Celestine Wanjalla takes a close look at cellphone video of a man recently diagnosed with both HIV and tuberculosis. She’s in Nashville. He’s in rural Kenya.
“He looks emaciated. You can see his ribs,” she points out. “But the good thing is that he’s breathing normally.”
Wanjalla is an infectious disease expert at Vanderbilt University Medical Center. AIDS is her specialty, so HIV cases come her way via a growing telemedicine linkup managed by the Addis Clinic.
A frontline worker sends text messages and the occasional video. Wanjalla asks questions through a web portal.
In this man’s case, his TB treatment seems to be interfering with his HIV medication, so his lymph nodes are swollen. But she wants more lab work.
“But he cannot afford to pay the laboratory fees for the biopsy and histology,” she’s reads from the text.
Wanjalla says working in Kenya — even remotely — is a reminder of how many limitations medical professionals navigate in the country where she was born and raised. But she says she knows her medical advice could help save lives, since the country has so few physicians with her level of training.
She’s one of the newest recruits for Addis Clinic, which has been on an expansion push after hiring its first executive director. After years as a volunteer effort by Dr. Stephen Chan from the University of Pittsburgh School of Medicine, the nonprofit effectively relocated to Nashville, where executive director Wade Munday lives.
The Addis Clinic currently works with 150 doctors based mostly in English-speaking countries, linking them to patients in several nations in Africa, as well as Haiti and Belize. Munday, a former Democratic operative and candidate, has been charged to triple the number of doctors over the next few years and help 10 times as many patients.
A big part of the recruiting role is convincing physicians telemedicine mission work is worth their time.
“You don’t have the same experience as being able to physically touch someone, but we think we’re leaving behind knowledge and skills for the frontline health workers who can adapt their practices and provide better care in the future,” Munday says.
Physicians will often send studies and research backing up their recommended course of action, effectively training the locals working on the ground to be more independent.
The model also maximizes the physician’s time. They help only when a case requires their attention, receiving a text message that alerts them to look at the online portal when a consult is needed.
Munday says the idea is to give physicians a simple way to serve without having to take expensive mission trips.
“It might not be sexy at the beginning, but it’s incredibly easy,” he says. “We ask our volunteer physicians to commit two to four hours of their time per month, and that’s on the high end.”
It works for Celestine Wanjalla’s schedule.
“I have a young family,” she says. “So I cannot travel and be on medical mission as often as somebody else might.”
So she puts the kids to bed, then spends half an hour trying to help save lives half a world away.