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3 April 2017

Dear colleagues,

Here is a brief note from Jo Martin, paediatrician, in response to my last newsletter. It was graciously accompanied by a generous contribution.

“Thanks for the opportunity again to support this worthwhile cause. So grateful to live and work in Australia, yet still support medical work overseas where it is needed most.”

Here is a letter from my current registrar, Kathleen Batty, which I would like to share with you.

Ghana 2013

Kathleen Batty

In 2013, I undertook a month long placement in a relatively large hospital in Takoradi, Ghana. I worked in the Obstetrics & Gynaecology department, assisting the local doctors as best I could. This experience enlightened me on how poorly we understand Third World health issues. While it was difficult for me to make a meaningful contribution based on language barriers, I was able to observe the treatment of women in childbirth. I was shocked to see women discouraged and shamed for expressing pain or emotional distress in the process of having or losing babies. Women who had stillbirths were told to put on a happy face to encourage a happy womb. They were placed on wards beside mothers of new healthy babies. No psychological support was provided. The surgical theatres were basic to say the least. A bucket and kettle lay on the floor in the corner of the room, and were used to sterilise the surgical equipment between cases. There was a daily struggle to allocate the few oxygen cylinders to the patients most in need, and yet brand new high –tech equipment sat un-used in the hallways. They were undoubtedly donated without considerations for training, education and needs. I found it distressing not to be able to “fix” what seemed unjust to me. I now realise that what I was observing was a deeper cultural disparity that I could not begin to understand as a foreigner. Our contribution to Third World health care should match actual rather than perceived needs.

 

From Kathleen’s letter I glean the following;

 

1. The need is huge! (Ghana is one of the “better off “African nations with GDP per capita of $4,400. For Zimbabwe, it’s $800 per capita.)

 

2. The aid needs to be intelligent, targeted, and focused on appropriate training rather than necessarily providing equipment.

 

3. Effective aid needs to be delivered by appropriately trained staff sensitive to cultural needs.

 

I am excited to report that our new project with our partners UNICEF is in Zimbabwe and involves local experts training medical staff in obstetric hospitals. I will elaborate soon!

www.twicethedoctor.org.au

 

Regards to all,

 

Rob Baume

(On behalf of the Directors of TTD)

Dear Colleagues

Despite our interesting and often rewarding jobs, burnout and associated mental health issues are distressingly common amongst Australian doctors and indeed doctors around the world. A recent survey of US physicians found burnout in just over 51% of doctors.

One of the major factors associated with burnout was found to be a low sense of personal accomplishment.

A major reason for the formation of the Twice the Doctor foundation was to help guard against burnout.

The reasoning was as follows:

I am feeling a bit stressed or even depressed and often feel that much of what I do is “process- driven” or defensive medicine. I spend quite a lot of time on allaying unnecessary anxiety born of misinformation from friends and relatives or debunking google searches. I do lots and lots of paperwork.

Question: 

What can I do to make my work more meaningful/rewarding?

Answer: 

I will do volunteering work in Africa like I always imagined I would when I first contemplated medicine as a career. I will be working on really sick and relatively young patients and I will be really appreciated.

Problems:

1.  I can’t just do highly meaningful medical work in the developing world because I don’t really have the particular skills required.

2.  I can’t just go for a few weeks. Enquires made with Medecins Sans Frontieres (SF) reveal that I need to spend a minimum of 9 months initially unless I have certain special skills (e.g. anaesthetist, obstetrician).

Solution:  After further research and enquiries I found that the best way I personally could make the greatest difference to some of the most needful patients in the world using my medical skills was to “volunteer” in my own office and use the proceeds of my medical activities to fund highly effective and efficient medical work in the developing world.

This adds significantly to my sense of medical accomplishment so not surprisingly it is a great remedy for, or firewall against burnout.

                                                             www.twicethedoctor.org

Regards to all

 

Rob Baume

On behalf of the Directors of Twice the Doctor Foundation

Dear Colleagues

In this caring, considerate Trumpian Era we find ourselves, let’s pause to reflect on the lay of the land in our own neighbourhood.

Currently Australian foreign aid is at the least generous in its history.

Most other donor countries, responding to unprecedented humanitarian challenges and recognising the importance of continued development progress for global stability, have been increasing their aid spending.  Total OECD aid reached a record high in 2015. In embarrassingly stark contrast, Australia has made savage cuts to foreign aid in recent years.

Australia ranks 7th on the OECD scale of most prosperous nations yet  on the ratio of foreign aid to national income – Australia fell from 13th to 16th in 2015.

Six OECD countries – Denmark, Luxembourg, the Netherlands, Norway, Sweden and the UK – have met the United Nations target to provide at least 0.7% of their national income as foreign aid.

In contrast, between 2012 and 2016, Australia’s foreign aid as a share of national income has fallen steeply from 0.36% to 0.23%. That’s less than 1/3 of the target.

Though I know we all studied hard and made sacrifices to get where we are and continue to work hard and with great responsibility, we should be cognisant of the fact that doctors in Australia happen to be among the highest paid in the world. In fact in 2014 we ranked second only to The Netherlands. The average Australian specialist earnings were $250,000 pa and average GP earnings were $100,000.

Contrast this with the country where I was born, Romania, where the salary of an average GP has recently increased to about $15,000 pa. I suspect many of you reading this newsletter where born in countries that generally pay doctors significantly less than we currently receive.

So … Caring about the less fortunate in a new world that in many was feels less caring seems like something that we , as extremely privileged professionals in an extremely privileged country (that perhaps isn’t pulling its weight on foreign aid), ought to consider. After all we are in a caring profession.

twicethedoctor.org.au

Regards to all

Rob Baume (on behalf of the Directors of TTD)

Dear colleagues,

The Historian and philosopher Yuval Noah Harari asserts that algorithms are essential to decision making.

Here is an algorithm that perhaps all doctors ought to consider:

1. We became doctors primarily to help patients.
2. We consider all patients, and indeed, all human beings, to be equal.
3. We prioritise our resources to patients most in need.
4. This should apply to patients no matter where they are in the world.

By supporting the Twice the Doctor foundation you are doing more than merely paying lip service to this compelling algorithm.

www.twicethedoctor.org.au

Please consider sending this algorithm to any of your medical colleagues.

Regards to all

Rob Baume

On behalf of the Directors of TTD

Dear colleagues,

Here’s some wonderful feedback from acting CEO of UNICEF, one of our major TTD partners. 

” I am writing to thank you for the gift of $75,000 from Twice The Doctor Foundation to support children in Sierra Leone. I am so thrilled to learn that the third year of Twice The Doctor Day has been a success.
…. In Sierra Leone  … Ebola has destroyed children’s lives. … Not only are you helping deliver vital healthcare, you are also helping build more robust healthcare systems that can better withstand disasters.
....  By providing multi-year funding to vital programs you are enabling us to make systemic changes to address the underlying causes of poverty”

 (Well over a quarter of a million dollars has been raised by the Twice the Doctor Foundation  for Unicef program’s in Sierra Leone in just over the two years.)

….  ” As medical professionals, you have taken your roles to another level and I really  hope you all feel proud of your achievements. On behalf of everyone at UNICEF Australia and all the children you are helping, I thank you sincerely.”

Adrian Graham

Acting Chief Executive

UNICEF Australia

I feel all of you who have participated /contributed richly deserve this type of appreciation; so enjoy!

Regards to all

Rob Baume    (on behalf of the directors of TTD)

20 July 2016

Dear Colleagues,

So far we have raised $125,000 towards this year’s Doctor’s Day in May campaign. That translates to the equivalent of salaries for approximately 5 doctors and 25 nurses for an entire year. That’s going to provide incredibly valuable services for thousands of patients in Africa!

We have now raised over $425,000 since inception about two and a half years ago. By all accounts- not bad! So well done to all who have contributed.

There’s now just two weeks to go till the end of the financial year. You can still make your fully tax deductible contribution and be part of this year’s effort at;

twicethedoctor.org.au

Remember there’s a whole other world of patients out there and when you are working for the developing world your first world problems seem to disappear.

Regards to all,

Rob Baume

(on behalf of the directors of TTD)

16 June 2016

Dear Colleagues,

So far we have raised over $110,000 towards this year’s Doctor’s Day in May campaign. This will be enough to fund the wages component for many thousands of lid surgeries for trachoma, the training of nearly one hundred community health workers in Sierra Leone and lend substantial support for the wonderful work being done by the Barbara May Foundation in Ethiopia.

There is still plenty of time to contribute to this year’s campaign and I hope this message received over the weekend from Allan Kelly, paediatrician, might inspire you;

“This is a fantastic initiative. Although it is called “Twice the Doctor” it enables us to be many more times than twice the doctor. We are so lucky to be living in a country where one day of our pay enables us be doctors for a whole month somewhere else. The riches of this world are so unevenly distributed that the least we can do as the lucky few is to help to redress that imbalance.”

Recall that we primarily became doctors in order to help patients. I firmly believe that this type of contribution is a particularly effective way to help some of the most needful patients in the world.

twicethedoctor.org.au

Rob Baume

(on behalf of the Directors of Twice The Doctor Foundation)

30.5.2016

Dear colleagues,

We have raised close to $90,000 dollars so far for this year’s Doctor’s Day in May. Well done to all! This goes a long way in Africa.

There are many of you who I hope will still contribute to this year’s effort having given generously in previous years.

For logistical reasons the main launch at Royal Prince Alfred and affiliate hospitals will be this coming Friday, 27th so let’s hope for a big response. Some most generous donations have already been received.

Here are some comments received in the last few days from contributors. I hope they will inspire.

“The more that can be done to support the health and rights of women and children in developing countries, the better the world will be”. -David Martin, surgeon.

“TTD is a fabulous concept and has made a tremendous difference to thousands of people around the world in a relatively short time.”- Stephen Cala, physician.

“Independent of the amount of funds raised, you are helping to transfer the paradigm of giving towards a more efficient, less parochial and higher impact model.”- Simon Baume, strategist.

Please consider your contribution to this year’s campaign at

twicethedoctor.org.au

Regards to all

Rob Baume

(on behalf of the directors of TTD foundation)

25 May 2016

Dear Colleagues

Doctors Day in May is this Friday. I hope that you are in a position to join hundreds of other doctors who are participating this year – some have already made substantial contributions.

Please recall,

1. This is quite possibly the most effective and efficient way for the majority of us to use our medical skills in order to make a real contribution to health in the developing world. In other words, in most cases this is at least every bit as effective as if you would have travelled to Africa and volunteered.

2. Your contribution is greatly appreciated. Remind yourself just how much…

https://vimeo.com/user22571367/review/111162076/252a4a8f79

3. Your contribution is fully tax- deductible and the directors pay all administrative fees of the Foundation so your contribution is further leveraged.

Just imagine if you contributed a day’s pay on a yearly basis for 12 years. That would be the equivalent of paying an African doctor’s wage for about 1 year. In other words you could look back in 12 years’ time and realise you had effectively “volunteered for a year in Africa”. It’s not quite the same but in some ways it is better because wages feed into the local communities and new skill sets are acquired and preserved (particularly by training nurses). You would also be inspiring other doctors to get on board and you would be mentoring philanthropy to junior doctors coming through.

Not a bad 12 days’ work in 12 years! Possibly the most effective medical work you could do. This is indeed an opportunity. If there wasn’t a huge need and there wasn’t a large discrepancy between medical wages here compared with Africa, this opportunity would not exist!

Please make your contribution for Doctors Day in May at

twicethedoctor.org.au

 

Regards to all

Rob Baume

(On behalf of the directors of TTD Foundation)

17 May 2016

Dear Colleagues,

There is less than two weeks till Doctor’s Day in May- Friday, May 20th

Hope you will join hundreds – (perhaps a thousand or so?) of your colleagues in making a significant contribution to this year’s effort.

Please recall:

1. We have already raised over $300,000. This has gone towards training hundreds of health care workers who see thousands of mothers and children in Sierra Leone to reduce child and maternal mortality.

It has also helped train and pay the salaries of trachoma lid surgeons who have performed thousands of blindness-preventing surgeries in Ethiopia.

2. Royal Prince Alfred Hospital and its affiliate hospitals are organising a major launch of the Twice the Doctor concept for Doctor’s Day in May. They have indicated that they are committed to an ongoing annual programme.

Their contributions will go to the Barbara May Foundation who do excellent work in Ethiopia to reduce maternal mortality rate and birth complications.

3. The New Zealand branch of Twice the Doctor is being established.

This is an indication of the leveraging power of your combined efforts and speaks of the potential for a widespread multi-national programme.

Regards to all

Rob Baume

On behalf of the Directors of Twice the Doctor Foundation