For World's Sick, Care Via E-Mail

[Guest guest]

Colleagues, the following is FYI and does not necessarily reflect my own

opinion. I have no further knowledge of the topic. If you do not wish to

receive these posts, set your email filter to filter out any messages

coming from @nutritionucanlivewith.com and the program will remove

anything coming from me.

---------------------------------------------------------

For World's Sick, Care Via E-Mail

http://www.washingtonpost.com/wp-dyn/content/article/2008/11/23/AR2008112302629_\

pf.html

By Sullivan

Washington Post Foreign Service

Monday, November 24, 2008; A08

WINGHAM, England -- Geese honked happily outside as Pat Swinfen sat in

the study of her 16th-century farmhouse, cozy and warm amid thick

Oriental carpets and a glowing wood fire.

Pure English countryside idyll -- except for the critically ill pregnant

woman in Iraq desperately in need of a neurologist.

Swinfen, a retired nurse in her early 70s, sat at her computer and

tapped out an e-mail, trying to connect doctors in Basra working on the

woman, who had suffered a brain hemorrhage, with a renowned neurologist

from Northern Ireland trekking in Nepal.

She soon had an e-mail response from the neurologist, who told Swinfen

to forward details of the case.

The Swinfens run the Swinfen Charitable Trust, a telemedicine charity

that uses e-mail to link sick people in poor, remote or dangerous parts

of the world with hundreds of medical specialists in some of the world's

finest hospitals.

Doctors in about 140 hospitals and clinics in 39 nations use the

organization to seek help for patients requiring specialized care beyond

their capabilities. Through the trust, they can be put in e-mail contact

-- often within hours -- with one or more of the 400 specialists who

work without pay as part of the trust's network.

Doctors in distant areas, including Afghanistan, Antarctica and the

Islands, e-mail photos (many taken with digital cameras supplied

by the Swinfens), X-rays, test results and case notes. The information

is reviewed by specialists, who respond by e-mail to help make diagnoses

and recommend treatments.

The only thing linking all the need and all the expertise is a desktop

computer in the Swinfens' home, an improbable global nerve center set

amid a cherry orchard and wheat fields in the soft English hills about

75 miles southeast of London.

" Help is just an e-mail away, " said Swinfen, who runs the operation with

her husband, Swinfen, a retired army officer and member of

Britain's House of Lords.

Neither had used a computer before they began the operation on their

36th wedding anniversary in 1998. Their system has since handled almost

1,800 cases and saved numerous lives.

" This is a simple solution that works, " said Rheuban, a pediatric

cardiologist with the University of Virginia Health System and

president-elect of the American Telemedicine Association.

Rheuban said the U.S. military runs a similar system for service members

in the field, and many organizations, including U-Va., run extensive

telemedicine programs that incorporate videoconferencing. But that

requires high-speed broadband and other equipment not often available in

the world's remoter areas.

No one other than the Swinfens, Rheuban said, has such an extensive

network using simple, inexpensive technology -- e-mail and digital

photos -- to provide immediate medical consultations to some of the

world's poorest people.

Rheuban, one of 40 U-Va. specialists who volunteer for the Swinfens,

said she recently consulted on the case of a young girl in Basra who was

having heart problems. Rheuban said she was able to diagnose the problem

and recommend specialized treatment by reviewing EKG data and other test

results sent by the girl's doctors.

The Swinfens are formally Lord and Lady Swinfen. He was elected to the

House of Lords seat held by his late father; she was awarded the Order

of the British Empire by Queen II in 2006.

They began their project (http://www.swinfencharitabletrust.org) while

Swinfen, 69, was working with a charity that helped people with

disabilities in Britain and Bangladesh. He said that a doctor with the

charity introduced him to the idea of telemedicine, and that he

immediately saw potential.

" We decided we had to do something to help the needy in the developing

world, " he said. " Everyone was doing something, but no one was providing

medical specialists this way. "

Cases started flowing in from around the world: a man in Bangladesh with

a leg crushed in a car accident, a baby girl in Papua New Guinea with

eye disease, a baby in Nepal with a hand deformity, women from all over

with preeclampsia and other pregnancy-related problems.

The greatest number of cases have come from Iraq, where 39 hospitals

have established links to the trust. The Swinfens said they have handled

a variety of cases, including gunshots and kidney failure, and even a

call for help from a U.S. Army field hospital in Iraq, where a sick

young Iraqi girl turned up during the March 2003 invasion.

The Swinfens -- and a single assistant -- monitor the computer at all

hours, and they do it by laptop or BlackBerry on their frequent trips to

medical conferences to recruit specialists.

Sitting in their old farmhouse, the Swinfens joked about how their

garden would be tidier if they didn't have the trust. They laughed about

how Swinfen's most recent Christmas present to his wife was a

filing cabinet.

But they also worried about how to raise money to keep the trust going

-- to pay for the cameras, tripods, batteries and other equipment they

send to people in the field. And they worried about who would take over

when they are gone.

" and I are not exactly in the first flush of youth, " Pat Swinfen

said, tapping away at the long list of e-mails on her screen.

That morning, an e-mail arrived from a doctor at a small clinic on the

microscopic Pacific island of Niue, asking to establish a link with the

trust. Pat Swinfen sent back a note: The trust doesn't refuse anyone, no

matter how small or distant.

" You can fill a bucket with sand one grain at a time, " her husband said.

" But you've got to start. "

--

ne Holden, MS, RD

" Ask the Parkinson Dietitian " http://www.parkinson.org/

" Eat well, stay well with Parkinson's disease "

" Parkinson's disease: Guidelines for Medical Nutrition Therapy "

http://www.nutritionucanlivewith.com/