The Hospital and Rehabilitation Center for Disabled Children (HRDC) was founded in 1993 and provides orthopedic surgery and rehabilitation to the underserved pediatric population throughout Nepal. Approximately three times a year, HRDC provides an out reach camp or field hospital in remote and rural regions of Nepal where medical camps assess pediatric patients with congenital and/or acquired osseous deformities. The evaluations/physical examinations are performed without imaging. I will work with the doctors and nurse practitioners providing training in basic ultrasound.
Many of the pediatric patients have never had access to medical care. Ultrasound is such a great modality to image musculoskeletal abnormalities as well as A screening tool. I will teach ultrasound evaluation for congenital hip dysplasia, fractures and basic abdomen ultrasound. Once a patient is identified with either an orthopedic abnormality that needs to be surgically corrected or another osseous medically necessitated abnormality, transportation will be arranged for the patient and family members to travel to HRDC hospital outside of Kathmandu for treatment and therapy. As a practicing radiologist, I will increase awareness of basic pediatric abnormalities which can be evaluated, diagnosed and assessed with the use of ultrasound.
Priority is given to children with physical disabilities from disadvantaged communities. HRDC embraces the children as a whole and addresses their full spectrum of medical, therapeutic and social needs. For example, in 2016, 23,500 children underwent consult at the hospital and field clinics. Approximately 2000 of those children screened went on to surgical intervention.
HRDC has established A working relationship with the local governments to help provide Financial support for transportation costs for the patients and families to the main hospital, outside of Kathmandu.
The focus of my mission is to improve Ultrasound education for the physicians and nurse practitioners assessing this pediatric population. In order to evaluate ultrasound image quality and pathology, ongoing teaching efforts is recommended either through webinars and/or follow up visits. Alternatively, if a physician or nurse practitioner has a question about an ultrasound finding, the image can be sent over WhatsApp for review.
This will provide sustainability to the physicians and nurse practitioners practicing at this particular hospital, HRDC.
Thank you for the opportunity to promote ultrasound education in Nepal, a low resource country. I am proud to be affiliated with Doximity and the organizational mission and vision of striving to make the world healthier and more sustainable through innovation. Imagine the impact of ultrasound finding an unsuspected developmental dysplasia of the hip in an infant. The earlier this malady is found, the earlier treatment can be initiated for a more successful outcome.
It is with this spirit I wanted to share my experience to Banepa, Nepal and the Hospital and Rehabilitation Center for Disabled Children (HRDC). HRDC ( http://www.hrdcnepal.org/ ) was established 34 yrs. ago by Dr. Ashok Kumar Banskota and has countless success stories.
My aim was to work with the Radiologist and local nurse practitioner on establishing the educational and equipment framework for evaluating developmental dysplasia of the hip utilizing ultrasound. This includes assessing the effectiveness of a portable ultrasound machine for the nurse practioner and the physicians to take "in the field", on their multiple mobile camps. Currently, the providers are only able to do physical exams during their mobile camps due to no available portable x-ray or ultrasound units. After discussing the pros and cons of each modality, ultrasound imaging was preferred and decided upon. Both the Radiologist and nurse practioner were very receptive and quickly learned the proper technique and ability to detect a dysplastic hip.
The importance of screening and identifying developmental dysplasia of the hip in younger patients is far more beneficial than older children. This impacts treatment as well as future mobility issues.
With deepest gratitude,
Carlin Ridpath, MD
