I deeply appreciated the opportunity to present a session during the Society of Diagnostic Medical Sonography (SDMS) Annual Convention earlier this month on Ultrasound: Changing the World. This topic is dear to my heart as it allows me to discuss my personal experiences supporting the development of pre-natal sonographic diagnostic care in rural areas of Uganda over a five year period in association with Imaging the World, as well as discuss other extremely worthy programs bringing imaging to the developing world.
What we do (in ultrasound and sonography) matters. Although the external demands tied to the economics of modern medical practice push us uncomfortably into an ‘assembly-line worker’ role, this really is not inevitable and preordained. When I hear the complaints about how medicine is performed today, I think of a lecture on High Touch in a High Tech World given by Steve Talbot RVT, FSVU, which explores these same ideas (One of the free CME activities we offer from our website).
I started the presentation with what I believe to be some sobering facts and statistics…
This statement from the World Health Organization explains the challenge in ‘macro’ terminology:
“Health workers are distributed unevenly across the globe. Countries with the lowest relative need have the highest numbers of health workers, while those with the greatest burden of disease must make do with a much smaller health workforce. The African Region suffers more than 24% of the global burden of disease but has access to only 3% of health workers and less than 1% of the world’s financial resources.”
Where developed nations average 1 doctor for every 300-350 people, in most African counties there is less than 1 doctor for every 1000 people. And this shortage is more pronounced outside their major cities, as competent medical personnel are naturally drawn into the larger cities by higher wage and career opportunities.
How this shortage impacts the remote population is very clear … in these regions, most medicine and treatment is based on symptoms, rather than early diagnostic care. This has a particularly devastating affect on women in childbirth and infants. Although according to WHO statistics maternal mortality worldwide has dropped over the past 20 years, in 2010 nearly 287,000 women died due to pregnancy and childbirth complications. In the remote (rural) regions of Uganda, it is estimated that 1 in 24 women die in child birth.
Almost 40% of these maternal deaths were attributed to hemorrhage and obstructed labor … conditions that can be very treatable with early diagnosis. Additionally, there is what I term a “cascade effect” in that infant mortality is also unnecessarily higher due to the lack of skilled diagnostic care during and immediately after birth. Up to 2/3rds of newborn deaths could be prevented if effective health measures were provided at birth and during the first weeks of life.
Although most of you are generally aware, of the struggles and deprivation associated with sub-Saharan Africa, what may be a hopeful surprise is how ultrasound technology will play a substantial role in changing the world in these remote, but developing communities.
In two weeks, I will outline the logistical challenges, some promising solutions, and also highlight specific programs I have observed that are turning the tide, and making an impact.
–Frank Miele, MSEE , President of Pegasus Lectures, Inc. Frank graduated cum laude from Dartmouth College with a triple major in physics, mathematics, and engineering. While at Dartmouth, he was a Proctor Scholar and received citations for academic excellence in comparative literature, atomic physics and quantum mechanics, and real analysis. Frank was a research and design engineer and project leader, designing ultrasound equipment and electronics for more than ten years at Hewlett Packard Company. As a designer of ultrasound, he has lectured across the country to sonographers, physicians, engineers and students on myriad topics.