Tuesday, March 25, 2014

All in a Day

As snow fell on the east coast of the U.S., the sun shone brightly on Port-au-Prince.  A day full of didactic sessions for physicians and radiographer, hands-on ultrasound and a competitive battle of "name that diagnosis" ensued as part of the clinical case review.  In addition, the ACR and University Hospital signed a MOU to assist in the training of the 10 radiology residents currently enrolled there. 

The day started with several outstanding presentations given by Bob Harris, M.D., (Co-Program Chair), Sung Kim, M.D. and Ron Adler, M.D. on musculoskeletal imaging.  Dr. Adler provided the basics and physics of MSK ultrasound along with lectures of the upper and lower extremities and a well-received talk on MSK ultrasound procedures.  Dr. Kim provided a talk on axial skeletal trauma, appendicular skeletal trauma and CT of the axial/appendicular skeletal trauma.  Dr. Harris provided a presentation entitled "Ultrasound of Superficial Lumps and Bumps".  The session concluded with Dr. Gina Joachim, a Haitian radiologist who presented on musculoskeletal ultrasound in Haiti. 

The afternoon ultrasound sessions included our two diagnostic medical sonographers, Tammy Stearns and Veronica Hernandez as well as Drs. Ron Adler, Rusty Brown, Bob Harris and Dorothy Bulas.  The Clinical Case Review led by Dr. Jim Borgstede and ably translated by Dr. Ernst Garcon became a battle royale of name that ailment on the ultrasound pitting on side of the room against the other.  The competitive juices were flowing as each side shouted out the condition or diagnosis on the screen.  The engaging session left many in the room laughing with no clear winner determined (although that is under review). 

While the morning sessions were going on, a leadership team comprised of Dr. Ellenbogen, Applegate, Brown and Borgstede travelled to the University General Hospital to meet with the Chief Medical Officer and the Executive Director.  Discussions ensued about plans for the new hospital and the training of the ten radiology residents.  Significant progress had been made to buildings damaged by the earthquake on the hospital's campus.  The new hospital is scheduled to open in December 2016 with the radiology department gaining new radiological equipment.  We took a tour of the radiology department and met with personnel on the ground.  We also toured the pediatric and emergency facilities as well as the nursing school that devastated during the earthquake. 

In the evening we toasted the end of a productive two-day conference with pizza and Prestige (a Haitian beer).  We met with colleagues from Chicago who were there to put on a program in pediatrics as well as representatives from Grace Children's Hospital, ICC, the University General Hospital and Hospital Bernard Mevs.  Enjoy the pictures below that highlighted a very busy day!

Approximately 100 physicians participated in the second of two Radiology Education Days in Haiti.  Here the audience is captivated by a presentation by Ron Adler, M.D. on Ultrasound of the Upper Extremity. 

Ron Adler, M.D. provides lectures, translated and interpreted in French by Ernst Garcon, M.D., to the audience on musculoskeletal ultrasound. 

Robert Harris, M.D. and Sung Kim, M.D. have an opportunity to discuss the morning's sessions prior to beginning afternoon didactic lectures and hands-on ultrasound.
The ACR leadership delegation toured the grounds at the University General Hospital including the pediatric unit where this small baby rested quietly. 

Patients wait outside the radiology department at the University General Hospital in Port-au-Prince

Child at the University General Hospital in Haiti. 

ACR Speaker Kimberly Applegate watches the University General Hospital's Executive Director, Dr. Maurice Fils Mainville, sign a Memorandum of Understanding for the organizations to work together to supplement the radiology resident's training.  The radiology resident program has increased from 0 to 10 in the past two years. 

Veronica Hernandez performs MSK ultrasound on a patient as physicians participating in the program watch.  Each physician had the opportunity to try their hand at the transducer to enhance their ultrasound imaging skills. 
Tammy Stearns helps guide a physician on a pediatric abdominal ultrasound procedure.  The ultrasound devices were generously loaned by Sonosite and GE.
Local radiologists and physicians take turns providing ultrasound to an infant during Radiology Education Days in Haiti. 
 Terry Konn, Ph.D. provides interactive session to a room full of radiographers at Radiology Education Days in Haiti
 Amy Hoffman lectures to radiographers at Radiology Education Days. 
 Jim Borgstede, M.D. and Ernst Garcon, M.D. engaged the room in a competition of "name that ailment on the ultrasound".  The highly enjoyed event was very engaging, illuminating and showed the physician community in Haiti to be both knowledgeable and quite competitive indeed. 
The faculty was fully engaged.  Here, Dr. Adler works with a physician as they ultrasound the foot and ankle of Dr. Kim, standing in as a patient during the musculoskeletal ultrasound session. 
Dr. Adler and local physicians collaborate over a finding during the ultrasound session. 
Patients enjoying some free coloring books and crayons as a reward for their patience and great behavior. 
After a long, but successful day, and after enjoying some pizza and Prestige, Dr. Paul Ellenbogen, Chair, ACR Board of Chancellors, thanked the volunteers, organizations, patients, staff and representatives that made the event possible.  He ended his remarks with a great joke. 

Monday, March 24, 2014

Successful Day in Port-au-Prince

Approximately 140 physicians and radiologic technicians (radiographers) attended didactic lectures, hands-on ultrasound sessions and clinical case review as part of Radiology Education Days. 

After Paul Ellenbogen, M.D., Chair, ACR Board of Chancellors and Josette Bijou, M.D., Medical Director of Grace Children's Hospital welcomed the attendees the sessions began in earnest.  The physician participants received outstanding presentations on pediatric imaging from Dorothy Bulas, M.D. (Program Co-Chair--WFPI), Kimberly Applegate, M.D. (ACR Speaker) and Jennifer Nicholas, M.D., (WFPI).  The faculty presented on pediatric chest, pediatric skeleton, radiographic imaging of the vomiting infant, child presenting with abdominal pain, pediatric cranial ultrasound, pediatric renal ultrasound, pediatric gynecological emergencies--radiographic evaluation, and the importance of ALARA.  These same participants were then provided an opportunity to test their knowledge with hands-on ultrasound studies on pediatric patients in the afternoon.  Ultrasound instructors included representatives from the SDMS (Tammy Stearns and Veronica Rodriguez) as well as Drs. Douglas "Rusty" Brown, Paul Ellenbogen, Robert Harris, James Borgstede, Dorothy Bulas, Kimberly Applegate and Jennifer Nicholas.  Drs. Bulas and Applegate moderated the Clinical Case Review and Ernst Garcon, M.D., a native of Haiti and professor at Columbia University provided interpretive services. 

Amy Hoffman and Terry Konn, Ph.D. provided an outstanding radiographer all-day didactic session on basic patient care and safety, radiation protection principles, occupational safety and radiographic pathology. 

The engaged participants stayed to the end of the course and looked forward to learning more tomorrow as the program switches from primary pediatric imaging to musculoskeletal imaging.  The entire team looks forward to further engagement tomorrow.  

Dr. Kimberly Applegate presents in front of a capacity crowd of 100 physicians as part of Radiology Education Days. 

Amy Hoffman presents on the topic of Occupational Safety to radiographers during Radiology Education Days. 

Radiology residents outside of Radiology Education Days.  The University Hospital radiology residency program started last year with a group of four residents.  There are now 10 radiology residents in training at the hospital. 
Applying knowledge gained during the didactic lectures, Tammy Stearns (SDMS) trains physicians on ultrasound techniques of a small child during Radiology Education Days in Haiti. 


Sunday, March 23, 2014

Arriving in Port-au-Prince

We arrived today in Port-au-Prince.  Our delegation had the opportunity to take a brief tour of Grace Children's Hospital.  Some exciting news is occurring at Grace.  New construction has begun providing expanding administrative and training capacity.  This is great news and I'm sure will be part of our discussion with ICC/Grace's leadership tomorrow.  We also drove through the city to see some of its highlights (and challenges).  A country of contrasts, much has begun to improve since the post-earthquake days and much remains to be done. 

It was great seeing old friends today.  The staff at ICC/Grace could not be more impressive serving as an outstanding host for our conference.  We start early tomorrow with roughly 140 health personnel expected.  After months of preparation, we can't wait to get started. 

Luggage including donated supplies and ultrasound equipment is brought on board a transport bus from the airport in Port-au-Prince. 

New construction begins at Grace Children's Hospital increasing their administrative and training facilities. 

Program faculty tours waiting areas leading to exam rooms at Grace Children's Hospital in Port-au-Prince. 

Saturday, March 22, 2014

Getting to Know You

One of the things I have truly enjoyed on our previous trips has been the instant camaraderie that develops among our faculty.  This evening was no different.  Arriving from as far away as North Dakota, we came from different places but sharing a common desire to assist medical personnel in Haiti. 

Tonight was for breaking bread, telling good stories and sharing experiences.  Tomorrow morning we head out for Port-au-Prince as we get ready to assist over 140 Haitian medical personnel with pediatric and musculoskeletal imaging, radiographer training, hands-on ultrasound and clinical case review.  We look forward to our journey. 

Wednesday, March 19, 2014

Getting Close

We received four ultrasound loaner units from our friends at Sonosite today.  Also, our great PR Team has begun getting information out about our trip.  You can access the press release at http://www.acr.org/About-Us/Media-Center/Press-Releases/2014-Press-Releases/20140319-Radiology-Experts-Return-to-Haiti-to-Educate-Local-Radiologists-and-Technologists.  Our registration continues to grow for the trip with over 100 attendees already signed up for the event.  We are excited to be staying close to the University Hospital and look forward to our trip to HUEH and Grace Children's Hospital.  Mostly, we look forward to working with the dedicated health care workers of Haiti who selflessly dedicate themselves to serving their fellow citizens.  Finally, after 8 inches of snow on Monday, I am personally looking forward to the warm weather.  The anticipation is definitely growing. 

Friday, March 14, 2014

Back to Haiti

The American College of Radiology Foundation is sponsoring a trip to Port-au-Prince, Haiti to assist physicians and radiographers with educational content and hands-on learning in diagnostic imaging.  The two-day program (March 24 and 25) chaired by Dorothy Bulas, M.D., FACR and Robert Harris, M.D., FACR will feature didactic sessions on pediatric imaging and musculoskeletal imaging.  Morning didactic lectures will be followed by afternoon ultrasound sessions.  The program will also feature interesting case review.  In addition to the physician training, the American Society of Radiologic Technologists will be featuring sessions both days for radiographers. 
The trip is a collaborative effort that includes participation from the following organizations:  the World Federation of Pediatric Imaging; the Society of Diagnostic Medical Sonography, the Society for Pediatric Radiology, the Society of Radiologists in Ultrasound, and the American Society of Radiologic Technologists.  Grace Children’s Hospital (of Port-au-Prince) and International Child Care are also sponsoring the event.  Sonosite and GE have provided loaner ultrasound machines in support of the program. 

In addition to the program, ACR leaders including Paul H. Ellenbogen, M.D., FACR, Chair, ACR Board of Chancellors and Kimberly E. Applegate, M.D., FACR, ACR Council Speaker will join former and current ACR Foundation International Outreach Committee chairs James P. Borgstede, M.D., FACR and Douglas “Rusty” Brown, M.D. respectively to meet with officials from multiple hospitals.   The ACR Foundation has been working with Grace Children’s Hospital and the University Hospital since its fact finding mission in early 2011.  The 700 bed University Hospital has recently started a radiology residency program and is planning to rebuild the facility featuring new radiology modalities.  The ACR Foundation, along with several other charitable organizations, are working with the radiology residents to assist with training on these newer modalities. 

This is the third broad-based educational program that the ACRF has sponsored in Haiti since the earthquake in 2010.  The previous programs, which have reached capacity in attendance, have been very well received.  This year’s meeting, to be held at the Plaza Hotel close to the University Hospital, is expected to reach capacity as well and will build on the learning to date. 
We are all very excited about the trip and to see our friends again in Port-au-Prince.