that a contribution to TTD is not just another donation but is in effect “virtual
    volunteering” where medical staff in Africa are acting as your avatar.
  8. Recall your contributions to TTD go further as a) the directors pay the administration
    costs and b) we make single large sum contributions- thereby reducing
    administrative costs of our partners.
  9. Because you can. We work in a privileged profession in an incredibly lucky country
    with one of the best medical systems in the world. In my country of birth, Romania,
    a GP earns about $40,000 pa (this having increased substantially in the last few
    years)-and the facilities suck!
  10. It’s the end of the financial year, your contribution is fully tax deductible and you’d
    rather give your money to African colleagues and their patients than to Josh

Australia’s spending on foreign aid has steadily declined for years. It’s now 0.27% of
gross national income which is a quarter of spending by Scandinavian countries and one third of the UK.

Regards to all and a happy new financial year,

Rob Baume (On behalf of the Directors of Twice the Doctor Foundation)

TTD/UNICEF Partnership in Zimbabwe

Dear colleagues and supporters,

Thanks so much for your response so far to this year’s Twice the Doctor fundraising drive and
particularly Doctors Day in May.

It is still of course early days but your colleagues have already contributed

                                     over $60,000 towards this year’s effort.

Please view the videos here.      

And also here.

Fortunately , Robert Mugabe who since 1980 has systematically destroyed what was an excellent
health system has been ousted. Amongst numerous problems, abysmal working conditions drove
20% of health professionals abroad each year.

Currently in Australia maternal mortality rate is:       5.5 /100,000 live births.
In Zimbabwe it is:       443 /100,000 … ie nearly 100x as much

There is some hope and expectation that the new administration will be significantly better but the
new government has allocated a disappointing 7.7% to health in the 2017–2018 national budget.
The people of Zimbabwe need our help.

Remember, the central concept of TTD is funding doctors in the developing world to do the work
that we hopefully would/ ?? could do if we went over to volunteer. This is “virtually volunteering” at
its best.

If you have not as yet contributed this year, please consider doing so.
Remember, all donations are fully tax deductible. The directors of TTD cover all our administrative costs so your contribution goes even further.

Regards to all,

Rob Baume (On behalf of the directors of Twice the Doctor Foundation)

Doctors Day in May Update

Dear colleagues,

Doctors Day in May was last Friday at Gosford/Wyong Hospitals and will be later this month at RPA
and affiliate hospitals. Posters will be displayed at a number of other hospitals encouraging your
colleagues to participate.

At Gosford and Wyong the RMOA organised a number of activities including meditation, lunch,
coffee vouchers, and a “pat-a-piglet” opportunity. Crazy socks were also encouraged.

I am proud that the Twice The Doctor Foundation (TTD) was the initiator of Doctors Day in May and
is an ongoing supporter of this valuable tradition. This is all to do with mental health and well-being
for doctors and I thoroughly believe that involving oneself in charitable activities/opportunities such
as those provided by TTD enhance and magnify the positive effects significantly.

I was recently fortunate enough to be interviewed for an article about TTD by Penny Durham from
Rheumatology Republic. I apologise that it is a little lengthy but I think it beautifully captures the
philosophy of TTD so I would love you to read it if you have time. Importantly it also includes a very
interesting interview with Andrew Browning AM who has worked extensively in Africa. Some of the
key figures he quotes means that it is likely that through an appropriately targeted contribution you
can prevent the obstetric death of a mother and baby for about $A 1,800. Remember, this mother
is quite likely to have other children who are then orphaned. In addition with the same funds you
are very likely to be preventing fistula formation, potential neonatal brain hypoxia and various other
devastating non-fatal potential complications of child-birth.

Please read the article if you have time, and please consider making your contribution for this year’s
Doctor’s Day in May at twicethedoctor.org.au

Also, please consider sending this on to your medical associates.

Regards to all,

Rob Baume (On behalf of the directors of TTD)

Doctors Day in May 2019

Dear colleagues,

We are fast approaching Doctors Day in May so I hope you are considering your annual
contribution. Please recall that as medical practitioners in Australia we are in really quite a
privileged position for the following reasons;
     1. We have interesting and fulfilling (though often stressful) jobs.
     2. We are very rarely unemployed.
     3. We are supported by a health system which, though far from perfect, is fairly uniformly considered
amongst the best in the world.

Couple this with knowledge that for just $300-$400 per annum channelled into highly
effective and efficient programmes in Africa, you can virtually double the QALYs you are
likely to generate in a year!

                 Which other profession has this opportunity?

(Sadly it is an opportunity that only exists due to the huge disparity in medical resources in
much of the developing world.)

Moreover as I write this, I realise that though I am going to donate some of my valuable time
and my hard-earned cash, at no time soon am I going to be dying for the cause, (I am
way too much of a coward!)- unlike some of our medical colleagues.

Please consider taking a bit of time to view the video link. 


Regards to all

Robert Baume (on behalf of the Directors of Twice the Doctor Foundation)

A Bit Of Philosophy

A bit of philosophy:


  1. There is not a person on earth who chose his genome, or the country of his birth, or the political and economic conditions that prevailed at moments crucial to his progress. (Sam Harris – neuroscientist / philosopher)


  1. Given that we are equipped with the capacity to sympathize with others, nothing can prevent the circle of sympathy from expanding from the family and tribe to embrace all of humankind, particularly as reason goads us into realizing that there can be nothing uniquely deserving about ourselves or any of the groups to which we belong. We are forced into cosmopolitanism: accepting our citizenship in the world. ( Steven Pinker- cognitive psychologist)


  1. Thought experiment: You walk past a lake and see a child drowning. Do you jump in and save her life even though it will cost $500 to replace your ruined suit? (Peter Singer-philosopher)


A bit of reality:


Here is an analysis of the good that doctors likely do. You may find it quite interesting and a bit sobering.


Interview with Greg Lewis



A bit of economics:


  1. Successive Australian governments have severely cut back foreign aid.
  2. You can almost certainly double your impact as a medical care provider on a global basis for a few hundred dollars. (If in doubt, read the article above)
  3. Your donations are fully tax deductible…..and it’s nearly June 30th.



Mercy Ships

Dear colleagues,


Recently there was an article in Medscape about volunteering on Mercy Ships which go to Africa to perform surgery on the desperately deprived. There is no doubt that this would be a fantastic experience but as the comments section of the article revealed, there are certain drawbacks and limitations of this type of volunteering such as;


  1. The dollar cost and substantial opportunity cost of going.
  2. The fact that, for example, a paediatric endocrinologist or a rheumatologist is not exactly what’s needed nor a specialist cardiologist or a dermatologist.
  3. The time away from one’s family and one’s own patients back home. (Usually many months.)


I think this is where the Twice the Doctor concept comes in. Just one day’s work a year (or part thereof) and you can effectively empower/ train/employ the precisely required African health worker for the most pressing medical needs. These doctors and nurses speak the local language and use their wages to help enrich the local community. They are also there for effective follow up. The training is often specific in order to avoid “brain drain” through emigration.


It would certainly be an unforgettable experience to work on a Mercy Ship but in reality we can all do a whole lot of good for African patients without ever leaving shore.


Remember, Twice the Doctor is about using your heart AND your head to leverage your medical skills for maximum effect to help developing world patients.




Regards to all


Rob Baume

(on behalf of the directors of TTD)

  1. Doctors Day in May is this Friday.
  2. Your contribution is fully tax deductible.
  3. The directors of TTD cover all the administration fees of the foundation so your donation goes even further.


Annual Doctors Day in May 2018

Dear colleagues,

May is well and truly upon us and it’s time consider your donation to Twice the Doctor foundation for this year. You have been generous in the past and hopefully will be again. You should not lose sight of the fact that in terms of quality adjusted life years of health (QALYs) your donation of about $500 can double your yearly impact as a doctor! Hard to believe isn’t it? But less difficult to understand when considering:


  1. Donations go to specific, highly efficient targeted programmes in African countries where health budgets can be as little as $30 per person per annum.
  2. Trained nurses delivering high end medical care (including lid surgery for trachoma) are often paid about $2500 per annum.
  3. In Australia we routinely pay $50,000+ for medical services/ procedures and especially certain medications to deliver a single QALY.
  4. All administration fees for TTD are covered by the directors so your donation goes even further.


Just this week I had the pleasure to meet Dr Ciku Mathenge from Kigali, Rwanda where she is 1 of 12 ophthalmologists……. for 12 million people. (See photo attached). In Australia we have About 40 ophthalmologists per million people.


Dr Mathenge helps coordinate and advise ophthalmic programmes for East Africa supplied by one of our partners, The Fred Hollows foundation, in order to deliver the most essential and most efficient interventions for the resources available. She is also starting a programme to train more ophthalmologists via resources in her private clinic – something that has not been done before in Rwanda.


Please remember there is a whole other world of medical need out there and how very privileged we are to live and work in Australia.


Donate at twicethedoctor.org.au


Regards to all


Rob Baume

( on behalf of the directors of TTD foundation )

New Twice the Doctor Project

Dear colleagues and supporters,


The Twice the Doctor foundation in collaboration with resident medical officers (RMOs) are currently working on a new project which will hopefully expand our reach significantly. It involves partnerships between local doctors and their patients to deliver resources to medical providers in Africa thereby expanding medical services to developing world patients.


It is envisaged that patients will help and encourage us to be “Twice the Doctor” while in a sense being “Twice the Patient”.


The concept should be seen as a ‘twinning exercise’- namely patients and doctors together contributing to providing services to other less resourced doctors and their patients in Africa. (So “while” patients here are being cared for, they are also being cared for in Africa.)


Please recall that the wage for a specially trained nurse in Ethiopia to perform tarsal surgery in order to prevent blindness from trachoma is approximately……$1 per procedure!


In countries where the annual health expenditure can be as low as $20 per capita per annum, it’s not surprising that just $1 can go an awfully long way.


           (Australia spends $ 4,700 per capita p.a.-2016)


It is envisaged that RMOs will be the prime designers, managers and executors of what is hoped to be a pivotal project and as such will not only leverage their medical status in order to expand their effectiveness in providing for patients (everywhere) but also deeply engage them in a team building project of which they can be justly proud both now and in the future.


 The TTD Foundation feels highly optimistic regarding the project’s potential success partly because of:


       1. Relationships that have been built over a number of years with RMO associations.

       2.The energy and drive displayed by RMOs in the past in support of TTD, and certainly not least of all:

       3. The runs on the “board”, namely  > $500,000 donated so far by you, our supporters.


Without the leveraging power of this impressive figure, I suspect this new initiative would face far stronger headwinds. 


So thankyou to you our contributors for making possible what we hope will be the next considerable expansion of the good that TTD can do while providing RMOs with a potential significant firewall against burnout.


Regards to all

Rob Baume

(On behalf of the directors of Twice The Doctor foundation)