Sustainable global health engagement - teaching ultrasound to change practice in Liberia

Dr. David Young
Earlier this year, I participated in a project to teach point-of-care ultrasound skills to residents studying in Liberia. This project, coordinated through Children's Hospital Boston and the Liberian College of Physicians and Surgeons, is essential in places like Liberia. There are few options for imaging diagnostics, especially at our main cite JFK Hospital in downtown Monrovia. While there is an X-ray machine, there is no official ultrasound department and no CT or MRI imaging available. While ultrasound requires training and practice, it is a very affordable, portable, and safe tool with hundreds of applications. 

The project was one year in duration and included several emergency medicine providers from American universities, including two providers from the University of Colorado. As the in-country Ultrasound Education Director, each provider worked with 12 residents across 5 specialties: Family Medicine, General Surgery, Internal Medicine, Obstetrics-Gynecology, and Pediatrics. 

Because there were 5 specialties, I devoted one day per week to one specialty. A typical day started with rounds, where I would attempt to interject ways in which ultrasound could have aided in the diagnosis or facilitated an intervention of one of the patients. After rounds, I would work with the residents to improve their ultrasound skills and increase their number of scans. Once a week, the Ultrasound Champions gathered for a lecture in the late afternoon to discuss a new application of ultrasound. In the month I was there, I focused on procedural skills such as US-guided IVs and central lines, paracentesis, and regional nerve blocks. 

The course was a resounding success. Even in the time I was there, I saw tremendous growth in all of the residents. I enjoyed sharing my ultrasound skills and learned quite a lot myself in the process. I am certain the Ultrasound Champions are working hard to share their knowledge to the next class of residents.