Imaging in Developing Countries

Special Interest Group

Unfortunately when the X-ray equipment was switched on it would not complete its start up process and showed an error code. This meant that the hospital was reduced to using a very basic mobile unit to provide its X-ray service.

In the meantime I had shown my colleagues in the X-ray industry some of the photos of the original broken piece of equipment to see if we could identify it and possibly acquire some circuit diagrams. Although the equipment was supplied by a British company (no longer in the medical X-ray business) we were all convinced that it was Italian in origin. One of my colleagues not only discovered the Italian manufacturer but also the fact that they were still in business and willing to send us a set of drawings and a manual.

The manuals duly arrived and were scanned and sent off by email to Malawi. I didn’t realise at this point that the telecom infrastructure in Malawi is not particularly good and that most dial up email is unreliable as is the mains power in many places. We did manage to get some drawings sent but it became obvious at this stage that a more hands -on approach was required.

In April 2008 John from the Raven Trust contacted me and asked if I was prepared to go out to Malawi and attempt to repair and set up both X-ray units. I discussed the idea with my wife Judith and we decided that it was the only solution to the problem and even then it could prove fruitless. I contacted John and it was agreed that I would travel to Malawi on 18th May for 10 days. We had originally planned that Judith and I would both go as if the equipment repairs were successful then Judith as radiographer could do some radiography and also some training for the local staff, but we decided that this may not be a good idea if the equipment could not be repaired.

Prior to my departure I had to visit my local GP to receive the various inoculations required for a trip to that part of Africa. I also had to sort out malaria tablets for the visit.

As the trip was to repair and or set up equipment I had to acquaint myself with one particular piece of Siemens equipment that I have seen in operation, but had no idea how to set it up, or what to look for if it didn’t work. A friend and colleague who had recently retired from hands on X-ray engineering spent some time and many emails explaining the electronics and service procedure. Fortunately the manuals, diagrams and service software had been sent out with the equipment. I had a set of drawings and a small bag of spare parts for the original Italian equipment which I was also hoping to repair.

I left home on the Sunday 18th May at 1:30 pm and travelled from Manchester airport to Amsterdam where I met with John Challis who had flown in from Glasgow. We boarded a Kenyan Airways flight to Nairobi. After a long wait in Nairobi we finally boarded a flight to Malawi via Zambia finally arriving in Lilongwe on Monday at 12:30pm. We were met by John Gulule a local technician who works for CHAM. It was good to see John and put a face to a name as we had been corresponding by email for quite a while but never met. We were taken to CHAM HQ where we were shown the workshop and introduced to Fergus Khonje Johns Gulule’s boss.

John Challis, John Gulule, myself and our driver then set off for our trip to the northern capital Mzuzu where we were to stay overnight before visiting our first hospital. Following a 4 hour journey up the M1 (The M1 runs the full length of Malawi and is similar to a small UK “A” road), we arrived at the Raven Trusts House in Mzuzu something like 28 hours after leaving home. We were met by Bob Baxter who had prepared a meal for us; Bob does a lot of work with various projects in Malawi. Following our excellent meal I showered and went to bed (my first night in Malawi, South of the equator and under a mosquito net).I was so tired I slept like the proverbial log.

The next morning after breakfast we were collected by the CHAM driver in his 4X4 pickup and set off on our journey to Livingstonia. (Named after David Livingstone although he never went there). The journey again on the M1 took us through some quite wonderful scenery passing interesting sights at almost every turn. Many places look similar to places in the wilds of the UK until you pass a village where the houses are made of mud or local bricks. The houses are normally roofed with grass but if you have a little money then you replace the grass with a tin roof. You occasionally find local birds and monkeys by the roadside. During this journey we passed a local coal mine (some coal is exported). Seeing miners in shorts, tee shirts and Wellingtons was a little unusual. Shortly after the mines we arrived at a small village on the shores of Lake Malawi. This is where you leave the M1 and travel the local dirt road to the hospital. The road was built by a Victorian engineer called Gould and its proper title is the Gould Road but due to pronunciation problems it’s called the Gorodi by the locals.

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