Nepal is a low-income country located in central Himalayas in South Asia with a population of 30 million. The structure for clinics and hospitals in Nepal is: sub health post → health post → primary care center → district hospital → regional hospital → central hospital. Healthcare is provided by both public and private entities, with resources mostly located in the capital. Nepal’s disease prevalence is higher compared to other countries in the region.
Simple x-ray and ultrasound units are available at district level hospitals and above. They remain the primary diagnostic tools in the absence of CT or MRI in most places. Many rural hospitals and health centers lack even a simple x-ray unit. However, some centers do have x-ray equipment, but no proper radiographers are available. Handwritten radiology reports are still in use. Electricity shortages are a major problem in Nepal, with frequent shutoffs lasting more than 12 hours.
Radiologists are trained locally or abroad, such as in India and the Philippines, and practice in larger and urban hospitals. Technologists are specifically trained in a chosen modality in dedicated programs for 3 to 12 months within Nepal. Dedicated sonographers are practically non-existent.
RAD-AID in Nepal
- RAD-AID performed radiology-readiness assessment (RRA) in 2014 and partnered with Tribhuvan University Teaching Hospital (TUTH) in Kathmandu. When earthquake struck Nepal in April 2015, RAD-AID provided assistance in May 2015 to six hospitals on providing care for trauma patients, implementation of trauma radiology protocols, radiology-infrastructure damage assessments, and helping to create a reconstruction plan. We sent a team consisted of 2 radiologists and 4 technologists, and partnered with TUTH, the WHO and other global NGOs.
In 2017, RAD-AID sent a team of sonographers, IT specialist, and radiologist to Kathmandu and Dhangadhi. A team of four volunteers, two ultrasonographers, one IT specialist and one Radiologist traveled to Kathmandu and Dhangadhi for two weeks October 2017. In Kathmandu, we provided lectures on PACS and general and emergency ultrasound at National Trauma Center and Chirayu Hospital.
In 2018, RAD-AID gave workshop on MSK ultrasound at several hospitals. We also conducted RRA at Hospital and Rehabilitation for Disabled Children (HRDC) and webinars. We are in the process of installing PACS at TUTH. Currently, the radiology residents in Kathmandu are taking advantage of our learning center with access to cardio-thoracic and abdominal lectures.
Under the leadership of Carlin Ridpath, MD, RAD-AID strives to improve radiology information system, radiology professionals’ education, and rural health care. MOU has recently been worked out between RAD-AID and HRDC. We are planning a return trip to Nepal in September/October 2019.