Salaam Clinic – 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.

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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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

Stay at home at least until May

salaamcleveland@admin — Mon, 06 Apr 2020 13:07:17 +0000

Key COVID-19 pandemic updates

Stay at home order extended to May 1
Continue hand washing and social distancing
Consider wearing face masks or cloth face coverings if you must go out to public places such as grocery stores in order to help slow the spread of disease
Anyone coming to Ohio from out of state should self-quarantine for 14 days

Dear friends,

On April 2, during his daily press conference, Ohio Governor Mike Dewine extended the stay at home order until at least May 1. This is a good move.

During the last blog post we wrote on the subject (on March 9, 2020), COVID-19 had not yet hit Ohio, and the world health organization had not yet labeled it a pandemic. Now both of those have changed, we are in the middle of a pandemic that very much affects northeast Ohio. At the time of writing this, in Ohio, we have 3,000 confirmed cases and over 50 deaths due to the disease. The United States has seen over 240,000 confirmed cases and 6,000 deaths due to the virus at the time of writing this. At the time of publishing, those numbers are assumed to be drastically increased (keep in mind the number of actual cases is greater than confirmed cases). The disease is also community spread, which means we can suspect over 100,000 local cases. It also has a lengthy incubation time, is highly viral, and can be spread through respiratory droplets as well as through touching surfaces and subsequently touching our faces. COVID-19 can be spread by asymptomatic individuals (asymptomatic means someone who has the disease but doesn’t have a fever or headache or any other symptom). It is important to understand that a healthy person with relatively minor symptoms can infect someone of a similar background and that the disease may overcome the second person and lead to their death. And the worst has yet to come.

According to covid19.healthdata.org, the peak hospital resource use will be on April 15, 2020. And in the USA, we are under-resourced by about 88,000 hospital beds, 20,000 intensive care unit beds, and have a need of around 32,000 ventilators. We see cities transforming facilities such as expo centers and arenas into makeshift hospitals. We’ve seen the viral videos of healthcare workers working without necessary protective equipment, and we’ve seen the news of the disease spreading rapidly throughout institutions such as cruise ships, long term care and rehab centers (including nursing homes close to home in Parma and in Aurora).

Here in Cleveland, we see our physicians rapidly being trained for critical care, medicine, and emergency medicine in order to meet the demand once the ‘surge’ of COVID-19 cases hits (at the time of writing this, projections show the expected surge to occur within another 2-3 weeks). And for the most part, we see an educated public who understands the severity of the pandemic at hand.

Is this an overreaction? Definitely not. President Donald Trump acknowledged that we may see 100,000-250,000 deaths in the United States due to COVID-19. Over 30 states plus the District of Columbia are now following a partial or full shut down and stay at home orders. In fact, we, as healthcare professionals, wish that once this pandemic ends (and it will end) we can look back and have it seem like we overreacted. That means we did our job and we saved those lives. Nonetheless, we continue to be prepared for worst-case scenarios.

So what can we collectively do to help?

We can stay at home. We understand the economic struggles that come along with this, but what we know is that it is much better to go through an economic struggle than to lose a loved one.

We can also limit our trips for essential supplies like a trip to a grocery store or pharmacy. We can make use of curbside and delivery services for essentials like groceries and medications. And if we must go out, place some sort of face-covering on, whether a medical mask or even cloth (though we suggest saving medical masks for the hospitals and clinics). We also have to collectively look after the elderly and aid them in getting their necessary supplies while they ride the pandemic out at home. We can make sure our loved ones don’t get lonely by calling and video conferencing with them. And we can finally take the time at home to cook something new, read a new book, or learn a new trade. To be able to see the least amount of disease and death during this pandemic, we must be smart, and play it safe, for just a few more weeks.

Syed Shoaib Z Shah MD
CEO Salaam Clinic

* If you have symptoms of COVID-19 such as difficulty breathing, fever, headaches, or other flu-like symptoms, please call your healthcare provider or any of the community hospital or health department COVID-19 hotlines for further information and next steps

Coronavirus Covid-19

salaamcleveland@admin — Mon, 09 Mar 2020 12:14:46 +0000

Coronavirus disease 2019 (COVID-19) is not the flu. It is worse.

When news of COVID-19 first broke, most in the medical community understood the gravity of the situation. The disease that is believed to have started in Wuhan was alarming for several reasons. For one, the disease is highly contagious and can spread rather easily, suspectibally through respiratory droplets (our breath), and through contact with contaminated surfaces and subsequently touching our faces. And more importantly, reports from China were highlighting the disease’s high fatality rate.

The virus itself is called SARS-CoV-2, and the disease it causes is called COVID-19. The fatality rate for COVID-19 is said to be anywhere from .5-1% all the way up to 3.5%. The danger increases with age, with a fatality rate of 8% at the age of 70-79, and at 14% for those above the age of 80 (compared to the flu fatality rate of 0.83% for those over 65) In any case, the lowest estimate places COVID-19 at approximately five times more deadly than the seasonal flu, and that number increased with increased age.

At the current moment, we do not fully understand SARS-CoV-2, and do not know if it will be seasonal, such as the flu that tends to come in winter time, or if COVID-19 will be year round. The medical community is also working hard to understand various facets of the virus such as mutation rate, the full clinical picture of the disease it causes, and if a vaccine can be produced.

At the time when news about COVID-19 first came out, we remained hopeful for containment of COVID-19 while at the same time learning about the disease and preparing for the fearful reality that the disease may spread.

Two months later that fear is a reality. The disease has had notable outbreaks in Italy, Iran, and South Korea. It has now spread to over 80 nations throughout the world, including community spread the United States (community spread . At the time of writing this (March 6, 2020), in the United States there have been 10 deaths due to the disease and 99 documented cases, with a potential outbreak at a nursing home in the Pacific Northwest. Sales of personal protective equipment such as gloves, masks, and gowns from suppliers have been put on restricted order or on hold all together. Cases of community spread, that is cases of the disease without a known cause (such as traveling to an infected area or known contact with someone who is infected), have now been seen in the United States, and cases have popped up on both coasts, with thousands under self quarantine.

With spread of the disease, also comes the use of resources at the same time. There may be a lot of absences from places of work, schools, and other places of gatherings. Hospitals and emergency rooms may become overfilled and overloaded. Other emergency medical services, police forces, and transportation industries may also be affected.

To help prevent spread of the disease, wash hands frequently with soap and water, and disinfect surfaces with a good disinfectant with bleach, such as Lysol disinfectant or similar. Keep away from public spaces if you feel symptoms developing such as cough and a fever with difficulty breathing, and contact your physician or healthcare provider as soon as possible, and limit travel to areas that have known outbreaks or risks. The question is no longer “if” the disease spreads to us in Northeastern Ohio, but “when”.

Syed Shoaib Z Shah MD
CEO Salaam Clinic

To learn more on how to keep safe from COVID-19, please refer to
https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html

Sources: Center for disease control, cdc.gov, Chinese center for disease control