Where ultrasound is a novelty
Doing good with TRF help
While pregnant women across the world are opting for 3D and 4D ultrasound tests at plush clinics to see their baby’s development, “this centre in Uganda didn’t have a couch, or even a table and a screen for privacy of the patients in the examination room,” says Rtn Dr Raju Sahetya, an obstetrician and gynaecologist, member of RC Bombay Airport, D 3140.
So he had to ask for two mats to be laid on the floor, one for the patient and the second for the machine and the doctor to sit on! He was part of the 7-member Vocational Training Team (VTT) sponsored by Districts 3140, India; 5500, Southern Arizona; 9211, Uganda, and TRF, for conducting training in Pre-natal Diagnostics and Nutrition for 23 rural healthcare providers at Uganda from April 17–19. The participants were midwives, clinical officers from the Ministry of Healthcare and four representatives from local AIDS information centre clinics.
Earlier in 2013, Rehema, a midwife in Jinja, Uganda, was uneasy conducting ante-natal consultations, because she was not sure about what was going on inside the pregnant woman. She reported this to Dana Thienemann Smith, a nurse from Arizona and a VTT member. With her own funds Dana purchased and shipped an ultrasound equipment to the midwife. “Within 3 days, this equipment helped save the life of a woman with an ectopic pregnancy,” she adds.
In 2014, a nationwide Uganda Healthcare Summit sponsored by D-5500 District Grant identified adoption of rural healthcare centres by Rotary clubs to enhance diagnostic capabilities in rural clinics, and provide better nutrition for expectant mothers and infants as a priority.
“Patients lined up in excitement because they had not heard of or seen an ultrasound machine,” says Dr Sahetya. The midwives under his supervision examined fetal movements and heartbeats of 15–40 cases a day. “The patients had tears of joy in their eyes when they saw their babies on the screen. That smile is something I am never going to forget,” he adds.
The captured images were saved and sent to the consulting hospitals (with whom a MoU has been signed with assistance from the VTT) using flash drives and printouts. Where net-connectivity was available, emails were sent, so that the radiographers could interpret them and give suitable directions.
Discussions revolved around what if the hospitals were reluctant to take on this additional task of assessing ultrasound reports from the healthcare centre? In a lighter vein, a participant suggested, “The power of personal relationships. Invite the radiographer or the doctor for a cup of tea as soon as this training ends, to create a rapport.”
Ethical issues
Having the ultrasound diagnostic capacity is a new ethical issue for the midwives. “India and China are two countries struggling with moral and socio-economic fallout from the new technology,” says Dr Sahetya. Termination of pregnancy because of gender or likely birth defects (congenital defects, Down Syndrome, etc) are issues which are raising several questions in these countries where the female child is considered a burden.
Dr Sahetya’s wife Malati, who conducted the evaluation procedure at the end of each session said, “They wanted to know so much more. Most of them wanted us to stay back there. It’s lovely how Rotary brings people together and changes your life forever. The midwife Philemon Tumwebaze says, “Rotary is doing a good job. We will need further training to enhance our skills. Please make sure you come back and teach us more. Thank you!”
