Providing medical imaging and radiology to rural communities in developing regions such as East Africa is not only about facilitating access to imaging hardware, but also concerns ensuring that sufficient highly trained radiologists and technologists are present in healthcare facilities to operate the equipment and provide safe high quality health care. As Dr. Sudhir Vinayak of the Aga Khan University, Nairobi, Kenya, highlighted in a recent interview, only around 25–30 radiologists are trained in East Africa each year to cover a region with 100 million inhabitants.³ In the interview he goes on to describe how his university has established a radiology training program producing radiologists of the highest calibre who are interchangeable with their peers from Europe and the USA. Their main focus is on excellence.
Data from RAD-AID suggest that there are less than 200 radiologists currently practicing in Kenya, serving a country with almost 46 million inhabitants.⁴′⁵ Expressed another way, there is about one radiologist for every quarter-of-a-million Kenyans. In comparison, in the United States, there are about 30,000 radiologists for a population of 319 million, which translates to about one radiologist for every ten-thousand people.
But how does a physician, technologist, or medical student working or studying in Kenya or Ghana, who is interested in specializing in radiology, find the funding for a period of training? The educational loans that are commonly available in advanced healthcare education systems are not widely available in developing countries. This major barrier is being addressed in an innovative manner by RAD-AID.
The concept of microfinancing is hardly new – there have been numerous high-profile and highly effective initiatives around the world. However, the concept has traditionally been applied to providing loans for agricultural programs and small business ventures. RAD-AID has recently identified a potential role for microfinancing in healthcare education.⁶ The program is outlined by Sarah Iosifescu, Director of RAD-AID Health Finance, in a webcast from the RAD-AID Conference that can be accessed at the Johns Hopkins University mediasite.⁷ In partnership with Deutsche Bank Global Social Investment Funds and local banking institutions in Africa, RAD-AID is in the process of establishing a microfinance program to fund the educational costs of individuals seeking training in radiology and medical imaging. The program will be open to physicians, technologists, nurses, and medical students. Furthermore, microfinance loans will potentially be made available for individuals and organizations wishing to purchase or lease radiological equipment, although initially the priority will be on training. Although RAD-AID is the creative driving force behind the initiative, the organization will not actually participate in the administration of loans. The knowledge and penetration of conventional microfinance institutions, and of local banks, are being utilized since, as Iosifescu notes, they have established relationships with clients living in both rural and urban areas, and understand local cultures, languages, and politics. This program, therefore, envisions a unique partnership across international banking, local finance, and radiology institutions to bring needed capital into growing areas of healthcare to meet the needs of underserved populations. RAD-AID has longstanding expertise in building such partnerships and multipartite bridges, and this track record was recognized by the Clinton Global Initiative for RAD-AID’s work in India and RAD-AID’s recent recognition as a UN/WHO-affiliated NGO.
While medical imaging in Kenya principally consists of radiography, other modalities such as CT, MRI, and particularly ultrasound, are increasingly becoming available.⁴ Consequently, the training programs are aiming to cover the operation of these modalities, together with the necessary IT skills, such as the use of picture archive and communication system (PACS), and radiation safety, including the new AFROSAFE initiative aimed to improve radiation safety in Africa.
A key aim of the educational program is sustainability: to provide short-term financing that propels the recipient along the path towards long-term self-sufficiency. RAD-AID recognizes that an important aspect of sustainability at the country level will be the ability to retain radiology professionals when they are fully trained and capable of gaining perhaps more lucrative work abroad. In order to address this, economic incentives will be offered to radiologists to encourage them to work in medically underserved areas of the country.⁴
The education microfinancing initiative aims to launch a pilot phase this year. Fabric of Africa will be sure to provide an update as it progresses.