Tuesday, April 1, 2014

Leaving/Thanking Old Friends and New

On Wednesday morning we awoke to clear skies and warm temperatures.  We ate a quick meal, settled up with the hotel and met our friends from ICC to take us to the airport.  Some members of our trip stayed in Haiti to assist in other endeavors. 

The trip seemed so quick yet a lot was accomplished in a short time.  A capacity of 100 Haitian physicians participated in an outstanding two-days of lectures and hands-on training The faculty presented 8 didactic lectures on pediatric imaging, concluding with multiple pediatric radiology case discussions and the hands-on application of pediatric ultrasound on the kidney, gastrointestinal, liver, gallbladder, cranial/spine, appendix and pylorus. 

On the second day, the faculty presented a total of 9 didactic lectures on musculoskeletal ultrasound followed by a competitive round of ultrasound clinical case review and five ultrasound stations focusing on musculoskeletal ultrasound including specific focus on shoulders, wrists, hands, ankles and feet. 

The two-day sessions also included a separate track for radiographers.  Once again a capacity of 40 radiographers attended didactic and interactive sessions focused on basic patient care and safety, radiation protection principles, occupational safety, radiographic pathology (including respiratory and skeletal), film processing, exposure factors and manipulation, pediatric radiographic considerations and developing exposure charts.  The session concluded with an excellent questions and answers exchange. 

We also used the opportunity to travel to Grace Children's Hospital to see new construction at that facility. We met with Dr. Josette Bijou and Billy Brandt, Chair, ICC Haiti to discuss developments for the ICC/Grace Children's Hospital which will be built in two phases.  We also had the opportunity to look at the donated Siemens hybrid portable x-ray machine that we donated to investigate its digital use in the near term. 

We met with Dr. Maurice Fils Mainville, Executive Director of the University General Hospital, and Dr. Carine Cleophat, Director of the University General Hospital's  Radiology Department.  We were elated by the news of the second class of radiology residents (a total of 10) now in training.  Should all 10 matriculate through the program, it would increase the total number of radiologists in the country from 19 to 29 (an over 50% increase).  We signed a Memorandum of Understanding to assist the hospital with its training program and prepare them for the new radiology modalities planned for the new hospital to be built by the end of 2016. 

We also met with leaders from the medical school to discuss a four-year radiographer program and with contacts from other institutions about possible collaborations moving forward.

The most difficult part of the trip is saying goodbye (or until we meet again) to our friends from Haiti and our impressive team (in action below).   

Kimberly E. Applegate, M.D., FACR, ACR Speaker (seated) discussing ultrasound on an infant. 
Former ACR Chair, ACR Board of Chancellors and Chair, ACR Foundation International Outreach Committee discussing ultrasound findings with Haitian doctor. 
Tammy Stearns, MS, RDMS, RVT, RT(R) works with group to illustrate the use of the transducer and ultrasound machine in Haiti. 

Jennifer Nicholas, M.D. (seated) discussing ultrasound on an infant. 

Dorothy Bulas, M.D., FACR provides a didactic lecture on Monday, March 24. 

Robert Harris, M.D., MPH, FACR provides ultrasound advice as Haitian physicians (and the patient) observe the machine.  Dr. Marie Excellent (far right) translates in Haitian Creole for attendees.  Dr. Excellent has provided outstanding assistance as a translator during all three courses of Radiology Education Days in Haiti. 

Amy Hoffman, MBA, RT(R), (CT), RDMS, CRA provides a lecture to an engaged radiographer class as part of Haiti Radiology Education Days. 

Sung Kim, M.D. delivers a presentation on musculoskeletal imaging

Veronica Hernandez, RDMS, RMSK works with group on MSK ultrasound. 
Ron Adler, M.D., Ph.D., works with attendees to review and assist with the use of MSK ultrasound. 
Paul H. Ellenbogen, M.D., FACR, Chair, ACR Board of Chancellors opens meeting by reviewing the ACR's efforts in Haiti. 
Terry Konn, Ph.D., LRT leads discussion in the radiographer courses during Radiology Education Days in Haiti. 

Ernst Garcon, M.D., from Columbia University and a native Haitian let's the faculty and attendees know how much their work is making a difference in Haiti.  Dr. Garcon has served as the major translator of all materials including slides as well as the primary translator during didactic sessions and clinical case review at each conference. 
Douglas "Rusty" Brown, M.D. (right) listens to the progress made at Grace Children's Hospital.  Dr. Brown is the current Chair, ACR Foundation International Outreach Committee and was program chair for the first two Radiology Education Days in Port-au-Prince. 
Chuck Phelps, M.D. and Jeannine Hatt, M.D. (far left and far right respectively) introduced the ACR to ICC and Grace Children's Hospital immediately after the earthquake.  The two have been volunteering at Grace Children's Hospital for over 15 years. 
Lauren Alfero has been an integral member of the team planning both the team's activities and coordinating on-site logistics for the program.  Lauren also assisted with the presentations during the conference. 

Preferring to stay out of the pictures, I am accompanied in this shot by Dr. Carine Cleophat, Chair, Department of Radiology at the University General Hospital.  I have had the great fortune to be associated with the ACR's ongoing program over the past four years. 

Our team from left to right (front row):  Terry Konn, Ph.D., LRT, Paul H. Ellenbogen, M.D., Lauren Alfero, Rusty Brown, M.D., Veronica Hernandez, (back row) Brad Short, Kimberly Applegate, M.D., Dorothy Bulas, M.D., Robert Harris, M.D., Jim Borgstede, M.D., Ernst Garcon, M.D., Ron Adler, M.D., and Amy Hoffman, MBA, RT(R), (CT), RDMS, CRA.  Not pictured are Sung Kim, M.D., Jennifer Nicholas, M.D., Chuck Phelps, M.D., Jeannine Hatt, M.D. and Tammy Stearns, MS, RDMS, RVT, RT(R).

Time for Thanks!!!

To our Organizational Friends:  We thank our friends from Sonosite and GE for assisting us with loaner devices for the ultrasound sessions.  Their assistance was critical to apply the knowledge gained during the lectures. 

We especially thank the following organizations for their co-sponsorship of the program, commitment to Haiti and to the improvement of radiological care:

American College of Radiology
Society of Radiologists in Ultrasound
American Society of Radiologic Technologists
Society of Diagnostic Medical Sonography
Society for Pediatric Radiology
World Federation of Pediatric Imaging

We thank our friends from ICC/Grace: To Emma Arana and Rosa Voltaire Damas, you were both gems helping coordinate the program, assisting with on-ground logistics and registration both before and during the conference.  Thank you both so much.  Keith Mumma and Michael Palmer--thanks for all you do to make ICC and Grace Children's Hospital a working reality.  We could not enjoy the relationship we have had without your support.  To Drs. Chuck Phelps and Jeannine Hatt--thanks cannot adequately express our sense of gratitude and indebtedness.  Thanks for letting us see the need and be a part of this outstanding effort.  We look forward to continuing our relationship.  To Billy Brandt and Dr. Bijou--thanks for your leadership and stewardship of the hospital. To Robenson Lucceus--you are the man!  Thanks for getting everything done on the ground while you juggled two conferences. To Dr. Gina Joachim--thanks for your ongoing commitment to radiology and your presentation during the conference.  To Mary Gomez and our new friends at Lurie Children's Hospital and the Chicago Consortium--thanks for making "lemonade" and making the total conference more than the sum of its parts.  To Mrs. Sharon Nicholas--thanks for your contributions before and after the conference and for raising such an amazing pediatric radiologist.  Finally to the Boards of ICC in both Haiti and the U.S.--thanks for your continued support and all you have done to envision better patient care to the children of Haiti. 
We thank our friends from the University General Hospital --To the radiology residents and Chief Resident Dr. Fabienne Joseph--thanks for your passion, commitment and collaboration in representing the future of radiology in Haiti.  To Dr. Carine Cleophat and Dr. Georges Michel--we thank you for your commitment to radiology and look forward to working with you and the residents to continue to get ready for the changes ahead at HUEH.  To Dr. Collimon--thanks for your support of our last two programs and your commitment as a pediatrician to your patients.  To Dr. Maurice Fils Mainville, we look forward to fulfilling our part of the Memorandum of Understanding. 

We thank the attendees of the program--To all of you who took the time to learn more about pediatric and musculoskeletal radiology, who came from us far as 5 hours away, we thank you for your passion and commitment to improving patient care in Haiti. 

Finally, we thank our team--Drs. Adler, Applegate, Borgstede, Brown, Bulas, Ellenbogen, Garcon, Harris, Hatt, Kim, Konn, Nicholas and Phelps and Ms. Hofmann, Hernandez, Konn and Stearns--thanks for taking the time and sharing your knowledge with the physicians and radiographers of Haiti.  Your efforts were greatly appreciated by all the attendees and your ongoing commitment and contributions to improving radiology in Haiti will serve the population for years to come.  We also honor your institutions for supporting your work while you were gone. 

Leaving Haiti for now 

Haiti is truly making progress but there are still many challenges ahead.  New building is occurring at Grace Children's Hospital and the University Hospital with more significant construction to come.  The radiology residency program, which was non-existent just two years ago, now has 10 active radiologists.  Roads are better paved and the clutter from the earthquake is largely gone.  Fewer tent cities are apparent as we drive the streets of Port-au-Prince.  We are cautiously optimistic that progress will continue and that radiology will become an integral part of the diagnostic capability of the Haitian health system but much more work will be needed to make it happen and keep it sustainable for the distant future.  We look forward to our ongoing contributions to a better day for Haiti and its people. 
While still present, fewer tent cities line the streets of Port-au-Prince since the earthquake devastated the area in January 2010. 
Representing the future of Haiti, school children are busily making their way to class as the clutter of street debris and rubble from the earthquake are no longer as prevalent. 
Representing the future of radiology, an impressive 10 radiology residents are now enrolled in a training program at the University General Hospital. 

Despite a recent drought, Haiti is still a tropical Caribbean island with beautiful flowers and trees.  A land of contrasts, the perseverance and resilience of its beautiful people are what set Haiti apart and provide optimism for a brighter future. 



  1. Is ultrasound a type of radiology? I was thinking it was because it has to deal with radio waves. My dad is actually a ultrasound technologist. http://www.mimrad.com

  2. Hello! I simply wish to give you a big thumbs up for the excellent info you have here on this post. I will be coming back to your website for more soon.

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  3. Thanks Sandeep. I appreciate your positive feedback. We will be going back to Haiti this spring to assist with the radiology residency program at the University Hospital.