Sonography and the Seeds of Education in Underserved Rural Clinics

How many of us began our sonography journey thinking about the number of callbacks that we would log per shift, the number of patients that we would scan in an 8-hour day, or, even worse, the number of career-ending ailments that we would amass? Zero; we didn’t. tammySterns_2017

We saw ultrasound as a way to contribute to something bigger than ourselves.

The complex, yet simplistic, science of sound drew us to the field. Looking at the screen and seeing the images come to life was fascinating, and being the first to see presenting pathology while shedding light on the diagnosis mesmerized us. The thought that even after 20 or 30 years in the profession we would encounter images of structures that we’d never seen before was enticing, and the opportunity to be a life-long leaner was thrilling.

Patient interaction and our role in their medical experience appealed to us. Not too much, not too little, but just the right amount of patient care time that allowed us to interact with them and leave a positive imprint on their journey. We imagined we would sit by their bedsides, walk them casually back to the exam rooms, and listen as they shared.

Our patients would come first.

Instead, too often, we found ourselves in the middle of a never-ending battle between cost-effectiveness and patient satisfaction reports. We logged more hours of callbacks than we ever thought possible, sometimes having difficulty even finding the correct key to open the ultrasound office door. We strived to create the profession that we had imagined within the confines of the variables that we’d been given. We did the best that we could, often to the detriment of our own bodies.

And, somewhere along the way, we forgot the wonder of our profession.

About 10 years ago, I had the opportunity to participate in my first overseas medical trip. A group of physicians and a few sonographers, with portable machines strapped in backpacks, were intent on sharing sonography with some of our peers an ocean away. It was during this trip that I saw the purest form of ultrasound come to life. We had one of the simplest of machines and the most basic of lectures and yet they came from miles to learn. The patients sat all day in the heat waiting for the opportunity to have an ultrasound scan. I witnessed ultrasound identifying and explaining pain that had existed for years. I saw tears of relief, joy, and despair as people received answers that changed their lives.

A few years later, I was able to return to the same place. I fully expected to find that they had not utilized our lessons on sonography to their fullest. Instead, our previous pupils greeted us with dog-eared textbooks, mastered skills, and the desire to know more! The seeds of education that we had planted had flourished as they realized the potential ultrasound held for their rural clinics. It offered the ability to quickly investigate and diagnose and you could see the wonder of ultrasound that we had once experienced reflected in their eyes.

Seven years ago, my family and I had the opportunity to move to a developing country. Living in the second-poorest country in the western hemisphere with limited medical availability, I now see every day the wonder of our profession come to life. All the benefits of ultrasound that we learned as students, that are often taken for granted, are the benefits that allow lives to be changed every day.

Portability – I can scan in a makeshift clinic, under a tree in a field, or in someone’s handmade shelter while they lay on the floor.

Inexpensive – Portable machines are relatively inexpensive and diagnostically sound, making them perfect for short-term trips or as gifts to native physicians.

Quick – Within minutes, we can scan and find answers to problems that have hindered the livelihood of those who are sick and in pain. One of my first patients was an OB patient who had been in labor for several days without any progress. A quick scan revealed placenta previa.

Relatively Safe – Without the worry of radiation and chemicals, ultrasound, when utilized by those who are qualified, provides a safe method of imaging.

True, my exam room isn’t exactly ergonomically correct and there are times that chickens and roosters run underfoot. I’ve had to prop the machine on a rock and scan in the brightest sun of the day. But I’ve also witnessed a mother’s face when she sees her baby for the very first time without me having to operate under the time constraints of efficiency. I’ve held a father’s hand as he realized that the pain he’s had for years isn’t the cancer he so greatly feared but a simple fix. I’ve scanned at the bedside of a daughter who lay dying without any medical options, and I fall more and more in love with our profession every single day.

Experience the wonder of ultrasound again.

If given the opportunity, I encourage you to participate in a medically related trip or volunteer opportunity. You will see firsthand how our profession and our images impact the world one life and one scan at a time. You don’t have to move permanently as we did to a developing country. Opportunities also abound in your local community from volunteering your time as a clinical instructor to scanning for local centers. Expand your horizons and allow yourself to experience the wonder of ultrasound again.

 

How have you seen ultrasound incorporated into medical care in other nations? Do you have an ultrasound story to tell? Comment below, or, AIUM members, continue the conversation on Connect, the AIUM’s online community.

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Tammy Stearns, MS, RT(R), RDMS, RVT, FSDMS, is Director of Women’s Ministry and Sonographer for Project H.O.P.E. in Managua, Nicaragua. She is also the President of the Society of Diagnostic Medical Sonography and an adjunct professor of Diagnostic Medical Sonography at Adventist University in Orlando, Florida, and a sonographer consultant for Heartbeat International.  She is also the author of “Know Hope” and “Living Worthy”.