IR at KCMC

In addition to observing the daily practice here at KCMC, Matt and I are trying to provide some instruction for basic percutaneous techniques for simple procedures such as abscess/fluid drainage and central venous catheter access. Thanks to the generous donations from the University of Washington and its associated vendors we have a supply of needles, wires, dilators, and catheters needed to carry out many of these procedures. We are currently working on a model to better demonstrate ultrasound guidance and the steps involved with placing a device into a patient. We have both given lectures on some of the basics of interventional practice and though there were many questions the topics seemed well received.

Interventional "Stock Room"

Dan and I brought basic interventional devices to donate to the department. We hope that given the local ultrasound expertise, they will also be able to do basic ultrasound guided procedures in the future such as abscess drainage. Here we are organizing the equipment for them. We hope to create a model to allow them to practice.

Maasai Village

We stopped at a Massai Village in the area; several Maasai are treated at KCMC. See wikipedia for more info.

A day at KCMC

A day at KCMC begins at 0730 with review of plain films for the medical and surgical services. Additional subspecialties such as orthopedics, pediatrics, urology, and otolaryngology have dedicated radiology rounds as well, though they occur less frequently throughout the week. Cases are displayed on a view box and a resident covers the findings and impression with Dr. Diefenthal present for further consultation.

Following rounds, the staff, comprised of assistant medical officers (i.e. PAs), residents, technicians, and attendings break to cover the CT, plain film, and ultrasound services. The majority of the time is spent doing ultrasound, where two machines are dedicated to general and obstetric exams, one for echocardiography, and one for pediatrics. Exams are performed/overseen by residents with assistance from an attending, though Dr. Diefenthal performs all pediatric exams himself. There are approximately 5 to 10 CT exams daily with each study monitored by a technician and an attending. Plain films are performed throughout the day and read in batches by the residents and attendings.

By 1500 the last remaining ultrasounds are completed and the staff breaks for lunch and an afternoon break. Dr. Diefenthal, the AMOs, and residents then reconvene at 1800 for a teaching session. Dr. Diefenthal instructs on the basics of radiologic physics as well as presenting cases within the pertinent modalities. Guest lectures are welcomed at this time.

Finally, the group returns to the hospital to read the remaining films of the day and to give a chance to the more junior trainees to take cases in a public forum. We return home around 1930 to have dinner and unwind. The residents take first call with the attendings serving as back up.

Taste of Safari

Grand Rounds

Wednesday mornings are hospital wide grand rounds which occur here. This week was on the TMJ including radiology(plain films) and surgical techniques.

Multipurpose Room

This room hosts clinician/radiologist conferences every morning from 7:30 AM until approximately 9:00 AM. It also serves as the plain film reading room and a room for evening "at the box" teaching by Dr. Diefenthal.

Kilimanjaro

Here is the view of Kilimanjaro on our walk to the hospital from this morning. It has been this clear every day so far.

Our Host - Dr. Diefenthal

The famous Professor Helmut Diefenthal getting into the KCMC SUV on the way to the hospital. He works nonstop 12 hour days with unrelenting energy.

Goodbye!

Dan and I are starting our Tanzanian journey. Hopefully we will have enough web access to upload pictures and update you on our experience. The ACR is helping support our trip and we will be the first recipients of a travel grant may become an annual tradition.

We would like to thank Dr. Bill Warren of the University of Washington along with Brad Short, Dr. Harvey Neiman, Dr. Jim Borgstede, and Dr. James Thrall with the American College of Radiology for all of their assistance.

Hopefully we will take some amazing pictures could be featured in the ACR bulletin.

Karibo

Welcome,

Matt and I will be posting messages, pictures, and video here during our stay in Tanzania. In brief, we will be working at the Kilimanjaro Christian Medical Center in Moshi, Tanzania as part of the East African Medical Assistance Foundation. We will be observing the daily practice under the instruction of Dr. Helmut Diefenthal and his colleagues. We are supported by the University of Washington and the American College of Radiology and greatly appreciate their dedication to resident education within the US and abroad.

Stay tuned . . .