April 2016: Kigali, Rwanda

PURE Ultrasound Rotation – CHUK Kigali, Rwanda

As emergency physicians we are no strangers to work in environments in which our resources are seemingly stretched to the limits. In my practice so far in the U.S., however, I have never waited three days to get a CT scan for a patient, or discharged them because they couldn’t pay for it. This can unfortunately be the clinical reality at times in Rwanda. In the bustling, frenetic, emergency department at the Central University Hospital of Kigali (CHUK), the ultrasound machines are in constant use. Patients are lined up in cots in the hallway, and more are always coming through the door, so there is pressure, as always, to make diagnoses quickly.

As an ultrasound educator with PURE, I worked with emergency medicine residents at CHUK, teaching them the basics of the eFAST, cardiac, lung, FASH and many other exams. In the first few days of the rotation we diagnosed miliary tuberculosis, liver and splenic abscesses, severe mitral valve stenosis, three cases of cardiac tamponade, and drained a 3L empyema. During this rotation the residents developed lasting skill sets to make quick diagnoses, perform procedures safely and effectively, and many times spare cost of imaging to patients. The very tangible improvement in quality of care that can be achieved through the skillful use of ultrasound in this practice setting is a testament to the enormous impact that ultrasound education can make.

Kavita Gandhi, MD
OSHU Emergency Medicine