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ABC NEWS video of Dr. Tilahun's life saving diagnosis.

Swedish Covenant WELL INFORMED Magazine, A Second Opinion, A Second Chance. (PDF download)

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JUF NEWS Magazine, Sinai Touhy Health Center, oasis of care

ABC News report of Dr. Tilahun's life saving diagnosis.

One doctor says a life saving diagnosis is also wake up call for Americans to start thinking globally when it comes to illness.

Rahel Taye has a smile as big as her appetite. But a year ago her life now would be hard to imagine. The 26-year-old from Ethiopia had been battling mysterious, crippling pains in her abdomen for months. "Really, really bad, bad pain," said Taye.
She was in and out of hospitals. No one had an answer for her but her health kept deteriorating. She finally ended up at the emergency room of a prominent Chicago hospital where she says doctors delivered the devastating news: that she probably had ovarian cancer. "The doctor told me she had two months to live," said Solomon Melesse, Taye's husband. She was advised to have surgery which meant she might never have children. Rahel and her husband were stunned and in disbelief. "I know they are wrong. I feel it," said Taye. Rahel trusted her instincts and was recommended to Ermias Tilahun, a specialist in internal medicine at Swedish Covenant Hospital. It was April of 2007. By then, Rahel was in very bad shape. "She was less than 80 pounds when I saw her," said Dr. Tilahun.

Like Rahel, Dr. Tilahun wasn't convinced it was cancer. He had a hunch as a result of working with other immigrants and being Ethiopian himself. At the time, Rahel was only 26, a very young age for ovarian cancer. He ran several tests and then he discovered some white looking nodules all over the inside of her abdomen. That led him to suspect something no one else had; tuberculosis. "After listening to their story, she migrated from Ethopia," said Dr. Tilahun. "The probability for TB goes up."

Tuberculosis is an infectious disease caused by a bacterium. It primarily attacks the lungs but doctors say the disease can affect other organs and tissues. That's apparently what happened to Rahel. She was diagnosed with peritoneal TB, an unusual infection that some doctors may not know can mimic ovarian cancer.

Rahel was started on anti-TB medications. Within two weeks, they say she was eating and smiling. Since then the couple hasn't looked back.

"Now we can have a family and live to have a family and kids," said Rahel.
Dr. Tilahun says Rahel's case is a perfect example of why U.S. doctors need to start looking beyond America's borders in diagnosing illnesses.

As more people travel, different forms of disease are making their way to this country. TB is just one of them. In this case, a late diagnosis almost cost Rahel her life.
"If we didn't consider TB for her she would not be around," said Dr. Tilahun.
Rahel is now going to school and planning to have a family.
And even though it's been more than year and half, the gravity of her ordeal is still overwhelming.

Dr. Tilahun says Rahel's form of TB was not highly contagious. He is not sure how she got it but suspects she may have picked up the bacterium after drinking raw milk.
He also says that if he had used the gold standard test for TB which takes about four weeks, Rahel probably would have been dead. Dr. Tilahun says instead he used a test not well know here in the U.S. which got him results within a couple days.

For more information:

Dr. Ermias Tilahun
Swedish Covenant Hospital
Internal Medicine
2740 W. Foster Ave.
Chicago, IL

JUF NEWS, Sinai Touhy Health Center, oasis of care, July 2003,
written by Staff Writer, Wendy Margolin


IN A TYPICAL DAY AT The Sinai Touhy Health Center, Dr. ErmiasTilahun, the Center’s medical director, sees more than 25 patients, who originate from a range of 44 different countries.  He speaks so many languages in a single day that once in a while, he sees a Hispanic patient and starts speaking Russian.  “It’s like flying around the world,” jokes Tilahun, who comes from Ethiopia.

Sinai Touhy Health Center, operated by Sinai Medical Group (an affiliate of the Jewish Federation of Metropolitan Chicago), was established in the 1970s to provide health care and social needs for Jewish immigrants from Eastern Europe.  The clinic provides health care services in a multilingual cross-cultural environment, making patients feel comfortable at a particularly vulnerable time in their lives.  Previously, Jews received care directly from Mount Sinai Hospital, the only hospital serving this population at the time.  However, when the Jewish population migrated farther north to the West Rogers Park area, the Sinai Touhy Health Center was established.

Beginning in the early 1990s, when the Hebrew Immigrant Aid Society (HIAS) sponsored refugees from Bosnia, the Center expanded its services to include them.  Though today patients come from a variety of different countries, the majority of the individuals the clinic serves continue to be from the former Soviet Union (FSU).

With a mission of providing efficient and compassionate health care, Touhy Health Center boasts a clientele of some 24,000 patients-- many of whom are refugees or are indigent.  Coming from countries like the FSU, Sudan, Iran and Ethiopia with little or no knowledge of the English language and the American culture, their first encounters with the overwhelming newness of a foreign culture bring nervousness and distress.

But the clinic serves as an island in a sea of frustration.  Its staff is mostly made up of immigrants, many of whom were once patients.  Together they speak multiple languages in order to better serve their clientele.  But language is not the only knowledge necessary to serve the patients.  “Every country has a different cultural way of approaching medicine,” says Tilahun.  “My approach is based on cultural context.”

In his six years at the Health Center, Tilahun has become increasingly familiar with the different cultures he encounters.  When approaching a patient from the FSU, he knows to ask if they are using unconventional treatment, like garlic, in addition to the medicine he prescribes.  Knowing that the husbands of his patients of Arabic descent are typically making all the decisions for their wives, Tilahun tries to establish rapport and build the women’s confidence.  With other patients of certain cultures who have no history of understanding of preventive care, he must convince them of the importance of basic medical care, such as mammograms and immunizations.

Tilahun’s sensitivity to his patients is mirrored by that of the other doctors, medical assistants, and staff at the Touhy Health Center.  They focus on all of the patients’ needs, not merely their medical care.  When an immigrant first comes to the United States, he or she must have a general medical screening examination within a limited number of days and follow-up care for nine months, and in the many cases these individuals remain long-term patients of the clinic.  The clinic provides them with care that is unparalleled by any other medical environment.  At times, when patients are elderly or in need of transportation, staff members go so far as to transport them in their own cars, or the physicians make house calls.

Knowing that they are in need of much more than just medical care in order to acclimate to the American culture, the clinic’s staff provides new patients with lessons from a book, “Health the American Way,” published by the Jewish Federation.

The care the staff provides is so personal and extensive that many patients will call to share their simchas or stop by the clinic just to say hi.  “The patients become friends to us and express all their feelings to us.  They know us personally,” says Aleksandra Zusis, a receptionist at the clinic.

The clinic’s unique approach to public health screening and primary care in a culturally sensitive environment has made it a national model  Medical providers from other cities, states, and even countries visit the clinic on Touhy to observe its operation.

The Touhy Health Center operates as a regular clinic serving patients with private health insurance and Medicare, and hopes to do outreach attracting Jews from surrounding communities.  However, based upon the belief that quality health care is a right, not a privilege, a significant portion of the care at the Sinai Touhy Health Center is provided for little cost.  Many of those with no health insurance receive medical services for 50 percent and 60 percent of the cost.  Those patients under a certain income level pay on a sliding scale system where expensive medical procedures, prescriptions, and even surgery are provided nearly free of cost.

The Jewish Federation provides an annual operating grant to Mount Sinai Hospital, a portion of which goes to the Touhy Health Center.  In addition, the clinic received several priority grants from JF, which help underwrite a portion of the costs of free prescription drugs, a geriatric social worker, and mammograms and breast care education.  The center also receives grants to serve refugees from the Illinois Department of Public Health and Human Services.

Because of reduced funding from the government due to a drop in the number of refugees coming to the U.S. since 9/11, the clinic’s financial health in the future will be more and more dependent upon the members of the Jewish community who embrace the clinic.  Nonetheless, the devotion of the Sinai Touhy Health Center’s staff will not be forsaken; it is an obvious requirement of their job.  “We’re dealing with refugees with post-traumatic stress and all the attitudes that go along with being a refugee,” says Tilahun.  “If we don’t approach them with open arms, we will get nothing out of them.”

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