Making a World of Difference

Published on in Children's View

Dr Vinograd with a portable ultrasound The 4-month-old girl was near death, and none of her doctors in Liberia knew why. Her belly was tender, but without any imaging equipment at the hospital, an accurate diagnosis remained elusive.

By chance, Alexandra Vinograd, MD, MSHP, DTM&H, was in Liberia on a training trip, and she had brought along a portable ultrasound machine. Vinograd got an image and quickly diagnosed telescoping intestines.

“It’s a fairly common and easily corrected condition, as long as you catch it early,” Vinograd says. “Without a diagnosis, it is life-threatening, often fatal. That’s why the ultrasound is such a powerful tool.” The goal of her Liberia trip was to provide ultrasound training to all medical residents there.

The baby had lifesaving surgery and avoided being counted among the 7 million children under age 5 worldwide who die each year of preventable or treatable causes. Most live in the developing world, where Vinograd — as the first graduate of the Pediatric Emergency Medicine-Global Health Fellowship at Children’s Hospital of Philadelphia and now an Emergency Department Physician — hopes to spend up to one-third of her time.

The new fellowship is one of only a handful in the United States. The rigorous, specialized curriculum covers treating diseases common in low-resource tropical countries, working effectively with local governments and organizations, and educating foreign healthcare providers and public health officers.

“These highly specialized physicians teach local healthcare workers high-quality care while collaborating on evidence-based research,” says Keri Cohn, MD, MPH, DTM&H, who directs CHOP’s program. “The goal is to go beyond helping one child with hands-on treatment to giving local providers the academic tools that will ultimately improve entire systems of care.”

In addition to Liberia, Vinograd also has worked in Rwanda, Uganda, Botswana, Madagascar, and Lesvos, Greece, where she cared for Syrian and other refugees. That type of international travel is expensive but essential for the comprehensive training, Cohn says. Because of high costs, only one fellow is accepted each year.

CHOP emergency physician Aaron Chen, MD, Director of Emergency Ultrasound, and his wife, CHOP anesthesiologist Elaina Lin, MD, made a donation to help launch the fellowship.

“I know what ultrasound can do in our Emergency Department — from diagnosing pneumonia to easing the placement of IV lines — and I saw the fellowship as an opportunity to support spreading these techniques globally,” says Chen. “There’s so clearly a need.”