Uganda

 Six rotary clubs partnered with the American College of Radiology Foundation (ACRF), Imaging the world (ITW) and DIMIST to apply for a global rotary grant of US$100k to deliver Ultrasound services for Mother and Newborn Health in Uganda. An estimated 6,000 women die in childbirth each year in Uganda. ITW is committed to lowering this number with ultrasound imaging, an important tool that can help ensure pregnant women get the prenatal care they need. This project integrates low-cost ultrasound programs into remote health care facilities that often lack radiologists and other skilled personnel, not to mention imaging equipment. 

The approach combines point-of-care ultrasound devices, proprietary software, training, supervision, and continuing professional development together with community awareness and funding models that promote self-sufficiency. We also take cultural and political factors into account, as well as healthcare access and other socioeconomic constraints.

The first ITW ultrasound site was established in Uganda in 2010 by Imaging the World Africa, an NGO registered in Uganda and affiliated with our US organization. Since then, its activities have grown to ten sites throughout rural Uganda and two sites in Malawi. Although the Ugandan ultrasound program was started to identify high-risk pregnancies, it is suited for expansion to other areas such as detection of breast cancer, evaluation of liver, kidney and thyroid disease, pediatric diseases, trauma triage, and echocardiography for rheumatic heart disease.

One of our major accomplishments has been the development of new software, called VICAT, which can transmit entire ultrasound scans over the internet. This allows scans to be reviewed remotely with the same image quality as seen by the onsite technician who is with the patient. With this software, any rural clinic with a cell phone signal can have images interpreted remotely, either for training or diagnostic purposes.

Initially, the ITW transmission software was at the core of the Ugandan program. Low-level health care workers could be quickly trained to generate and transmit ultrasound sweeps of pregnant women and the images could be interpreted elsewhere.  Now, ITW’s training programs are enabling clinics and hospitals to move towards self-sufficiency. Newly trained medical personnel provide onsite readings without the need to send scans out for interpretation.

To-date over 200 clinical officers, nurses, and midwives have been trained by Imaging the World Africa to produce high-quality obstetric scans at the point of care. Eight of the trainees have become full sonographers and are now trainers in the program, underscoring the sustainability of the model. The VICAT software is still essential to our program, but scans are not routinely read remotely any longer. Rather, the software enables remote scans to be used for quality assurance, training, and readings of difficult cases.

The Rotary grant extends the ITW program with another 2 units and includes infrastructure, training, monitoring, project management and supplies to make sure that this project is sustainable.