Electronic Health Reporter

One Texas physician leads a global healthcare mission from Moscow, supporting thousands of poor and underserved Russians, while maintaining a full-time practice in Midland, Texas.

Part 1 of a two-part series.

For more than 10 years, Dr. David DeShan has been traveling between Midland, Texas, and Moscow, Russia. DeShan is a physician and a missionary — serving patients at Midland Women’s Clinic in Texas and providing needed prescriptions, exams or treatment to hundreds of indigenous Russians.

The contrasts between the two worlds in which DeShan lives are stark. Here in the United States, he’s connected to his patients through electronic health records and secure web-based practice portals that allow him to communicate, share records and provide consultative services. Likewise, his patients can connect with him through any web-enabled device from anywhere in the world where there’s an Internet connection. His practice, which is building a new state-of-the art clinic, provides 21^st century medical care.

In Russia, he is the president of Agape Unlimited, an international Christian medical mission program.  Through Agape he visits people that are often secluded in very remote villages far removed from first-world creature comforts. Sometimes, as part of his medical mission work, he travels days into the lost wilderness of one of the world’s most vast and remote regions.

Four to five times a year he ventures outside of Midland, Texas, for up to four weeks on each trip. The majority of his travels are to Moscow where he oversees the nonprofit and its network of clinics. His involvement with Agape includes both the oversight of the organization in addition to traveling to the countryside to administer medical care. Despite being half way across the world he is able to effectively take care of his patients and colleagues in Texas.

In 2002, when Dr. Deshan first started his missionary work in Russia, he was completely detached from his practice in Texas. Needing to reach his patients, he eventually secured a satellite phone. Today, with the help of his EHR, he is fully connected irrespective of his location. Dr. Deshan has access to patient charts and tracks their progress remotely. Occasionally, he will use the information from the EHR and Skype his clients if a face-to-face conversation is warranted. Either way, when he returns to his patients in Texas, he never misses a step.

“None of what I’m now able to do through the ministry and the practice would have been possible without our EHR,” Dr. DeShan said recently. “I run the ministry over there, provide medical education over there, conduct outreach in Siberia and bring doctors here to the U.S. to train. The EHR really allows me to stay connected, in a fashion not available just a few years ago. It’s nice to have the opportunity to live in two worlds at the same time, and the EHR technology really makes it possible.”

Empowering an impassioned dream

Being a full-time physician and president of Agape is highly demanding and Dr. Deshan works up to 90 hours a week.

He has been on 14 expeditions into central Siberia and has made another 16 trips to Russia working in Moscow for a total of 30 trips since 2002. Outside of the expeditions to the countryside he does not practice medicine in Russia. “My role with our organization is to administer, encourage and enable our Russia staff to do the work and to invite others to join us,” DeShan said. “I have also been spending more time in medical education working with the medical schools and hospitals in Russia.”

Healthcare is different there than in the United States, as would be expected. The system is more socialized and less open compared to the U.S. Technology is also limited and use of such tools like EHRs are minimal. In fact, DeShan says there are just a few EHR-like systems in place in Moscow at elite practices.

Each workday, he logs in remotely to his EHR, reviews the pap smears, lab work and patient calls that need his response. His nurse highlights any abnormal mammograms and scans them into the system for his review, and he reviews the physician assistant encounters with his patients. The only things remaining when he gets back home is to go through the mail and review the bone density exams and normal mammograms, usually taking about 30 minutes.

“The EHR is truly what enables me to work in Russia yet still stay caught up. Since I can do this from Russia, it greatly reduces the burden on my partners and most of my patients really don’t miss me while I am gone because everything is still answered in a very timely fashion,” DeShan said.

From Midland to Moscow

DeShan said he’s always been drawn to serving his faith through medicine.

“I’ve always been very interested in Christian outreach, and I see medicine as a tool to this end. I wanted to find an organization for Christian doctors and I went to Russia once and kind of got hooked. I just felt like I was supposed to do more. It called to me,” he said.

He leads a handful of international volunteers from Germany, Canada and the U.S. and a staff of 10 in Russia working on the ministry and 40 working at Agape’s clinic. About 50 serve on expeditions each year. Despite resources, these folks see more than 365,000 patients a year at the group’s clinical network throughout Moscow and provide more than 2,000 pairs of eyeglasses to people throughout the country. Outside Moscow, more than 70,000 consultations have been given since DeShan became involved with the mission.

Though Russia is considered a first-world country, more than 75 percent of its rural residents don’t have plumbing.  Without running water, medical infrastructure is not just impossible, it is a wishful hope.

“There’s a tremendous need for care, especially in rural areas out there, for medicine, and things like glasses,” he said.

What is Agape Unlimited?

Agape goes where no others go, taking action to improve the health of people who may have never seen a physician. This takes the organization to remote areas in Siberia and beyond, as well as to Moscow, meeting the needs of the medically underserved in the capital city, DeShan said.

Since 1993, Agape has been providing medicine, medical consultations and assistance to those who have little or no access to medical care in Russia. Agape sends teams to areas where the need for medical help is urgent , focusing on both the most remote and isolated people in the Arctic and Siberia, as well as the poor and overlooked in rural and urban areas,.

Agape’s medical expeditions always work in conjunction with a church within the region; this way the work continues in the community after the medical missionaries leave.

Agape provides everything to its patients for free. There’s no cost for the consultation, for medication or for the glasses received. Because of the care provided for the folks in the rural areas, sometimes this is the only medical treatment they’ll receive for years. Word of mouth spreads and people come for miles. In one instance, a group of patients rode on a reindeer-pulled sleigh for more than 24 hours for a visit with an Agape physician.

For more about Agape Unlimited, visit www.agaperu.org.

Read part 2 of this story, “Into the Wild: Agape Unlimited Brings Medicine and Treatment to the Most Recent Regions on Earth.“