Tag Archives: Outreach

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.

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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.

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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:

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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!

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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.

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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.

 

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

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:

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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.

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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

Making a difference in Papua New Guinea

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Dr. Nayana Parange (at centre with scarf) with PNG team and trainees, displaying their certificates (image courtesy of Dr. N Parange for ISUOG Outreach/ASUM)

ISUOG Outreach Volunteer, Dr Nayana Parange has recently led the Papua New Guinea Outreach mission in October, conducted in partnership with the Australasian Society of Ultrasound in Medicine (ASUM). In this blog, she recounts her experience on the field and her impressions with the local dynamics.

Papua New Guinea – the land of striking natural beauty with fascinating tribal customs. It is also one of the toughest places in the world to become a mother.  With great excitement, I was coming back to Papua New Guinea (PNG) for my fifth annual visit for another intensive workshop, but this time with an enthusiastic team. The team comprised of Dr Sujatha Thomas from Darwin, Dr Kris Barnden from Tasmania, Dr Alice Robinson from Melbourne and I from Adelaide, and all of us arrived in Port Moresby on Saturday, 22nd October 2016.

Our intensive workshop commenced on Sunday morning, and Prof Glen Mola, an Australian-trained Obstetrician/Gynecologist, introduced us to the trainees, all of whom were doctors training in OB/GYN, as well as rural and remote emergency medicine. The trainees were eager to start training on a Sunday morning, full of hope and keen to learn basic techniques to use ultrasound to help their patients.

We started off the workshop with a quiz to establish the baseline knowledge of the cohort. This enabled us to plan and focus efforts on aspects of hands-on training, such as the ISUOG “six-step” method  of evaluation. As the workshop progressed, we also got several opportunities to interact with medical students, midwives and consultants, and we were able to conduct several presentations for the whole department as well.

It is hard to envisage the reality of pregnant women in PNG. Nearly 15,000 women deliver in Port Moresby General Hospital, and women able to find their way to the hospital are some of the more fortunate ones. Maternal and perinatal mortality is high with 88-98% of these deaths being preventable. Extreme poverty, remote geographic location, mountainous topography leading to inaccessibility of health services, sociocultural factors and most importantly, inaccessible and ill-equipped health centres with a shortage of skilled professionals have contributed to the poor maternal mortality rate in the country.

We came across a wide range of pathology and I was deeply moved by the stoicism displayed by the women, especially when given bad news. One such incident that has been indelibly imprinted in my memory, is where Sujatha and Alice scanned a lady at around 14-16 weeks of amenorrhoea, and diagnosed an abdominal ectopic pregnancy of nearly 16 weeks gestation. We then got to know later that she could be operated upon, in a timely manner, where although she lost three litres of blood, she recovered from the surgery. At least one life saved because of ultrasound!

Common causes of maternal death in PNG include sepsis, low lying placenta leading to postpartum haemorrhage, ectopic pregnancies leading to catastrophic bleeds. Fetal and neonatal deaths here are common because of growth restriction and prematurity. A vast majority of these problems can be recognised on ultrasound, and most often, interventions can be applied to prevent mortality and morbidity, but there is a shortage of skilled personnel to diagnose these problems to be able to manage them effectively.  The dedication of the health professionals though, often overworked and under resourced, is inspiring. Despite the insurmountable challenges, as Prof Glen Mola says, there are many people doing amazing things within the given constraints and making a difference in so many lives through sheer will and personality. “We can’t give up”, he often says.

I would be remiss if I didn’t mention the effort and dedication of the trainee doctors to master the content as much as possible within a short duration. All of them were quite proficient by the end of the training program, and were able to obtain anatomical landmarks and measurements correctly, and confidently perform the six step approach. Quiz scores improved from a 20 percent average to 90%!  A job well done!

Thank you ASUM, ISUOG and our wonderful outreach team! I feel very grateful and privileged to have been able to participate and play a role in PNG ultrasound outreach. We have a long road ahead of us, and the path is not easy, but onwards and upwards from here. Together, hopefully, we will be able to make a difference.

 

“Individually we are one drop. Together, we are an ocean” –  Ryonosuke Satoro.

Humbled. Elated. Empowered.

Blog by ISUOG Ambassador and Trainer Reem S. Abu-Rustum

Humbling. Elating. Empowering. That is how I would describe my first Outreach mission with ISUOG to Sudan.

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Gesu Antonio Baez introducing ISUOG Outreach

From the moment our team of trainers met, it was obvious how compatible we all were with our different ethnic backgrounds and personal experiences. Under the watchful eye of ISUOG’s phenomenal Gesu Antonio Baez, and the leadership of insightful Dr. Mirghani, we knew that this was destined to be a most impactful mission for all involved.

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On the Lakeshore of Rahad

Humbling it was to be received by the warmest most genuine people of Sudan who welcomed us like royalty, and escorted us with pride all over Al Obeid and North Kordofan State. Despite the logistical challenges, they made sure we had the most comfortable accommodations and an organized clinic set up with all the necessities in place, not to mention the unforgettable “Jebana” coffee. The Minister of Health, his Excellency Dr. Abdullah Faki Omer, never left our team: from receiving us at the airport to escorting us as we departed. Dr. Khidir was the driving force behind our entire mission on the Obeid front: the true embodiment of commitment and dedication.

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Rahad Lake

Elating it was to have the privilege to participate in the sonographic education of 30 most dedicated Ob/Gyn and Radiology Physicians who had come from all over North Kordofan State to attend our 5 intense days. We had their undivided attention whether it was during the didactic or the hands-on sessions. They had such a hunger and eagerness to learn, and were so receptive to any instruction or criticism to help them improve their sonographic skills. The trainees were divided into 4 groups and rotated on a daily basis with the trainers. On the last day, each team of trainees ended up with their trainer from the first day. I had the “Red Team” and it was amazing to have them back with me on the last day: the progress they had made was unbelievable. They were secure and confident in utilizing the systematic 6 Steps Approach, were able to recognize key anatomical landmarks and were able to manipulate the probe to arrive at the required biometric planes.

Dr. Samira Demonstrating 6 Steps and the Red Team

Empowering it was to be able to play a role, albeit indirect and quite small, in the future of the mothers of Sudan. Visiting the labor ward at the Al Obeid new Maternity Hospital, a referral center for the area, offered us a glimpse of the challenging conditions faced by both physicians and patients. Though all the basic necessities are met, the patients have to secure and purchase key “material” for labor, and they are usually discharged 2 hours postpartum to make room for the other 15-20 daily parturients, not counting the cesarean deliveries. Nonetheless, there is an unshakable commitment from the Sudanese Government led by the Ministry of Health, and an army of health care providers dedicated to improving the maternal and neonatal mortality rates and their co-morbidities. It was most empowering for me, as a member of the ISUOG Outreach Team, to be a part of Sudan’s vision for a future where every woman has access to a properly performed sonographic examination in order to identify and safeguard against the major contributors to maternal morbidity and mortality.

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Our Entire Team

Humbled. Elated. Empowered. That is how I feel. That is what Sudan and its beautiful people have left me with. I feel honored and privileged and I eagerly look forward to our next mission amongst the most gracious Sudanese…

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Closing Ceremony 

 

ISUOG Outreach is off to Sudan!

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(From left to right: The Sudan Outreach Team – Prof. Hisham Mirghani, Dr. Reem Abu-Rustum, Dr. Angela Ranzini, Ms. Yasmin Casmod and Mr. Gesu Antonio Baez – ISUOG’s International Development Coordinator)

We’ve got more news and we’re excited to share with you!

ISUOG Outreach is proud to announce its first program taking place in El Obeid, Sudan from 13-17 November 2017. Led by ISUOG Ambassador to UAE and the Middle East, Prof. Hisham Mirghani (UAE/Sudan), the team comprises of Ms. Yasmin Casmod (South Africa), Dr. Angela Ranzini (USA) and ISUOG’s Ambassador to Outreach in Lebanon and the Middle East, Dr. Reem Abu-Rustum (Lebanon). ISUOG’s International Development Coordinator, Gesu Antonio Baez, will also be joining the team in coordinating the project and working with key stakeholders on the ground.

The team will be training 28 trainees from North Khordofan State with the aim to have them become future trainers in OB/GYN ultrasound locally over time. ISUOG Outreach is very grateful to partner with Salamat Doctors Charity, the University of Kordofan and the Sudanese Ministry of Health on this endeavor.

Watch this space as more updates come up as the project develops. For more information on the project, please visit our website.

ISUOG Outreach off to Papua New Guinea!

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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!

 

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Village near Port Moresby
Image courtesy of Nayana Parange

Guest Bloggers wanted for ISUOG Outreach!

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(Image by G.A Baez for ISUOG Outreach)

The ISUOG Outreach Program thrives on one thing – passion. Whether on the field or in the scanning room, we aim to share that passion with all our followers via our blog and on Facebook.

Have you volunteered with ISUOG Outreach before? Are you currently on the field conducting Outreach around OB/GYN ultrasound training? Have you yourself benefitted from ISUOG Outreach?

We are now accepting guest bloggers for 2016. Interested? Email us and let us know what you want to share. Your experience on the field? A topic related to ISUOG Outreach work? Something else?

This is a small way to make a big impact on how the world views ISUOG Outreach. Email outreach@isuog.org with you name, profession, country of residence and what you want to share.

Milestones: ISUOG’s role is to become the bridge in education

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(Image courtesy of ISUOG Outreach – Somaliland)

Paulina Stachnik is ISUOG’s Events and Education Assistant. Passionate about delivering high quality educational resources, she has worked as a teacher on three continents and completed her MSc in International Development in 2014 at the University of Edinburgh. She believes that comprehensive education and skills building are the key to long-term and sustainable growth around the world. As a result, she’s chosen to share how her passion and education mix in with ISUOG’s overall mission.

 

Milestones are a unique occasion for pause and reflection. While ISUOG has done little in terms of slowing down, with a growing list of 13,300 members, 25 years marks a significant chapter in the journey of an organization with humble origins and mindful values: quality, innovation, leadership, and learning.

Milestones are also an opportunity to come full circle and to gauge our progress, not only by how far we have come from the starting line, but also by how true we have remained to the ideas that have sparked ISUOG’s conception. As new initiatives continue to take form, ISUOG remains mindful of the most valuable—and renewable—resource it offers: education.

Picture this: one doctor in Ghana region attends a course on prenatal genetics via live streaming. She shares the knowledge with ten colleagues at her hospital; each doctor scans fifteen women every day—two spot an anomaly they would have otherwise not known about.

One Chinese trainee’s newly acquired knowledge of a Doppler technique shifts the direction of a fetus’ development, significantly increasing the chance of the recommended treatment’s success.

A case study presented by a young Turkish researcher starts a conversation between two doctors who come to a conclusion about an unresolved diagnosis.

ISUOG’s role is to become that bridge—for sharing knowledge, progressing research, encouraging discussion, redefining expertise—and after a quarter of a century, that bridge links a community of medical professionals in 126 countries. Momentum continues to build—ISUOG’s online CME platform makes learning a click away, as easily accessed from a suburb of Doha as a home office in London; translated guidelines make critical information clearly understood in native tongues; over 730 scientific abstracts for the 2015 World Congress in Montreal arrived from every continent.

Soon, it’ll be time for a birthday cake and birthday wishes. Though 25 candles may not be needed, as ISUOG’s ultimate goal of making comprehensive education and training for all professionals, anywhere in the world, is becoming a reality.

And we’re just getting started.