A Glimpse Into Radiology in the Developing World in Africa
RSNA members Stanley Ogoinja, MBBS, and Mayomi Onuwaje, M.D., both from Nigeria, said they are among less than 60 radiologists that serve their entire county of 190 million people.
When I attend evening sessions at any of the medical conferences I go to throughout the year, I always look forward to meeting doctors who can talk about what they do on a daily basis to get a reality check on the true current state of healthcare. As an editor of a new technology magazine, you get a skewed sense when you only see work-in-progress and brand new FDA-cleared products. At the 2017 Radiological Society of North America (RSNA) meeting in late November, I attended a Toshiba evening event and met two radiologists from Nigeria. We had a great conversation about the state of healthcare in their country. It also gave me a reality check as to the state of medicine in developing countries, compared to the U.S. and Europe.
RSNA members Stanley Ogoinja, MBBS, from Yenagoa, and Mayomi Onuwaje, M.D., from Warri, said their African country of 190 million people has a major shortage of doctors. They are among a group of less than 60 radiologists that serve the entire country’s population.
Access to advanced imaging systems like CT is limited to about one machine in most large cities, mostly 16-slice or lower systems. MRI access is even lower. However, Dr. Ogoinja showed me spinal MRI trauma images on his iPhone that are from his 1.5T MRI system that matched the excellent quality of anything I have seen from U.S. hospitals.
They said access to care is limited to people who can pay out of pocket, since very few Nigerians have insurance. The annual income of most people is about $50 per month and the cost of an MRI is about $200, so MRI is often used as a last resort or is reserved only for people who have higher incomes. The cost for surgery is sometimes lower than CT or MRI, so exploratory surgery is still used as a less expensive option. Point-of-care ultrasound is widely available and is the primary imaging modality available, they said.
Access to hospitals is also an issue, as people from rural areas may take several days to get to a city hospital. This, combined with the high cost of care that makes many people come to hospitals only as a last resort, leads to poor outcomes with many diseases. They said this is most pronounced in cases of stoke and coronary disease. Ambulance and paramedic services to the hospitals also are nonexistent.
Radiologists make about $2,000 a month and the cost of a good apartment is about $1,000 per year, they said. The cost of living in Nigeria is also pretty low, compared to Europe and the U.S., so they said doctors can live pretty well there.
In Africa, they said Egypt and South Africa are the two main hubs of education and advanced imaging and healthcare. In central Africa, Kenya and Ghana are the two most advanced in terms of access to care and advanced imaging capabilities, they said.
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