Interventional radiology (IR) encompasses a unique but critical sphere of medicine that revolutionized treatment of many medical conditions. Examples include minimally invasive image-guided biopsies, image-guided abscess drainage, life-saving embolization of postpartum/traumatic/gastrointestinal hemorrhage, image-guided ablation of liver and kidney cancer. Without IR, treatment of these medical conditions may require invasive high-risk open surgery. However, many low-income countries have limited or complete lack of IR services. 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 4 years, Road2IR has initiated East Africa's first IR training program, training the first generation of interventional radiologists in the country. While IR education of these young radiologists has been largely remote these past 2 years due to the pandemic, hands-on side-by-side procedural training is the key to developing confident, competent, and successful interventional radiologists. As an academic diagnostic and interventional abdominal radiologist at Duke University with over 20 years of experience with trainee education, I plan to teach diagnostic and interventional radiology to the trainees at Muhimbili National Hospital in Tanzania. I will provide a combination of didactic material (lectures) and hands-on teaching, first with simulation (practice ultrasound-guided liver biopsy in ex-vivo animal livers) followed by demonstration and trainee supervision of clinical casesin patients. I will also bring two boxes of over 50 medical devices donated by Argon Medical and Cook Medical which includes biopsy needles and drainage catheters.
While this program most immediately serves the 60 million people living in Tanzania, training IR physicians locally will have a 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. He has already begun the process of expanding these efforts there and plans to begin training the first generation of Rwandan IR trainees in late 2022. One of the prospective 2022 graduates in Tanzania is from Nigeria and will return there after completion of her training and start her own program in Nigeria. As such, our goal is to eventually serve the entire population of sub-Saharan Africa.
IR training of faculty and residents will directly impact and improve patient care by increasing access to life-saving or life-changing interventional procedures and therapies. These techniques are best taught by direct hands-on demonstration and supervision. Once these trainees have learned these skills, they can in turn teach them to future generations of radiologists in Tanzania.
The people who were most impacted by this trip were the Tanzania Interventional Radiology (IR) and Diagnostic Radiology (DR) residents and patients at Muhimbili Hospital in Dar Es Salaam, Tanzania. In addition to reviewing and discussing the management of patient cases with the Tanzania IR residents, I spent time with IR residents supervising and direct hands-on teaching of how to do image-guided biopsies of patients with pancreas, liver, and renal masses. I showed the IR residents how to use Computed Tomography (CT) and Ultrasound imaging to guide placement of needles into abdominal masses in order to remove tissue for pathological analysis. In addition, I gave four lectures on abdominal imaging to the Tanzania DR residents. The lectures were on CT and MRI imaging of the kidneys, urinary tract, female pelvic organs, and adrenal glands. Also, I brought a large box of donated supplies which included biopsy needles, drainage catheters, guidewires, and vascular access kits (59 items in total). I also met several radiologists from other U.S. hospitals who were also helping teach the IR and DR radiology residents.