I had the privilege of traveling to Iraq Kurdistan twice in the past two years to help bring much needed telemedicine infrastructure and surgical services to refugees and the local inhabitants. For this I have to thank the work of renowned hepatic surgeon Dr. Gazi Zibari.
Dr. Zibari’s Story
Dr. Zibari, a former Kurdish refugee and survivor of Saddam Hussein’s regime, has made it one of his life’s missions to bring accessible healthcare to his people. To do that, he has spent over 20 years doing humanitarian outreach and community-building in Kurdistan. When Dr. Zibari first started, the Kurdish medical system was perhaps two to three decades behind that of the US. Pharmacy shelves were empty, ultrasound and X-ray machines were antiquated, and there was no internet. While great strides have been made, there is still much work to be done to reach the goal of building a complete health care system from the ground up.
Go here to read a complete report on Dr Zibari’s many projects.
In 2014 and 2015, Dr Zibari’s team visited refugee camps to care for the people who had escaped from ISIS. They relied on VSee video and telemedicine to consult with doctors in the USA for specialist opinions.
Best Practices for Telemedicine Infrastructure
Over the course of several trips into the region, Dr Zibari has learned several lessons in managing outreach trips and building capacity for local health services. Here are some best practices in preparing for medical outreach missions:
- Start with a fact-finding mission to assess patient needs to determine the specialties that are in greatest demand.
- Travel with the support of a recognized health care outreach organization, such as the ACS Operation Giving Back Program, AHPBA, Operation Hope, or World Surgical Operation.
- Learn as much as possible about the culture and customs of the country where you will be providing care. The last thing you want to do is to offend the patients whom you are trying to help.
- Ship supplies ahead of your scheduled arrival, and make sure a contact person in the host country can verify that necessary equipment clears customs and is available for use. Carry any must-have devices (such as reusable instruments, Bovie devices, and retractors) and keep a list of supplies/equipment to bring on subsequent trips.
- Seek help and advice from local government, as well as from the health care system leadership.
- Start with straightforward, low-risk cases initially to build confidence and trust among your hosts.
- Prepare to revisit the same destination multiple times to have a meaningful impact on capacity building.
- Help host surgeons become members of US surgical societies.
- Plan at least a day for an academic symposium during your visit.
- Encourage host physicians to publish clinical papers and assist them in establishing their own surgical journal if one is not available, so they can share their research and best practices.
Following many of these tips, VSee has successfully done its first medical outreach to orphans and street children in the Philippines. And following Dr. Zibari’s tips, our plan is to be in the Philippines again next year so we can start making a real impact.
Building a complete and modern health care system from scratch is no easy task. The job is even more difficult in a region that is not yet recognized as an independent country. Nevertheless, we are optimistic that these efforts will lead to accessible health care for all the people of Kurdistan.
Learn More at the Telehealth Failures & Success Conference
You can learn more about how to successfully do telehealth and surgical outreach to underserved countries at the Telehealth Failures & Secrets To Success conference, Dec. 2-4, 2016 in San Jose, CA. There will be a special session from Doctors Without Borders surgical advisor Mohana Amirtharajah, MD.