A friend of mine, William Cherniak – a family medicine resident in Canada at the University of Toronto- has been working on a project. Not just any project, but a global impact project with the help of KIHEFO (Kigezi Healthcare Foundation) and his own group that he created called TO-the World. What is this project, you ask? Well, it was to show how minimizing maternal to child transmission (MTCT) of HIV can be helped by simply having and letting the women know in the region that a portable ultrasound has arrived. This project will be presented at Global Health 2013
The project in brief: “In alignment with the WHO 2010 guidelines for MTCT elimination and the Ugandan government’s adoption of plan B+; KIHEFO, in collaboration with TO – the WORLD, designed a structured maternal health camp [sMHC] centered on providing expectant mothers in rural Uganda with a free obstetric ultrasound [OBU]. The four‐pronged approach of MTCT elimination was followed in the design of the sMHC. In one day, 45 women rotated through registration, pre‐test counseling, testing for HIV and Syphilis, family planning, obstetric ultrasound and, for the women identified as being high risk by triage, dental and/or medical services. Each woman received fansidar, multivitamins, folic acid and filled in a pre‐ designed questionnaire. In total, 10 women identified themselves as being HIV+ at registration, surprisingly only half were currently being treated with ARVs. An additional two women were diagnosed as being HIV+ during the health camp. All women received counseling and were started on ARVs for life. Only 7 women had ever previously had an OBU, and all 45 women verbally identified that the reason for attending the antenatal health camp was to receive a free OBU.” – Now that is just amazing. The power of what a portable ultrasound can have on a community in fighting MTCT of HIV. Bring the ultrasound, and they will come – that is your way to start the healthcare and assessment they need.
They continue to state how they hope to solve the problem of high maternal death and high infant death rates: ” Solving the Problem – Ultrasound and Outreach to Reduce Maternal Mortality. As stated above, the leading causes of maternal mortality include hemorrhage, eclampsia, obstructed labor, infections, and birth defects. Studies have shown that obstetric ultrasound imaging can prevent most outcomes by providing early diagnosis and intervention. By providing useful information such as whether or not the mother is carrying twins, has an ectopic pregnancy or otherwise a mother and her partner can make an informed decision about whether or not to deliver at home with untrained professionals, or a health center where they can receive life‐saving treatment. Furthermore, the World Health Organization (2003) recognizes ultrasound technology as ideally suited to low and middle income countries, as it is relatively low‐cost, low input, and easily maintained and transported. Additionally, studies conducted on the use of ultrasound technology in two rural hospitals in Rwanda have indicated that after an initial training period, an ultrasound program led by local health care providers can be sustainable and lead to accurate diagnoses. Ultrasound imaging is beneficial to rural populations as it is a simple a nd non‐invasive procedure. This helps to reduce levels of fear from women who have previously maintained their cultural preferences for receiving treatment and giving birth with untrained birth attendants in their local villages.
receiving ultrasound imaging for the first time indicated that the majority of women were satisfied with the information provided from the procedure, despite not initially understanding its purpose. The ultrasound procedure provided women with the ability to see fetal positioning, fetal sex, and to recognize any potential pregnancy complications. Information, particularly the latter, resulted in guiding treatment for the woman’s particular birth – helping her make an informed decision as to where and how she would deliver. This particular study in Tanzania concluded that the ultrasound imaging was useful in reducing the risk of maternal mortality, although the treatment should be accompanied by a thorough education campaign and consent program.”
The future? “Currently, TO – the WORLD is in the process of raising funds to purchase two portable ultrasound machines. These machines will be purchased locally in Uganda to ensure sustainability in maintenance and economic stimulus for the communities in which they serve. Multiple outreach camps will be conducted in 2014 with the previously designed model based on the WHO four‐pronged approach to MTCT elimination of HIV.
The WSJ actually spoke of what happens when an US machine is taken to a developing country – more antenatal visits!
Here is the video William made to support his cause:
HIV. Accessed March, 2013 at
2. IRIN Humanitarian News and Analysis –A service of the UN office for the coordination of human
affairs. Accessed March, 2013 at http://www.irinnews.org/Report/96308/UGANDA‐Government‐
3. WHO Executive Summary, April 2012. Use of Antiretroviral Drugs for Treating Pregnant Women and
Preventing HIV Infections in Infants. Accessed March, 2013 at
4. World Health Organization. Statistics on Maternal Mortality in Uganda, accessed March, 2013 at
5. Kigezi Healthcare Foundation website, accessed March, 2012 at www.kihefo.org
6. Maternal Health: Investing in the Lifeline of Healthy Societies and Economies. Africa Progress Panel
Position Piece. September 2010.
7. Yaw A.W., Alexander T.O., and Edward T.D. The Role of Obstetric Ultrasound in Reducing Maternal
and Perinatal Mortality, Ultrasound Imaging ‐ Medical Applications, InTech, Accessed March, 2013.
Available from: http://www.intechopen.com/books/ultrasound‐imagingmedical‐applications/the‐
8. Shah S.P., Epino H., Bukhman G., Umulisa I., Dushimiyimana J.M., Reichman A., Noble V.E. Impact of
the introduction of ultrasound services in a limited resource setting: rural Rwanda. BMC
InternationalHealth Human Rights. 2009;27:9‐4
9. Firth E.R., Mlay P.,Walker R., Sill P.R. Pregnant women’s beliefs, expectations and experiences of
antenatal ultrasound in Northern Tanzania.African Journal of Reproductive Health. 2011; 15(2):91‐