Elevating Patient Care in Cape Verde

Nicole Dhanraj, Ph.D., R.T.(R)(CT)(MR)
Dec. 27, 2016

Nicole DhanrajFrom a young age, my parents instilled in me the importance of knowledge. Their mantra to me was, “knowledge is power.”

I didn’t understand how true that statement was and the value it held until I was an adult and someone approached me about being a mentor. When I said I didn’t have the experience needed, that person reminded me that I didn’t have to have extensive experience in every aspect of the profession, I just needed to have knowledge or experience that someone else didn’t and the willingness to share it.

This was a changing point for me. I recognized that whether it’s one hour of experience or 10 years of experience, my knowledge is of value to someone who has no experience. Since that moment, it has been a passion of mine, and a privilege, to share my knowledge with others. I am constantly seeking ways to give back to the radiology community and use my knowledge to improve patient care around the world.

This past summer, I had the opportunity to work as an ASRT Foundation Community Outreach Fellow in Cape Verde (an island country located 350 miles off the coast of West Africa) as part of a RAD-AID International outreach team. This donor-funded fellowship through the Foundation provided me the perfect avenue to share my imaging knowledge with R.T.s in a developing nation.

Our project had two major goals: provide ultrasound services and implement a PACS in São Felipe, the capital of Fogo Island, and provide ultrasound services to a small agricultural town called Mosteiros. Both hospitals we worked in were clean and well organized but lacked the resources we sometimes take for granted here at home.

Our first few days in São Felipe were stressful. While we had planned to work around the clock to ensure we imparted as much knowledge as possible and implemented the PACS quickly, we hadn’t taken into consideration the very laid-back culture there. The cultural and language differences between the United States and Cape Verde presented themselves quickly, requiring us to adjust our approach for accomplishing our goals. Once we did, we were able to better connect with the staff and started making noticeable progress toward our objectives — getting the PACS set up, providing radiation safety training and learning how their hospital operated so that we could provide the information they needed for their day-to-day work.

The radiology department was an intriguing combination of the past and present. The department used analog and digital equipment, but where digital radiography has overtaken the analog age in places like the United States, in São Felipe the digital equipment provided support for analog use. And because the facility doesn’t have many biomedical or PACS personnel, the digital equipment was not fully used, as no one was able to configure and fully establish the digital system. During our time there, the digital system was nonfunctional because the cassette reader was broken, so all examinations were being imaged on film. We shared various tips and tricks to help them work more effectively and efficiently with the equipment they had. We also reiterated radiation safety and use of markers for proper documentation.

In Mosteiros, we provided ultrasound services at a small hospital and even did a few house calls with mobile ultrasound machines to remote clinics and people’s homes in the mountain villages. Dozens of people flocked to the hospitals and clinics for ultrasounds, some waiting for hours to be seen, but we never heard a single complaint. They seemed excited and grateful to be seen by medical professionals.

The x-ray equipment in Mosteiros was not functional, so my role at this location was to capture information from the radiology readiness questionnaire. This questionnaire helps with planning future outreach projects by identifying the next most important thing to implement that can be sustained by the resources available. As far as clinical work, with the help of a translator, I was able to use my basic clinical skills to help with patients in the wound care clinic.

In the two weeks we were in Cape Verde, we accomplished our main goals and learned a few lessons along the way ourselves.

It’s critically important to build relationships and understand the culture in a new environment before trying to share your knowledge. You can’t assume that others will grab the opportunity to learn from you simply because you have knowledge to share. It’s important to build a rapport before you can be credible, regardless of your experience. The people of Cape Verde were very appreciative of us being there to help and valued the knowledge we were sharing with them. They were grateful that we came to offer them our help and that we plan to continue being a resource for them.

Regardless of a country’s economic state, R.T.s everywhere want to provide their patients with the best care possible. Although the people of São Felipe and Mosteiros lacked financial resources, the quality of care displayed was deeply rooted in the historical underpinnings of medical care; that is, the importance of human touch and the focus on the interaction with the patient.

Volunteering is not just about sharing knowledge but about building community and collegial bonds. It’s about bringing communities together to create sustainable change and move the profession forward around the world. When communities unite and support each other, they become stronger and gain the confidence and ability to do great things.

Sharing my operational and technical knowledge helped the R.T.s and administrators on Fogo Island better care for their patients and manage their operations. It will have an impact on future R.T.s and other health care personnel for years to come, and that’s a rewarding feeling for me, but one of the best parts of this project was the relationships I built with my colleagues in Cape Verde. The connections I made with the staff there will last forever, and I will continue to be a professional resource for them.

Our team imparted knowledge that those R.T.s can use to help elevate patient care, and they in turn helped us become better professionals and, more important, better people. In the developed world, sometimes we become so focused on the bottom line, productivity and the business aspect of radiology, that we lose sight of the patient as a person, which should be our main focus. This experience brought our mission as health care professionals — to be of service to the patient — to the forefront of my mind.

I encourage everyone to support the Foundation’s community outreach efforts. Projects like these are desperately needed in underserved regions like Cape Verde. Patients should not suffer or receive lesser treatment because of lack of equipment, qualified personnel or knowledge. It is extremely rewarding to see the impact that sharing knowledge can have on a community and to know that you made a difference.

Foundation donors are supporting projects like this one all around the world. Access to basic health care services should be available to everyone, regardless of which corner of the world they live in. Generous donors and volunteers are bringing us one step closer to that point with each outreach fellowship. Generous donors make these fellowships possible.

As my parents always said, “knowledge is power,” and with the continued support of donors, we as a global community can share our knowledge to empower R.T.s all over the world to better serve their patients.