Ayako Fujita, MD
Ayako Fujita, MD
Internal Medicine · Oakland, PA

Point of care ultrasound for local providers

January 25th
Lilongwe, Malawi

Project Description

This project aims to provide an introductory course on point-of-care ultrasound (POCUS) to clinicians and medical students to provide practical guidance for use at Kamuzu Central Hospital (KCH) in Lilongwe, Malawi. There will be five didactic sessions held over the course of 10 days and four clinical scanning sessions on patients in the wards. The goal is to train clinicians in enough basic POCUS that they can begin to incorporate POCUS into their clinical practice.

Population Served

Kamuzu Central Hospital is the largest tertiary hospital in Lilongwe, Malawi. It serves patients throughout Lilongwe and acts as a referral center for the entire country.

Expected Impact

The ultimate objective of this course will be to provide enough instruction such that clinicians at KCH will be able to utilize POCUS to diagnose the following conditions: pleural effusion, congestive heart failure, pericardial effusion, ascites, cirrhosis, and hydronephrosis. By "training the trainer" we hope to provide capacity building in the medical providers in Malawi, who can then train other health care providers. Since advanced imaging is often limited in Malawi, ultrasound serves as a highly useful imaging and diagnostic tool.

Trip Photos & Recap

The ultrasound course was promoted during morning handover which is a gathering of medical students, interns and physicians at Kamuzu Central Hospital in Lilongwe, Malawi. The first session - “Introduction to POCUS” was held in the afternoon and there were three participants who attended, two of whom were interns and one of whom was a physician. They were introduced to basic POCUS concepts and had the opportunity to practice scanning on each other. During this session, we discussed what would be an optimal learning environment moving forward and the decision was made to transition from afternoon lecture style to an “ultrasound on- the- go” format during rounds on the medical wards. We also determined that the highest yield application for local providers would be to practice ultrasound guided procedures including paracentesis and thoracentesis. Thus, we decided to focus the remainder of our time on these skills and target medical students as well. We held two formal didactics during the morning handover - one focused on ultrasound-guided paracentesis and the other focused on ultrasound-guided thoracentesis. There were about 40 medical students, interns, and physicians attending each didactic total. After the didactic, we split the medical students into groups of 8-10 and demonstrated these techniques on patients. They were each given the opportunity to practice using the ultrasound during this time as well. In addition to these formal didactics, we held informal “ultrasound rounds” about 2 times per week, or 8 times total. For each of these sessions, there were 3-4 interns, physicians, and medical students present.