Updates: Keep up to date with projects as they happen by reading our Outreach blog.
Project Title: ISUOG Outreach training in ultrasound in obstetrics and gynecology, Part 2
Location: Kumasi, Ghana
Dates: 23 - 28 May 2011
Project partners: ISUOG is extremely grateful to its industry and logistic partners in this project for making the Outreach trip possible. Siemens donated the 3 ultrasound machines used in this, and the original training last September 2010. Millennium Cities Initiative are our local project partners and have coordinated the participants and the training in Kumasi. Physicians for Peace are our logistical partners and have assisted with travel logistics for this project.
MCI was represented by MCI Regional coordinator, Abenaa Akuamoa-Boateng. Abenaa was very helpful in organizing transfers, accommodation and transportation for the trainers to the different hospitals. Abenaa and her team visited the different hospitals during the training to ensure there were no problems that needed to be addressed, and organised meetings between ISUOG and hospital and government health representatives.
Training team:
Ann Tabor, Denmark(team leader)
Dario Paladini, Italy
Anthony Johnson, USA
Nayana Parange, Australia
Christian Bamberg, Germany
Karen Wøjdemann, Denmark
Manna Kamio Badiella (ISUOG Outreach Program)
From left to right: Karen Reinhold Wojdemann, Anthony Johnson, Ann Tabor, Dario Paladini, Nayana Parange and Christian Bamberg
Participants / trainees:
11 participants from 3 hospitals where ultrasound equipment had been donated in September 2010, consisting of 4 physicians and 7 nurse midwives
Ultrasound machines
The 3 ultrasound machines had been allocated to Suntreso, Maternal and Child Health Hospital (MCHH) and Manhyia hospitals.
Format of the course:
The first day was a theoretical course held at Kumasi South Hospital, reviewing material from the first course, and with live demonstrations of early and late obstetrical scans.
During the following three days, the team of trainers broke up into groups of two and carried out decentralised practical hands-on training at the three facilities with ultrasound donations. This was done with the aim to help ISUOG see the extent to which scanning has been integrated into daily clinical practice, and to work together with the trainees to find ways in which this can be further encouraged.
Suntreso Government Hospital
Trainers: Anthony Johnson and Karen Wøjdemann
Trainees: 2 doctors and 2 midwives
Manhyia hospital
Trainers: Dario Paladini and Christian Bamberg
Trainees: 1 doctor and 2 midwives
Maternal and Child Health Hospital (MCHH)
Trainers: Nayana Parange and Ann Tabor
Trainees: 1 doctor, 2 midwives and 1 nutritionist
Patients for the hands-on scans were booked in advance by the three facilities, and were very active, with between 15 and 34 patients being scanned at each site every day.
The trainees took turns at scanning and observing, with the trainers mostly supervising. The patients were gynaecological cases and a good mix of early, midtrimester and late pregnancies. Some abnormal cases were found – lobar holoprosencephalus, a vanishing twin, a 5 week pregnancy in a uterus with necrotic myomas, polycystic ovarian syndrome, premature ovarian failure, IUGR, oligohydramnios, missed abortion and complete spontaneous abortion. These cases were referred to physicians for follow-up treatment.
Reports were written using the ISUOG reports provided in September 2010. ISUOG logbooks were given out to the trainees and filled out after each scan.
Lessons learned and next steps:
In recent years Ghana has introduced the National Health Insurance Scheme which allows every pregnant woman to have two ultrasound scans. By looking at patients’ Maternal Health Record Books, it is clear that this opportunity is being taken up by most women. However, it also became clear after two days in the local setting that there is a need to ensure that all midwives are trained on what ultrasound means for their practice and what information can be derived from the scans and how to interpret it. The need for further training in gynecology was also identified.
There is a clear shortage of doctors and midwives in the system and our trainees lead extremely busy workdays but they were very engaged and enthusiastic about further integrating ultrasound as a monitoring and diagnostic tool in their practice for improving maternal health.
ISUOG, hospital management and the trainees have also agreed to continue communicating in order to improve reporting and feedback, crucial to improving the way ultrasound is being used in the clinical setting as well as for tailoring the next training course to identified needs specific to the Ghanaian environment.
The Kumasi ISUOG Scanning Club, which was founded following the September 2010 course, will continue to organize meetings of the trainees, this effort will be coordinated by Erica, Dr Hamilton and Yusif.
There was a great synergy between the trainers, with each person bringing a little bit of their personality and style to benefit the teaching.
ISUOG and the Outreach team would like to thank all the partners and trainees in helping to make this project a success. We would especially like to thank the trainers who took time out of their busy schedules to participate in this project.
Read the report from September 2010.
Updates: Keep up to date with projects as they happen by reading our Outreach blog.