No Words Are Strong Enough

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Low- and middle-income countries have always faced major health difficulties related to lack of human resources, facilities, and access to drinking water and electricity. Added to these factors are the lack of a suitable road, geographical remoteness, and poverty. Hence, the management of patients is compromised both diagnostically and therapeutically.

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Point-of-care ultrasound (POCUS) offers wide possibilities to health professionals who work in areas with limited resources by means of the portable machine with a good battery. Therefore it is possible for the clinician to go to low- and middle-income countries to dispense quality care services on the spot while giving access to diagnostics and guiding the management and emergency invasive procedures. IMG_20200513_100229

As a primary care physician, I was trained on clinical ultrasound through the Canadian platform in the emergency unit. I use it in my routine practice as part of my physical exam with my patients, which greatly increases my precision. No words are strong enough to describe how we feel when we examine a young woman who consults for severe pelvic pains associated with metrorrhagia and we suspect an ectopic pregnancy and the B-HCG urine test comes out positive, so you grab your US probe and you find an empty uterus, a hemoperitoneum. The fact that you saw the patient’s interior and were to be able to show her what exactly is wrong…. It’s a strength beyond what the words can explain, the precise diagnosis is reliable and prompt.

Once a month, I travel to Yabassi, a small village surrounded by a forest in the littoral region of Cameroon, which is difficult to access and rarely supplied with electricity, to do ultrasound for pregnant women discouraged by the bad state of the road and the distance to reach the nearest town. I help them meet their babies for the first time and I enable adequate follow up for the pregnancy and prevent certain complications that might occur during the delivery.

With a minimum of 1 doctor for 30,000 people, it is imperative for the clinician to go to the patients and not the reverse. And POCUS can help in these situations because of its ability to save the images to be shown to other experts for their expertise if needed. Ultrasound offers immense possibilities in upper-income countries, and I think it’s even more important in low- and middle-income countries to have access to that highly efficient and accessible method, to greatly improve the management of patients while offering quality healthcare at a low cost.

 

Yannick Ndefo, MD, is a general practitioner at St Thomas hospital in Douala, Cameroon.

Interested in learning more about ultrasound in low-resource settings? Check out the following posts from the Scan: