Libin Abroad: Echocardiography program educates local doctors in Guyana

(L-R) Abiola Nelson, Guyana’s Minister of Health Dr. Bheri Ramsaran, Dr. Ramkuran Ramsackal, Dr. Debra Isaac, Dr. Kishore Ramdass, Dr. Alexandra Harvey and His Excellency, Mr. David Devine, High Commissioner of Canada in Guyana

Three Guyanese doctors have successfully completed an intensive eight-week education course in the performance and interpretation of cardiac ultrasound (echocardiography) and graduated from a program that was developed by Canadian cardiac specialists.

This summer, cardiologist Dr. Debra Isaac and a team of eight sonography technologists travelled to Georgetown, Guyana to implement the Guyana Echo program, with support from the Libin Cardiovascular Institute of Alberta.

The program was developed and headed up by Isaac and cardiac surgeon Kishan Narine. It’s an initiative supported by Dr. Bheri Ramsaran, Guyana’s Minister of Health, and His Excellency, Mr. David Devine, the High Commissioner of Canada in Guyana.

The eight-week course taught three public hospital physicians and one radiology technologist—Dr. Kishore Ramdass, Dr. Alexandra Harvey, Dr. Ramkuran Ramsackal and Ms. Abiola Nelson—how to preform echocardiographic studies and to identify common cardiac pathologies.

Covering basic ultrasound physics principles and standard echocardiography imaging views and windows, the hands-on learning experience allowed these Guyanese health professionals to develop diagnostic skills. The long-term benefit is improved cardiac assessment and care at the Georgetown Public Hospital (GPHC) and also for the larger
population across the country.

A formal echocardiography lab has been set up and equipped at the GPHC. Doctors who have completed this program are looking forward to providing access to this important cardiac diagnostic test to the public health system.  Echocardiographic studies identify the structures of the heart, and the function of the pumping chambers and valves of the heart.  Identification of cardiac abnormalities by echocardiography results in improved diagnosis, and improved diagnosis leads to better ability of the doctor to treat the patient. As a component of this education program, students were also given updates on the management of cardiac diseases by Canadian cardiologists.

“At this point in Guyana, there are very few places to get a cardiac ultrasound in Georgetown, and these are all private, for profit” says Dr. Isaac, the program director. “The most important part of this project is that it’s for the public medical system. People who need an echo can get one and not have to pay but also, the doctors looking after these patients can make better diagnoses and decisions.”

The project idea stemmed from a trip originally intended to bring donated pieces of echo equipment, but Isaac soon realized that nobody knew how to use the machines.

“That led to thinking that, if someone goes down there, a couple of weeks at a time, that doesn’t help either. So, why don’t we empower them to do it and teach them?

“When you want to do work in a developing country,” says Isaac, “You have to ask yourself: ‘Am I doing something to them, for them or with them?’ Unless it’s the latter, it’s not going to work.”

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Echo techs from the Peter Lougheed, Rockyview and Foothills Hospitals, as well as Northwest Cardio Diagnostics echo lab responded to the need, donating their time to help develop and teach this program. Two machines
have already been donated for use and the team is currently trying to raise funds to send two additional machines down.

Isaac says her team plans on building on this initial program. Hopes are that in the fall, they can return with a pediatric cardiologist and adult congenital cardiologist and spend another two weeks focusing on the need in pediatrics.
Maternal and fetal death is still a big problem in the country and Guyana’s Minister of Health has already expressed to Isaac a need for personnel who can do obstetrical ultrasound.

Isaac points to the opportunities this program has for expansion into other areas of cardiology such as cardiology prevention planning, heart failure planning and management.
“In one year, we’d like to hopefully get these three doctors up to speed so they can also be mentors in the future,” she says. “The best way to learn is to teach.”

Read more about this in local media stories out of Guyana.

“GPHC, Linden Hospital Staffers begin ultrasound, neonatal care training”, Stabroek News

“GPHC staff in ultrasound training”, Guyana Times

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