Tag Archives: Maternal Health

Supporting Outreach work in Yangon – round two!



Dr. Philippe Jeanty and team in Yangon (from left to right: Dr Gwan Ju, Dr. Jeanty, Dr. Ya Chiao, Dr. David Berck and Dr. Federico Badano)

Last year, ISUOG Outreach supported the work of dedicated Outreach Committee Member and renown expert, Dr. Philippe Jeanty in launching a program in Yangon, Myanmar. Now returning for Trip II with his team (Federico Badano from Argentina, Gwan Ju of South Korea, Ya Chiao from Taiwan and David Berck from USA), Philippe reports from the field midweek to share with our followers some updates from training.

“The second course to Myanmar has started, with all the previous students minus four, delivery, maternity leave and two who were not able to get replacement (the obstetrician who came to the course had to be cross-covered by a surgeon for the emergency C-section section). One of the students, whom I like very much, is one of six obstetricians for a city of 4 million people!!

We had asked the students to fill a spreadsheet with all the findings they made during the year and they did a remarkable job at it: probably a first in ISUOG Outreach history!

I like how no one could find cardiac or skeletal dysplasia ( so not a defect on me 😊 )

This table is big, but it shows the constant efforts they did during the year.

Today, we started with the second set of lectures we were provided by from ISUOG, of which Federico enriched very substantially with many video clips. I added some cases related to the lectures and to insure participation, we got four students to come to the front of the class and answer each case. Nothing like being in the hot seat to focus attention! They did pretty well.

The afternoon and the end of the morning we actually did scan. We had not pre-selected the students and some were still fairly hesitant, so we redistribute them into basic, intermediate, advanced level so that the teaching could be more focused; that worked out to be better.

Most of the patients had not undergone ultrasound in pregnancy before.  Our cases included numerous twins, suspected growth restriction, and placenta accreta.

The more interesting case was a hydranencephaly with retinal detachment and it was their first time seeing retinal detachment (a nice case )

On the second and third day, we went on with the lectures. We had asked all the students ahead of time to prepare a 5-minute presentation and with the firm hand of Dr Yin Yin Soe and Dr. Khin Latt (our local contacts) they had all prepared one or several cases, including many ectopic pregnancies, ovarian masses and pre-eclampsia with IUGR. The 2 more striking cases were an abdominal pregnancy and a 38 weeks tubal pregnancy in which the location had not been correctly recognized. This was great way to re-emphasize the routine exam: after the first sweep always document the cervix, size, competence and vasa previa.

The students were very comfortable giving the presentations and very organized in doing so. Mostly their images were poor, often too gained, with depth too far, and captured with cell phone. To remedy this, we went over the depth setting, the gain, and Ya Chiao Hu gave them a short presentation on how to save images digitally on a memory stick!

Dr Gwan Jun Kim, who was with us last year and participated during all trips of the Outreach program in 3 Mongolia, gave the CNS and cardiac lectures with his usual brand of humor and animated descriptions. He is always popular!

Dr. Federico Badano also lectured with great calm and a ton of videos to the ISUOG.

Dr. David Berck, who is also a veteran from Mongolia, was with us as well. In the end, we ended up all adapting Gwan Jun technique of abundantly moving around, using the many dolls that Dr Khin Latt had prepared.

We had a very large supply of patients, and even an extra ultrasound machine. The course is sponsored by Mindray and the local distributor “Concordia” and Dr Than Win had really gone out to make sure we had all that we needed. The extra machine allowed the students to practice under less time constraint. Ever efficient Justin Liu was going from machine to machine making sure everyone was alright with the knobology. He was part of it group last year too but was much less shy this year and has remarkably improved his fluency in English. By the way, all the students speak perfect English but with a British flair (liquor.. for amniotic fluid) and an accent sometime difficult for my deficient ears.

The only really problem was that it is incredibly hot here and the Air Conditioning could not keep up with the 30 people in the room, plus the patients and six ultrasound machines. I was dripping over my students who would provide me wipes and water every three minutes. So sweet!

The students are very comfortable with us. Last year, being shy, I had asked them to write their questions on paper and leave the questions on our desk for us to answer. This year, there was no problems at all. I think that getting them to come answer the cases in front of everyone, although terrifying at first, gave them much more confidence. It helped that Thao and Ya rewarded the correct answers with a gold medal of chocolate. A old trick I used in Mongolia too.

On to the fun part where David was interested in the local dress that men wear here, called Longi. Dr Khin Latt generously gave one to each of us!! Resulting in a rather unique picture (as see at beginning of blog).

Tomorrow is it last day and we are already nostalgic about leaving our students for a year.”

Follow our blog for more stories from the field!


Coming to full circle: Outreach returns to Ghana for its last trip



Local Ghana Trainer Osei Bonsu explaining a lecture to the trainees

As the year comes close to an end, so does ISUOG’s Outreach Program in Ghana as the team heads over to Kumasi this weekend for the last of six trips made to the Ashanti region over the years since 2011. Led by Dr. Anthony Johnson (Chair of the Outreach Committee), the trainers (Dr. Theodora Pepera-Hibbert of Ghana/UK and Dr. Janet Horenstein of the United States) will be passing over the baton to the key trainees who have now been identified as local trainers to train a new batch of trainees from all over the Ashanti region. Both ISUOG’s International Development Coordinator, Gesu Antonio Baez, and GE Healthcare’s Tammy Anderson will also be in Ghana to support this last effort in Kumasi in partnership with Kumasi Metro Health Services and local NGO partner Women’s Health to Wealth. Follow our blog all next week as we share more inspiration from the field. To find out more of what we’ve done in Ghana, visit our website.

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.

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.



22 trainees and 90 degrees…..Outreach in Haiti continues!

Day Two of the ISUOG Outreach Program in Cap-Haitien continues again today. Reporting straight from the field is Project Led Dr. Lisbet Hanson who recounts the day’s success in today’s blog post:


The ultrasound dream team (Left to right: Dr. Stephane Michel (Haiti), Dr. Vladimir Lemaire (Haiti), Gail Ghiretti (USA), and Dr. Lisbet Hanson (USA) – Photo by L. Hanson)

“22 Trainees; 4 Trainers; 5 ultrasounds (not always working); 90 degrees Fahrenheit

We hit the ground running early Monday after Opening Ceremonies with the playing of the Haitian National Anthem, a warm welcome from the Hôpital Universitaire Justinien Administrative Director and a benediction by Dr Cyril Leconte, Chef de Service d’OBGYN.

Stéphane, Vladimir and Gail’s excellent lectures have included a variety of basic introduction to ultrasound topics, including ultrasound physics, transducers, knobology, biometry, etc. We are using the standardised ISUOG lecture sets and adding videos and images when we want to emphasise a point. The trainees consist mostly of OBGYN and Family Medicine Residents, but also a few seasoned practitioners. They are not afraid to speak up when they have questions or to debate a point passionately. Some have never touched an ultrasound machine before. Most have had a little exposure in their residency. Dr. Leconte is clearly an impassioned educator. His vision is to develop and incorporate a formal ultrasound-training program into the three-year OBGYN Residency at HUJ.  I am really enjoying the opportunity to finally meet him and get to know the man who applied to ISUOG Outreach for this training opportunity a few years back.  That evening, he gave us a tour of the city and with a little history lesson on the way home; it was very interesting!


Cap-Haitien (Photo by L. Hanson)

Our lecture hall is above the busy Maternity Ward where 300+ deliveries are performed monthly. The ward consists of six large open rooms with up to ten beds in each. Every single bed is occupied, not only by the patient but the family caring for her and her newborn; there is zero privacy. Those in labour can be seen walking the open halls, sitting on the front steps or crouching in the hallways. From time to time, one hears a labouring woman cry out.  Nurses in starched white uniforms, tights and shoes navigate the crowds to deliver medication, checks IV’s or get a blood pressure.

Our afternoons are spent scanning. Most of the patients have been obstetrical though we have had at least two that insisted they were pregnant but alas, no IUP was discovered.  It is very hard to convince these ladies that they are not pregnant. I am told this happens quite often here in Haiti.  The rooms for scanning are small but the enthusiasm high. The trainees critique each other:

“Slide, don’t rotate.” says one.

“Where is the stomach on the abdominal circumference?” says another.

The patients wait patiently for their scans. Most are more than 24 weeks GA and having their first scan. We practice our 6-Step-Approach and the four transducer moves. By the second day, the trainees are getting really getting good.


Patients waiting patiently (Image by L. Hanson)

Around 5:30 PM, the ISUOG Team heads back to the hotel for a shower and dinner.  We talk about the day, call home to check on family, review the next day’s lectures and fall into bed.

After all, the rooster will wake us up in just a few hours….. “

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.


ISUOG Outreach returns to Haiti!


Day 1 ISUOG Outreach in Cap-Haitien (Photo by V. Lemaire)

ISUOG Outreach returns to Haiti this week – this time, the Northern city of Cap-Haitien. Partnering with Hopital Universitaire Justinien (HUJ) and local NGO Zanmi Lasante, the lead – led by Dr. Lisbet Hanson, will be training a group of 18 doctors on basic ultrasound in Obstetrics and gynecology. For this endeavour, Philips has donated a machine for the project to the University Hospital. What makes this program so dynamic is that ISUOG Outreach is proud to site that one of its previous trainees from the ISUOG Haiti (St. Damien) program, Dr. Vladimir Lemaire, has now joined the team as an ISUOG Outreach Trainer! Catch his blog below as he explains how the day unfolded and the emotion it brought:

“After a very early morning breakfast, my heart was completely full as I walked back to the Hopital Universitaire Justinien (HUJ) here in Cap-Haitien where almost 13 years ago, I undertook my own residence. Inspired by the familiarity and with both great pride and humility, I returned but this time as a trainer.


Dr. Vladimir Lemaire teaching with the donated Philips machine (Photo by L.Hanson)

During the time I was there for my residence, ultrasound training seemed to me at the time completely out of reach, But after ceremonial formalities and a brief introduction from Dr. Lisbet Hanson (USA – Haiti Team Leader), time was of the essence and we went rapidly into the subject. Dr. Stéphane Michel (Haiti), Ms. Gail Ghiretti (USA) and myself gave our presentations one by one, with the pre-test interwoven between the first and second talks.


Trainees listening attentively to lecture (photo by V. Lemaire)

We were pleasantly surprised by the quality of the questions and case studies of the participants during the lectures and this feeling was reinforced during the practical lesson where they really showed a good level of skill.

The day ended with a debriefing with Dr. Hanson, during which she reemphasised the “points to improve on”, responding the last questions from the participants – it was an incredible day!”

Check out more about our previous work in Haiti by visiting out website and stay tuned for more blogs straight from the field during the week!


Visions of Burma – supporting training in Yangon


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!


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!



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

Day 1 in Sudan and ready to learn


(ISUOG Ambassador and Trainer Hisham Mirghani speaking to trainees; image courtesy of G.A Báez for ISUOG Outreach)

Sunday the 13th of November kicked off the ISUOG Outreach program in El Obeid, Sudan with 30 trainees eager to get started at the Planned Parenthood Headquarters in El Obeid. The morning began with an opening ceremony, presented by the Minister of Health, Dean of the University of Kordofan, along with ISUOG Ambassador Hisham Mirghani and ISUOG International Development Coordinator Gesu Antonio Báez. This was followed by a practical scanning session. And the sessions were big – up to 70 patients were in the waiting room ready to be scanned by the trainees who were also eager to learn.



(Hands on training with ISUOG Trainer Yasmin Casmod; image courtesy of G.A Báez for ISUOG Outreach)

MindRay generously loaned two machines to the program to enhance the training experience. The rest were provided from local hospitals and were functioning in full form!

Each trainee was divided into groups based on their years of experience with ultrasound in order to provide a tailored approach to their learning. This also allowed them to get to know other trainees who came from afar – some travelled up to five hours from other parts of Sudan!

Dr Reem Abu-Rustum ended the day with theoretical training by going over the “Six Step Method”.  Prof Mirgani demonstrated how to properly handle the probe, Yasmin Casmod covered knoblology and Dr Angela Ranzini spoke about Fetal Biometry.

With day one already a success, the group looks forward to taking the scanning skills of the groups to next level. With hope, it will be a successful week to follow, or as they say in this part of the world “inshallah”.


(ISUOG Trainer and Ambassador Reem Abu-Rustum with trainees; image courtesy of G.A Báez for ISUOG Outreach)

The purpose of the ISUOG Outreach project to Sudan is to provide ultrasound training to local OB/GYN practitioners with the intention that these trainees eventually become local trainers.

Phase I comprises of three week-long training programs, which will take place in a 12-18 month time frame with a space of 6 months between training. Between training, trainees will be mentored by designated trainers from the project team to provide guidance on scanning. By the end of Phase I, trainees will be competent in ultrasound scanning techniques and conduct quality scans in line with basic training outreach templates (SO2).

For more information on the goals and outputs on the program see http://www.isuog.org/Outreach/Projects/Sudan/Sudan+1.htm

ISUOG Outreach off to Papua New Guinea!


Training in Papua New Guinea
Image courtesy of Dr. Nayana Parange

Some exciting news – in partnership with the Australasian Society of Ultrasound in Medicine (ASUM ) on their first Outreach endeavor – ISUOG Outreach will be supporting a program in Port Moresby, Papua New Guinea from 23 October to 27 October. Led by ISUOG Outreach volunteer Dr. Nayana Parange, a team of three from Australia (Dr. Alice Robinson, Dr. Kris Barnden and Dr. Sujatha Thomas) will be training nine trainees from around the area in basic OB/GYN ultrasound at the Port Moresby General Hospital. While they will be working on the current two machines in place, GE Healthcare has partnered with the program to lend portable machines for this endeavor.

Of all the countries in the Asia/Pacific region, Papua New Guinea (PNG) has the highest levels of maternal mortality and has actually shown little (if any) progress on achieving the previous Millennium Development Goals (MDG’s) on reducing maternal mortality at a staggering 230 women dying for every 100,000 (according to HDR 2014 Report).  More statistics on PNG can be found here via the World Health Organization.

With the levels of women dying in the country due to preventable causes, providing basic training in OB/GYN ultrasound is vital to help identify issues in advance. Be sure to watch this space as we hear more from the field and provide more updates from the team!



Village near Port Moresby
Image courtesy of Nayana Parange

Why women’s health is a vital part of global human rights


Mothers in Ghana
(Image courtesy of Gesu Antonio Baez for ISUOG Outreach – Ghana)

10 December was Human Rights Day. When Hillary Clinton made the statement, “Women’s rights are Human Rights” during the 1995 UN Conference on Women in Beijing, it rocked global consciousness in recognising women’s rights as an integral part of human rights. But what about women’s health?  Is it a part of human rights and how does ISUOG defend this? ISUOG’s International Development Officer, Gesù Antonio Báez, explores this topic further.


It would be foolish to believe that women’s health didn’t play a crucial role in global women’s rights or human rights in general. Yet somehow, despite the numerous international conventions and covenants that have been championed by the UN and its global partners, women’s health has been pushed as merely a topic for development and humanitarian endeavours, as clearly demonstrated with the now defunct Millennium Development Goals (MDGs) and newly initiated Sustainable Development Goals (SDGs) this past September.

Of course, this is not to belittle its category as an important item on the developmental agenda; in fact, it’s paramount to it! But women’s health amounts to so much more than as a single task to accomplish in a nation’s pursuit towards overall development. Because truth be told, women’s health – particularly their right to quality healthcare – is vital not just for global development, but crucial in the fight to defend women’s rights. For if women are the backbone to society and essential for a country’s empowerment, then denying them adequate healthcare is both a violation of their human rights and a denial for a country in achieving its true potential in global development.  Human rights are, first and foremost, a matter of preserving dignity and guaranteeing women access to competent doctors and health services is a task in which all nations and key human rights agents must be willing to invest upon in order to properly demonstrate their commitment to the Universal Declaration of Human Rights (UDHR), adopted by the international community exactly 68 years ago on 10 December 1947.

As an agent for women’s health, ISUOG’s mission is to ensure that every woman has access to competent ultrasound scanning and that OB/GYN conditions are effectively diagnosed because it is a women’s right – her human right – to receive proper treatment and care.

Either via an ISUOG Approved Course in Nigeria, a World Congress in Rome, an International Symposium in India, or an Outreach program in Papua New Guinea,  ISUOG strives to ensure this sacred right is respected and honoured by empowering OB/GYN professionals with the necessary skills needed to conduct a proper scan with quality educational resources, no matter where in the world they are located because the key to ISUOG’s mission is every woman.

Women’s rights are human rights as Hillary Clinton said nearly twenty years ago in Beijing, but women’s health is a fundamental part of this because it honours the women’s right to live. Through ISUOG’s mission and role in the important task of upholding this right, I believe we are on the way towards making an overall respect for this right completely universal.