Aid that's more than skin deep

(Edmonton) A telehealth project started by a University of Alberta dermatologist just two years ago has expanded into Africa to help patients with infections, burns, anthrax and slow-healing snake bites.

Jaggi Rao, a practicing dermatologist and director of the Dermatology Residency Training Program in the Faculty of Medicine & Dentistry, originally started a teledermatology program known as Consult Derm to assist patients with skin problems in northern and rural Alberta and the Northwest Territories.

The program is so successful that about 450 physicians in those regions are accessing the technology. Altogether, the six dermatologists who take part in the program provide 1,500 consults a year.

“The patients, who are too sick or too far away to see a dermatologist, like the program. And the family physicians like the program too,” said Rao.

Considering the success of the program here, Rao says he was eager to develop a philanthropic arm of the venture. Rao and third-year medical student Russell Wong created an organization called Telederm Outreach and contacted some philanthropic organizations, including Canadian Physicians for Aid and Relief, about their plan to give free online expertise to help those in third-world countries. The organization forwarded Rao’s contact information to Frank Artress, an American physician in Tanzania, and a partnership was born.

Now, physicians in Africa simply log onto a secure website and note a patient’s symptoms and location of the skin condition, and take photos. Rao then logs on and assesses the cases, after which he gives his diagnosis and suggestions for treatment.

Wong headed to Tanzania this August to train Artress on the teledermahealth program and set up the program at a local orphanage. Wong also gathered a list of available medications in Tanzania so that consulting physicians in Canada would know what drugs were available to patients.

“The most common skin conditions I saw were fungal infections of the scalp and torso,” said Wong.  “When kids get fungal infections on their scalp, they lose their hair, and it’s very traumatic for them. They are scared and get stigmatized.”

Wong said he also came in contact with some rare situations that dermatologists typically don’t come across.

“I saw a four-year-old child who crawled into bed one night and a snake was there waiting for him, and it bit his thigh,” said Wong. “He had major scarring. I saw him six months after he was bit, and the skin still hadn’t healed.”

Since the system was implemented in the late summer, Rao has already provided numerous consultations to help African patients. Rao and Wong would ultimately like to see this program expand to multiple countries and involve scores of dermatologists who could volunteer one to two hours of their time each month.

“Physicians in Tanzania see lots of skin disorders, and they either don’t know what the disorders are or they don’t know how to treat the conditions,” said Rao, who also uses the program as an opportunity to teach medical residents here about skin conditions common in third-world regions.

“We really want to make a difference, and there is no shortage of opportunities to help.”

Later this year, Rao and a team of dermatologists hope to travel to Tanzania to teach physicians there how to obtain tissue for biopsies and how to remove scar tissue or cancerous growths.