A MEDICAL charity set up by a retired York GP will this year celebrate a decade of saving lives around the world.
Outreach EMR, set up 10 years ago by former Haxby GP Peter Smith, now operates in 23 different clinics in nine of the world’s poorest countries, helping more than 220,000 patients worldwide.
And it all began with a visit to the loo in a remote Ugandan village 12 years ago.
Peter had just retired from 30 years as a GP with the Haxby Group Practice.
Thinking he still had something to offer, he signed up to spend nine weeks, at his own expense, working in a small medical clinic in the village of Bumwalukani in eastern Uganda.
It was a desperately poor area. Illiteracy rates were at 90 per cent, infant mortality was 15 times higher than in the UK, and there was no running water, no proper roads, no internet.
“Many of the children were running about with no shoes – and a lot of the adults were, too,” Peter said.
The clinic where he was working was a brick-built affair put up by an NGO, and did at least have a generator for electricity and clean water to drink.
It also had a limited supply of some 20 basic medications – anti-malarials, antibiotics, rehydration pills for children suffering from diarrhoea.
But Peter was seeing 90 children every day – and he quickly realised that there was a problem. No-one was keeping any medical records.
It meant he was effectively treating children in the dark.
He didn’t know where the children had come from, what drugs they’d been treated with in the past, whether they were allergic to any medications – even how they’d contracted the conditions he was treating them for.
That came home most forcibly when he went to use the local latrine - without running water, there were no flushing toilets.
People in that part of Uganda recycled everything, he said – including whatever scraps of paper they had to hand.
Which is why, in the latrine, he saw a note he’d written about a patient’s HIV test. It had been recycled as loo paper.
“That was a real moment for me,” he said. “After 30 years as a GP, I know how important it is to have the medical history of your patients.”
He began to think about the best way of ensuring staff at the clinic kept medical records.
He knew the system had to be simple and easy to use. So when he finished his nine weeks in Bumwalukani and returned home to York, he got chatting to a friend who works in IT.
The friend wrote some simple software for laptop computers – software that, by the use of clever drop-down menus, could enable clinic staff with even fairly basic literacy to keep a record of their patients’ medical histories.
And so, 10 years ago, Outreach EMR was born.
It began in clinics in Uganda. And now, 10 years on, it is working in no fewer than 23 clinics in nine of the poorest countries in the world, including Haiti, Nicaragua, the Philippines, Zambia, India and Costa Rica.
And it is making a real impact, Peter says – not only by enabling local medical staff to treat their patients more effectively, but also by enabling them to track local outbreaks and work out what is causing them.
“It has saved lives. There is no doubt about that,” he said.
He still can’t quite believe how far Outreach EMR has come.
“I thought I was just going to Uganda for nine weeks,” Peter said. “But 12 years on, here we are.”
To find out more about Outreach EMR, visit www.outreachemr.org/
How medical records save lives
Without proper medical records, doctors and medics are working in the dark.
“You don’t know patients' immunisation record, what drugs they have had in the past, what they might be allergic to,” says Peter Smith.
But it goes much further than that. Proper medical records also help you to track the progress of a disease through an area – and take steps to stop it.
In the remote villages of eastern Uganda where, over the past 10 years, Peter has spent a total of seven months working in local clinics, it is malaria, diarrhoea (caused by dirty water) and pneumonia that are the big killers.
Without medical records, Peter says, you don’t know which village the patients you are treating have come from, so you can’t spot patterns of disease.
With medical records, however, you can – which means you can take steps to prevent disease spreading.
“If you are treating a lot of children with malaria, and know which village they are from, you can go to that village and give them mosquito nets,” Peter said.
“Or if you have a lot of children with diarrhoea from the same village, you can go to that village and see what is happening.
“It might be that people are digging latrines too near the stream that drinking water comes from. So you encourage them to dig their latrine further away. It’s that simple.”
Outreach EMR provides the software that enables its easy-to-use medical records system to be quickly installed on clinics’ laptops.
The charity also provides routers so that the system users can set up their own wi-fi hotspot and don’t need to rely on non-existing internet access.
The software uses clever drop-down menus that enable clinic staff with even fairly basic literacy to keep a record of their patients’ medical histories.
It takes just two days to train local staff – usually nurses – to use the software effectively, Peter said.
The system can then be used to store – and, where necessary, share - details of 300 diseases and a whole range of data about the clinic’s patients.
It can also be used to ‘stocktake’ – it keeps a record of what drugs are available in each clinic, so local practitioners know when to order more medication.
The system is saving lives.
“We know we have made a difference,” Peter said. “For example, pockets of malaria and diarrhoea have been found.”
The charity has a small UK team of 14 people – mainly volunteers - who provide the knowhow.
Five are current or retired York GPs - including Peter - who make regular visits to clinics. The system itself is then operated in those clinics by local staff or NGOs.
The charity, which turns 10 this year, needs to raise £15-£20,000 every year to keep going.
This year, to mark the 10th anniversary, it hopes to raise £30,000.
The next fundraising event is on June 1: a book and picture sale at St Olave’s Church in Marygate from 10am-4pm.
To make a donation to Outreach EMR, visit www.outreachemr.org/
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