Thursday, March 28, 2013

Saying Thanks is Much Easier To Do

While saying goodbye was a difficult thing to do, saying thanks is much easier. 

To start, thanks to Paul Ellenbogen, M.D., Chair, ACR Board of Chancellors for his leadership and commitmen to this trip and for the commitment to improving radiology at GCH and in Haiti.

Thanks to Jim Borgstede, M.D., Chair, ACR Foundation International Outreach Committee for his foresight in developing the College's international outreach efforts. 

Thanks to Bibb Allen, Jr., M.D., Vice Chair, ACR Board of Chancellors and Howard Fleishon, M.D., Speaker, ACR Council for their participation in the program and their observations on ways to improve what we can provide for radiology in Haiti.

Thanks to Rusty Brown, M.D. for his program leadership during this and our June program last year.  His patience, wisdom and direction were essential to the success of these programs. 

Thanks to Chuck Phelps, M.D. for opening doors and making long-lasting connections in Haiti and for his sense of service and generosity. 

Thanks to Jeannine Hatt, M.D. for her insights into ICC and Grace and for her wisdom and relationships with pediatricians both in the U.S. and in Haiti that made this trip possible. 

Thanks to the amazing faculty compiled largely from the World Federation of Pediatric Imaging, the Society for Pediatric Radiology, the Society of Radiologists in Ultrasound, and the Society of Diagnostic Medical Sonographers.  This collaboration proved in part that we can get a lot done working together.  Special thanks to our faculy members including Eva Rubio, M.D., Rebecca-Stein Wexler, M.D., Ron Cohen, M.D., Marthe Munden, M.D., Jennifer Nicholas, M.D., Ernst Garcon, M.D. and Michelle Wilson, Ed.D(c), RDMS for their inspired teaching, dedication and achievement.  Also special thanks to Gina Joachim, M.D. for her presentation, interactions with patients and cases and ongoing service to the people of Haiti. 

Thanks to Dorothy Bulas, M.D. and Don Haydon for helping us identify such a great faculty team. 

Thanks to Ernst Garcon, M.D. and Marie Lina Excellent, M.D. for their invaluable translations of program materials and lecturs. 

Thanks to the our friends at the ICC offices including Keith Mumma and Tom Willson whose planning was critical to our success.

Thanks to our friends at Sonosite particularly Wendy Schall and the outstanding international loaner program team.  Your willingness to provide these devices helped roughly 100 physicians improve or be introduced to a necessary diagnostic tool for the people of Haiti. 

Thanks to our friends on the ground at ICC/Grace.  Of particular note was the leadership of ICC Board Chair, Billy Brandt, Grace Children's Hospital Medical Director, Josette Bijou, M.D., program meeting manager Robenson Lucceus and the indispensible Rosa Voltaire Damas.  Their hospitality and graciousness to help host and run the program was instrumental. 

Thanks to the fine physicians who directly helped us along the way including Gina Joachim, M.D., Carrine Cleophat, M.D., Jacqueline Gautier, M.D., Marie Lina Excellent, M.D., Josette Bijou, M.D. and the many others seeking to improve patient care in Haiti. 

Thanks to the various executives we met including Billy Brandt, Jacqueline Gautier, M.D., Margaret Mehu, the Doctors Bitar (Marlon and Jerry), Gabou Mendy, M.D., Josette Bijou, M.D. and Maurice Mainville. 

Thanks to the 100 participants whose thirst for knowledge and willingness to come great distances to improve their knowledge to the betterment of their country was an inspiration to us all. 

Special thanks to Lauren Alfero, whose staff support was instrumental last June and whose full logistical support both planning and helping execute the program was invaluable to its success. 

This was a tremendous team effort.  I hope I did not leave anyone out because it took a lot of hard working, dedicated and

Wednesday, March 27, 2013

Saying Goodbye is Hard to Do

We ended our trip with a nice dinner and many fresh and poignant memories.  Despite more airport issues (our flight was delayed in Port-au-Prince followed by delays in Miami’s Customs) the trip ran smoothly. 

We walked away with 100 physician attendees receiving intensive didactic and hands-on training for their pediatric patients.  We provided direct case content for contemporary cases being experienced in Haiti.  We provided access (via Sonosite) to ultrasound services on pediatric patients and assisted the physicians with the proper use and detection of anatomic features and disease specific findings.  We visited, met and/or toured five major hospitals in the Port-au-Prince and surrounding area including Hospital Bernard Mevs, St. Damien’s Hospital, the General Hospital (HUEH), the University Hospital in Mirebalias.   We heard from executives, doctors, patients, and others about the ongoing challenges in medicine, radiology and life in Haiti.  We successfully collaborated with SRU, SPR, WFPI, SDMS, ICC/Grace and Sonosite.  Most importantly, we were able to contemplate improved, long-term and sustainable radiological care for Haiti’s health care system.  We remain committed to this longer term cause which was reinforced by our visit. 

Mostly, today it was simply hard to say goodbye. It was hard to say goodbye to the Haitian physicians and dedicated health workers, to the people of Haiti we met along the way, to the staff at ICC/Grace and those who transported us to our many destinations, and maybe, most importantly, to the bonds we made with each other collectively working in the service of others. 
When I first went to Haiti, Chuck Phelps, M.D. tugged me on the shirt as we were making our way on to the airplane and said simply, “You better watch out, once you get into Haiti, Haiti will get into you.”  Haiti remains in me and in the hearts of those of us fortunate enough to have witnessed a country ravaged by challenge but optimistic about its future.  It has once again been a privilege to be part of this ongoing effort.

Team gets ready to head back home--from left to right: Chuck Phelps, M.D.,  Paul H. Ellenbogen, M.D., Ernst Garcon, M.D., Jeannine Hatt, M.D., Jennifer Nicholas, Eva Rubio, M.D., Douglas "Rusty" Brown, M.D., Michelle Wilson, Ed.D(c), RDMS, Bibb Allen, Jr., M.D., Marthe Munden, M.D., Jim Borgstede, M.D., Rebecca Stein-Wexler, M.D., Howard Fleishon, M.D., Ron Cohen, M.D., Brad Short and Lauren Alfero (ACR staff)

Tuesday, March 26, 2013

Third Day in Haiti is Literally as Hot as the Program

The third day on our trip has been another outstanding day of content, dialogue, engagement and productivity. 

The day once again started with outstanding programming featuring a wonderful presentation on Measures and Strategies for Radiological Exploration in Some Pediatric and Clinical Settings by Gina Jaochim, M.D., radiologist from Haiti.  Next Eva Rubio, M.D. gave a compelling lecture on Genitourinary Ultrasound in the Pediatric Patient.  Rebecca Stein-Wexler, M.D. followed with an informative session on Imaging of the Premature Infant.  Marthe Munde, M.D., provided an excellent presentation on the topic of Radiographic Presentation of Sickle Cell Disease.  Following a break, Rebecca Stein-Wexler presented an engaging session on the topic of Neonatal Head Ultrasound.  Although CT is a fairly new technology for Haiti, Dr. Ron Cohen introduced much of the audience on the promise of the technology with a compelling session on Pediatric Head CT.  The Clinical Case Discussion was led by Drs. Jesssy Colimon, Jeannine Hatt, Chuck Phelps, and Ernst Garcon. 

While the morning session was underway, ACR leaders visited the largest hospital in Haiti, the 700 bed HUEH or General Hospital.  The institution has reinstated its radiology residency program.  This is very significant given that Haiti has an estimated 19 radiologists for a population of roughly 10 million.  There were many opportunities for collaboration discussed.  The ACR leaders met with Dr. Maurice Mainville, Exective Director of HUEH, the chief resident, Dr. Saint Louis "Mike" Evans,and Drs. Claudine Cleophat and Dr. Gina Joachim both Haitian radiologists.  The ACR viewed the radiology department and left with a list of items to follow-up on as potential areas of collaboration. 

The afternoon hands-on sessions were once again well-intended and well-received.  Hands-on ultrasound provided by Sonosite for the neonatal head, gastrointestinal tract, liver, biliary, spleen and genitourinary tract were provided by Michelle Wilson (SDMS), Drs. Munden (WFPI), Borgstede (ACR), Brown (SRU), Ellenbogen (ACR) and Fleishon (ACR).  Image review sessions were provided in separate learning rooms by Drs. Nicholas (ACR), Stein-Wexler, M.D. (WFPI), and Rubio (WFPI).  Clinical case discussions that focused on specific cases in Haiti were given by Drs. Gautier (St. Damien's Haiti), Hatt (Grace Children's Hospital/ICC), Phelps (GCH/ICC), Garcon (ACR) and Cohen (WFPI). 

The pictures below capture some of the images of a day filled with excellent presentations, engaging discussions, collaborative meetings, attentive and bright students and an outstanding faculty. 

Eva Rubio, M.D. engages the audience during a presentation on genitourinary ultrasound in the pediatric patient on Tuesday morning.
The audience listens intently as Dr. Joachim of Haiti lectures on Measures and Strategies for Radiological Explorations in Some Pediatric Clincial Settings
During lunch, ACR leaders meet with Dr. Bijou of Grace Children's Hospital to go over plans for the radiology unit in the planned hospital
Jim Borgstede, M.D. provides guidance to an attendee as they perform pediatric imaging of the abdomen to an infant.
 Dr. Brown illustrates proper technique to students as he scans an infant. 
During a lighter moment, infant with mom tries her hand at scanning prior to the procedure. 
Jennifer Nicholas, M.D. provides a session on clinical image review.  These small class sessions were highly interactive and well-received by the attendees. 
Michelle Wilson, Ed.D(c), RDMS provides instruction on technique in handling the ultrasound transducer.
ACR leadership team meets with executives and radiologists from the University or General Hospital (HUEH).  HUEH just started a radiology residency program admitting four students in January.  

Monday, March 25, 2013

Radiology Pediatric Imaging Program Highlights Active Day in Haiti

The program got off to a great start today.  The day started early as the facility was prepared at the Visa Lodge for the 100 attendees. 

Chuck Phelps, M.D. supervises as a sign goes up at Visa Lodge.

The meeting was kicked off with opening comments from Paul Ellenbogen, M.D., Chair, ACR Board of Chancellors, Jim Borgstede, M.D., Chair, ACR Foundation International Outreach Committee, Dr. Josette Bijou and William Brandt of ICC/Grace Children's Hospital. Dr. Ellenbogen thanked the physicians of Haiti for their interest in pediatric imaging and especially cited the work of ICC/Grace Children's Hospital in making this effort possible. He also thanked the program chair, Douglas "Rusty" Brown, M.D., and cited the outstanding faculty represented by the WFPI, SPR, and SRU.  He further thanked the SDMS for their contribution to the hands-on session.  Dr. Borgstede also thanked the College, Grace/ICC and most importantly the dedicated medical personnel throughout Haiti for their interest in further education in radiology. 

Paul Ellenbogen, M.D. kicks off meeting at Visa Lodge
Drs. Bijou and Mr. Brandt welcomed the attendees and thanked the ACR Foundation and the faculty for continuing their efforts to improve radiological care in Haiti. 

Drs. Bijou and Brandt (3rd and 4th from left) join leaders and faculty members just prior to beginning Radiology Education Days. 

The meeting progressed throughout the morning and included lectures on the Basics in Pediatric Chest and Abdominal X-ray Interpretation by Eva Rubio, M.D., Radiographic Evaluation of Pediatric Respiratory Infections by Ron Cohen, M.D., Radiographic Evaluation of Pediatric Abdominal Emergencies by Ron Cohen, M.D., Basics of Ultrasound Screening and Interpretation by Rusty Brown, M.D., and Gastrointestinal Ultrasound in the Emergency Pediatric Setting by Marthe Munden, M.D.  Following these didactic lectures, clincial cases were presented and discussed. 

Ron Cohen, M.D. of WFPI provides a lecture to attendees on pediatric respiratory infections.

The afternoon sessions provided outstanding opportunities for participants to use ultrasound on pediatric patients focusing on neonatal head, gastrointestinal tract, liver, biliary tract, spleen and the genitourinary tract.  In addition, image review sessions and clinical case discussions were used to bring real life cases to the attendees. 
Participants in Radiology Education Days in Pediatric Imaging get a hands-on opportunity to use portable ultrasound technology provided by Sonosite to visualize the kidneys.

While the morning didactic sessions were going on ACR leadership had an opportunity to visit Grace Children's Hospital and learn more about plans to rebuild their destroyed facilities. 

ACR representatives including Drs. Ellenbogen, Fleishon, Allen, and Borgstede, and pediatrician and ICC Board Member Jeannine Hatt, M.D. meet with Drs. Bijou and Mr. Brandt to go over renderings of new Grace facility.
In addition, the team took a tour of the current transitional facilities and saw the portable hybrid x-ray unit generously donated by Siemens and facilitated by the ACR in use. 

Drs. Ellenbogen and Borgstede stand next to donated Siemens portable x-ray unit. 
The event received local press as Dr. Ellenbogen was interviewed for television by local Haitian reporters (below). 

The leadership team also was invited to Hospital Bernard Mevs to see their mobile GE CT scanner, tour their hospital facilities and learn more about a radiologic technician program that they have initiated. 

Despite a busy day, the team found enough time to enjoy some time with the patients.  Here Howard Fleishon, M.D, Speaker, ACR Council plays with young patient following some ultrasound scans. 

In all a very busy, productive and enjoyable day.  The program will continue tomorrow with outstanding lectures, more hands-on opportunities and a visit to the 700 bed University Hospital. 

Sunday, March 24, 2013

First Day in Haiti Goes Well

The first day of our journey began today.  We had a busy but enjoyable day.  Following a close call at an unusually busy Miami International Airport we took off for Haiti mid-morning.  We arrived in Port-au-Prince at lunchtime and proceeded on to the Visa Lodge where we checked in and enjoyed the local faire. 

Our mid-day trip included an outstanding presentation given by Drs. Marie Lina Excellent and Jacqueline Gautier. 

Children in pediatric inpatient area at St. Damien's

Members of team listen to Dr. Gautier at St. Damien's

Following an informative visit, we took off for a tour around town.  There continues to be progress made from the earthquake.  Of most significance is the reduction in tent cities and the clearing of rubble from the streets. 

 Despite clearer streets some scars remain in Port-au-Prince from the earthquake

Following our visit we met with Drs. Jean  Claude Cadet and Gina Joachim to discuss the training of radiologic technicians in Haiti.  Next we were joined by Dr. Gabou Mendy, Chief Medical Director from Partners-in Health's Hospital in Mirebalais.  We discussed potential collaborations and networking opportunities.  I want to personally thank all of our hosts today.   We gained a significant amount of information about both radiology and pediatric medicine in Haiti.  I also want to thank Dr. Jeffrey Mendel for helping us make a connection with Dr. Mendy and with his significant work volunteering in Mirebalais.

Tomorrow starts an even busier day as over 100 attendees are coming to listen to the outstanding faculty (special thanks from the WFPI, SPR, and SRU) who will present on topics in pediatric imaging in the morning followed by hands-on training (thanks to SDMS) on four Sonosite portable ultrasound units.  I want to thank ICC/Grace Children's Hospital for making this program possible.  Also in the morning ACR leadership will meet with representatives of ICC/Grace Children's Hospital and the Hospital Bernard Mevs. 

Tuesday, March 19, 2013

Capacity Already Reached as Team Readies for Haiti

We have already reached the limit of 100 attendees for Radiology Education Days to be held March 25-26 in Port-au-Prince, Haiti.  A waiting list has been developed in case of cancellations.  The program is focused on pediatric imaging, an important and necessary service in this country of 10 million.  I want to thank the fine staff at Grace Children's Hospital and ICC for their logistical support.  We are especially indebted to the efforts of Rosa Voltaire Damas in registrering Haitian physicians and fielding questions about the program. 

Yesterday, we received four portable ultrasound units from our friends at Sonosite.  Sonosite generously provided loaner units with multiple transducers that will assist our hands-on training each afternoon.  Special thanks go to Wendy Schall and the outstanding staff at Sonosite for quickly turning around our requests in rapid time. 

We are all very excited to initiate this next stage in our efforts in Haiti. 

Friday, March 8, 2013

ACR Goes Back to Haiti as Radiology Education Days Focuses on Pediatric Imaging

We are headed back to Port-au-Prince, Haiti for our next education session which will be held March 25-26 at the Visa Lodge.  We have over 80 pre-registrants signed up for the event which will include didactic lectures as well as clinical image review sessions and hands-on ultrasound training. 

I cannot thank enough the following people who will be attending the program:

Paul H. Ellenbogen, M.D., Chair, ACR Board of Chancellors
Bibb Allen, Jr., M.D., Vice Chair, ACR Board of Chancellors
Howard Fleishon, M.D., Speaker, ACR Council
James Borgstede, M.D., Chair, ACR Foundation International Outreach Committee
Jeannine Hatt, M.D., ICC USA Board of Directors,
Chuck Phelps, M.D., ICC USA Board Affiliate
Douglas "Rusty" Brown, M.D., Program Chair from the Mayo Clinic
Ernst Garcon, M.D., Columbia University
Ron Cohen, M.D., World Federation of Pediatric Imaging (WFPI),  Children’s Hospital, Oakland, CA
Marthe Munden, M.D., (WFPI), Texas Children's Hospital
Jennifer Nicholas, M.D., Lurie Children's Hospital, Chicago, IL
Eva Rubio, M.D., (WFPI), Children’s National Medical Center, Washington, DC
Rebecca Stein Wexler, M.D., (WFPI), UC Davis Children’s Hospital
Michelle Wilson, Ed.D(c), RDMS, Society of Diagnostic Medical Sonographers, Napa, CA
Lauren Alfero, ACR Staff

In addition, I want to thank the generosity of the following organizations the ACR Foundation is partnering with including:

Grace Children's Hospital, Port-au-Prince, Haiti
World Federation of Pediatric Imaging (WFPI)
Society for Pediatric Radiology (SPR)
Society of Radiologists in Ultrasound (SRU)
Society of Diagnostic Medical Sonographers (SDMS)

I would also like to especially thank Sonosite for their ongoing support through the ultrasound loaner program.  The units are an essential ingredient in providing hands-on training.

I would also like to thank Drs. Maria Ines Boechat and Dorothy Bulas of WFPI for their support and help in identifying an outstanding faculty.  Finally, I would like to thank in advance Drs. Billy Brandt, Josette Bijou and Gina Yoachim and Rosa Voltaire Damas for their on-the-ground support and Keith Mumma and Tom Willson of International Child Care for their guidance and direction. 

There will be many more to thank in the days to come. 

We are truly looking forward to reacquainting ourselves with old friends, establishing new friends and most importantly continuing the ongoing progress to improve radiology in Haiti. 

Tuesday, January 8, 2013

Back to Port-au-Prince

The ACR Foundation will be sending a team back to Port-au-Prince in late March to put on a two-day program focused on pediatric imaging. While plans and faculty for the program are being finalized, we are planning on utilizing both didactic and hands-on training for the session. More information to come. The program dates are tentatively scheduled for March 25-26.