Sabah al khair min El Obeid! Good Morning from El Obeid! The Outreach Team carries on with Day II of the program here in Sudan. Sharing her experience on the ground is Outreach Trainer Dr Angela Ranzini who describes her experience:
“Greetings from El Obeid! Today is Day 2 of our week in the Sudan. Once again, the week seems to be just flying by.
Our day today actually began on Sunday! One of the first things we did on day 1 was to ask for feedback from the trainees, and found that they are hungry for more “hands-on” training. Yesterday evening we compiled the results of the initial “hands-on” 6-step evaluation and reshuffled the trainees into new groups for today.
As sometimes happens, the best made plans change, and as trainers, we adapted. Last year, we had planned to have lectures in the morning and “hands-on” scanning in the afternoon, but when we got to El Obeid, we found out that the patients typically come to the clinic early in the morning, so we reversed the schedule to have “hands-on” scanning early in the morning and lectures after lunch.
This year, we found that patients typically come earlier in the week rather than later. So, given the trainees desire to have as much “hands-on” as possible, we adjusted the schedule. After an initial lecture on normal and abnormal heart (planes 7, 8, 9, 10) by Dr. Reem Abu-Rustum, the day was mostly spent doing directed scanning with the new groups, breaking for prayer and lunch, which was kindly provided by the International Planned Parenthood facility we are using for the training.
I have been consistently impressed with the trainees here in the Sudan. We have 28 trainees and lost only 2 over the past year (one relocated out of the country, and one was on her honeymoon) which I think shows an amazing dedication to the program. The eagerness to learn is palpable. The other thing that impresses me, is how hard these men and women work. All of the trainees are Ob/Gyn or Radiology physicians with their own practices here in the city or in the surrounding state. After class ends, many of them see patients in their offices until all hours of the night and some of them even into the morning. Despite being very busy and probably sleep deprived, they pay attention, don’t fall asleep and don’t get out their cell phones during lectures! During the lunch break, some did pull out their cell phones – to get second opinion consults for complicated anomalies that they recently identified in their patients.
Attentive and hard-working trainees in El Obeid
My “hands-on” scanning group consists of both Ob/Gyn’s and Radiologists. Today we scanned one patient each ½ hour or so, and rotated trainees, so all people scanned at least one patient and some two. We used a portable Medison machine, which has quite a nice image and is equipped with color and pulsed wave Doppler, which proved useful in patients with small babies. Most of the trainees stuck around before and after their scan time to assist in offering scanning suggestions to the trainee.
The trainees are very supportive of each other and not shy about asking questions. After performing the “6 steps” with each patient, we progressed to doing axial “sweeps” of the fetus from bladder through the three vessel view, noticing all of the structures in between. We had good conversations about technique and management of some abnormalities.
Hands-on ultrasound training
Most of the patients present were there for their first ultrasound between 26 and 34 weeks, although we did have one scan at 20 weeks. They are not hard to scan since they typically have normal BMI’s. They are eager to have an ultrasound, despite having 8 people in the room watching, and like women everywhere, want to know the gender of the child. Fortunately for the patients, we didn’t see any anomalies today in my group.
Patients waiting to be scanned
After the training session was over, the team relaxed with a Diet Coke and warm French Fries (chips) back at the hotel and traded observations about the day.
In the evening, we were invited to watch a football match by the Government. El Obeid played Khartoum and won 2-1. As the Government’s guest, we were escorted up the red carpet to our really comfortable red covered chairs at midfield. We were greeted by Dr. Abdullah, the Minister of Health, just after his arrival. What a treat!
The stadium was all lit up and colored flags ringed the upper wall. Two bands, one for each team competed for our attention with horns, drumming, dancing, flag waving and periodically, tongues of fire to celebrate a goal. Behind the stadium, two minarets were lit up with white and coloured lights as if to celebrate the game, and at half time, we were treated to jebena, a delicious spiced coffee served sweetened, in small glass cups. The heat of the day had dissipated and a bit of a breeze filled the stadium, making it a perfect evening to finish the day.
El Obeid vs Khartoum soccer game
It is a privilege to be teaching ultrasound in the Sudan with such a dedicated partnership: ISUOG, The Minister of Health, International Planned Parenthood and Salamat NGO, all dedicated to improving pregnancy outcomes for the women of the Sudan and creating a sustainable ultrasound teaching program.”
-Dr Angela Ranzini