Blog – Salaam

Doctors without Borders: Physicians and the ultimate sacrifice

sara — Fri, 09 Jul 2021 13:14:12 +0000

Murder in the Tigray region of Ethiopia

Physicians already give up a lot to pursue service to others. Time, money, relationships. But for a few, their sincerity, and love for their profession, and service to others leads them away from their nation, and their homes. These are the physicians of Doctors Without Borders. Dr. Mohamed Fadlalla, a big supporter of the Salaam Clinic, is one of those physicians who answered a medical call to arms, who left home to help the underserved in lands far away.

On Father’s Day this past June, Dr. Fadlalla took time away from his family and friends to speak to volunteers and students at Salaam Clinic about Doctors Without Borders and the experiences he has had with them. This deserves recognition, as this was during a brief time off he had between medical trips to Uzbekistan and Sudan. The discussion revolved around how to get involved, is it worth it (yes), and the differences in healthcare in America and parts of the world Doctors Without Borders operates in.

As appreciative as we are for Dr. Fadlalla, we are even more appreciative now as just a few days later, three of our colleagues in Doctors Without Borders were murdered in the Tigray region of Ethiopia. This abhorrent attack on our colleagues in Doctors Without Borders has led to the suspension of medical work in that region in Ethiopia. Thus far, no one has claimed responsibility for the murders.

As physicians, we often see our work undermined by political motives, and in times of political uncertainty, we become easy targets. Nonetheless, we continue to sacrifice and will continue to sacrifice for the sake of others and in service to others.

Read more about Doctors Without Borders and the situation in the Tigray region of Ethiopia.
ethiodia-msf-demands-investigation-killing-three-staff-members-tigray

Watch Dr. Fadlalla speak with Dr. Shah, CEO of Salaam Clinic, about the differences in community care in America and Uzbekistan.

Mass Vaccinations Begin in Ohio

salaamcleveland@admin — Fri, 19 Mar 2021 13:51:37 +0000

We have collectively been waiting a very long time for vaccinations to begin at this level,

Here in Cleveland, the mass vaccination site is at the Wolstein Center at CSU. At the time of writing this (3/18/2021), Ohio is currently accepting those in groups 1A, 1B, 2A, 2B; and on this Friday (3/19/2021), eligibility will include those over the age of 40, and those over the age of 16 if you have chronic conditions.

By the end of March, vaccine eligibility will be for all people over the age of 16.

For children, studies are currently being conducted to ensure their safety and also to confirm an immune response. Once the FDA approves these vaccines in children, vaccination of them won’t be far behind.

This is great news. At best it means the end of the widespread pandemic, and at the least, it gives us breathing room and a chance for some sense of normalcy. And though the road is still long, we can see our destination. Families can begin to see one another again without fear or guilt, businesses can strengthen, and couples can go out once again. But with this hopeful future, we still need to remain vigilant and safe today.

Although fully vaccinated individuals can meet together without masks, when in public or around unvaccinated individuals, or you are unsure, the same mask and distance precautions apply.

Ohio’s Goals:

Governor DeWine stated very clearly that health orders may be lifted once we reach below the level of 50 new cases per 100,000 people. Right now Ohio is around 100-200 new cases per 100,000. We are trending downwards and in the right direction, and now is not the time to let off the steam. We need to carry forward full strength ahead without letting up, and God willing, this can be behind us by summertime.

To sign up for the vaccine, or to read more about it and FAQ’s please visit gettheshot.coronavirus.ohio.gov

There is light at the end of the tunnel, though the tunnel is more than bumpy

salaamcleveland@admin — Thu, 17 Dec 2020 13:18:17 +0000

With the start of vaccine distribution for COVID-19, there is light at the end of the tunnel.
We commonly hear that the vaccine came out too quickly to be trusted, or that shortcuts were taken. This, like most misinformation, is part truth, and majority falsehood. The timeline was quick, due to the urgency and deadliness of the pandemic. And shortcuts were only taken in bureaucratic areas and financial areas where shortcuts were possible. The bigger and more important truth is that absolutely no shortcuts were taken when considering and assessing the safety and effectiveness of the vaccine in humans.

And even though there is light at the end of the tunnel, and we are working hard to combat misinformation, the tunnel that is left to traverse is more than bumpy. We are seeing surges of covid-19 spread, with ICU beds nearing capacity. Widespread shutdowns are once again popping up around the nation. Our healthcare workers are also being stressed even more than they have been since the pandemic began, living most of their waking hours in PPE. And to increase the stress, staffing is being stretched. In fact, with coronavirus being in our communities, a major problem is the lack of medical personnel who are out with the virus more so than available space and resources such as ventilators, etc. What this will mean is we have more death to deal with over the next few months. And even with better treatment of covid-19, daily deaths are now the highest they have been in the state, along with hospitalizations and number of cases. This means upcoming scenes of loved ones passing away, morgues filling up, and resorting to ordering refrigerated trucks to store our deceased loved ones. I’m not saying this to instill fear or to be scary, because the truth remains, that it is scary.

Around the nation, without relief, we see millions of Americans on the verge of eviction (as of writing this on 12/16/2020, congress is inching closer to making a deal on a roughly $900 billion relief package). We see crime inching upward, and desperation starting to set in. Access to food and housing security is starting to dwindle, and many are in the cold as furnaces stop working (as one resident has stated, what is the use of making rent if only to sit in a cold apartment’). And while we look out for our neighbors, we must also look out for our families by taking precautions. And precautions work.

Flu hospitalizations compared to a 5-year average are down, though we are not out of the weeds yet (In Ohio, January-March are the months with the highest hospitalizations due to flu). This is seen as a by-product of the covid precautions we are taking. This includes masks, social distancing, and keeping gatherings to a minimum. There are a lot of differences between the flu and COVID-19, such as incubation period, how long you are infectious, and how easily it spreads before knowing you have an illness, etc, which explains why COVID-19 is spreading at the rate it is while flu numbers are currently less than the 5-year average.

So yes, with the vaccine, there is light at the end of the tunnel, but until there is the widespread availability of the vaccine, we must keep up the fight by limiting gatherings to household members, masking up, and keeping away from places where you will be in close quarters and contact with those outside your household, unless necessary.

Sources:
coronavirus.ohio.gov
odh.ohio.gov

Putting your phone down and taking a break

salaamcleveland@admin — Fri, 06 Nov 2020 14:01:40 +0000

When data overload can lead to increased anxiety and decreased attention spans.

Coronavirus. Politics and elections. Masks. Social Media. Holidays filled with joy and social distancing…and short attention spans with an overload of data.

On average American adults spend more time looking at a screen than they spend sleeping. And naturally, children spend even more time in front of screens than adults. And studies show that the trend is not slowing down any time soon.

And though cell phones, computers, pads, and TVs are not bad in and of themselves, we do find overuse and too much screen time associated with lower well-being, especially in regards to anxiety and attention spans.

This week, start to give yourself a break from your devices.
Below are a few tips to help you get started.

Maintain a schedule – Give yourself an allotted amount of screen time through the day for various apps you may have.
Turn off phone notifications from apps you don’t necessarily need. A benefit to this is increased productivity and better workflow free from distractions if you must use your devices for work.
Don’t use your devices in bed and charge them away from your bedroom.
Hold yourself accountable – jot down how many times you check your phone or other devices without cause. Over time, make this number trend downward
Find replacement activities. As mentioned in previous blogs, find replacement activities and hobbies as opposed to the television or phones, ones that require attention over a prolonged period of time on a single task; this includes reading a book, landscaping, painting, puzzles, board games, DIY home improvement projects, and many more.

Wishing you the best of health.

The need for our children’s healthcare, Salaam Clinic Pediatric Day #2

salaamcleveland@admin — Thu, 24 Sep 2020 12:01:48 +0000

On Sunday, September 13, 2020, Salaam Clinic had its second pediatric day. Though the number of uninsured children has been decreasing over the past few years, we expect an increase in the fallout of the COVID-19 pandemic. Nonetheless, access to care still remains a major barrier for our children and their healthcare.

Access barriers can include poverty, costs involved with care, lack of transportation, and a lack of awareness about services that are offered.

In Cleveland and the surrounding areas in Northeast Ohio, approximately 66% of adolescents have had a wellness checkup, which is a lot lower than the CDC’s goal of 76%. As of 2019, about 30% of adolescents have not seen a doctor within the past year.

This is why Salaam Clinic is proud to offer these free health checkups for our community’s children, in a safe way that mitigates the risk of being exposed to COVID-19.

Our free clinic pediatric days are made possible by our selfless physician and nurse volunteers, in addition to a grant awarded by the Greater Cleveland Rapid Response Fund.

To request an appointment, please call 216-505-9800. For more information or for news on upcoming events, please subscribe to our newsletter.

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5 Simple Steps To Stay Healthy While Working From Home

salaamcleveland@admin — Fri, 11 Sep 2020 12:50:43 +0000

For most of us, the change in lifestyle brought upon by the COVID-19 pandemic hasn’t exactly been the most healthy of changes.

A lot of the errands we would traditionally do on foot and by car have been reduced to sitting in one place using a phone or computer. Our food can be delivered by a few clicks & swipes, and with a little more typing & clicking, we can write our business emails or join our conference calls, all from the comfort of a couch or a bed, and pajamas we haven’t changed out of in a week (well, hopefully not a full week).

If not all, then most of the gyms were closed in lockdowns and when they reopened, we (most of us) are still hesitant to work out at them. For the few of us who have exceptional motivation, we decided to run outside, and lift heavy items inside…for the rest of us, we decided to once again sit on the couch and scroll through our phones or tv screens to find a new binge-worthy tv show.

For the sake of our health, we need “simple” more than ever. And though simple is hardly ever truly simple, here are five “simple” tips to help you and your family stay healthy through this time of uncertainty.

Create a structure by restructuring your space

This means don’t work, eat, and sleep all in one place (your bed or couch)…Instead keep a designated space within your home for work, a space to eat, a space to exercise, a space to unwind, and a space to sleep.

Limit technology and use it to your advantage

Limit the time you spend on social media apps and news. Give yourself 15 minutes to half an hour to catch up on the news, then stop. Same with social media.
Learn a new hobby, trade, or skill by using popular video apps like youtube.

Do more exercise

You don’t necessarily need equipment to stay in shape. Even 15-20 minutes of an at-home cardio workout can do wonders for one’s health. (If you don’t have a starting point, youtube can save you once again)

Learn new recipes

It is easy to order food with all the takeout and delivery options now available to us. Meals at home are usually healthier than meals from outside, and with internet access, you have access to thousands upon thousands of healthy and fresh recipes. I suggest trying recipes from around the world, be confident with it, there is no need to be humble inside your own home. Try something you know is out of what you think is your ability and see what happens! Even if you mess up, the next time you will get better.

Take time off to relax, and enjoy the small things, mindfully.

Relaxation rejuvenates one’s self and decreases one’s anxiety. But relaxation does not mean sit down and use your phone mindlessly for an hour. Try making it a habit to do a relaxing thing and make an event out of it. For example, this may mean making a cup of tea and some snacks and sitting by a window. Or read a book…or paint…or do anything that you enjoy doing that does not involve a phone or the tv. (If you want to get crazy with it, try drinking a cup of tea and reading a book).

Syed Shoaib Z Shah MD
Chief Executive Officer, Salaam Clinic

New county specific COVID-19 orders

salaamcleveland@admin — Tue, 14 Jul 2020 16:10:36 +0000

On July 2, 2020, Governor Dewine made masks mandatory for select counties across the state. This includes Cuyahoga. The new guidance follows a country-specific risk level that will dictate as to whether masks in public are required or not.

The indicators which affect the risk level of a county include the following:

It will always amaze me at the stories that come from our clinic. If I could, I would list each patient interaction…but let me share with you one story about how we all collectively saved a life.

The patient walked in, deciding that he would have a checkup as it is free and in a comfortable location (in a community center). He hasn’t been to the doctor’s office in quite some time. His situation was such that visiting a physician was a low priority due to changing life situations and financial stressors. Our volunteer physicians were able to detect an unwanted weight loss (which is often a red flag for other problems). And after the patient had the appropriate follow up with referrals, the patient had a relative come in to let us know that we saved his life. The patient had a tumor, and without the appropriate care, he would have passed away.

There are two takeaways from this story.

New cases per capita over a 2 week period
Sustained increase in new cases over a 5 day period
Proportion of cases in a non-congregate setting
Sustained increase in ER visits related to COVID-19 over a 5 day period
Sustained increase in outpatient visits related to COVID-19 over a 5 day period
Sustained increase in hospital admissions due to COVID-19 over a 5 day period
ICU Bed occupancy, at least 80% of a county’s ICU Bed occupancy is occupied in 3 of the last 7 days.

If 4 out of the 7 above indicators are met, then those in that county are required to wear masks in public settings and failure to do so is a misdemeanor. If 6 or 7 are met, then it is considered to be a “severe” spread, and residents should stay home except for necessary supplies and services.

So what does that mean for us? It means that COVID-19 is still here. At this time we cannot pretend it does not exist, while at the same time we must collectively work for solutions to continue life as close to normal as possible to prevent further fallout socially and economically.

Although this is a daunting task, the easiest solution is to follow public health guidance and wear masks wherever necessary, regardless if the order is enforced by police or not. Please watch our video on masks below

Make a mask at home – COVID-19

Make a mask @ home – Salaam Clinic
#COVID19

Posted by Salaam Cleveland on Saturday, 11 April 2020

Salaam Clinic Updates

salaamcleveland@admin — Fri, 26 Jun 2020 16:09:09 +0000

Dear all,

Thank you for supporting Salaam Clinic. With your donations and support, you are actively saving lives by supporting safety-net healthcare in northeast Ohio.

I am proud of the work we are able to do thanks to supporters such as yourself. Since starting operations in October of 2019, we have been able to affect thousands of lives positively, treat hundreds of individual patients who are uninsured or underinsured, and we have been able to educate tens of thousands through our outreach and educational efforts.

“…you know, he wanted me to make sure you all know, that he credits Salaam Clinic with saving his life.”

It will always amaze me at the stories that come from our clinic. If I could, I would list each patient interaction…but let me share with you one story about how we all collectively saved a life.

There are two takeaways from this story.

The first is obvious, that with a simple checkup, we can save lives.
The second is not so obvious. The lives we affect are often not just the patient’s life, but that of their families as well. The patients we see are often sole breadwinners or caretakers of other family members. They often have to pick and choose between medications and doctors visits, or a paycheck. They also often have limited financial resources to use for their own care. So when we treat a patient, we aren’t just treating the patient in and of themselves, we are treating the community at large.

The reality of funding in the peri and post COVID-19 era

Two main challenges occur during a pandemic when it comes to healthcare organizations, especially nonprofit healthcare organizations.

One is healthcare itself. Resources can run out or are forced to be reallocated. In our clinic’s case, we had to shut down physical visits for a time and turn to continued care through telehealth services, while at the same time ensuring safety for all for restarting physical visits (which have begun as of now).

The other is fiscal. Our fundraising took a huge hit. We expected $150,000 in funding for the clinic project this year; however, due to canceled fundraisers, events, and paused grant-seeking activities, we achieved around half of that.

Not all is bleak, however, and we have reason to be hopeful for the future. We received our first grant of over $15,000. The Cleveland Foundation and the rapid response fund granted us $25,000 to restart physical visits and expand telehealth and electronic medical records. Though this is far from the first-year goal of $150,000, it can not be stressed enough that this amount was unexpected once the situation changed. That is to say, we expected only $10-15,000 to come in during the pandemic and shortly after without any fundraising events, and we achieved beyond that. We are working hard on a new fundraising plan and renewed grant seeking efforts, with exciting new partnerships starting to form and take shape in this “new normal” world.

Salaam Clinic plans for the future:

The long term goal has always been a tertiary care hospital with an affiliated teaching institution. Our community deserves it. And we owe it to the larger community as a form of commitment at the highest level of professionalism and education; from our organizations and communities to our neighbors. The steps to get there are many, but attainable over a period of time of sustained growth and fiscal responsibility.

In the medium term, we are still looking for our own standalone clinic with a staffed provider and administration, alongside a team of volunteer physicians, nurses, physician assistants, students, and others leading the way. We are also looking to expand the free clinic program to other nonprofit organizations and institutions such as other area mosques, community centers, and other nonprofit centers, etc.

In the short term, we are creating exciting new partnerships with local hospitals and other healthcare-related nonprofits, while planning to extend our free clinic project to other areas. We also have some exciting, innovative, and “out of the box” type relationships that we hope will blossom soon.

Once again, we must sincerely thank you for supporting Salaam Clinic and to help save lives. Your support is everything to us and to the patients we serve.

Syed Shoaib Z Shah MD
Chief Executive Officer, Salaam Clinic

Support the organizations working to improve conditions

salaamcleveland@admin — Fri, 12 Jun 2020 14:22:10 +0000

As the conversation of systemic racism, and implementing change becomes a focus of both our community and America at large, it’s of utmost importance for us to support those who are in our community fighting these daily challenges. In fact, the time to take action has always been ‘now’, whether it is yesterday, today, or tomorrow. And taking that action requires dedication, sacrifice, and endurance.

We need to help those in our community who make the sacrifices that are needed to address these issues. Those who are trying to build organizations, institutions, and communities whose systems are reliable and just. This means the work and the mission carries on undisturbed, regardless of any problems, in a way that sustains itself and sustains growth, that will then do more good. And we must support those who try to build a new culture around our institutions and organizations, that can bring sustainable advancements to our community and to those around us by directly facing the challenges before us.

We must support projects and organizations like Salaam Clinic, who hit at the heart of the effects of systemic racism, of which one is healthcare and poor health outcomes for the marginalized communities in our city.

Cleveland City Council declared systemic racism a public health emergency on June 5, 2020. It is a known fact that systemic racism has led to poorer health outcomes for whole communities, especially in the predominantly black neighborhoods of Cleveland. This in turn affects families not just in personal health, but also in other areas of life, such as financial and economic stability, housing and neighborhood environments, education, social support systems and community, and of course the healthcare systems themselves. We call these the “social determinants of health”. The poorer the social determinants, the poorer the health outcomes. In short, healthcare is weaved into every layer of society itself. And with systemic racism ingrained in some of our institutions, we see those poorer health outcomes among black and other marginalized communities right here in our beloved city.

This is why Salaam Clinic exists. To bring equitable access to up-to-date and evidence-based care, in a culturally competent manner to the uninsured and underinsured patient population. A patient population that historically has been designed to be affected the most by systemic racism.

The road is long and arduous, but by committing help towards organizations that directly change situations, organizations like Salaam Clinic, you are committing help to a whole community who has felt the effects of systemic racism and systemic injustices. This help will affect whole generations, continuously, in a positive manner. You are helping your community directly combat the effects of systemic racism, and this help goes beyond any statements or any proclamation. We are not the solution, but together we can be a part of a broader solution to rectifying systemic injustices.

Syed Shoaib Z Shah MD
Chief Executive Officer, Salaam Clinic

Ohio Reopens under threat of COVID-19

salaamcleveland@admin — Thu, 14 May 2020 18:01:22 +0000

As Ohio reopens, we must remember to remain safe, and we must remember that COVID-19 is still very much around. While we undergo the lengthy process of reopening Ohio, it may be easy to become absentminded or inattentive to the world around us. Life can, and will, get back to normal as long as we remain playing it safe and do our part in preventing more spread of the disease.

Though the restrictions are easing, the same precautions we have been taking are still very much in play. This includes keeping a social distance, keeping gatherings of individuals to less than 10, wearing a mask when in public, and not needlessly going to places a lot of people may gather at once.

Ohio led the nation in following the advice of healthcare and public health professionals in shutting down quickly once COVID-19 arrived. And due to the quick action of Governor Dewine, Ohio Department of Health director Dr. Amy Acton, and others, we were able to collectively slow the spread of the disease to a manageable point. But among the good news, exists some not so good news.

Testing still is not widely available for the general public, there is no vaccine or cure for COVID-19, and there still remains the ever-looming threat of a full-on outbreak as we reopen. In addition, health disparities have magnified, disproportionately affecting those with poor social determinants of health. Domestic violence is on the rise, as is alcohol and drug abuse, affective disorders such as depression, and in the near future, we may see trauma-related behavioral health issues arise in healthcare professionals, as well as in the general population. These increases in behavioral health conditions coincide with an increase in demand for services such as online therapy and telepsychiatry. Another ill-fated side effect of the pandemic has been hesitation to visit emergency rooms during medical emergencies such as stroke and heart attacks.

If facing a medical emergency during this time, please call 911, and do not hesitate to go to the emergency room.

Health is connected, shutting down in order to prevent the spread of a deadly disease in COVID-19, which leads to an increase in other problems such as drug and alcohol abuse, domestic violence, and gaps in routine healthcare which may lead to preventable emergency room visits. As we reopen Ohio safely, we will also be reopening access to routine healthcare. It is a fine balancing act between being safe and sound and preventing further disease (COVID-19 or others), and being reckless and causing a COVID-19 outbreak which may shut us down again. It comes down to us, and how safe we play the game.

Syed Shoaib Z Shah MD
CEO Salaam Clinic

*Tips on keeping safe and healthy

Continue practicing Social distance and limit gatherings to up to 10 people.
Wear masks in public and wash hands frequently.
Disinfect frequently touched surfaces daily, hourly if touched by many people.
Ensure workplaces are following best practices and report any violations to the Ohio Department of Health
Take a time out from News outlets and Social Media each night