Emma Polgar, one of our Ultrasound Clinical Application Specialists (CAS), talks about her experience in the field of obstetric sonography and recent voluntary work teaching point-of-care ultrasound for antenatal care in Kenya.

?

1. Why did you initially join Mindray?

The thing I love about ultrasound is the technologies change so fast. I was (and still am) always reading the latest journals and product releases to see what¡¯s new. I had specialised in obstetric ultrasound and fertility but when I found out about the Clinical Application Specialist (CAS) position with Mindray I was intrigued by the company¡¯s drive for innovation and using those technologies to make healthcare more accessible to everyone. That vision resonated with me, and I saw the chance to be among the cutting-edge companies I was reading about ¨C that was exciting!

2. What does your role entail?

As a Clinical Application Specialist I provide a lot of support to customers, mainly with end user training so they can get full value from their ultrasound systems, but it¡¯s not a one-way relationship. There¡¯s a lot of collaboration with customers to see how we can enhance the software and smart tools in our ultrasound systems so we deliver the best clinical value.

?

When I joined, I didn¡¯t want just a job, I wanted a career. I¡¯ve been given quite a few opportunities to work with other parts of the business, especially with research projects. I really enjoy being a link between our customers and R&D to spearhead new technologies. Although I¡¯ve changed jobs, I¡¯m still doing some agency work at the Liverpool Women¡¯s Hospital on the weekends. It¡¯s a chance to give back and ensures I¡¯m always refining my clinical skills.

3. How did teaching antenatal POCUS in Africa come about?

Some of my former colleagues reached out to see if I¡¯d be interested in joining them as a volunteer for a charity that was teaching POCUS in Kenya to help tackle the high maternal mortality. I¡¯d be helping to train rural midwives, nurses and doctors how to use POCUS for antenatal care. Ultrasound is so important for managing the health of expectant mums and their babies. I was immediately interested.

?

After speaking with Massimo at Rainbow4Africa, the charity running the training programme, it seemed like a great opportunity to make a difference. In addition to providing training, this project is also putting more ultrasound equipment into rural areas. The Kenyan government has launched a lot of initiatives to enhance healthcare provision and quality. This is one of 14 projects that have received grant funding from the UK government's Tropical Health and Education Trust (THET). Rainbow4Africa is delivering this training as part of a 5 -year programme with their sister charity Rainbow4Kenya and the Masinde Muliro University of Science and Technology (MMUST).

4. How could POCUS improve maternal mortality in Kenya?

Currently, most expectant mums in Kenya don¡¯t have an ultrasound scan. If they do, it¡¯s late term. Part of this is down to the cost of medical care, but for women in rural areas, the time and cost associated with travelling to a hospital that might be hundreds of miles away could be prohibitive. Most mothers still deliver their babies at home.

?

This means hidden complications such as having twins or a breech baby, can go undiagnosed. That puts mums and babies at much greater risk. There is still a fee for point-of-care ultrasound, but if mums seek antenatal care at a local clinic as opposed to a hospital, the cost is much lower.

?

This project will teach rural midwives, doctors and nurses how to use POCUS in antenatal care and fund more ultrasound machines for rural services. The hope is that mums will get scanned earlier in their pregnancies, so complications get identified sooner and they can be referred faster to hospital for tertiary care with transport put in place.
Their target is to train 80 clinicians per year for the next 5 years. As part of that they will create an international clinician network that supports continuous professional development.

5. What did the training cover?

For many participants it was their first time using ultrasound. There was an academic session at the start to show the physics of how ultrasound works, but the majority of time was dedicated to practical, hands-on training.

?

We focused on life-saving, essential checks - how is the baby laying ¨C are they head or bum down? Is the placenta blocking the exit and at risk of rupture during labour? Is there enough fluid around the baby or do we need intervention for a leak in the amniotic sac?

?

Even knowing how many babies you have makes a difference ¨C the first woman I scanned found out she was having twins! Using the ultrasound system we showed how to check the number of placentas. In this case there were two. This is critical information. If a placenta is not removed after the births, it could cause sepsis.

?

By the end of the course we were helping the delegates to do measurements so they could estimate how old a baby is. It was the truest form of ¡®point-of-care'.

6. What did you gain from this experience?

It's been really rewarding to teach this first cohort. The delegates were fully engaged and asking lots of questions. Senior government officials attended parts of the course too. They really want this to succeed. You can get so much information from an ultrasound scan and I am sure the project will have a very real and positive impact for Kenyan mums.

?

To mark the first training course, we were invited to do a tree planting ceremony. It was an honour to add my name to a tree in Kenya.

?

When Mindray UK found out about the volunteer work they donated a TE Air handheld wireless ultrasound probe to the programme. With it being portable and wireless it¡¯s really practical for everyday use, especially if you¡¯re travelling. It also means that if there are any issues like power cuts, care delivery shouldn¡¯t be affected as much. It¡¯s great to work for a company that can and will support life-saving charity work.