Healthcare Equality and the Butterfly IQ

Oda's new Butterfly IQ, a revolutionary portable ultrasound technology, is currently one of 3 in the country of Nepal. We could not be more excited. We can never overstate that the Oda Foundation clinic's level of healthcare, for a population this marginalized and impoverished, is completely radical - and now, even more so.

Over Oda Foundation's 7 years, we have shifted from a "scattershot" clinic approach (supplying medicines, often to more extreme cases), to bringing in more technical staff and focusing on preventative care, global health research, and generally providing resources and health-seeking behavior counsel - more similar to the role of a primary care physician. Crucial to Oda Foundation’s mission, we have worked hard to develop partnerships with the Nepali government, allowing us to bring in more clinicians, finance a new Birthing Center, and provide sustainable support for this work.

That said, we still do it all - countering AMR (anti-microbial resistance), delivering children, developing a birthing center (under construction), and providing life-saving care for extreme cases of infection or undiagnosed ailments. Explains Chief of Staff Narendra Bogati, "The Oda Foundation clinic is perceived as second only to the District Hospital. Patients are willing to walk for three hours and bypass other health posts."

Even with the highest-quality clinical staff, our clinic is primary care (in layman's terms, no surgery) and still in a deeply remote location: hours from the nearest road, and with inconsistent access to internet. Now with Butterfly IQ, we can provide detailed health information with confidence for a host of complications - heart conditions, potential kidney stones, pre-natal and ante-natal concerns, and more.

We are beyond thankful to the many hands who have contributed to the Butterfly IQ - and to all of the clinic happenings in general. ""It is a privilege to be using this," says Clinic-in-Charge, Dr. Prasana Khatiwoda." Moving forward, we have 3 staff members fully trained on ultrasound, with CMA Sarita Singh as our lead technician. We are now at work with training all staff on how to use the device and integrate ultrasound technology into our clinic practice.

Explains Clinic-In-Charge, Dr. Prasana: "Our very first case with Butterfly IQ is a perfect example. Before when we had a case like this, where their back is hurting, and there's a history of frequent burning urination, we had no way to know is there a kidney stone or not. We refer, and that's a huge expenditure and time spent for them - and people are already so impoverished, so this is truly a hardship. We had a patient with classic signs and symptoms of stone, and I was thinking, this is a referral. Then I realized: We have Butterfly IQ. We can know this for certain."

The Butterfly IQ made it to Oda via a team effort between Director Nick Kraft, prior Health Fellow Sarah Helms, student-researcher Hannah Wilson, and support from Butterfly IQ itself. "Hannah, a classmate of mine in undergrad, had the idea of getting a portable ultrasound out to Oda. When the stars aligned that I would head back to Oda for a few months, and Hannah would come to do some agriculture research, we got serious about finding a way to make it happen," Sarah explains. "In many ways, it's just a refined tool, right? It helps clinicians do their work. But to me, it certainly represents why Oda Foundation exists in the first place - people in Oda deserve quality healthcare and deserve not to unduly suffer. And because women's healthcare has different requirements than men's healthcare, having an ultrasound on the ground shows that women's healthcare is equally catered to. I want it to be normalized that women deserve high-quality healthcare, and when possible, that includes assurance of safety during pregnancy with the standard of modern healthcare."

At the Oda Foundation clinic, the Butterfly IQ has already been used for several antenatal visits, kidney stone concerns, and a few stomach-related cases. "The Butterfly IQ makes sense for renal stones, anything acute in the abdomen, appendicitis versus gastritis cases, and obviously pregnancy and women's healthcare," says Dr. Prasana. In one case, we had an antenatal visit, and then the woman delivered at the clinic a few days later. With 50% of women still giving birth at home, and high infant and maternal mortality rates (20% of women in Kalikot have a child die before age 5), developing accessible women’s healthcare is paramount.

"As the Clinic-in-Charge, it's scary when a woman shows up to deliver without any ultrasound documents. We still advise that women go to the District Hospital for an ultrasound, as this is the government-mandated system and they receive a stipend for prenatal visits, but for the many women that can't or won't go, we have something available to make sure we don't end up in an emergency situation that was preventable."

She continued, "We have had about 17 deliveries this year, and this is while the new Birthing Center is under construction. With the Birthing Center, this will increase. We would have used the Butterfly IQ for all of these! I chose to refer a patient to a larger hospital because I was unwilling to take a risk without knowing the placenta and cord location."

In a location like Odanaku - 3 hours from the nearest road, and at best, 2 additional hours from a hospital - a portable ultrasound meets the need for critical care. As Dr. Prasana described, "Places like this, you can't get a full-scale ultrasound. This, you can take it in the field like a thermometer. And we can teach so many people how to use it. We can even introduce it in camps [Health camps are set up in rural areas, where doctors from larger urban centers come to treat those usually without access to a specialized physician] and do a special station for heart screenings or for prenatal scans."

Since 2013, Oda Foundation clinic has been here to serve Kalikot. With an increasing patient base - now exceeding12,000 patients a year - we are grateful to all who have supported the clinic's journey. Whether it's facilitating the women's cooperatives, developing systems to support youth, or providing healthcare- with your help, we make the world a bit brighter, every day.