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Dear colleagues,

I am pleased to report we have raised over $80,000 so far this financial year.

A very big thank you to all those who have contributed and a reminder to those that are considering a donation that there’s still time.

Just a brief recap on the reasons you might wish to contribute.

1. Our field partners ( UNICEF, Fred Hollows Foundation, Barbara May Foundation, SURGICALife) have long term experience in achieving effective outcomes.

2. TTD donations go towards training of medical staff so your contribution can and should be considered as a way to expand your medical services in areas that desperately need them. The staff trained by your contribution will in a sense be doing the job you, as a doctor would have done had you actually travelled all the way to Africa. (Please reflect on the logistics, the costs and the dangers of the actual trip.)  Hence, our entire concept of “ Twice The Doctor”; you are working here but at the same time you are empowering a doctor to work in Africa on your behalf.

3. Your contribution goes an awfully long way in countries where a nurse often gets paid less than $200 per month.

4. The directors of TTD pay all administrative costs so your donation goes further and all donations are fully tax deductible.

Regards to all,

Rob Baume 

On behalf of the Directors of Twice the Doctor Foundation

Dear Colleagues,

Thank you so much for your response to this years Doctors Day in May. So far we have raised over $60,000 which as you know goes a very long way in providing health services in the developing world.

Real figures are very difficult to obtain in Africa but major depletion of health workers is and will continue to be inevitable. Just look at the poster below and imagine the situation in countries where PPE is so hard to come by and even testing for Covid is extremely patchy at best.

And what about the patients?

A recent Lancet study found that among 3,077 critically ill Covid patients admitted to African hospitals, 48.2 percent died within 30 days, compared with a global average of 31.5 percent.

A big part of the problem is the lack of training of health workers- something that TTD particularly focuses on.

Further in the Lancet report: 

Almost 16 percent of hospitals had ECMO, but it was offered to less than 1 percent of patients. Similarly, although 68 percent of the sites had access to dialysis to treat kidney failure, which is common in severe Covid cases, only 10 percent of the critically ill patients received it. Half the patients who died were never given oxygen, but the authors of the study said they had little data to explain why.

A Lancet editorial by experts not involved in the study said, “It is common in Africa to have expensive equipment that is non-functional due to poor maintenance or lack of skilled human resources.” Some 40 percent of the medical equipment in Africa was out of service, according to a 2017 report by the Tropical Health and Education Trust, the editorial said. Another factor is that few doctors in Africa have the training in pulmonary and critical care that is considered essential in treating Covid patients. 

May is almost over. 

If you have not already done so, please consider joining with your colleagues who have already contributed and thereby greatly supporting health worker colleagues.

www.twicethedoctor.org.au       

Regards to all

Rob Baume

On behalf of the Directors of Twice the Doctor

Dear colleagues and supporters,

“Doctors Day in May” is now upon us. It is a day when hundreds of your colleagues in Australia have occasionally or regularly made a substantial contribution to train and equip medical workers in Africa. I am hoping you might make a contribution this year.

Here is a bit of an update as to what is going on in Africa, that vast continent of 1.3 billion people of which 500 million live in extreme poverty( <$1.90 per day). According to WHO fewer than 2,000 working ventilators have to serve hundreds of millions of people in public hospitals across 41 African countries, (compared with > 170,000 in the US).

The COVID pandemic has made a worldwide midwife shortage worse with midwifery services being disrupted and midwives being deployed to other health services.

A study in The Lancet in December concluded that alleviating the midwife shortage could avert roughly two-thirds of maternal and newborn deaths and stillbirths, saving 4.3 million lives a year.

One of our partners, the Fred Hollows Foundation, has been deployed (at government request) to help control COVID in Africa by disseminating information and basic resources for preventing spread. Their organisation has vast experience in this type of activity from many years of treating trachoma – a program that has had long term support from TTD.

I am delighted to inform you that Andrew Browning, Medical Director of one of our partners, The Barbara May Foundation, has put out a book. I have personally met Andrew on several occasions and find him a truly inspiring individual and a hell of a nice guy. You will no doubt find his many years as a surgeon in Africa a fascinating read.

So if you feel you can make a contribution, please do so and bear in mind that it’s fully tax deductible.                                    

Regards to all

Rob Baume

On behalf of the Directors of Twice the Doctor

Dear colleagues and supporters,

As the concept of “Doctor’s Day in May” approaches (when I hope that those who can, will consider making a significant donation to help your medical colleagues help their patients half a world away), please consider the following recent news items.

30/3 – Besides dealing with other deadly outbreaks including Ebola, polio and measles, many nations in Africa are also dealing with vaccine inequity as developed nations hoard doses and seek to inoculate their entire populations. So far, only 7.7 million vaccines have been administered on the continent, according to the World Health Organization, which last week warned of a slowdown in deliveries even as initial batches were exhausted.

31/3 – KABUL, Afghanistan — Three health workers, all women, working for the government’s polio vaccine campaign were shot dead in Jalalabad in eastern Afghanistan. Basira, one of the victims, a vaccine worker since her teens, had been enlisted for a five-day vaccine campaign for which she would be paid less than $30.

31/3 –  Dr. Francisca Crispi, a regional president of Chile’s medical association, said that 20 to 30 percent of medical professionals in the country have gone on leave because they are so exhausted. Many are experiencing mental health problems and suicidal ideation, she added.

Further, please consider the following;.

The Yale happiness class, is one of the most popular classes to be offered in the university’s 320-year history. Over 3 million people have taken the course.

Research for the course found that the main causes of happiness are;

1. Adequate sleep.

2. Gratitude for the good things in one’s life

… and 

3. Helping other people.      

Regards to all

Rob Baume 

On behalf of the Directors of Twice the Doctor Foundation

Dear colleagues,

I hope all have remained safe and well. It has obviously been a horrible year for so many people around the world. We, in Australia have been extremely fortunate-probably from a combination of good management and good luck.

In Italy alone, about 300 doctors have died of COVID 19.

With regard to healthcare workers in general, in the UK, about 1000 have died and in the USA , it’s well over 3000. Not surprisingly in a recent survey, burnout in USA doctors has hit record levels.

Other than in South Africa, which has suffered terribly with 1.5 million cases and 50,000 deaths (in a country off 60 million people), and over 400 health care staff deaths, Africa, superficially, seems to have fared fairly well. However, as noted in my last newsletter, most of Africa has the additional major challenges of extreme poverty, lack of medical staff and poor medical infrastructure.

In addition, there is almost certainly a massive underestimation of COVID cases in Africa. Testing is distinctly uncommon and even deaths are often not properly tabulated.  Moreover, – The following report from a few days ago;

“Deaths from COVID-19 in Africa have surged by 40% in the last month, pushing Africa’s death toll towards 100 000 since the first reported case on the continent on 14 February 2020. This comes as Africa battles new, more contagious variants and gears up for its largest-ever vaccination drive”.

“The increasing deaths from COVID-19 we are seeing are tragic, but are also disturbing warning signs that health workers and health systems in Africa are dangerously overstretched.” Said WHO Regional Director for Africa .“Health facilities have become overwhelmed. Preliminary reports which WHO has received from 21 countries show that 66% reported inadequate critical care capacity, 24% reported burnout among health workers and 15 countries reported that oxygen production, crucial for severely ill COVID-19 patients, remains insufficient.”

We need to support our colleagues in Africa not only for their sakes and the sakes of their patients and because it is the right thing to do but also to protect ourselves. We will get vaccinated but what if a new virulent strain develops in Africa that our current vaccines don’t protect us from?

In very many ways, we are all in this together.

                                                                                www.twicethedoctor.org.au

Regards to all

Rob Baume

On behalf of the Directors of Twice the Doctor Foundation

Dear Colleagues,

I would personally like to thank you for your tremendous response to this years appeal.

Despite the great economic and logistical challenges to many medical practices, you have managed to contribute over $80,000 for distribution to our partners in the field to shore up medical services in Africa.

That brings us to a remarkable milestone – namely nearly 3/4 of a MILLION DOLLARS raised since inception of the foundation.

There is of course still work to do. It seems we are just at the beginning of the Covid outbreak in Africa.

• From 17/6-24/6 the number of cases in Africa increased by 28% and death rate by 25%.
• South Africa alone has 100,000 cases.
• Nigeria has 20,000 cases of which 5% are health workers.
• Sierra Leone and Guinea Bissau have health workers accounting for more than 10% of their cases.
• There is almost certainly massive under reporting of both cases and deaths.

The pandemic has overwhelmed fragile health systems disrupting programs for treating HIV, TB and Malaria. The WHO projects that deaths from these diseases could double. Treatment interruptions also raise the threat of drug resistance – already a formidable problem and a factor that might potentially affect all of us.

If you have not as yet made your (tax- deductible) contribution but wish to do so this financial year, there is still time!

Regards to all

Robert Baume

On behalf of the Directors of the Twice the Doctor Foundation

Dear colleagues

Thank you to the many generous doctors and supporters who have contributed to this (financial) year’s drive. As a result we will be able to pass on a total of nearly $50,000 to our various partners in the field – namely UNICEF, Fred Hollows Foundation, Barbara May Foundation, SURGICALife. 

Healthcare systems in Africa suffer from neglect and underfunding, leading to severe challenges across the six World Health Organization (WHO) pillars of healthcare delivery.

A study was conducted as part of a recent African Epidemiological Association Meeting in Maputo, Mozambique with participants drawn from 11 African countries, Cuba, Portugal and the United Kingdom.

Researchers found that the leading challenges in the healthcare sector as identified by the study participants were:

1. inadequate human resource for health

2. inadequate budgetary allocations to healthcare

3. poor leadership and management in healthcare. 

Please recall that our funds are concentrated on programs aimed at expanding human health resources.

There is still plenty of time make a contribution this (financial) year if you find yourself in a position to do so. (All contributions are fully tax deductible.)

                                                           

Regards to all

Rob Baume

On behalf of the Directors Twice the Doctor Foundation

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

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
health.

Regards to all
Rob Baume

On behalf of the Directors of Twice the Doctor Foundation

PS:
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/

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
   training.
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
   $50,000+!
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
    Frydenberg.

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)