February 2010
Five Days in Haiti
The world was shocked by the damage that a 7.0-magnitude earthquake wreaked on Haiti last month. Only four days after the quake, Nabile Safdar, M.D., assistant professor of diagnostic radiology and nuclear medicine at the University of Maryland Medical Center in Baltimore traveled to the country to lend a clinical hand to the relief effort. Initially, he was overwhelmed. Now he wants the radiology community to think about the next disaster.
Q: What prompted you to lend your skills to Haiti?
A: I think I probably felt the same way many other people felt across the board; we wanted to help in whatever way we could. Luckily, I had a friend who had done relief work in other disasters, so he called and asked if I would like to go because they could use more people. When he called, he was talking about leaving within 48 hours, so it was short notice, but I knew at the time that there was an acute need not just for all types of surgical care but also for primary care. I felt comfortable doing basic primary care.
Q: What did you do upon arriving in Port Au Prince?
A: In all honesty, we weren’t sure where we were heading; we had to trust our local partners [members of Aimer Haiti] to identify a safe site that would be valuable as a clinic location. It was evening, and we pulled into a walled facility; in looking up, I saw it was an amusement park with several pavilions for video games, foosball, and concessions. The concession pavilion was structurally intact and had shelving, counters, and it was in a place where we felt we could safely control traffic, so we put out all of our supplies and organized them, and then our partners in Haiti had us stay with them in their own homes.
Q: What kinds of injuries did you see?
A: This was now six days after the quake, so I was expecting that people would have had access to some type of medical care, but at least in this part of the city, the patients who came to us hadn’t yet been seen by anyone. The very first patient had a lateral compression fracture of the pelvis. She brought her own X-ray. There were a few facilities that had X-ray capability, but they were so overwhelmed. You could go over to this other facility and have an X-ray or other imaging done for an injury that clearly needed surgery, but they were so inundated that they’d give this patient a copy of the X-ray without further consultation. Fortunately, she had a stable fracture, so we helped her with pain medications, crutches, and reassurances.
The next patient was a 3-year-old girl with a femur fracture, and she hadn’t had any pain control or seen anyone for six days. Her leg was rotated and shortened, so we already knew it was broken. It was something that she needed to have casted and reduced, but at that time, our clinic didn’t have that capability. Now it does have plaster of paris and an orthopedist to help. Otherwise, there were a lot of fractures, infected wounds, and a good amount of dehydrated patients.
Honestly, I only saw two X-rays the entire time I was there.
Q: What do you take away from this experience?
A: As radiologists and as a radiological community, we need to be more proactive about finding ways to be prepared to provide imaging in disaster situations because, essentially, we didn’t have any imaging infrastructure, and what was there was not enough for the population. I feel like we can do more to partner with vendors and charitable organizations, to think about ways that we could help. For example, maybe we could somehow provide portable facilities or equipment, with generators, things [that are] robust for fieldwork and that in many ways are designed for this type of situation.
In many cases, imaging would have made a big difference for a lot of the patients we saw in Haiti, but we had no way to give them what they needed. We could only tell the patients where a few imaging facilities were. It’s gotten better now because there are other relief teams on the ground, but the peripheral and surrounding areas of Port Au Prince are still not being well served.
We have a collective responsibility to make imaging a priority because it’s something that can really make a difference, and it won’t necessarily be any other specialty that has as much influence on all players to get it done. It would be great if, in the future, we were able to do more in terms of helping logistically and adding relief capacity.
This natural disaster set Haiti back a really long way, and it was a fairly poor place to begin with, so just raising awareness and continuing to give whatever we can afford is doing a lot.
How You Can Help
The ACR has established a Haiti Relief Fund to help supply health-care facilities on the ground in Haiti with necessary radiological support, both for immediate relief assistance and long-term rebuilding efforts. We've already raised more than $7,000. Help make it grow!
Q&A With the Expert
Linda Moy, M.D., from the Breast Imaging Center at the Cancer Institute at the New York University School of Medicine, New York, and her colleagues completed a study on using breast MRI in inconclusive mammographic findings. Moy recently agreed to offer an inside view of the study, its results, and what it means for breast imagers.
ARRS Updates and News
Practice Quality Improvement: Radiation Overdose
Is radiation overdose preventable? How can a basic quality-improvement program help prevent mistakes, such as the highly publicized error at Cedars-Sinai Hospital in Los Angeles? Michael A. Bruno, M.D., associate professor of radiology and medicine and director of quality management services and patient safety in the Department of Radiology at the Penn State Hershey Medical Center in Hershey, Penn., answers these questions and more in an exclusive Q&A interview.
Women's Imaging Online: Offering Organized Resources
Search WomensImagingOnline by specialty. From original articles, to Webcasts, to expert interviews, you'll find everything you need sorted by specialty for each category.
Publications Highlights
InPractice: Should You Hire a Wealth Manager?
Radiologists face a variety of business and economic pressures that all have one thing in common: they can reduce take-home pay. Read more to determine whether you need professional financial help.
AJR: Risk Assessment for Ovarian Carcinoma: Hope or Hype?
Women's imaging, including ovarian cancer, is the focus of the new February issue, which features this article from Section Editor Marcia C. Javitt, M.D., FACR.
ACR Bulletin: Navigating the Media
When the press is knocking on your door, do you let them in? We discuss the benefits and pitfalls of a relationship with the media in the February issue.
JACR: The 2009 ACR Forum: Health-Care Payment Models
Last year's ACR Forum addressed health-care payment models, the strengths and weaknesses of different models under consideration, their implications for radiology, and the role radiologists should play in the debate. Where do you stand? Read this free article by Richard B. Gunderman, M.D., Ph.D., et al. in the February issue.
Editor's note: ARRS membership includes subscriptions to InPractice and the AJR; the JACR and the ACR Bulletin are valuable benefits of ACR membership.
Spotlight on Education
What You Don't Know About the Annual Meeting
Take a sneak peek at the Caldwell Lecture, the Business Symposium, and even the categorical course, "Practical Approaches to Common Clinical Conditions: Efficient Imaging," with the annual meeting preview. Don't forget to register by March 26!
Suggest CERT Lessons to Your Radiologic Technologists
There's a new CERT lesson available, "Perspective on Contrast-Induced Nephropathy," and it's the second in the new format that features a summary of the selected AJR article, written in a style that's more beneficial to technologists.
Do You Interpret Thoracic Images? Sign Up for the Chest Symposium
The basics of chest imaging and beyond are the focus of the ARRS-ACR Chest Imaging Symposium, scheduled May 15, in conjunction with the ACR's AMCLC in Washington, D.C.
Make the Most of Your ARRS Membership
E-mail or address change? Update your membership information by logging into the ARRS Web site. Just click on "LOGIN" in the top right corner. Once you have logged in, cut and paste this link into your Internet browser to update your record: http://www.arrs.org/membership/MemUpdateContactInfo/.
Check out the newest members of ARRS!
We would also like to remind you of our complimentary in-training memberships for residents and fellows throughout the world. Please encourage your in-training colleagues to join the ARRS by completing an online membership application.
Comments on InPractice Insight?
E-mail Raina Keefer, editor at rkeefer@acr-arrs.org.