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Emergency Ultrasound

International Ultrasound: Update from East Africa

By Brian Coné, MD and Trish Henwood, MD

GenthonUganda
Dr. Alissa Genthon lectures to ob-gyn residents
and midwives about first trimester pregnancy
in Mbarara, Uganda.  

The need for ultrasound education around the globe continues, and in this quarter’s newsletter we provide an update on the efforts occurring in East Africa to educate local healthcare professionals in point-of-care ultrasound. The PURE initiative (Point-of-care Ultrasound in Resource-limited Environments), led by Dr. Trish Henwood, continues to expand its training initiatives across Africa. This spring another successful training cycle was completed in both Mbarara, Uganda and in Kigali, Rwanda.

This spring, the main teaching effort took place in Mbarara, Uganda with health care providers in the ob-gyn, surgery, medicine, and pediatric departments. Phase one of training in Mbarara was coordinated by Dr. Katie O’Brien and began in September 2014. Several PURE volunteers organized an introductory course followed by hands-on scan time over the subsequent five-month period through January 2015. The demand for further education was so high that a follow-up six-week training session was organized during April and May of 2015. Basic skills such as the FAST exam and first trimester pregnancy assessment were reinforced, while more advanced topics such as cardiac ultrasound and the FASH exam were introduced to the trainee cohort. 

NewmanRwanda
Dr. David Newman instructs residents
in Kigali, Rwanda
about advanced point-of-care
ultrasound applications.
  
  

The response from our Ugandan colleagues was again overwhelmingly positive. The obstetric midwives were one of the most enthusiastic groups of learners. As they provide the majority of prenatal treatment to the women of Uganda, they were eager to learn a new skill set that would enhance their ability to care for their patients. The basics of first trimester pregnancy were taught to those first learning OB ultrasound. For the more experienced midwives, techniques such as gestational age calculation and placenta position were introduced. Over the course of their training, the Ugandan midwives along with the PURE instructors identified numerous high-risk obstetric cases such as twin gestations, breech presentations, and ectopic pregnancies with the help of point-of-care ultrasound technology. These patients were quickly scheduled for relevant procedures or more intense follow-up care and monitoring.

 ConeUganda
Dr. Brian Coné instructs midwives in
Mbarara, Uganda
on how to use point-of-
care ultrasound to determine fetal

presentation, gestational age, and placenta location.
 

In addition to ultrasound training in Uganda, several weeks were spent training our physician colleagues in Rwanda, where PURE initially started. Their educational needs are more advanced as many of the basic point-of-care ultrasound applications have been mastered by former trainees who now independently lead training sessions for new learners. Training on topics such as soft tissue evaluation and the FASH exam was requested. Subsequently, the PURE team spent several weeks covering these and other applications in Kigali.

PURE will continue training efforts in Uganda and Rwanda while also expanding to West Africa this summer. This July, PURE will kick off a four-month ultrasound training program in Liberia for the resident physicians in pediatrics, surgery, internal medicine and obstetrics & gynecology.

 

For more information about the organization and getting involved with their upcoming projects, visit the PURE website at www.pureultrasound.org.


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