The World Health Organization has identified medical imaging as an important tool for ensuring the possibility of an appropriate treatment, and in setting out modalities and regulations for the training and certification of medical imaging professionals (radiotherapists, radiographers and Sonographers) stipulated that to be able to manage an ultrasound or radiographic equipment, you need to have a minimum of 300 and 1000 clinical contact hours respectively with patients under the supervision of suitably qualified professionals.
In Ghana, unfortunately, there has been a proliferation of small scan centers as well as unlicensed imaging units (both hospital-based and stand-alone) , manned by some SONOGRAPHERS or Technologists of questionable ‘qualifications’.
Sadly enough the actions of these quacks are usually connived, condoned and financed in many instances by some rogue medical professionals (Doctors, Lab Scientists, Pharmacists, Radiographers, Nurses and many others), who set up Ultrasound/ X-ray centers as stand-alone, attached to laboratories, or run these scan units as part of their medical centers.
For this brief, I will focus on the ultrasound centers, in later briefs I will do well to expand to cover other areas.
In recent times, the springing up of these ultrasound centers nationwide is an issue that needs urgent attention and management. These centers, mostly run by unqualified persons usually lead to either misdiagnosis, missed diagnosis, false positive or negative outcomes in medical management based on reports churned from such centers.
What happens in most of these centers is this:
- The operator (with no clinical background) goes for a 2 week or 3 weeks under supervision of some unaccredited professional
- They then purchase low cost ultrasound machines (x-rays are far more expensive) that are of low resolution (aimed at making a quick return on investment)
iii. They set up centers, usually next to or in the premises of an existing lab, and set out to do business. (Advertisement is brisk with offers of kickbacks for referrals from staff of medical facilities)
Patrons are usually misled by the bold display of the Registrar generals Business registration certificate and sometime the IRS tax stamp displayed in their premises. These are to tell the patrons that they are registered to offer their services, but in actual sense they are licensed to run a business, but not to run medical equipment protected by international laws and protocols which they are not certified to run.
When the trust of patrons are won, they then proceed to give medical meaning to various diagnosis they sometimes coin up, and proceed to make money out the health plight of patrons (“madam, this your condition, you need to have it operated on immediately” or “Daddy, this your condition, cannot be managed in the hospitals, so rather seek herbal remedy”) these antics stemming from unqualified operators usually scare the very life out of the patrons that they end up parting with so much money, but getting worse off than they would be in the care of qualified professionals.
The medical and psychological damage these centers are causing is so much that in extreme cases innocent lives have been lost, while some patients have resorted to unorthodox means to seek care.
The new technique also adopted by some is to operate a door to door service, by visiting maternity homes and centers, where they deploy and scan all available patrons. In haste to complete and make their cash quickly, they gross over several protocols that mostly leads to missed diagnosis, there by contributing to the increased reported cases of fetal anomalies that are not detected early in pregnancy, thus potentially increasing Child and maternal mortality rates.
I have personally witnessed situations in private facilities where unqualified ‘operators’ had misdiagnosed viable pregnancies as uterine fibroid. Where ectopic pregnancies were reported as normal pregnancy. In some of these instances, patients have been operated on, or the pregnancy allowed to thrive based on those wrong scan reports.
All these happen as a result of the fact that the operator may not have any clinical experience and have not been adequately trained.
They end up mis-diagnosing patients and giving false interpretation to what they see on the scan screens.
For these mushroom centers, many of them scattered around highly populated areas, their main aim is to generate as much profit as possible from unsuspecting patrons.
I believe, regulatory bodies set up by law, should implement the laws passed to check the activities of these unqualified individuals creating health menace in our society.
The question is; WHEN are we going to see the regulation in full effect?
The unfortunate aspect of this call to action is that, some powerful beneficiaries in the current situation will try to impede actions needed to be taken because that might affect them financially.
Secondly most of the policy makers and implementers will not be in haste on this as they personally will not visit such places for medical care. However, the fact still remains that their extended relatives, your extended relatives and my relatives might find themselves caught up in this web, and by the time we are able to come to their aid, the harm would have been caused.
Ghana, let’s sit up. As I ponder the actions that could be taken to remedy the situation, Bob Marley’s song just won’t stop ringing in my ears “…chase those crazy bald heads out of the town…”
Every life counts.
Let us do what is necessary to safeguard and protect one another.
Snr. Diagnostic Radiographer and Radiographic Clinical Supervisor.
La General Hospital