Interventional radiology (IR) is indicated for many conditions and has numerous advantages over traditional surgical options, often significantly decreasing associated morbidity and mortality. Examples include image-guided abscess drainage, image-guided biopsies, uterine fibroid and prostate artery embolization, pulmonary embolism thrombectomy, and embolization in the setting of trauma or GI bleeding. However, many countries have limited or a complete lack of IR services.
According to the WHO over 4 billion people globally lack access to diagnostic imaging, with likely more than 5 billion lacking access to IR. As of 2017, there was not a single interventional radiologist in Tanzania, leaving a population equivalent to that of California and New York combined without access to a broad range of life-saving treatments. Over the past four years, Road2IR has initiated East Africa’s first IR training program, training the first generation of interventional radiologists in the country. Africa’s first Master of Science in IR curriculum at Muhimbili University in Dar es Salaam was officially announced in October 2019 (https://medicine.yale.edu/news-article/yales-tanzania-interventional-radiology-initiative-approved-for-msc-program/), which gives testament to the rapid upscaling of the training program. An overview of the program was published in the Journal of Vascular and Interventional Radiology in 2019 (https://www.jvir.org/article/S1051-0443(19)30687-6/pdf). In 2021 the first class of three fellows graduated.
This program is based on high-frequency, short-term teaching trips, coordinated by Road2IR. Every month, we help coordinate deployment of at least one IR teaching team to East Africa. Each team typically consists of 3-5 individuals, including IR faculty, trainees, nurses, and technologists. These teams spend two weeks in East Africa, providing hands-on training for local IR trainees, nurses, and technologists.
Tanzania is a country with 60 million people with only approximately 60 diagnostic radiologists. For that population, a radiologist cohort of 600 would be more in line with similar proportions in the United States.
While this program most immediately serves the 60 million people living in Tanzania, training IR and diagnostic radiology physicians locally will have regional impact. One of the first IR fellows who graduated with the first class in 2021 in Tanzania is from Rwanda and has returned there as the first IR physician in the country. Since then, Tanzania has gone from 0 to a total of 11 interventional radiologists. He has already begun the process of expanding these efforts there and plans to begin training the first generation of Rwandan IR trainees soon. Additionally, one of the graduates from the class of 2022 in the Tanzania program returned to her home country of Nigeria with a goal of starting her own program there. As such, Road2IR’s goal is to eventually serve the entire population of sub-Saharan Africa.
Expanding the many obvious benefits IR already provides to patients in high income nations can be quickly expanded to billions of people around the world in low-income nations by training young physicians locally. IR provides a broad range of life-saving procedures and can have an immediate impact, as has been demonstrated in Tanzania over the past several years. These contributions can help level inequalities in global healthcare and present an opportunity for us to share our medical resources and experiences with a country that faces a severe shortage of practicing radiologists.
I want to continue the past work performed by the organization in Africa, potentially reaching over one billion people who currently have no access to these important treatments. I also would like to continue supporting the critical training pathway to produce more diagnostic radiologists in Tanzania, where they are desperately needed. The goal is to create a continuous, year-round training pathway that will also become self-sufficient and that can service the entire population of sub-Saharan Africa.
I traveled to Muhimbili National Hospital/Muhimbili University of Health and Allied Sciences in Dar es Salaam, the largest hospital in Tanzania. The hospital is a very busy referral center for the country and serves patients who present at very advanced stages of disease.
My trip was planned in conjunction with Road2IR, which seeks to expand Interventional Radiology access via supporting training programs. My primary responsibilities during this trip were to provide didactic lectures and readout sessions for the diagnostic radiology residents at MNH/MUHAS. The residents and faculty were extremely accommodating to us and were very active during our teaching sessions, asking great questions and responding to our questions in turn. I learned a lot about the unique challenges facing radiologists in Tanzania, and also connected with them about universal challenges that affect both of our institutions.
Overall, my experience in Tanzania was extremely positive and I am grateful for the experience to learn, to educate other trainees, and to appreciate their culture as well.
