Global Reach

ACR's Goldberg-Reeder Grant sends residents to communities in need across the globe.global reach

In communities throughout the developing world, access to valuable medical imaging remains out of reach for much of the population. With this in mind, each year, the ACR funds projects for up to four residents interested in using their training in a humanitarian project abroad.

Each resident receives $1,500 to help transform an idea into reality. Four recent volunteers spoke with the ACR Bulletin about their experiences.

Robin N. Sobolewski,  MD, Cape Verde, January-February 2013

Tell us about your project.

Global reach sobolewskiI raised money to purchase an ultrasound machine for a local clinic and taught staff the basics of ultrasound scanning. With access to this portable machine, it is my hope that the local health-care providers can help improve overall health of the community.

Why Cape Verde?

Right out of college, I taught English in Cape Verde with the Peace Corps. I also went back during medical school to satisfy an international health elective. It was really nice to go back again, and a lot of people remembered who I was. They were very grateful to have an ultrasound machine in their hospital.

What was your biggest challenge?

Time. I had hoped to get so much more accomplished than I could conceivably have done.

What did you learn about the culture?

I was struck by the strength of the community bond in Cape Verde. People help one another celebrate births, raise children, build houses, and mourn their loved ones. There is a strong respect and love for each other as human beings.

What results did you see?

By the time I left, the doctor and nurses were able to do some basic scanning. That was really rewarding. The scans are read by a radiologist and an ob-gyn who are stationed on the other side of the island. The primary care doctor that runs the hospital interprets what he can and occasionally emails me images for input.Global reach sobolewski 2

In addition to training, I did as many ultrasounds as I could. While I was there, two other volunteer radiologists and I performed more than 125 ultrasounds and 30 X-rays. Some of the patients had been waiting months to get their procedures done.

“I was struck by the strength of the community bond in Cape Verde. People help one another celebrate births, raise children, build houses, and mourn their loved ones.” — Robin N. Sobolewski, MD

Ifeanyi C. Onyeacholem, MD, Mozambique, September-October 2012

Tell us about your project.

global reach onyeacholemI worked with Centrale Maputo Hospital to set up a resident exchange program between their radiology department and the University of California at San Diego (UCSD). I also gave lectures to the medical residents about ultrasound and worked with the radiology department to learn about the different radiologic approaches in a developing country.

Why Mozambique?

UCSD's medicine department had already established a resident exchange with Centrale Hospital. I wanted to start a similar exchange focusing on radiology residents.

What was the most rewarding part of the experience?

Experiencing a different culture. I met so many people from all over the world because Maputo, the capital, is such an international city.global reach onyeacholem 2

What results did you see by the end of your trip?

When I arrived, the medicine department had recently received a portable ultrasound machine. I helped train staff to use the machine, and by the time I left, the residents were more comfortable using it to diagnose patients. The hospital's radiology department had also agreed to have more residents visit from UCSD in the future, so the exchange program is in its early stages.

Mary F. Wood, MD, Chile, September-November 2012

Tell us about your project.

I investigated the factors influencing low mammography rates in two different populations of women in Chile, one at a private institution and one at an under-served university-affiliated clinic.

Why Chile?

Overall, screening compliance rates are lower in South America than in the United States. In Chile, specifically, the screening compliance at one clinic was reported to be just 12 percent (compared to 66-75 percent in the United State). I wanted to go to Chile to get a better understanding of the barriers and facilitators for screening and to ultimately help increase breast cancer and mammography awareness.

What surprised you most about your experience?

global reach woodWorking internationally can be challenging and intimidating at times, but it has been remarkable to experience the overwhelming goodness and generosity of others. Immediately upon my arrival, the radiology residents were very welcoming and included me in their daily conferences, lunches, tumor boards, and even their annual medical school party.

What was the most rewarding part of the experience?

Working with the people in the hospital and clinics was the highlight. My project would have not been possible without the help of the researchers, residents, teachers, hospital staff, and patients. It was also very gratifying to see how receptive the women in the waiting rooms were to discussing their experiences with mammography and health-care access.

What results did you see by the end of your trip?

We exceeded our goal of collecting 100 surveys. Preliminary results show that mammography screening compliance was not significantly different between the two groups: 56 percent of women in the hospital and 44 percent in the clinic reported having a mammogram within the past two years. However, when we grouped women based on income, insurance, and perceived number of barriers to screening, we found significant differences in compliance, with cost as the most commonly reported barrier.

“Working internationally can be challenging and truly intimidating at times, but it has been remarkable to experience the overwhelming goodness and generosity of others.” — Mary F. Wood, MD

Surbhi Grover, MD, Botswana, March, July, and November 2013

Tell us about your project.

I'm working on a variety of projects aimed at building capacity in cancer care in Botswana. In March, I focused on training medical staff to use a recently acquired brachytherapy unit. I'm also involved with a project that is looking at treatment tolerability of women with cervical cancer who are HIV positive, a subject without a lot of data currently.

When I go back in July and November, I'll also be doing some educational outreach. My team and I will create teaching booklets of common oncology cases found in Botswana. Every time someone from our team returns, we hope to teach sessions around those cases. I'm also planning to help set up cancer guidelines for the country, which currently has none.global reach grover

After I finish residency, in June 2014, I'll be going back to Botswana for a whole year. I will be spending my time teaching, doing clinical work, and starting new research projects with the medical students and staff in Botswana.

Why Botswana?

There is a lot of interest from within Botswana in strengthening cancer care in the country, which aligned well with my passion for international health and my training in radiation oncology.

What has been the most challenging part so far?

You can set your timeline, but you have to understand that it takes awhile to get things done. For example, we spend a lot of time discussing cancer guidelines for the country; however, nothing can be done until a governing body approves the group of people to be officially involved with creating the guidelines. Early on, it was challenging, but the more time I spend in Botswana, the more I get to know the people and the more I understand how the system works.

What has surprised you most about the experience?

How incredibly open the people are in Botswana. They're very welcoming to outsiders and to new ideas. This made my first trip very fruitful and motivated me to return to contribute more. I have also met some very inspiring people in the medical field.


By Lyndsee Cordes

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