Helmut and Rotraut Diefenthal: Annual Report 2005-2006

A copy of the Diefenthal 2005-2006 Annual Report is available.

August 14, 2006

During the last year, we had a steady increase in the number of examinations: an average of 50 ultrasound and 80 X-ray examinations, both with a wide variety.

We are thankful for the generous gift of two modern ultrasound machines from the St. Paul Radiology Clinic, especially Dr. John Knoedler. We were struggling with older and persistently malfunctioning machines. These new machines have high-frequency probes for the increasing demand for vascular ultrasound. We are still trying to get a transducer for cardiology.

Maintenance and repair for biomedical equipment has been and still is a critical problem. This does not only apply to radiology but also to the high tech equipment used in surgery, anesthesia, endoscopy, the laboratory and the intensive care stations as well. Much of our equipment is old, often disowned by the manufacturers and not working. Two years ago I proposed to the director, Prof. Shao, to create a new department to deal with the problem. However, maintenance and repair are not attractive items for donors and, therefore, are a low priority. Every two weeks, I reminded the administration of the necessity of preventative maintenance. I argued that we are losing money. Now I am happy to report that I was called by the director two weeks ago and a preparatory committee was installed. The ball is rolling. We hope to have within two months a detailed plan, including the original cost, recurrent expenses and personnel. It will be submitted to potential donors, the American and German Embassies and the industry.

Two librarians from St. Paul visited us. They did a good job in cleaning up and reorganizing our existing library in the hostel for AMO radiology residents. In consultation with the director of the School of Medical Records, we interviewed and hired a student of his school. She will graduate in September and then work for our library half days. Her name is Sofa. She will take care of books and control the Internet access that will be established this fall. I used a government grant to our school to buy a new computer and PowerPoint projector. The system shall be fully operational before the end of this year.

Both of the two teaching programs are continuing. The four-year residency for medical doctors now has eight residents. The examinations took place in early August. Dr. Elsie Kiguli-Malwadde, the head of Radiology of the Makerere University in Kampala, Uganda, Dr. Mike Nelson and Dr. Jim Roelofs were external examiners. Dr. Svetlana Karenga graduated last week. Dr. Mnenei failed to submit a satisfactory dissertation. We will try to give him an extension. Two new residents will start this October.

Four Assistant Medical Officers also graduated. They got the same cases as the M.D.s and performed just as well. One of them so well that Dr. Malwadde thought he was an M.D. He wants to become a full-fledged M.D. and gave me a letter to the Board asking for assistance. I do not know whether the Board is willing to accept a commitment of this kind. I can only say that he will be a good investment. Dr. Jim Roelofs knows him because he was one of his examiners. Five new students are enrolled for the next school year, the 14th year since we started in 1993. There is still a backlog of 30 applicants who could not yet be admitted. We now have 49 graduates. Most of them work in the district and regional hospital where they came from. A few came from and returned to Zambia and Zimbabwe. I talked to a number of hospital directors who got AMO radiologists from our program. They were very satisfied with their services. Therefore, we are getting many new applications. There is no need to advertise.

The graduation ceremony with caps and gowns took place last week. All external examiners were present.

Any department of radiology, especially one in a teaching institution, needs a fairly large library of X-ray, CT and ultrasound images. This is not possible if you cannot afford to copy films. The library has to be accessible to staff and students. Inevitable, the best films disappear. We found a solution that makes it possible to copy films at almost no cost and to make them available not only to our hospital but also to our alumni and whoever needs images for learning and reference. Films are photographed with a digital camera and stored in a computer in PowerPoint format. Up to now, we have 1500 images (over two GB) with appropriate annotations. They are distributed to our graduates on five CDs and will soon be available on our Web site. Almost all regional and district hospitals and many individual doctors have computers with Internet access. The library is a work in process. It is updated every six months and can be downloaded at minimal cost. It proved to be a great tool for lectures and presentations. An additional advantage is that even films of marginal quality can be transformed into good images with the editing tools of the computer. We also obtain detailed views of important features that are not well seen on the large film. The library is peer reviewed by the radiologists and Makerere University in Kampala, Uganda.

We also offer tele-radiology through e-mail. A practitioner can send images via e-mail. The radiologist in Haldom hospital regularly sends us CT images.

We attended the third Pan African Congress of Radiology and Imaging (Pacori III) in September 2005 in Dar es Salaam, Tanzania. Mike Nelson, Jim Roelofs and three other members of KCMC also participated, presenting a total of six papers. It was the first time PACORI took place outside of Kenya. With over 150 participants, it was a good success.

The International Society of Radiology has their meeting this year in Cape Town, South Africa. At their invitation I will present two papers: (1) the radiological features of HIV-AIDS that we see in Moshi. They are different from those seen in the West, e.g. much more pulmonary tuberculosis, less PCP. (2) Radiology training in East Africa. I will also give hands-on demonstrations of echocardiography. They wanted me to show this technique because few radiologists in the West are allowed to use it.

Our department has four specialists in radiology: Dr. Kalambo, Dr. Moshi, Dr. Jusabani and myself. Dr. Jusabani is supported by EAMAF; the other two are not. I think it may be good to review this policy considering the contributions of all of them to the department.

The Medical College of the Tumaini Univeristy is expanding. Last year's freshman class had 70 students; this year 100 will be admitted — more than half of them women. A new building with classrooms is under construction. Computers will be available in all classrooms. Teaching uses PowerPoint almost exclusively. Interaction between teachers and students is more difficult to establish in classes of this size, especially as Tanzanian students are used to passive learning only. We are still short on teachers.

Altogether, it was a successful year.

Helmut Diefenthal