2016 Global Health Symposium: War leads to life lessons, apps to improve health care

Dr. Mohamad Dalwai provides a medical consultation to one of the 800-1000 migrants and refugees who are living amongst boats on an abandoned military base on the outskirts of Tripoli. Many have been there for the duration of the conflict, been robbed of all identity papers, money and live in constant fear, without access to healthcare or security. MSF has provided medical consultations and assistance to the community, and are calling for their protection.

Operating in war zones in Libya, Syria and Pakistan taught Dr. Mohammed Dalwai that medicine may not be enough – physicians must be ready to fight for their patients’ rights.

“Before you go into a war zone, you think there’s a good side and a bad side,” Dalwai says. “Unfortunately, there’s not a good side or a bad side in war. It’s just chaos.”

The South African emergency physician, Médicins sans Frontières (MSF) veteran and tech pioneer is the keynote speaker for the 2016 Global Health Symposium, “Global Crises: Today’s Response, Tomorrow’s Hope.”

The 12th annual Global Health Symposium convenes at 4:30 p.m. Wednesday, March 30, in the Health Sciences Learning Center. The event, hosted by the University of Wisconsin-Madison Global Health Institute (GHI), is free and open to the public and includes almost 40 poster and live presentations of UW-Madison and community global health projects and a special Zika virus panel on UW-Madison’s response to the outbreak.Register Here

“It’s rare to find people who are well-versed in multiple disciplines,” says Dr. Janis Tupesis, a UW-Madison emergency medicine physician and GHI-Graduate Medical Education Liaison, who is collaborating with Dalwai on a GHI Seed Grant project to develop a mobile app focusing on emergency care guidelines in resource-limited settings.

Lessons from the war zone

Dalwai can articulate his clinical experience from war zones and the technical knowledge needed to develop mobile apps. “That doesn’t happen all that often,” Tupesis says.

Dalwai operated in Syrian caves where local people welcomed the physicians into their homes while helicopters tried to bomb them. He was among the MSF physicians who sneaked into Libya shortly before Muammar Gaddafi fell. He found camps where prisoners had no food, water or sanitation and lived in fear of rape and beatings.

“It was at that moment you realize you can just continue treating medical issues, but if you don’t advocate for those patients and bring the world’s attention to those people, the abuse will continue and happen again and again and again,” he says.

Dalwai will share lessons he learned about advocacy, compassion, and care. He’ll also describe how his experiences in African and southwestern Asian war zones pushed him to develop mobile apps to improve care around the world.

“You don’t have to be a genius or a superhero. You just need to be a normal doctor who wants to improve the lives of your patients.”—Mohammed Dalwai

Improving care for all

Dalwai helped MSF implement its first paper-based triage system to ensure patients with most critical needs are seen first. He was honored as a 2014 TEDGlobal Fellow after co-founding The Open Medicine Project South Africa. The Open Medicine Project has built a number of free, open access apps including a mobile triage app with prompts and pop-ups to eliminate life-threatening errors common in overburdened clinics and hospitals.

“I started realizing as clinicians we are not always equipped with the best tools to help our patients,” he says. “We doctors don’t like to talk about fear, especially our own fear (but) we wonder if we can do the best for our patients given limited resources and poor access to the information we need.”

Even a broken arm may mean a patient has traveled more than two or three hours to get to the local hospital. The orthopedic clinic might be more than 200 miles away and only open one or two days a week. Referring a patient on the wrong day can mean a two or three day wait in an unfamiliar city. “I would never want my mother to go to a hospital and wait 72 hours,” Dalwai says. “Because our patients are poor or come from rural areas, we accept that they get poor service delivery because of our lack of information.”

Mohammed Dalwai (left) and Janis Tupesis met at an African Federation of Emergency Medicine meeting and knew their work to use technology to improve care was similar.
Mohammed Dalwai (left) and Janis Tupesis met at an African Federation of Emergency Medicine meeting and knew their work to use technology to improve care was similar.

The Open Medicine Project and Tupesis want to change that. They are collaborating on the Essential Medical Guidance app to give clinicians the right information at the right time.

A GHI Seed Grant is funding development of the geolocated app that will answer questions such as: What is the best clinical care for this patient at this time? Does this patient need a CT scan? How do I order blood? Who should I refer to a specialty clinic? When is the clinic open?

“How do we get practical clinical practice guidelines to real people in real time?” Tupesis asks. “Up-to-date, local information is vital for good patient care.” The app could also guide public health efforts by showing what information is being accessed and is most needed in each area.

By Ann Grauvogl/ March 3, 2016