Trainers and trainees reunited in Sudan for Phase I Trip II

The ISUOG Outreach team has returned to El Obeid to conduct Phase I Trip II of the Outreach program in Sudan. Led by Prof. Hisham Mirghani of UAE  (ISUOG Ambassador to the Middle East), the team is comprised once more of Dr. Angela Ranzini of USA, Dr. Reem Abu-Rustum of Lebanon (also ISUOG Ambassador to the Middle East), Yasmin Casmod of South Africa, Sami Mahmood Abdelkhair of Sudan and ISUOG’s International Development Coordinator, Gesu Antonio Baez. The team was also accompanied by ISUOG’s local partner on the ground Salamat Doctors Charity President, Dr. Sohaib El Badami.

The week began with excitement as trainees were reunited with trainers who had been mentoring them all year via WhatsApp. Trainees sent their images for review and trainers sent them cases to go over to allow them to remain in touch with training.

The day commenced with an assessment of the trainees’ retention of previous materials covered via a pre-test assessment and a practical assessment examining their knowledge of both fetal biometry and their systematic approach to the six-steps. These assessments helped give the trainers a greater idea on how to tailor hands-on training for those struggling trainees so as to best help fine tune their skills.



Prof. Hisham Mirghani delivering a lecture 

The day ended with lectures on the 20 planes approach to the routine mid-trimester scan, evaluating fetal anatomy from longitudinal section, as well as distinguishing between normal and abnormal appearances of skull and brain. Despite a long day, most of the trainees asked to start earlier to conduct more hands-on training. Stay tuned for more stories from the field this week as we cover more of ISUOG Outreach Trip II in Sudan.



“Coming Full Circle Under the Sudan Sun…”
Collage by Dr. Reem Abu-Rustum 


Closing day of trip 1 to Oman: Phase 1 to be continued in April!

After an exciting week, Phase 1 Trip 1 of ISUOG Outreach in Oman officially came to an end. Trainers conducted post-assessments and noticed significant improvement in scanning. Trainees were anxious to know how they would keep in touch with their newly designated mentors. Both ISUOG Local Liaison Dr Mouza Al Salmani and ISUOG’s International Development Coordinator Gesu Antonio Báez reassured them that the WhatsApp groups recently created per team will help them keep in contact and help to fine tune their skills before the trainers return for Week 2 in April.

The day ended with a Closing Ceremony with the Omani Ministry of Health and distribution of certificates. Project Lead Dr Titia Cohen-Overbeek explains the day in detail:

“We left early for the Royal Hospital on the final day and started with the last set of lectures. ISUOG’s Education Committee had introduced for this project not only a theoretical assessment with pre and post-test questions, but also a pre and post practical assessment.  This meant that on the first day the trainees had to show whether they could obtain five specific planes before any teaching was done and the same planes had to be demonstrated today by them after four days of theoretical training and practical hands-on sessions. And what a difference!

If you are not familiar with ultrasound in obstetrics and the challenges the continuously moving fetus causes, this probably means nothing to you, but we could observe enormous changes in scanning abilities.  The trainees were also aware of the impact this week had brought. We had many discussions, particularly about the fact that a scan is only valuable if done correctly. The importance of using the same charts throughout the country so measurement obtained anywhere will reveal the same results, was also an issue the Ministry of Health would address.

WhatsApp groups with the trainees and their designated trainer were made to guarantee continuous communications for exchanging images, questions and education. The day ended with a happy closing ceremony in the afternoon.  


Closing ceremony at the Royal Hospital in Muscat

This has been a very enjoyable first week and with the open and positive attitude of the Omani people we look forward to our return in April for the second week – inshallah!”


Dr Titia Cohen-Overbeek

A royal celebration on day 4 in Oman

Day four in Oman carries on with more exciting updates from the ground. ISUOG Outreach Trainer Dr. Valeria Angioni from Estonia shares her experience working in Muscat.

“Despite being 7am, we are already on our way to begin the fourth day of this incredible training week. While our driver leads us through Muscat to Royal Hopsital, Oman keeps spoiling us with yet another beautiful, sunny, and warm morning. It’s all so good that by now I’ve almost forgotten how cold and dark the mornings are in my hometown.

At our arrival, we find the Royal Hospital being beautifully decorated with the national colours and the portrait of his Royal Highness, the Sultan Qaboos bin Said al Said. The country is getting ready to celebrate the Sultan’s birthday on 18 November and even though the big day is still ten days away, the passion in the preparations for the event is a clear sign of its importance to people throughout the entire country. His Royal Highness, the Sultan Qaboos bin Said al Said is seen as a visionary, whose intuitions and wisdom improved the lives of the Omani people by, for example, going great lengths to develop a public education system that reached all parts of the country and included all sections of society.

ISUOG trainers in the decorated Royal Hospital 

One cappuccino later, we are all ready to begin yet another day of action. And by “we” I don’t mean only us the trainers, but also our great trainees who are all ready and eager to practice their scanning skills.

We start with the simulation training for transabdominal and transvaginal ultrasound and today the trainees can practice their skills on different obstetric and gynecological cases. Transvaginal ultrasound stimulation is particularly important as many trainees have a very limited experience in this field because of a troublesome acceptance of this approach due to cultural reasons.

Later during the day we move onto our hands-on training; today we are working on a checklist of competence for every trainee. It might not seem like much now, but this will be an enormous help when it is time to provide the feedback for further improvement.

On a personal note, I have to admit this is yet another moment that makes this experience so precious and special. For me, it is a true pleasure to have the opportunity to share knowledge with doctors that are so motivated and so enthusiastic about their job.

After our lunch break, the afternoon section features lectures on twin pregnancy, fetal growth, ectopic pregnancy, and gynecological pathology that can be related to pregnancy like ovarian cysts and fibroids.

Work doesn’t stop in the evening either, even though the settings change and the rooms of the Royal Hospital are replaced by the area next to the swimming pool of our hotel in Muscat. After a relaxing swim, it’s all about discussing how the day went at the hospital, sharing feedback on the training to learn from what went well and planning the activities for an amazing Day 5.

One could say Outreach work never stops in Oman – and, seen from a swimming pool in Muscat, I can promise you it’s amazing!”

Dr. Valeria Angioni

Practicing ultrasound with the probe on day 3 in Oman

We’re halfway through the Outreach Program in Oman and the trainees remain engaged while the trainers remain passionate and focused on delivering the program. Offering both an insightful and culinary insight is ISUOG Trainer Pauline Schut from the Netherlands blogging on her experience.

“Today was already the third day of the ISUOG Outreach Program in Oman, which means we are already halfway through the program; time goes by so quickly! We’ve also noted this during the hands-on training; so far we haven’t been able to stick to the time schedule. Fortunately, the trainees stay concentrated and motivated, which makes the teaching very rewarding.


Busy day of hands-on training

Most of the trainees were even willing to come earlier to have more practice on the simulator, even though some trainees have to travel more than an hour to reach the site. Their eagerness to improve their ultrasound skills, together with the structured lectures provided by members of the Outreach Committee and Basic Training Task Force, have fulfilled their purpose and we’ve already seen a large difference in the quality of the images compared to the first day. Therefore, we are very curious about the results of the pre- and post-test assessments. 

Proper holding of the probe is still a challenging issue for the trainees, since most hold it as if it were a pen. Perhaps they handle it very carefully out of fear they might damage the delicate piezoelectric crystals (after the physics lecture), but we try to encourage a correct posture and ergonomics. 



Pauline Schut helping trainees with proper holding of the probe

We’ve already encountered some interesting cases during the training, such as placenta praevia, growth restrictions and some structural abnormalities, which was useful from an educational point of view. In the meantime, we’ve learned a lot about the Omani health care system and antenatal care in particular. The differences are sometimes surprisingly small and problems that sonographers and obstetricians are facing can be quite similar. As an example, maternal obesity and its associated complications are an increasing problem in Oman.

After these days we can confirm that being on a diet seems like an impossible thing to do, as the food is very tasteful and served in huge portions.  This was once again clear when after a day of training and lecturing, we were invited for a dinner with Dr. Mouza, Dr. Fatma and Dr. Salwa of the Omani Ministry of Health: one delicious dish after another was placed on the table. We had a lovely night with these wonderful ladies, who explained us a bit more about family planning, premarital screening and also the improved educational level of women in this country over the last decades, of which they are the living proof of. 

Dinner with the Omani Ministry of Health and ISUOG trainers

During our after-dinner walk, we as trainers agreed that we are very happy to have been selected for this Outreach project. The organisation has been very welcoming and because of the positive attitude of the trainees, we feel that the goals of this project can be achieved.”

Pauline Schut

Applying concepts from image optimization on day 2 in Oman

It’s Day Two in Muscat for ISUOG Outreach with training still underway. ISUOG Outreach Trainer Dr Nimrah Abbasi reports her experience from the field as a trainer in the program:

“Every day our adventure in Muscat starts with early morning breakfast followed by a scenic drive to the Royal Hospital alongside the majestic mountains and mosques as we discuss the itinerary for the day and review our lecture material for teaching.  Today, the morning begins with ISUOG ambassador to the Middle East, Dr. Hisham Mirghani’s elegant presentation on probe movements reviewing sliding, rotation, dipping and angling motions as well as basic knobology.  Immediately following this, participants have the opportunity to practice these manoeuvres and review the 6 steps approach to carrying out a systematic obstetrics scan, which includes establishment of fetal lie and presentation, viability, number of foetuses, placentation, amniotic fluid volume as well as biometry in a hands-on workshop in the outpatient center.

Muscat in the morning

Muscat in the morning

It is only the second day, but it is clear to all of us trainers, that the enthusiasm is high and the learning curve is rapid among these highly motivated learners.  We are impressed to see participants quickly grasp and apply concepts from image optimization, as they learn to use various features and knobs on the ultrasound machine and begin to demonstrate proficiency in basic biometry.  What’s most inspiring to us is witnessing the relationships being built among learners during the practical sessions as we watch them encourage, teach and help one another complete learning exercises.  This further reassures us regarding the long-term sustainability of this Outreach project in Oman.

Hands on training and lecturing

Following a busy day of hands-on scanning and teaching about early pregnancy assessments and documentation we decided to spend our evening in the Frankincense scented alleys of the Muttrah Souq, which is one of the oldest Omani markets that sells traditional cloths, herbs, sweets, perfumes and gold.  After shopping for gifts and souvenirs, we were ready for a traditional Omani meal at Bait al Luban.  We chose traditional floor seating in true Omani style, and enjoyed famous local delicacies of shuwa, halwa and Omani coffee while debriefing about the day’s events, planning for the remaining sessions and discussing ways to improve the experience for our learners in the Oman ISUOG Outreach project.”


ISUOG trainers enjoying a traditional Omani meal

Dr Nimrah Abbasi

Marhaban bikum fi Oman! Welcome to Oman for day 1 of ISUOG Outreach

Marhaban bikum fi Oman! Welcome to Oman, where ISUOG Outreach has just launched its inaugural program in Muscat, capital city of the Sultanate of Oman. A team of five have headed down to commence ultrasound in OB/GYN training, in partnership with both the Omani Government and GE Healthcare. They are training 28 key trainees from across the country who are destined to become trainers locally with intention to disseminate ultrasound training throughout the country. Leading this endeavour is Dr. Titia Cohen-Overbeek from the Netherlands, who shares her experience with the following blog post:

Yesterday the team arrived from different parts of the world for our first week of ISUOG Outreach training in Oman. The team consists of Dr. Nimrah Abbasi from Canada, Dr. Valeria Angioni from Estonia, Pauline Schut, myself from the Netherlands and naturally Mr. Gesu Antonio Baez (ISUOG’s International Development Coordinator) from London.

opening ceremony

ISUOG’s Mr. Gesu Antonio Baez and ISUOG trainers Pauline Schut, Dr Valeria Angioni and Dr. Nimrah Abbasi

We inspected the Royal Hospital of Muscat in the evening together with Dr Mouza Al Salmani – Local Outreach Project Liaison – who is one of the driving forces from Oman behind this project and the Head of the Fetal Medicine unit and the Obstetrics and Gynecology Department of this tertiary care hospital. The lecture theatre and four ultrasound rooms are excellent facilities for our teaching purposes.  To our pleasant surprise we found that the Ministry of Health had recently acquired an ultrasound simulator with both a transabdominal and a transvaginal probe, including a multitude of cases to use for teaching. This guarantees a continuing teaching program for the trainees between our visits and enhances the success of this project.

day 1

ISUOG trainers Dr. Tita Cohen-Overbeek and Prof Hisham Mirghani with the Omani Minisrty of Health

During these first few hours in this new country, it is immediately confirmed how kind and open the Omani people are wherever you meet, and their hospitality to make us feel at home is tremendous.

On Sunday we are joined by Professor Hisham Mirghani (ISUOG Ambassador to the Middle East) and at seven in the morning, we are off to the hospital. During the Opening Ceremony by the delegation of the Omani Ministry of Health and the Department head of the Royal Hospital, we are informed about the mother and child health figures of Oman. They tell us that these figures have remained stable during the last five years while they aim for a reduction in maternal and fetal mortality, which they believe can be brought about through the introduction of ultrasound at a high qualitative level for all Omani women. It is clear that we have our goal set and we start to work with the 28 trainees selected from the 11 regions of Oman.

group photo

Group photo of trainers, the Omani Ministry of Health during the first day

In the morning, we first took an assessment of theoretical and practical knowledge before the real teaching could start. We encountered different levels of experience  with some quite proficient compared to others with little familiarity with ultrasound. The trainees are a mixture of obstetric and gynecology experienced doctors, some even with fetal medicine experience, and even family medicine physicians. The kind nature of the Omani and their willingness to help each other is very evident, which is encouraging as the aim of our project is that these women trainees will become the teachers of the near future.

Following lunch, which included a very nice story on the origin of the famous Omani bread pudding Umm’Ali, we started the lectures in the afternoon. Many questions were asked, which was so encouraging! After this first day, we are all in good spirits and look forward to the rest of the week.”


Dr. Titia Cohen-Overbeek

ISUOG Outreach is off to Oman!


ISUOG Outreach is excited to announce that it will be launching Phase I Trip I of its Outreach Program in Muscat, Oman starting Sunday, 5 November. Led by ISUOG Outreach Committee Member, Dr. Titia Cohen-Overbeek and supported of ISUOG Ambassador to the Middle East, Prof. Hisham Mirghani, the team consists of an international group such as Dr. Nimrah Abbasi of Canada, Dr. Valeria Angioni of Estonia and Ms. Pauline Schut from the Netherlands, with ISUOG’s International Development Coordinator Gesu Antonio Baez joining the team to deliver the program. The team will be teaching a group of 30 trainees from across the country in basic ultrasound in obstetrics and gynecology. With the backing and official partnership of the Omani Ministry of Health and GE Healthcare in supporting machines on loan, the ultimate goal of the program is to train key doctors from vital regions of the country to spread ultrasound knowledge and training in order to foster a sustainable environment in OG/GYN ultrasound education. Stay tuned on our blog for updates on the field as they happen! For more information about our program, visit our website for more details.

Le dernier jour….the last day of Outreach in Haiti


After a jam packed week of training in the North Haitian city of Cap-Haitien, the Outreach “Dream” Team finally wrapped it up on Friday, 27 October 2017. In wonderful prose, ISUOG trainer Stephane Michel recounts the excitement of the last day and the passion shared by both trainers and trainees for ultrasound. They truly show how much they “#LoveUltrasound.


ISUOG Outreach Trainer Dr. Stephane Michel giving a lecture (Photo by L. Hanson)

“The exhaustion after four loaded days was definitely felt waking up this morning. The tiredness was immediately replaced by the excitement of this last day. The journey to the Hôpital Justinien where the training has been taking place has now become a routine – one that always becomes an opportunity to enjoy the stark contrast of landscape of this city on the cape (hèlas, Cap-Haitien). The city is awoken: children are joyous as the march on to school, the morning rush-hour with motorbikes coming at us in all directions. It’s a lively and beautiful city; the streets, the bars, the music and the food bring back memories from the time I was here for my residency – a time I long thought lost.

I’m so energetic before delivering my last presentation and to guide once more these trainees who are so receptive and perpetually happy. They have the secret of the people of Northern Haiti – the secret to win over guests to their land. It’s such an adventure being here – one that I am so delighted to participate in. This ambitious project will have multiple medical impacts; for the residents and the doctors, this is a further skill. For the hospital, it’s an effort to reduce the maternal mortality rates linked to certain conditions. For the women, it’s the possibility to receive quality care. I just can’t help but say “Vive l’échographie !” (Long live Ultrasound!).

And then there’s jeopardy! That’s how we started the training in the first place. Dr. Hanson (our team lead) asked questions to the two competing teams, formed of the trainees, who didn’t make it easy for themselves. The score was tight but wasn’t predictable. Then the final question: “which heart chamber is closest to the spinal columns?”

We were so renewed by their desire to learn through fun. In the end, everyone won through knowledge and the fun, thanks to ultrasound.

Then came the moment to head to the practical session and into the scanning room. The ultrasound machine that preformed the best with the real quality images that surpassed the rest was without a doubt the Phillips cx30. One of the trainees brought his own ultrasound machine to use for the practical aspect as well and to take the opportunity to master imaging via his own machine. It was a complete pleasure to to help him.

GAIN…..TGC….FOCUS….DEPTH……whoops, not obvious. Doing this was also a way for me to learn about the knobology of his machine because – to be perfectly honest, dear followers – it was really hard to scan with the machine!

But hèlas, it not a farewell my friends! Yes, it was truly the end of an amazing week but the adventure will continue for the good of women and for a world where as we say in French “Où le son (ultrason) continuera à nous réunir la sonde à la main.”

For more information around our work in Haiti, be sure to visit our website. Stay tuned in the coming week as the Outreach team heads to Oman, Sudan and Ghana for more inspiration and education.

Another busy 14+ hour long day of ISUOG Outreach

Project lead Dr Lisbet Hanson describes another busy day of teaching and scanning as trainees discover the relevance of ultrasound in Haiti.

We started with a 6 AM petite déjeuner in lush surroundings. By 8 AM our driver, Sebastian, had delivered us to the hospital, expertly dodging what can only be described as a sea of humanity: pedestrians, motorcycles, 3-wheeled tap taps (taxis) and cars weaving through the busy streets to their destinations. An 18-mile ride takes 45 minutes. The hospital is downtown and surrounded by city noises with blaring horns, shopkeepers hawking their wares and children on the way to school. Even the sound of music from a funeral procession filters into our conference room.


Team debrief over breakfast and street life in Cap-Haitien

Today there were lectures on ectopic pregnancy, multiple pregnancy, ultrasound in labor and postpartum, as well as a lecture on GYN issues in pregnancy. Dr. Lemaire and Dr. Michel gave a case presentation of a woman who developed early onset pre-eclampsia and IUGR. It was a dramatic story of the challenges women in the developing world encounter accessing appropriate care.


ISUOG Trainer Dr Stéphane Michel lecturing and trainees with their youngest visitor!

After lunch we did hands-on scanning and trainee evaluations. We had patients ranging in age from 16 to 87. We scanned non-stop until 6:30 PM. Four machines were operational, two had vaginal probes and everyone was intent on having an opportunity to do scans.

Earlier in the week we had been challenged by one of the trainees with the question, “What relevance does ultrasound have in Haiti today?” And after four days of scanning, the question had been laid to rest.

Despite the extended hours of scanning, we could not accommodate all the patients and had to ask a dozen to come back the next day. Over dinner at our hotel we came up with questions for a game of “Ultrasound Jeopardy” that we plan to play with the trainees tomorrow, our last day.


ISUOG Trainer and Project Lead Dr Lisbet Hanson (centre) with trainees.

This week has been both exhilarating and exhausting – another ISUOG Outreach experience I’ll remember fondly. I look forward to returning soon again!

Hot weather. Spicy food. Welcome to Outreach in Haiti


ISUOG Trainer Gail Ghiretti (pictured centre) with fellow ISUOG trainer Dr. Stephane Michel (pictured left in blue) during the practical training session (Photo by L. Hanson)

It’s day three of ISUOG Outreach in Cap-Haitien and the trainees are showing more progress by the day! ISUOG Trainer Gail Ghiretti writes to us from the field in today’s featured blog:

“Hot as in weather and spicy as in food. 

Food is very spicy here and found in the most unusual things …like peanut butter. This is my first visit to Haiti and my first time volunteering with ISUOG. I have worked in various places around the world teaching ultrasound but I must say this group is the most enthusiastic I have seen in awhile. It’s Day 3 and they are still interested in our presentations! And they all participate in hands-on without becoming bored by watching others scan ; they help and encourage each other with a positive attitude.


ISUOG Trainer Gail Ghitetti delivering a lecture (Photo by L. Hanson)

There’s lots of laughter in my scanning room but unfortunately, I am not sure what they are saying because everyone is speaking French to each other. My high school French teacher would be appalled since – believe it or not – I did get all A’s in class but that was a long time ago. I am learning new words and should be fluent by end of the week.

When someone asks a question, a great response for scanning instructions are responses like such as “gauche” and “droite”. Impressed ? Oui, n’est – ce pas ?

It has been a pleasure working with the trainees and I look forward to working with them in the future. À bientôt !”

Keep following our blog throughout the week for more live updates from Haiti. For more information around our work in Haiti, be sure to visit our website.