Global Health: Teaching ultrasound in Malawi – Dr Bergman
Global Health is more than providing medical care in resource limited countries. To create sustainable global health, four physicians from Contra Costa Family Medicine residency traveled to Malawi to do an ultrasound training for Malawian clinicians. They were kind enough to send us lots of photos and the following summary:
For the past five years, Contra Costa has taught a comprehensive point-of-care ultrasound course for its Family Medicine residents. While these skills have become quite useful in the hospital and the clinic in the US, their ultrasound skills have become particularly important while they are working in under-resourced settings both at home and abroad.
We were invited to give this ultrasound course by Dr. Martha Makewero, the director of Malawi’s nascent Family Medicine residency, to do a similar ultrasound training for first year residents in Malawi as part of our UCSF-Contra Costa Global Health Fellowship’s mission to support the development of Family Medicine in Malawi.
Although the hospital had two ultrasound machines -including a Titan which was chained to the wall in radiology, none of the clinicians had been trained to use them! Thanks to Sonosite, we were able to hand-carry two M-Turbo ultrasound machines to assist with the training.
We did a two-day ultrasound training for 20 clinicians, including Family Medicine residents, Clinical Officers, nurses, and Surgery residents at the Mangochi District Hospital. We created a special curriculum that was geared toward pathology seen in Malawi, including an module on the FASH exam (Focused Assessment of Sonography in HIV & TB).
The response was extremely positive from the learners, who collectively rated the course a 4.7 out of 5 on their evaluation forms, and many verbalized their desire for more trainings for a longer period of time.
Of note, our first teaching model patient (who had been admitted for two days with undifferentiated abdominal pain and had been waiting for a formal ultrasound), was found to have a positive FAST exam, and was sent immediately to the operating room where she was found to have a ruptured ectopic pregnancy, had bleed 2 liters into her peritoneal cavity, and a had a hemoglobin of 4.7. She recovered well. Also, we identified a young boy in decompensated heart failure with severe mitral regurgitation, and expedited his care to the tertiary care referral hospital. The two Sonosite’s ultrasound loaners may well have saved both of their lives.
Attached are some photos from the course.
Kevin, Neil, Jay, Danielle
Contra Costa Family Medicine Residency Program