Last fall I was given the opportunity to volunteer abroad, supported by the RAD-AID/SIR Global Interventional Radiology Program grant. I traveled to Nairobi, Kenya, with RAD-AID Kenya director Robert Dixon, MD, FSIR; Jessica Salerno, MSN; and Brian Baigorri, MD. We worked at the Kenyatta National Hospital (KNH), which is connected to the University of Nairobi (UofN).
We received a warm welcome from the faculty, staff and residents with whom we worked daily. Our days consisted of working on cases in the morning, followed by daily teaching conferences in the afternoons. These teaching sessions included didactic lectures provided by me, Dr. Dixon and Dr. Baigorri, as well as multiple sessions with the Mentice angiographic simulator.
During our visit, their angiography machine was not working so the cases were limited to those which could be done with US and CT guidance. A portable C-arm was available for nephrostomy tubes and biliary drains. Arterial angiography was not able to be performed. Most of the procedures performed were biopsies (including breast mass biopsies), superficial abscess drainage and thoracentesis/paracentesis. Despite the lack of an angiography machine, the daily schedule was full—approximately 10 cases were performed each day.
Every day we felt accomplished, working on cases, networking with the community, and aiding in the development of the UofN VIR fellowship curriculum and significant leadership advances.
Throughout our time in Nairobi, we were able to educate and be educated. A core group of residents participated in our daily didactic lectures, and their passion and drive to help the Kenyan people despite monumental challenges was a source of inspiration to me.
Having the chance to network with the current residents at UofN and share our passion for VIR made this a great period of my training and professional development. I am proud of the work SIR and RAD-AID are doing around the world and am proud to have had the chance to make a small contribution in Nairobi.
Q&A: Volunteering around the world
Each year SIR members contribute to global health by teaching abroad and helping develop critical IR infrastructure in emerging and underserved communities. However, there are many important considerations and nuances that anyone looking to serve should be aware of before engaging with organizations who sponsor such programs. IRQ asked Andrew Kesselman, MD, director, RAD-AID Interventional Radiology, to share some of his insights and lessons learned in organizing outreach programs.
What kind of opportunities are out there for IRs looking to volunteer on global health projects?
There are significant opportunities for IRs to make an impact in global health. RAD-AID currently offers deployment opportunities with both educational and clinical goals. Our current training program sites include Vietnam, Kenya, Nigeria, Ethiopia and Ghana. Each site has been vetted with an IR readiness assessment, perquisite comprehensive diagnostic radiology program, supportive in-country stakeholders and signed memorandums of understanding. We aim to send two to four deployment teams a year to each site, and we are exploring other sites for future development.
What are some large or unexpected differences, both cultural and technical, that IRs may experience while working globally?
Practicing medicine in low- to middle-income countries requires cultural sensitivity, patience and a bit of ingenuity. Our volunteers often encounter both cultural and technical differences in practice. For example, in Kenya, our daily schedule in IR included the customary break for tea during the day. Unlike in the United States, the majority of procedures are performed under local anesthesia only with minimal IM or IV medication administration. At most of our partner sites, we see constraints with consumables, necessitating careful use of the limited available inventory.
What logistical challenges may IRs face while practicing, learning or educating abroad?
Though requirements for practice vary in each country and institution, obtaining the appropriate temporary licensing or hospital clearance is critical. RAD-AID helps with that process, as well as with obtaining additional insurance coverage when applicable.
What should IRs look for when researching organizations to pair with for global health projects or international program involvement?
Track record and transparency are important. Organizations should also prepare their volunteers and set them up to succeed, and education should be the main focus for any volunteer. RAD-AID provides each of our volunteers with a travel policy, volunteer checklist and on-boarding materials. Malpractice and travel insurance policy information is provided to ensure a safe and supported experience.
What tips do you suggest for IRs preparing for their time abroad?
If possible, consider registering your trip with your institution. To make the most of your experience, it can be important to prepare educational objectives tailored to the local practice, to keep an open mind and to stay flexible as unique opportunities may present themselves while in-country.
SIR Endorsed Badge
RAD-AID International and SIR have partnered to give society members the opportunity to teach, guide and mentor IR personnel in RAD-AID’s partner health institutions in low- and middle-income nations. SIR members are an integral part of RAD-AID’s interdisciplinary clinical outreach teams. RAD-AID has a sustainable approach to advance IR in global health that focuses on education, training and local infrastructure development.
To see opportunities to volunteer with RAD-AID, visit rad-aid.org/programs/interventional-radiology.
