Training in Ultrasound in resource limited settings: Trish Henwood

For Trish Henwood, ultrasound use in resource limited settings is a perfect fit. Nowhere has Trish seen ultrasound have more of an effect on patient care and outcomes, and save more lives, than in resource limited contexts. Trish uses the example of a training program in Zanzibar to highlight the scope that ultrasound provides. Using ultrasound on a daily basis to the medical centre is able to screen for antenatal complications that may necessitate transfer to a setting with a higher level of care. Trish also leans of health professions recounting their experience with ultrasound. Fatma – a nurse/midwife – recounts her tales of finding many cases of molar pregnancies, placenta previa, eclampsia and ruptured ovarian cysts. Through the available resource of ultrasound, she has saved many lives (of both mothers and babies.) Gabin in Rwanda has taken the basic ultrasound training he received to diagnose a multitude of cardiac conditions in his centre and Olivier tells the story of a young man with an altered mental status on whom he diagnosed infective endocarditis using ultrasound. These real-world examples show a tiny fraction of the benefit of ultrasound in resource limited settings. Although there are challenges to initiating training programs including resources and equipment limitations, focusing on the bright spots is important. Similarly, the scale of need, wide burden of disease, and complex systems challenges can at times be overwhelming in the global health arena. Focusing on small wins and long-term investment is key to programmatic success and sustainability. Training clinicians in bedside ultrasound effectively uses the same human resources to help shrink the gap between the broad imaging needs of a population and limited consultative capacity of radiology. The result is enhanced patient care, provider empowerment, and improved job satisfaction. Growing point-of-care ultrasound trainees into trainers themselves allows for local solutions to ongoing education needs and helps develop and address the most relevant home-grown research questions, results of which may have broader international practice implications. Building broader networks for bilateral point-of-care ultrasound training and research opportunities will be of global benefit.

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