Eight steps.
No magic.
A full walkthrough from the moment a donor’s Stripe payment clears in Dallas, to An elder patient walking home from Warri Central Hub with his refilled hypertension script. Every layer of the system is named, costed, and defensible.
From gift to medicine in hand.
48 hours
A gift lands
A donor gives — $50 fund-a-visit, $149/mo family sponsor, or a general Pillar 01 gift. The transaction clears Stripe and a program credit is posted to the Iwere Care budget the same day.
A patient requests a consult
An elder patient calls Warri Central Hub (or his CHW Omoye), or his daughter in Dallas books through /iwere-care/patient. the hub nurse Okoye pulls the chart, triages, books the slot.
Vitals + intake
At the hub, a community health worker takes vitals, allergies, medication reconciliation. The chart goes to the physician queue. Patients who arrive walk-in follow the same flow.
Starlink + solar stay up
The hub is Starlink-uplinked (100+ Mbps, rain-resilient) and solar-battery powered (15 kWh on-site). Edge-compute node bridges video through connectivity dips. WPA3 + VPN.
Video consult begins
A diaspora physician picks up — A volunteer diaspora physician in Houston, A volunteer diaspora physician in Oakland, A volunteer diaspora physician in Austin, or the next available MD. Itsekiri-language interpretation is on by default. CHW stays in-room.
Diagnosis + Rx
SOAP note logged. Prescription signed to the formulary. Chronic case? A 90-day care plan is attached and scheduled for monthly review. Red flags (stroke, chest pain, sepsis) route to ambulance dispatch immediately.
Omadino Pharmacy dispenses
Generic-first. The Rx is transmitted directly to Omadino Pharmacy (our dispensing partner). If the patient is in a remote riverine village, the CHW carries the meds on the next boat out.
48-hour CHW call
The CHW phones the patient at 48 hours. Adherence, side-effects, any new concerns. Outcome logged. Aggregated (anonymized) into the Iwere Care registry so donors, physicians, and the board can see the real picture.
Four layers keep quality consistent.
Top-down, auditable.
Infrastructure
Starlink uplink, 15 kWh solar + lithium, edge compute, WPA3 VPN. Zero data unencrypted. 24/7 even when NEPA is down.
Physician workflow
Login → accept consult → SOAP note → Rx → CME. 15 minutes median. Platform rotates load to keep MDs at exactly 2 hrs/week.
Patient journey
Walk-in or CHW-booked → vitals → video → Rx dispensed → 48-hr follow-up. Always escorted by a CHW who speaks the patient’s language.
Clinical protocols
WHO primary-care adapted to Niger Delta epidemiology. Nigerian MoH-aligned for maternal/child. AI-triage score for escalations. 90-day chronic plans.
When a consult becomes an emergency.
Rehearsed monthly.
Iwere Care is not the ER.
We know exactly where our scope ends. These six scenarios skip video consult and route directly to ambulance dispatch + our partner hospital in Warri. Every CHW rehearses the matrix monthly.
- Chest pain with diaphoresis · immediate ambulance dispatch + partner hospital handoff
- Stroke symptoms (FAST) · ambulance + notify receiving facility en route
- Severe bleeding / OB emergency · escalate to partner hospital OB on call
- Sepsis flags (fever + altered mental status) · IV access at hub + transport
- Pediatric red flags (lethargy, severe dehydration, seizure) · pediatric escalation path
- Mental-health crisis · tele-psychiatry bridge + safety planning with CHW