Monthly Archives: March 2017

Wrapping up Ghana – inspire and empower

It’s been an incredible week but as the saying goes “time flies when you’re having fun”! The Outreach Team wrapped up Phase II Trip II of the Ghana project on Friday, 17 March. At this point, many of the strongest trainees felt comfortable enough to actually assist in training the other trainees on scanning techniques. This served particularly useful when the trainees had to undergo the competency checklist under the supervision of their trainers to determine their strength in scanning. After an intense morning of more practical training and scanning, the day finally ended with a closing ceremony presented by the Kumasi Metro Health Services and local representatives of the Ministry of Health.

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Dr. Janet Horenstein filling out Trainee Scanning Competency form for one of the trainees after evaluation
Image courtsey of G.A Baez for ISUOG Outreach

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Dr. Alberta Britwum-Nyarko, Director of Kumasi Metro Health Region, addresses the audience during the closing ceremony
Image courtesy of G.A Baez for ISUOG Outreach

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Outreach Committee Chair, Dr. Anthony Johnson, goes over what will be expected of the trainees in the coming months.
Image courtesy of G.A Baez for ISUOG Outreach

Throughout the week, some trainees really stood out as potential trainers to consider for the next and final trip of Phase II of the Outreach Program in Ghana. These trainees – Jonah Adams Abbekah, Bernice Nsobilla, Prince Owusu, Osei Sarpong, and Albert Adu Poku – in addition to our local trainer in Kumasi, Dr. Buah Hamilton, will take the efforts made by ISUOG in the Kumasi Metro region since 2010 to the next level. ISUOG Outreach is looking forward to working with the Ghanaian Ministry of Health, our on the ground partner Women’s Health to Wealth (WHW) and GE Healthcare to empower local practitioners with ultrasound training and provide the quality scanning and care that all Ghanaian women deserve – stay tuned as we’ve only just begun.

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It’s only just the beginning! Group picture at end of Phase II Trip II
Image courtesy of G.A Baez for ISUOG Outreach

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ISUOG’s International Development Coordinator, Mr. Gesu Antonio Baez, takes a selfie with the trainees from Old Tafo Hospital
Image courtesy of G.A Baez for ISUOG Outreach

Gratitude for ISUOG ultrasound training

Trainee Adam Abekkah and selfie with Sarah Stephens and the training midwives in Old Tafo
Image courtesy of G.A Baez for ISUOG Outreach

For day 3 we’re following Dr Janet Horenstein and Dr Theodora Pepera-Hibbert training the group at Old Tafo.  Dr Pepera started the day with a review of gynecological scan techniques which carried on into conducting transvaginal scans during a good portion of the day. The strongest of the group, Adams Abekkah, even began training the other trainees (under the watchful eye of Dr Horenstein). The Old Tafo clinic was lined with patients. About 20 were scanned today, which gave plenty of opportunity to practice for the group!

Midway through the training, the chief clinical director paid a visit to the team and expressed his gratitude to ISUOG and the training being given in Kumasi. He explained seeing a notable difference in the quality of mothers lives in the region and the accuracy of diagnosis thanks to the ultrasound training skills. Needless to say, such mention surely made the team beam with pride!

Training gynecological scan techniques
Image courtesy of G.A Baez for ISUOG Outreach

Follow us as we continue to report from the forks.

Improving practical scanning skills in Ghana

GE Healthcare’s Sarah Stephens teaching machine optimizing and practical sessions at South Kumasi Hospital
Image courtesy of G.A Baez for ISUOG Outreach

Day two of Phase II Trip 2 in Kumasi, Ghana kicked off and we’re now following the training group in Kumasi South Hospital for another day of ultrasound training. GE Healthcare’s Sarah Stephens met with the group today to give a lecture to better optimize their skills on the GE Voluson machines that were donated to the program a year ago. Some tips or “pearls” she shared with the team included how to make the image blacker or whiter in order to achieve a sharper image when scanning.

Most of the patients seen were in their third trimester and there was even one with multiple pregnancy with fetuses that moved constantly making it difficult for the scanners (but good practice!). The team was stronger today, measuring femur length quickly and confidently with sonographer Prince Owusu even leading on training other trainees on a few scanning skills.

Meanwhile in the other sites, some highlights included the Suntreso group with Dr Theodora Pepera-Hibbert leading the group in recognizing ectopic pregnancies and scanning more than 23 patients in one go.

“The trainees have been very ready and very attentive.” said Dr Janet Horenstein, who worked with Project Lead Dr Anthony Johnson at Old Tafo Hospital. “They are still not at level they should be, but hopefully with more scanning they’ll get there soon.”

Sonographer and trainee Prince Owusu scanning with new skills thanks to guidance of Sarah Stephens
Image courtesy of G.A Baez for ISUOG Outreach

Stay tuned for more updates from the field as we report from Ghana!

Successful start to training in Ghana

Picture above are ISUOG trainers Dr Tony Johnson, Sarah Stephens, Dr Theodora Pepera-Hibbert Dr Janet Horenstein and ISUOG International Development Coordinator Gesù Antonio Báez
Image courtesy of G.A Baez for ISUOG Outreach

We’re back on the ground in Ghana. The ISUOG training team, led by Outreach Chair Dr Anthony Johnson (USA), immediately hit the ground running for Phase II Trip II as if no time had past since the last time we worked in Kumasi back in 2015.

The training team is currently working in each of our key hospitals for the project: Old Tafo, Kumasi South and Suntreso. The 18 Ghanaian trainees were divided between each of the hospitals to work with each different trainer including Dr Janet Horenstein (USA), Dr Theodora Pepera-Hibbert (Ghana/UK) and local trainer Dr Bush Hamilton (Ghana). GE Healthcare Sarah Stephens also joined the team to give an overview of the three GE Voluson machines donated last time.

Hands-on training in session
Image courtesy of G.A Baez for ISUOG Outreach

It was remarkable to note how eager the sonographers were not only scan, but also to help train other trainees (such as the midwives).  It really left an impression on the trainers who noticed little by little the “teach the teachers mission” slowly unfold for them.

The main part of the day was focused on review of lectures, especially going over the key “6 step approach” and providing more hands-on training to really hone in on their skills from last time. And they definitely did get practice with the team at Old Tafo, scanning well into 5:30 PM – after training ended at 4:00 PM.

Stay tuned for more stories from our project on the ground in Ghana and follow our blog for more Outreach journeys.

Visions of Burma – supporting training in Yangon

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Outreach team (from left to right: Franti Grochal from Slovakia, Dr. Philippe Jeanty from USA, Ya Chiao Hu from Taiwan and Federico Badano from Argentina).
Image courtesy of Dr. Philippe Jeanty of TheFetus.Net

On 7 March 2017, Outreach Committee Member and Founder of TheFetus.net Dr. Philippe Jeanty (USA), led a group of trainers in Yangon, Myanmar to train 30 trainees from across the country in basic OB/GYN ultrasound. ISUOG Outreach supported this mission and below, Dr. Jeanty provides his first impressions of Yangon from early this week.

“First day:

This is the first Outreach course we’de done in Yangon, Myanmar. The first day was rest and recovery from very long trips! Federico Badano was the longest distance flyer (29 hours from Argentina), followed by Franti Grochal (26 hours from Slovakia). Ya Chiao Hu from Taiwan and Gwang Jun Kim from South Korea had an easier time but still pretty long trips!
We did some light visiting, taking a local train to site see. Interestingly, we crossed the tracks a few time to get from platform to platform. Very surprising to me!  The train was full of colorful people. They use some ground up stone for makeup and sunscreen. In the train there was a panel with 3 warnings: you can’t smoke or litter, but more surprisingly, you cannot kiss on the train!

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Yangon train
Image courtesy of Dr. Philippe Jeanty of TheFetus.Net

The train was really packed and vendors circulating with all types of food, drinks and trinkets. They even sell betel leaves that people keep in their checks, a little like the coca leaves in the Andes with similar bad effects on teeth! We chatted with some people who were very friendly and quite interested in us. Actually mostly interested in Ya Chiao and we learned later that Korean movies are very popular here and they thought she was a Korean actress!!
We visited a pagoda with an immense Buddha statue made of a single block of marble imported (if I am correct)  from Nepal.
The food is very varied and influenced by Chinese and Indian cuisine.
Today was the first day of the course and we met with our local contact, Dr Yin Yin Soe, who organized the course.
We had 30 students and they come from all over Myanmar! It was incredible that many had come from hospitals with only one obstetrician so it was apparently difficult to get government permission for them to attend the course and have surgeon cover their absence. Many travelled by train the night before. Compared to previous Outreach courses, they are much less intimidated which makes the contact easier.
We had class room in the morning and workshop the afternoon.
It is very very hot! 37 C/99 F, but the students were really eager to learn!

Second day:

Ya Chiao scanning

Yao Chiao scanning with a trainee
Image courtesy of Dr. Philippe Jeanty of TheFetus.net

Since I am so hard at hearing, I got in the habit of asking people to write their questions on paper and drop them on the desk. This is also a great technique for shy students and women who otherwise would not ask questions. Well, we were inundated and the questions reflected a very good level of knowledge. This is an interesting situation with knowledgeable students who just have very little hand-on practice. So I worry that our lectures were too basic.
For Ya Chiao, this was her very first ever presentation in front of a class and even behind her impassible stoic face, she was clearly nervous! Sonographers don’t often teach physicians in Asia but she did a very good job!
Gwang Jun had the second presentation and talked about CNS anatomy and the views. As expected, he had a great presentation and has a unique style of teaching, for instance a way to remember the ventricular system by folding the fingers was a refreshing approach to the usual topic!
Federico and Franti then did their presentation with the ease of someone who has spent years doing them.

Group photo

Trainers with trainees
Image courtesy of Dr. Philippe Jeanty of TheFetus.net

The afternoon we had tons of patients with anomalies, including large cephalocele, missed AB, triplets and so on. Some patients needed TV examination which we rarely do in courses like this and Concordia rapidly got us a TV probe and we did several scans. It helps that women here are accepting and that almost all the students are women.
They know what they need to look for but needed help in coordinating what they see on screen with the movement of the transducer. So I hold their hand and show the movement. And invariably they look at my hand moving theirs instead of looking at the screen! So finally I took a patient chart as a “blind” to force them to just look at the screen!
The machines we have are uneven resolution. The three top end machines are fantastic but the low end one makes you realize what it is to scan in a country that has a hard time affording to machines: we are very spoiled!”

Stay tuned for more stories from Myanmar and next week, as we report from Ghana!

 

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Outreach team (from left to right: Franti Grochal from Slovakia, Dr. Philippe Jeanty from USA, Federico Badano from Argentina, Ya Chiao Hu from Taiwan and Dr. Gwang Jun Kim from South Korea)
Image courtesy of Dr. Philippe Jeanty of TheFetus.net