Thanks to the Class of 2010’s generous gift I was able to travel to Roatán, Honduras for my 4th year elective. I spent the month teaching local physicians the basics of Point-of-Care Ultrasound (POCUS) at Clínica Esperanza. This clinic, located on Roatán, one of the three Honduran Bay Islands, is resource-limited, with no access to XR, CT or MRI. Ultrasound (US) is the only diagnostic imaging modality available to the physicians in the clinic. Unfortunately US expertise is limited on the island and the physicians are not trained in basic POCUS.
Elizabeth Dearing MD, NUEM ’15 travelled to the clinic in 2015 to lay the ground-work for US education. However, physician turn-over at the clinic is high therefore the group that Dr. Dearing trained had already left by the time I arrived. The current physicians had minimal to no experience using US, including the physician assigned to the OB/GYN patients. An on-going US educational relationship with the clinic is key.
I taught an introductory POCUS lecture and spent 6 hours per day for 3 weeks teaching hands-on US skills at the bedside to two physicians in the clinic. Initially the physicians weren’t sure how to turn on their machines, how to correctly orient the probes or even why they would consider using an US machine. By the end of my time at the clinic, they were successfully identifying intrauterine pregnancies and IUD’s on transvaginal US, checking fetal heart tones, identifying the sex of fetuses, diagnosing biliary colic, renal colic and abdominal aortic aneurysms! We even introduced the bedside diagnosis of pneumonia!
Originally the clinic had 2 small US machines- one point of care unit that was collecting dust and another small but non-portable machine. Shortly before my arrival, the clinic acquired a larger comprehensive machine which a skilled and talented local US tech used one day per week for comprehensive scans. This tech was unfortunately overwhelmed by the volume of scans and unable to complete them in a timely fashion. The introduction of POCUS was fundamental in order to decrease the number of comprehensive scans ordered in order to aid in more rapid diagnosis of time-sensitive conditions.
As a current US fellow, this elective was integral in developing my understanding of teaching US in a resource-limited setting in addition to developing skills in order to teach US novices. This experience also highlighted the importance of a longitudnal continued relationship with the clinic and I plan to return to continue the US education.
Lucky for me, Roatán is also a beautiful Caribbean island therefore downtime was as equally enjoyable. Among many other adventures, I learned to scuba-dive and met a sloth!
Thank you again to the Class of 2010- your generosity will not be forgotten!