Uncategorized

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)

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)

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.

                http://rheuma.com.au/physician-clone-thyself/15785
 
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)

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. 
 
http://www.stopbombinghospitals.org/

www.twicethedoctor.org.au

Regards to all

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

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)

 

2. 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)

 

3. 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

 

https://80000hours.org/2015/08/how-can-doctors-do-the-most-good-an-interview-with-dr-gregory-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.

 

www.twicethedoctor.org.au