Interesting Cases

January 2011

Many hospitals in the Developing world and areas of conflict have only a few doctors at Consultant grade, some have none. We have a growing panel of Medical Consultants, from many countries, in a wide variety of specialties and sub-specialties who give their advice, free of charge, to help their professional colleagues in difficult situations.

Their advice is designed to shorten illness, prevent or ease disability and at the same time provide medical education to the referring doctors and their colleagues.

Some typical cases:-

An 18 year old pregnant married woman, in Iraq, suffering from severe pre-eclampsia. Her doctors wished to abort the baby in order to save her life. We put the doctors in touch with an Obstetric and Gynaecological Consultant in Leeds and a Specialist Anaesthetist in Spain. They both gave continuous advice by email on a daily basis for some 2 ½ weeks, until the foetus was viable, and a healthy baby was then delivered by caesarean section. Mother and baby went home.

A 16 month old baby girl, abandoned in an orphanage in China, with a severe heart condition – who was going to be allowed to die – was referred through us to a Paediatric Cardiologist in the USA. Following the advice given her condition improved so that she was able to have surgery and become strong enough to fly to the United States with an American couple who adopted her.

A 4 year old girl in Northern Iraq who was critically injured when a mortar bomb struck her home was expected to die. Following expert advice given by a UK surgeon to her doctor she was stabilised and treated by her doctor for a number of weeks until she was well enough to return home.

Advice was sought from Madagascar on a 3 year old boy with severe cataracts. We obtained advice from a leading ophthalmologist in London for the local ophthalmologist, who was then able to operate successfully, restoring the child`s sight.

A seaman who fell into the hold of his ship in rough weather in the South Atlantic Ocean, fracturing his left femur, badly lacerating his face and fracturing his jaw – losing most of his teeth in the process, breaking his nose and possibly sustaining severe internal injuries, was taken to the 4 bedded hospital on the island of Tristan da Cunha with its lone general practitioner doctor. Following the advice obtained through Swinfen Telemedicine the patient was stabilised, and the fractured leg set. He was then cared for until a suitable ship came that was able to take him to Cape Town, where a Maxillo-facial Specialist was able to attend to his facial injuries.

Four years before going to a doctor a farmer in Nepal noticed a spot on his arm. By the time he visited a doctor in Gorahi he had a large lesion on his left arm and the problem had spread to both legs. Using digital images of the condition, advice was sought from a consultant dermatologist in Australia. The recommended treatment cleared up the condition in a few weeks.

We were asked to obtain help for a married couple in Iraq, who had been trying for 5 years to have a baby. Advice was obtained from a Specialist in fertility in Wales, which resulted in the birth of a healthy baby girl, followed two years later by a sister for her.

October 2010

Follow up to our story nurturing by email September 2009

Tu Tu was so sick in early life that, had it not been for a dedicated nurse, Karen Norman of International China Concern, who nurtured her to a state of health where she was able to have a life-saving operation, the on-going advice from our own Consultant, Dr Karen Rheuban and Swinfen Telemedicine, who facilitated the exchange between Consultants and the hospital, we would not now be able to make this report. She has now celebrated her second Birthday and after a journey of some 25 hours is at home in the United States with her adoptive parents who have praised the work of those involved, including Doctors in China for their compassion and for the compassion and care bestowed on their precious daughter Candice (Tu Tu) by all those involved.

December 2009

News from Mali

A child had a condition which the local ex-pat Doctor could not solve, so it came to SCT. It was sent first to a paediatric generalist in Australia and then with the Doctor’s permission on to a specialist in tropical medicine and infectious diseases. He diagnosed and said what surgery needed to be done. The surgeon operated and the child’s condition, having been correctly diagnosed as a giant omental cyst was alleviated.

September 2009

Cameroon

14 year old Michaelou fell from a tree in Cameroon and landed on a branch which penetrated his skull. Although he was treated with great care, he was not expected to live. However SCT Consultants were able to give advice and funds were raised locally to have him operated on by a Neurosurgeon and as our picture shows he is now apparently both physically and mentally very well.

‘Many thanks for your help. It is hugely reassuring here in the ‘bush’ to know that expert help is readily available.’
Dr Hamish Tait

September 2009

Nurturing by e-mail

A tiny orphan weighing only 5.3 kg, at age 16 months with a serious heart condition, was severely malnourished and had difficulty in holding her head up. One of our Consultants, over a period of time, was able to recommend treatment that allowed this small person to be prepared for surgery.

“Thank you so much for your assistance, it makes a big difference to us here”.
“Thank you for your advice, it is so reassuring that there are people like yourself just an e-mail away”.
Referring Doctor

Iraq

Featured on the BBC ONLINE NEWS in December 2005, this was the first surgical procedure of its kind to be carried out in Southern Iraq.

The woman had suffered a severe prolapsed uterus and doctors feared that they might have to operate and perform radical surgery or hysterectomy.
Quote from the Iraqi doctor who performed the operation, following guidance and advice from SCT gynaecology consultants Kim Hinshaw and Charles Cox, and Andrew Mathieson who organised the visit to Iraq, bringing essential medical equipment for the surgery.

"With your help and support we were able to do sacrohysteropexy for the first time in Southern Iraq" My thanks to all of you, especially Pat and Roger for your unlimited support"
NB we do not mention the doctor's real name, to protect him in Iraq.

This case concerned an 18 year old married lady, who was admitted 30 weeks pregnant suffering from severe pre-eclampsia and possible cardiomyopathy.

The medical team asked for urgent help on two fronts, 1) to determine whether she was suffering from pre-eclampsia or cardiomyopathy and 2) whether to terminate the pregnancy immediately to save her life. Advice and guidance was supplied by an SCT specialist consultant in pre-eclampsia Prof. James Walker and an SCT specialist in Anaesthetics, Dr Clive Cory. They both continued to support the medical team for two weeks until the patient had a caesarean section and was delivered of a healthy baby. The medical team director, as well as the clinician who performed the surgery and the anaesthetist all wrote heartfelt letters of thanks to SCT and the consultants.

Tibet

A child from a farming family who spent months with nomads developed painful swellings on different parts of her body that eventually discharged small larvae. Help was sought in identifying an effective treatment other than to keep children away from animals. Digital photographs were sent via the Trust to a Parasitologist for advice, the problem was identified and effective treatment followed. (2006)

Iraq

As a result of a telemedicine consultation with SCT in Obstetrics and Gynaecology, consultant, Nazar Amso, who provided advice and support to the prospective parents, before and during the pregnancy, baby Ayah was safely delivered. "Her family are most satisfied and very happy, they appreciate our work together with all the help". (2005)