Developing Interventional Radiology in Uganda: The Road2IR Initiative
Mehrshad Bakhshi
Introduction
Interventional radiology (IR) is a medical specialty which utilizes imaging guidance to perform minimally invasive procedures for diagnosis and management of various diseases. The Road2IR initiative aims to build self-sustaining IR training programs in East Africa, training interventional radiologists in Tanzania since 2019, and having now expanded the training model to Uganda since 2023.
I participated in a three-week rotation in Uganda alongside a visiting pediatric IR physician from the United Kingdom, Dr. Adu, as well as a visiting team of interventional radiologists, IR nurses and radiologic technologists from various American institutions, volunteering to train the Ugandan IR fellows. Through this visual journey I wish to portray my experience participating in this initiative, to share a piece of Uganda’s diverse cultural landscape, and most importantly to demonstrate the international efforts in collaborating to achieve equitable access to healthcare across the world.
Picture 1. Saying goodbye and embracing the unknown: a new adventure begins.
Picture 2. Arrival and view of the capital of Uganda, Kampala, the city built on seven hills. Uganda is a multilingual and multicultural country of 45 million inhabitants with over 70 estimated spoken languages. English and Swahili are the country’s official languages.
Picture 3. Entrance to the Mulago Hospital: teaching facility of Makerere University College of Health Sciences, and the most specialized and largest public hospital in Uganda, founded in 1913.
Picture 4. Part of the Mulago Hospital building, which has an established bed capacity of 1790 beds, and offers numerous outpatient services as well.
Picture 5. Part of the department of radiology, where a variety of diagnostic tests and interventional procedures are conducted using X-ray, fluoroscopy, ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) machines.
Picture 6. Procedure room where interventional radiologists perform biopsies, drain placements and other ultrasound-guided interventions.
Picture 7. Control room where CT and MRI studies are conducted. Interventional radiologists utilize this room to perform CT-guided interventions.
Picture 8. The adventure begins! Reviewing consultations and available imaging, assessing patients, and planning for a variety of IR procedures. Other than digitalized imaging, sometimes patients may bring their physical films.
Picture 9. Local IR fellows, Dr. Nabawanuka and Dr. Bugeza, performing an ultrasound-guided procedure with the supervision of visiting attending physician from the United Kingdom, Dr. Adu.
Picture 10. Dr. Nabawanuka, Dr. Bugeza and Dr. Adu performing the first case of percutaneous sclerotherapy for lymphatic malformation in Uganda on a four-month-old baby, under ultrasound and fluoroscopic imaging guidance.
Picture 11. Dr. Adu delivering a lecture about pediatric IR to radiologists, pediatricians, pediatric surgeons, and trainees.
Picture 12. Strolling through the vast Mulago Hospital grounds and discovering the joyful pediatric ward.
Picture 13. Sightseeing and visiting Kabaka’s Palace, the royal compound of the king of Buganda. Buganda is the largest of the traditional kingdoms in East Africa, encompassing at least 52 recognized clans within the kingdom.
Picture 14. Driving through the bustling downtown streets of Kampala during rush hour, packed with motorcycles known as boda boda.
Picture 15. Discovering the multicultural landscape of Uganda through traditional music and dance.
Picture 16. Enjoying the juicy tropical fruits, fresh produce, various spices, and succulent cuisine of Uganda through traditional foods such as Matoke, Ugali, groundnut sauce, cassava, fresh fish and plantains.
Picture 17. Barkcloth making: an ancient art of the people of Buganda, where craftsmen beat the harvested bark of the Mutuba tree into a thin textile, which can be used for clothing and making various artwork such as canvas for beautiful paintings.
Picture 18. Uganda is known as the “Pearl of Africa” for its beautiful landscapes, abundant wildlife and diversity. One can enjoy diverse activities such as gorilla trekking, safaris, or rafting through the Nile River, the source of which is in Uganda. (Picture courtesy of Dr. Adu)
Picture 19. Warm farewell from the Kampala sunset before departure for Montreal. Reflecting on all the experiences learned, and promising to return to the memorable country of Uganda in the future.
Picture 20. From left to right: Dr. Bugeza (radiologist and IR fellow in Uganda), Dr. Nabawanuka (radiologist and IR fellow in Uganda), Aziz (hospital driver), Dr. Adu (visiting pediatric IR physician from the UK), Mehrshad Bakhshi (visiting medical student from McGill University).
Picture 21. Road2IR founder, Dr. Laage Gaupp, and the international team of visiting IR physicians, nurses, radiologic technologists, and trainees meeting with the Dean of Makerere University School of Medicine, and the Head of Department of Radiology of Mulago Hospital.
Mehrshad Bakhshi
Mehrshad Bakhshi is a fourth-year medical student at McGill University. He has a passion for global health, outreach and medical imaging. He is very grateful to have had the chance to participate in this trip and to learn from both the visiting and local teams about the various aspects of implementing an interventional radiology service, while gaining perspective on a new cultural environment. This experience has further fueled his interest for global outreach, to which he hopes to contribute further in the future. He is grateful for the supervision and mentorship of Dr. John Adu (visiting pediatric IR physician from the UK), Dr. Eva Nabawanuka (radiologist and IR fellow in Uganda), Dr. Samuel Bugeza (radiologist and IR fellow in Uganda), and Dr. Alex Mugisha (radiologist and IR fellow in Uganda), as well as the help of Dr. Martin Mutonga (IR resident from Yale University, USA) and Dr. Fabian Laage Gaupp (Road2IR founder and IR physician at Yale University, USA) in making this experience possible. He is grateful for funding received from the McGill Global Health Programs.
Road2IR (https://www.road2ir.org/)
Road2IR is an international consortium of physicians, nurses, technologists, and trainees working together to bring minimally invasive, image guided procedures to East Africa and beyond. Through outreach and education, Road2IR aims to build self-sustaining training programs to create broader access to much needed minimally invasive procedures in resource limited settings.