All in a day: Mubende Regional Referral Hospital, TB Clinic and more

Wednesday, 11:30 pm, Mubende district, Uganda. Population: over 600,000

It’s almost midnight and I’m exhausted. We spent the day at Mubende Regional Referral Hospital in Mubende, Uganda. Our day started at 8:30 am and ended just about an hour ago (10:30 pm). It was a very insightful and productive day in so many ways. The drive to Mubende through the picturesque Ugandan countryside dotted with tea plantation, sugarcane farms and vibrant tropical foliage was breathtaking.

Our first stop was at the Mubende District Headquarters where we met with the key district officials: the District Health Officer (DHO) and the Chief Administrative Officer (CAO). Dr. DeStigter shared the progress of the ITW program within the district. We also had the opportunity to show them the ultrasound device. Dr. DeStigter described the product as a game changer in facilitating access to care within the district. Both the DHO and CAO were very impressed with ultrasound system; specifically it’s potential to enhance access to care within the district.

Dr. DeStigter and I demonstrating the ultrasound system to the DHO while Dr. Motovu looks on

The team with The District Health Officer and Chief Administrative Officer of Mubende district

Next stop was at the Mubende Regional Referral Hospital. The Mubende Regional Referral Hospital is a government facility and is one of fourteen such regional referral centers in Uganda, each serving approximately three million people. Patients from HCIII clinics (like Nawanyago) are referred to these regional centers. The regional center offer both out-patient and in-patient services as well as has OR capabilities.

Mubende Regional Referral Hospital

At the Mubende hospital, Dr.Belard and Dr. DeStigter set up pediatric scanning clinics for diagnosing Tuberculosis (TB) using ultrasound. Dr. Belard is an expert in the use of ultrasound for detecting TB. Her research has found that ultrasound is a very good tool to diagnose TB in children, especially in the case of extra-pulmonary TB. This is a novel and very promising application for ultrasound especially in areas where TB is endemic. The worldwide TB burden, specifically in low and middle income countries is very high. Here are some numbers from the WHO: • TB is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent. • In 2012, 8.6 million people fell ill with TB and 1.3 million died from TB. • Over 95% of TB deaths occur in low- and middle-income countries • In 2012, an estimated 530 000 children became ill with TB • TB is a leading killer of people living with HIV causing one fifth of all deaths. The use of ultrasound for detecting TB, combined with the availability of ultra-portable handheld devices along with new care delivery models utilizes local skill availability has the potential to become a game changer for TB diagnosis in this market. We ran two parallel TB scanning rooms and finished up at around 8:30 pm, you can imagine the volume of patients that were scanned. We met a young girl who had been treated for TB on and off for over 5 years….she must have been around 7 or 8 years old. As a marketer, the need for and potential value of an ultrasound based TB detection program was very clear. On a personal note, this was by far the most difficult part of the trip. It was heart breaking to see so many children, mostly under the age of 6, that were infected with TB and/ or were HIV positive. The team scanning with ultrasound in one of the TB scan rooms

Parallel to the TB clinic, I was able to get feedback from the radiologists, radiographers and sonographers on the ultrasound device. They were all very excited about the image quality, portability and form factor. They offered some great feedback on how handheld systems might be optimized for their market. Dr. Matovu, a surgeon at the center who works closely with ITW was most excited about the possibility of taking hand-held ultrasound systems into the community for antenatal care, early diagnosis of breast cancer and various other conditions.

After the TB clinic (8:30 pm), we went to the maternity ward and were able to offer ultrasound scanning for patients in their third trimester, some of them were in active labor. This was the first scan for many of the women in their entire pregnancy.

Maternity Ward

Lastly, here’s my picture of the day. Can you guess what this is?

X-Ray films are hung from this structure to be dried in the sun. The facility has a digital X-Ray system but they still save films for each patient.

- Meera Gopalakrishnan Philips Healthcare

Featured - NOTITW Team