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Health Care Chronicles: Helping developing countries get radiology ready

January 03, 2011
This report originally appeared in the December 2010 issue of DOTmed Business News

By Ronald de Jong

Many people in developing countries are dying prematurely because they lack access to the high-tech equipment the developed world takes for granted - mammography that helps doctors spot lethal cancers while there's still time for treatment, or even nuclear medicine exams to help them see if the heart is strong and healthy.

That's partly why many in the developed world generously donate medical equipment to hospitals and clinics in the Global South badly in need of advanced imaging systems. But donations, while laudable, often aren't enough. Unfortunately, this potentially life-saving equipment sometimes sits idle, unused and even unpacked in the box it was shipped in.

Why? For much of the developing world, the problem isn't just one of radiology access. It's one of radiology readiness. That is, many countries lack the trained personnel and even energy infrastructures necessary to make use of donated goods.

Take Liberia, a country on the west coast of Africa with 3.5 million people. According to Dr. Daniel J. Mollura, the founder of the nonprofit RAD-AID International, you could count the number of X-ray technicians in the entire public sector on your hands - there are only six nationwide. The situation is similarly dire in other African nations. In Uganda, there are only 30 radiologists in the whole country, meaning the ratio is one radiologist per 1 million people. By contrast, in the United States, the ratio is one radiologist per 100,000 people, according to the American College of Radiology.

This lack of trained personnel puts a huge burden on these systems. In Jordan, for instance, a relatively well-off and developed country, the average wait time for an MRI scan is nearly 8 months, because of significant backlogs.

But it's not just a human problem. It's also a technical one. Some technical conditions need to be in place for advanced imaging equipment to work: quite simply, you need to have power. It sounds very basic, but you wouldn't believe the issues we face in some parts of China and India, or Russia for that matter, where you have regular power outages.

This is why Philips has been collaborating with RAD-AID, Project HOPE and local groups to run Radiology Readiness assessments, to help make sure rural clinics, hospitals and doctors' offices - the typical recipients of aid - are ready to embrace radiology. For example, site readiness checks for an MRI means ensuring there's a dedicated room that's climate-treated, and that the staff on-hand has the know-how to make the best use of the technology. Training can be Web-based, or better yet, through exchange programs with developed world universities and hospitals.