A heartfelt value: From left, Gupta; Choy; Worrell; Carmen Alvarez, manager of Faculty Development for Imaging and head of Marketing and Public Relations for Imaging Global Health Programs; and Sjirk J. Westra, MD, and Arun Krishnaraj, MD, MPH, both MGH radiologists and group members
According to a recent report from the World Health Organization (WHO), two-thirds of the global population lacks access to diagnostic imaging care. At the MGH, a team of Imaging staff is working to address this need through a new initiative: MGH Imaging Global Health Programs.
"The lack of access to safe, quality imaging care is a complex issue that affects people everywhere," says Garry Choy, MD, MS, the MGH radiologist who leads the effort. "Our team has taken on a range of projects to address the issue from all possible angles."
At the most basic level, says Choy, health care facilities in developing nations lack up-to-date imaging equipment. In addition, hospitals need assistance selecting technology that is appropriate to both their patients' needs and caregivers' capabilities. The most recent example of MGH Imaging Global Health Programs' efforts related to this problem is its work with Partners in Health and the American College of Radiology to secure a computed tomography (CT) scanner for Mirebalais Hospital, which is under construction in Haiti. Once the CT scanner is operational, the MGH has committed to providing training and teleradiology support because even when a health care facility has the latest equipment, it may not have the resources to use it to its full potential.
One of the group's longest ongoing projects related to overcoming this challenge has been providing teleradiology services for Butaro Hospital in Rwanda. While this hospital houses some of the latest imaging equipment, its staff is limited and has little access to formal radiology training. Using technology such as a film digitizer or even their personal smartphones, Rwandan caregivers send images to MGH radiologists, who provide at least one teleradiology consultation a day. The number of consultations continues to grow through new collaborations.
Still, supporting hospitals in developing countries through clinical care only addresses a small part of a larger problem.
"The underlying issue is the gap between increasingly available advanced technology and the number of radiologists who have been trained to use it," says Choy.
In light of this, members of MGH Imaging Global Health Programs are working to improve training worldwide. In April, MGH radiology fellow Supriya Gupta, MBBS, MD, received a grant from the Radiological Society of North America to create an ultrasound training curriculum for radiologists at Butaro Hospital. The curriculum includes web-based multilingual lectures, video demonstrations, hands-on training workshops and online questionnaires for assessments.
In addition to Gupta's grant, a project led by radiology fellow Stewart Worrell, MD, MPH, is advancing radiology education in Afghanistan. After much of the area's medical infrastructure was destroyed by warfare, new equipment was purchased for the National Military Hospital located in Kabul. But the staff there lacks adequate access to the specialized training needed to use some of the machines. Collaborating closely with U.S. Navy Cmdr. Robert Cargile, MD, Worrell has helped identify areas in need of improved training.
"Commander Cargile and I are exploring opportunities for him and radiologists from the hospital to attend educational conferences in the United States," says Worrell. "We also have approached the American College of Radiology about providing these radiologists with access to its training program, which it has agreed to do."
Whatever the method, solving this complex problem is incredibly important, says Choy. WHO reports that, in 20 to 30 percent of all medical cases, clinical considerations alone are not enough to make a correct diagnosis.
"Quality imaging care is crucial to the health of the global community," says James H. Thrall, MD, MGH radiologist-in-chief and one of the group's advisors. "This new initiative within our department speaks to a heartfelt value at the MGH of wanting to help our neighbors in medical need, whether they be in our own community or on the other side of the globe."
For more information about MGH Imaging Global Health Programs, access www.massgeneral.org/research/researchlab.aspx?id=1414.