Laos Friends Hospital for Children
[UPDATE: Xray technicians found!!! Still looking for ultrasound people. PLEASE CONTACT US before maling any plans. General job expectations are to teach, assist, mentor our xray/ultrasound technicians. LFHC hopes to start a full teaching program eventually and will be looking for help in its organization.]
Laos Friends Hospital for ChIldren opened its doors in Feburary 2015. Set up and supported by Friends Without a Border (as is Angkor Hosital for Children in Cambodia, above), LFHC is the first full-service pediatric hospital in northern Laos, offering inpatient & outpatient departments, 24 beds, emergency room, intensive care unit, operation theater, laboratory, pharmacy, radiology, lecture rooms & library to teach pediatric medicine to the future leaders of the hospital, kitchen & laundry for families visiting the hospital, and a vegetable garden to teach families how to prepare nutritious meals. See Friends Without a Border website (here) for more background information on the initiation of this new and much welcomed hospital.
As of mid-May 2015: LFHC offers a growing outpatient clinic seeing up to 100 patients per weekday, which includes approximately 5-10 ultrasounds and 5-10 radiographs per day. Any patient requiring inpatient care is immediately transferred next door to the adjacent Provincial Hospital which has its own radiology department. This Provincial Hospital department is staffed by approximately 6 radiographers who perform both the radiographs and ultrasounds. The ultrasounds are interpreted by the radiographer with an example image(s) often printed and sent with the patient including an interpretative hand-written note, while the X Rays are sent back with the patient to be interpreted by the ordering MD. This radiographer team has no specific pediatric radiology training, and the hospital has no onsite radiologist. Subspecialty pediatric care (CT scan, MRI) is only available - at a cost - in the capital of Vientane, 340 km and thirteen hours by vehicle away, despite government-provided health care for children under the age of 5. The transportation cost alone is prohibitive for many families in the region.
UPDATE NOV 2015: the hospital is rapidly growing:
+ Currently operate in outpatient and inpatient setting with approximately 5 Laotian MD’s seeing approximately 30-70 patients a day with the performance of approximately 2-10 radiological exams (combined radiographs and ultrasounds) per day
+ November 2015: scheduled opening of the ER
+ January 2016: scheduled opening of the ICU and operating room theater
• Continues to expand radiological services + Site visits for sonographers + Continuing RAD-AID support of PACS
RAD-AID's pediatric coordinator for Asia, Dr Michael Reiter, visited LFHC in May 2015 to assess future collaboration and support. Following the visit, Dr Reiter and LFHC's director, Dr. Nijssen-Jordan, contacted WFPI for tele-second opinions for LFHC's embyronic imaging department (the hospital does not have a radiologist hired yet to interpret the images for a newly installed US and portable radiography unit). First referral received on 23rd May, cases coming in since! We're happy to support this new hospital and all it is aiming to achieve.
Progress report, January 2016: 210+ cases referred to WFPI by LFCH via the tele-platform - the number of referrals for WFPI volunteer second opinions increased significantly from late November on. Most cases have been chest radiographs, also radiographs of skull, mandible, spine, leg, and abdomen, as well as one head CT. They raised diverse clinical questions, including queries on infection, heart failure, beriberi, storage disease, tuberculosis, sellar tumor, dental abscess, thalassemia and acute abdomen.
More information on this project and the pediatric imaging set up can be found here
Laos Friends Children's Hospital is looking for a volunteer Xray and US technician visit: see here.
Angkor Hospital for Children, Siem Reap, Cambodia
Angkor Hospital for Children (AHC) is a 103 bed charity pediatric hospital serving children affected by poverty and disease. Founded in 1999, the hospital has grown to include a 12 bed intensive care unit, a surgery program including open heart surgery cases assisted by visiting teams, the beginnings of a cancer care program, a neonatal ward and a newly renovated and expanded outpatient department. More information can be found at www.angkorhospital.org.
AHC’s two radiology modalities are X-ray and ultrasound (no CT scanner or MRI Machine. CT scans are occasionally obtained at other facilities in Siem Reap on an as needed basis.) The good quality images are done with a very simple mobile machine. A phosphor plate system is in place, thus X-Rays and descriptions can be reached from the ward. ACH uses SONIX SP (ultrasonix) ultrasound machine with three probes: C7-3/50 , L14-5/38 and PA4-2/20. Since its repair in early March 2014, the machine has ceased to function with Pulsed and Power Doppler. There are 15-20 ultrasound examinations/day, mainly severe soft tissue masses and eye injuries. There is no small convex probe. Generally speaking there are no normal finding, just severe pathologies. AGH has one radiologist and plans to add an additional physician to train as a pediatric radiologist.To date WFPI has given opinions on aproxmiately 120cases, largely on plain radiographs, with a few ultrasound studies, contrast exams and CTs. Opinions were returned within 24 hours (often sooner).
Site coordinator: Dr. Seng Hap. WFPI coordinators and tele-readers: Drs. Veronica Donoghue and Eva Kis. Project identified by Dr. Catherine Owens/Royal College of Radiologists, UK
© Cambodia images: George Taylor
Other imaging interventions at Angkor Hospital for Children
WFPI is far from the only organization to offer assistance to this facility. AHC pediatric staff members are trained by ultrasound faculty at UMass Memorial Medical Center through onsite lectures and hands on training. UMass physicians travel to Siem Reap about 3-4 times per year for onsite education. Pediatric radiologist Dr. Joe Makris has been among them. See here for more.