“Radiology professionals in our partner institutions are always appreciative of your time. These are smart people who soak up knowledge — and who want and need more,” says Carlin A. Ridpath, MD, RAD-AID program director overseeing multiple projects in Nepal. In that role for more than three years, Ridpath and her team of volunteers have held hands-on workshops on MSK US. She is currently working with the Hospital and Rehabilitation Center for Disabled Children, and the RAD-AID team is in the process of installing PACS in the country’s handful of hospitals. The program also supports residents through RAD-AID’s learning center, which offers access to subspecialty lectures/webinars, including cardiothoracic and abdominal lectures.

Ridpath recently presented at the 12th annual RAD-AID Conference on Global Health Radiology, which focuses on low-resource regions and medically underserved communities. The gathering of community leaders, volunteers, partners, and supporters from around the world stressed the importance of RAD-AID, how far it has come, the number of lives touched, and ambitious plans for the future. The Bulletin caught up with Ridpath to discuss why efforts to establish and maintain better radiology services in underserved countries are a win-win for volunteers and international project sites alike.

Why did you get involved with RAD-AID?

I felt entrenched in my day-to-day duties as a radiologist. I wanted to do something different for people who needed radiology services outside of my immediate sphere. Giving your time to something like RAD-AID can actually be a cure for burnout. Yes, it’s work, but you get back as much as you give, if not more.

The other thing that drew me to RAD-AID was its commitment to sustainability. There are other international radiology programs that seek to improve access to radiology services in underserved countries, but they do not have the same infrastructure as RAD-AID. Many organizations do not stay true to their original mission statements, but I have learned that RADAID is all about sustainability after the initial setup at a project site. Another strength of RAD-AID is avoiding a cookie-cutter approach. Each region or community you are trying to assist has unique needs and barriers to care.

What is your approach to bolstering radiology in developing countries?

You must have a strong foundation if you want to make a difference across borders. That foundation starts with assessing the ability to build radiology capacity and the needs of a region or community. RAD-AID has a Radiology Readiness Assessment tool — a data collection resource developed to determine how we might help in a particular area. When we receive a request for assistance to improve or expand imaging services or technology, we consider a country’s existing infrastructure, its regional challenges, and how our volunteers might meet patients’ unique medical needs.

Do you feel you are making a difference through your work with RAD-AID?

I have asked myself, “How can RAD-AID help in Nepal?” The Nepalese are largely a rural people and MSK injuries are common. They have access to plain film and US, but it can be difficult to diagnose soft tissue injuries with these modalities. We did a conference there with hands-on training for MSK US and about 90 Nepali radiologists attended. The Nepali Radiologists’ Association said it was the best turnout they had ever seen. These are opportunities where we can really make a difference.

What are some asks of RAD-AID from underserved countries?

More education is always needed. Before COVID-19, we did in-person lectures and workshops. Most of the countries we work with just do not have advanced imaging. It is great if you supply a CT scanner, for example, but you have to make sure that machine is running — before and after you leave. I have heard too many times that something breaks down and just sits unused because the facility cannot afford to fix it — and that’s if anyone local is qualified to service the equipment. A big element of RAD-AID is revisiting sites as often as possible. These visits will resume post-pandemic to send RTs and to teach locals about maintenance of their equipment.

How does RAD-AID handle expenses?

RAD-AID has grants available for many volunteers, and there are online applications at RAD-AID’s website (see sidebar). Some RAD-AID volunteers decide to donate the cost of their travel to a site, which RAD-AID greatly appreciates so that limited grant funds can be given to those who are not able to cover the cost of travel. Some of our funding for volunteers is available through RAD-AID’s partnerships with professional societies, such as the ASRT, the Canadian Association of Medical Radiation Technologists, the Society of Radiographers, and Sonography Canada for RTs, sonographers, and radiation therapists; the American Association of Medical Dosimetrists for radiation densitometrists; the Society of Nuclear Medicine and Molecular Imaging for nuclear medicine professionals; the Society for Imaging Informatics in Medicine for radiology informatics specialists; the Society of Interventional Radiology for IRs; and the SBI for breast radiologists. RAD-AID also has partnerships with several large radiology private practices — such as Radiology Partners, vRad, and Envision Physician Services — so that staff at these practices have resources to volunteer on RAD-AID teams. So, if volunteers apply to RAD-AID and are also members of RAD-AID’s partner organizations, they may qualify for funded positions. Others may choose instead to donate the cost of their travel as a charitable contribution. There is a flexible range of options to get support from RAD AID for global health projects.

Much like COVID-19 compelled healthcare professionals to shift gears to use more Zoom calls and host virtual seminars, RAD-AID has shifted its approach toward more remote learning and instruction. It is not as personal, but it is less expensive than physically traveling to the sites — so there are ways to volunteer remotely and on-site.

I wanted to do something different for people who needed radiology services outside of my immediate sphere. Giving your time to something like RAD-AID can actually be a cure for burnout.

What can volunteers expect when they get involved with RAD-AID?

There is no minimum time commitment for RAD-AID volunteers, and we are very grateful for any amount of time they can give. Medical students are highly encouraged to participate; RADAID has a global health curriculum for medical students to earn a certificate and experience in medical imaging outreach. Volunteers should know they will never be sent to a host country where there is unrest, political or otherwise. Volunteers’ safety comes first.

Volunteers should understand that efforts at each project site address different needs. For example, there are limited radiology subspecialists in Nepal, so RAD-AID is focusing on getting more subspecialist expertise for education. Each project is based on RAD-AID’s Radiology-Readiness Assessment for best leveraging volunteers’ experience to impact radiology development at the site through culturally and medically appropriate strategies. Volunteers are also carefully matched through the application process to a RAD-AID management team member for projects on interdisciplinary teams that involve physicians, nurses, RTs, IT specialists, and others. The countries partnering with RAD-AID are so diverse — radiologists and residents looking to volunteer can pretty much choose where they want to volunteer based on personal skills and interests.

How important is it to have ongoing, constant communication with people at the project sites?

It is critically important from a sustainability standpoint. When trust is established, so is open communications on follow-up issues or changes within the program. We have weekly calls within RAD-AID to catch up on what is happening in different countries to determine how we should modify, adjust, or accelerate what we are already doing there. However, RAD-AID managers do not micromanage. We assist when asked and when needed. Consistency is important, and it starts with the program manager. I have developed some really good relationships with the radiologists in Nepal. They know they can reach out to a reliable contact — someone familiar with their challenges since the onset of the site assessment.

Would you say the future of RAD-AID is bright?

Absolutely. The younger generation has a passion for global health, and ACR may attract more young members by supporting international volunteer opportunities. RAD-AID has many different needs, across all modalities and specialties. In addition to diagnostic imaging, our programs include radiation oncology, 3D printing, nursing, medical physics, and maternal-infant health. RAD-AID aims to invest more resources in radiology professionals in the U.S. and abroad to foster greater international collaboration in charitable outreach to low-resource communities.

While some programs have slowed down during the COVID-19 pandemic and pivoted toward remote support, as the global situation becomes safer, we will be pursuing our work at full steam.