A Helping Hand
Imaging equipment gets a second life in developing nations.
Imagine while out harvesting grain one day, a young Ugandan woman notices a lump in her breast. She knows the dangers the lump represents, but she also realizes that proper medical equipment is unavailable in her village.
So she leaves her farm and sets off for the capital, Kampala. Located halfway across the country, Kampala is home to Mengo Hospital, one of the few facilities in the country equipped with ultrasounding technology. The trip is arduous, but when she arrives at the hospital, she is able to get the scan and treatment she needs.
The equipment at the hospital, along with the expertise to operate and maintain it, may well have been supplied by a U.S. organization. Imaging equipment manufacturers, hospitals, and radiology practices often donate used medical imaging technology to facilities in underdeserved countries. Whether through programs sponsored by manufacturers or by way of foundations dedicated to improving diagnostic imaging in the developing world, many options exist to refurbish and donate preowned equipment. In addition, several organizations educate radiologists to use and maintain the technology.
Doing Good Abroad
One organization that facilitates in this donation process is the nonprofit Global Ultrasound Equipment Dontation Foundation (GUEDF). Established by Barry B. Goldberg, MD, FACR, the foundation helps to place technology in underprivileged countries around the world. Over its nine years in existence, the organization has found homes across the globe for more than 300 donated ultrasound scanners.
When companies or health-care facilities donate equipment to the GUEDF, Goldberg employs the nonprofit Assist International (www.assistinternational.org) of San
Francisco, Calif., to help. Assist partners with professionals in the medical field to ensure the equipment is in good working order. Moreover, says Goldberg, Assist staff members fill out the import/export paperwork. This is a key step that requires special expertise, since each country has its own regulations. Assist then ships the equipment to its final destination.
Sustainability: The Name of the Game
Simply shipping equipment to another country is not sufficient to see positive returns, however. A concept central to the GUEDF's philosophy is sustainability. "When you send equipment abroad," Goldberg explains, "you must make sure the individuals receiving it are trained and know how to use it. The worst thing I've seen in my travels is equipment that's just lying in the corner of a facility, and the recipients say 'We received it, but we don't know how to use it.'"
Brad Short, ACR senior director of member services, agrees that placing equipment in countries of need is just one piece of the puzzle. Short helps run the ACR Foundation International Outreach Program (ACRIOP, online at http://bit.ly/InternationalOutreach), which is a hub for domestic donations of equipment and aid for international facilities in need. The ACRIOP also serves as a place for radiologists to register for international volunteer opportunities. One guiding principle of the foundation, Short says, is sustainability.
For example, in its first boots-on-the-ground effort, the ACRIOP facilitated the donation of a portable X-ray unit to Grace Children's Hospital in Port-au-Prince, Haiti, in the wake of the 2010 earthquake. Later, the organization partnered with both the American Society of Radiologic Technologists and the Society of Diagnostic Medical Sonography to send Short and a team of 11 radiologists to Haiti. They brought with them four portable ultrasound units, and over a two-day period, the volunteer faculty members taught Haitian medical professionals how to use the technology.
"Our project in Haiti focused on sustainability," explains Short. "We want to ensure that equipment isn't defunct, broken down, or no longer useful. So you've got to put a lot of time and effort into thinking about logistics, support, culture, political systems, traditions, and language barriers when you go into these countries."
One of the challenges faced when donating equipment to the developing world is ensuring that machines can be properly maintained and utilized. "From an equipment standpoint, there are so many challenges," Short continues. "When we got to Port-au-Prince, we toured University Hospital. Interestingly, we saw a CT machine sitting outside that had been completely destroyed by the weather. They couldn't fit it in the front door. So there are a lot of well-intentioned organizations and people that are involved with this types of work, but you've got to really think through the logistics as part of the donation process."
Richard N. Hirsh, MD, FACR, founder of Radiology Mammography International (RMI, online at www.radiologymammography.org) in Akron, Ohio, agrees that sustainability is an important part of the process. RMI's missions involve supplying mammography equipment, technical assistance, and training to underdeserved countries. Hirsh says, "Simply donating medical equipment without providing training is totally useless, especially for mammography... Practically all of the developing countries where I do my projects do not have any real breast imaging training for technologists or for radiologists." He says, "Hands-on training is the key piece to the success of my projects."
Though there are many avenues to donation, it's easy to agree on one thing: giving refurbished equipment to underdeserved populations is a rewarding experience. While radiologists cannot solve all of the world's troubles, they can make a big impact on communities in need. With a mix of determination, cooperation, and an eye towards sustainability, organizations can help those who need it most.
By Chris Hobson