I am seeking support to continue an ongoing radiology capacity-building collaboration at Connaught Hospital, Sierra Leone’s primary adult tertiary referral and teaching hospital, in partnership with the Ministry of Health and Sanitation, the Ministry of Technical and Higher Education, COMAHS, and local clinical leadership. This work focuses on strengthening sustainable imaging education, workforce training, and diagnostic infrastructure in a setting where access to trained radiology personnel remains critically limited despite expanding imaging technology.
Sierra Leone is currently seeing increased access to modalities such as ultrasound, digital radiography, mammography, and CT imaging. However, the growth of imaging equipment has significantly outpaced the development of the trained workforce needed to operate, maintain, interpret, and integrate these tools effectively into patient care. As a result, equipment is often underutilized, imaging studies may be delayed or inconsistently interpreted, and patients experience preventable morbidity and mortality due to gaps in diagnostic capacity.
During this trip, I will work directly with radiology staff, technicians, physicians, nurses, trainees, and institutional leadership to provide hands-on education and mentorship focused on ultrasound, chest imaging, trauma imaging workflows, CT utilization, and point-of-care ultrasound (POCUS). We will also continue discussions regarding long-term imaging workforce development pathways through COMAHS and national educational partnerships aimed at strengthening sustainable local training programs for future radiology technicians and sonographers.
This project is intentionally structured as a longitudinal partnership focused on sustainable systems development rather than short-term service delivery. The goal is to help strengthen local imaging education, mentorship, and workforce capacity under Sierra Leonean leadership.
This project serves patients and healthcare professionals at Connaught Hospital, one of Sierra Leone’s largest tertiary referral and teaching hospitals. Connaught Hospital cares for a high volume of medically complex patients from across the country, including trauma patients, obstetric emergencies, infectious disease cases, surgical patients, and critically ill adults who often require advanced diagnostic imaging.
Although Sierra Leone has made important progress in expanding imaging infrastructure, there remains a major shortage of trained radiology personnel, imaging educators, sonographers, radiographers, and radiologists. This shortage creates a significant bottleneck in patient care. Imaging studies may be delayed, unavailable, underutilized, or inconsistently interpreted due to limited training opportunities and workforce capacity. These gaps contribute directly to delayed diagnoses and increased morbidity and mortality from conditions such as pneumonia, tuberculosis, trauma, obstetric complications, malignancy, and surgical disease.
The direct beneficiaries of this work include radiology technicians, radiographers, physicians, nurses, trainees, and healthcare educators working in a rapidly evolving healthcare environment with limited access to continuing imaging education and mentorship.
Through collaboration with the College of Medicine and Allied Health Sciences and national ministries, this initiative also aims to support broader workforce development and sustainable imaging education pathways that can ultimately improve diagnostic access and patient outcomes throughout Sierra Leone.
The immediate impact of this project will be continued hands-on radiology and ultrasound education for healthcare professionals at Connaught Hospital through bedside teaching, case-based instruction, mentorship, and collaborative systems development. This includes direct support for radiology staff, technicians, physicians, nurses, and trainees working in high-acuity clinical settings where access to imaging expertise remains limited.
One of the greatest healthcare challenges in Sierra Leone is the growing gap between expanding imaging technology and the limited workforce available to fully utilize it. As newer modalities such as CT, ultrasound, mammography, and digital radiography become more available, healthcare systems require parallel investments in training and education. Without trained personnel, imaging equipment alone cannot meaningfully improve patient outcomes. This disconnect contributes to delayed diagnoses, avoidable complications, prolonged hospitalizations, and preventable mortality.
Expected short-term outcomes include increased clinician confidence in imaging utilization, improved ultrasound skills, enhanced imaging workflows, and strengthened mentorship relationships between local and international partners. Longer-term goals include supporting sustainable radiology training pathways, improving local teaching capacity, and helping build a stronger imaging workforce under Sierra Leonean leadership.
Improved radiology capacity has the potential to impact nearly every aspect of healthcare delivery, including trauma care, maternal health, emergency medicine, surgery, infectious disease management, and inpatient medicine. Earlier and more accurate diagnosis can directly reduce morbidity and mortality by enabling faster clinical decision-making and more targeted patient care.
This trip marked an important transition from relationship building and concept development to implementation planning across several interconnected maternal and child health initiatives in Sierra Leone. The work centered on strengthening sustainable health systems through partnerships with Princess Christian Maternity Hospital (PCMH), the Ministry of Health, the University of Sierra Leone, Penn Medicine, CHOP, and other collaborators.
A major focus was the continued development of national Point-of-Care Ultrasound (POCUS) initiative, refining plans to train approximately 500 midwives nationwide in obstetric ultrasound. Rather than simply teaching ultrasound, the project evolved into a comprehensive maternal health strategy designed to translate diagnostics into improved clinical decision-making, earlier recognition of high-risk pregnancies, and reductions in maternal mortality.
One of the most significant discoveries during the visit came through participation in obstetric morbidity and mortality conferences at PCMH, where it became evident that peripartum hemorrhage remains one of the leading causes of maternal death, with inadequate access to banked blood emerging as a critical systems failure. The current practice of requiring women to recruit family blood donors before delivery highlighted an opportunity to redesign the pathway.
This observation led to the development of a new integrated concept linking antenatal ultrasound with voluntary community blood donation. Rather than incentivizing donation in ethically problematic ways, the vision became creating a culturally appropriate campaign that normalizes blood donation while using pregnancy as an opportunity to educate communities about maternal survival.
The visit also strengthened planning around radiology and diagnostic imaging at Connaught Hospital and COMAHS, with discussions focused on expanding ultrasound capacity, improving imaging workflows, supporting workforce development, and creating sustainable educational partnerships rather than short-term missions.
Academic collaborations continued to grow as well. Planning advanced for resident education, fellowship opportunities, and long-term exchange programs between Sierra Leone and Penn/CHOP, including support for Sierra Leonean OB/GYN residents applying for international educational experiences.
Outside of healthcare, the trip also reinforced opportunities in Sierra Leone's broader development landscape. Discussions around agriculture, food systems, fisheries, and entrepreneurship helped shape longer-term thinking about sustainable economic development alongside health initiatives.
Overall, the trip represented a pivotal evolution for me—from a collection of promising ideas into a coordinated strategy focused on building sustainable clinical care pathways. The central vision became increasingly clear: using diagnostics, education, implementation science, and cross-sector partnerships to create measurable improvements in maternal and child health while strengthening Sierra Leone's own health system capacity.
Perhaps the most important outcome was recognizing that ultrasound training is not the endpoint, but the entry point into a much larger maternal survival ecosystem—one that integrates earlier diagnosis, timely referral, strengthened blood systems, improved clinical decision-making, and community engagement into a single, scalable national model.
