The challenges of radiography in Zambia

Feeling stressed? Is your department under staffed, are you over worked? Do you feel like there aren’t enough resources? The staff in your department never have time for CPD? Are your waiting lists always breaching?  I think these are all common moans and groans that we, as radiographers can all relate to, along with other health care workers.

I found these to be common grumblings throughout the department when I was working clinically, especially within interventional radiology. I used to find that there was nothing worse than telling clinicians that they would have to wait for potentially 2 weeks for their patients to have an examination slot. This is one of the reasons as to why I went into vascular access as an advanced practioner in order to try and reduce waiting times, as you will have seen from my previous blogs.

In January I was lucky enough to have the opportunity to travel to Livingstone in Zambia in order to teach qualified radiographers and medical staff at Livingstone General Hospital. Initially, I thought I would deliver to them an overview of radiography in the UK and discuss the benefits of advanced practice and show some examples of advance practice in use.

However, on my first visit to Livingstone General Hospital I realised that all my plans would be irrelevant. The hospital has very limited resources and advanced practice is far from what they required teaching in. This wasn’t because of disinterest or a lack of desire to advance their skills but simply because that wasn’t what the radiology service required.

The radiology department works using wet film, chemical temperatures are issues the radiographers contend with on a daily basis which often affect their image quality. Repeat examinations are not always performed even though the radiographers recognise that they are needed but there is the worry that they are running out of film. A queue of 50 patients waiting for x-rays when there is only one machine is a normal daily occurrence, especially in the morning, in conditions that are not ideal, cramped and hot temperatures with no waiting room for patients to sit in. As well as the radiographers dealing with a busy department, and limited services, they have limited radiologist support, there is only one radiologist at Livingstone General who has limited time. Therefore they have no clinician for support and many decisions are made on their own accord. This presents challenges to other clinicians that are using the radiology service, as image interpretation is carried out by them rather than having a formal radiology report. Therefore my image interpretation teaching sessions went down a storm.

When a patient on a ward requires a chest x ray but they are on oxygen, staff have to run with the patient from the ward to the department as there are no portable oxygen cylinders, a simple basic need that most health workers at home in the UK would now take for granted. Why not use a portable machine instead of taking that risk? I hear you say. Well this is because portable machines are not accessible and the hospital is also spread out between several different buildings. Patients are transported upon converted golf carts from building to building; therefore portable machines could not be transported between buildings.

My experiences taught me how lucky we are to have simple pieces of equipment such as portable oxygen cylinders or portable xray machines which allow us to carry out many examinations on inpatients that require imaging. Where in Livingstone these patients were often just unable to receive the basic imaging that they required.

So when you think that you are understaffed, you don’t have enough resources… think of the equipment that we do have.

….A CT scanner that can be operated because there has been the money to train staff adequately… unlike Livingstone where their machine is out of use.

….Portable oxygen cylinders so inpatients can be transported from differing departments.

….Portable x ray equipment so all ill and unstable patients can still receive their imaging.

This is just some food for thought when having a groan. We really aren’t that bad off. 

















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