Mammography Project
Bluefields, Nicaragua
May 21 - 29, 2016

Radiology Mammography International completed a breast imaging training project to Bluefields, Nicaragua this past May. This trip was a follow-up to the recent donation and installation several months ago of a new Hologic M IV mammography machine, which replaced the recipient hospital's donated 12 year old unit, which finally stopped working. In addition to fine tuning the hospital's film processor and calibrating the new mammography machine, this one week project provided advanced individual hands-on training in breast imaging to the hospital's female X-ray technologists and radiologists. Our training included breast positioning for screening and diagnostic mammograms, enhanced film interpretation skills, preoperative needle localizations, and ultrasound guided biopsy procedures. And daily academic lectures in the fields of Breast Cancer and Breast Imaging were presented to the general medical staff and to medical students.

This mission was the fourth training visit to Bluefields over a twelve year period. This clinical site on the Caribbean coast of Nicaragua represents one of the most successful, enduring, and sustainable missions in RMI's twenty six years of teaching experience in developing countries.

For this, we recognize the dedication, persistence, and passion demonstrated by the hospital administrators, radiologists and general medical and nursing staff.

Members of our volunteer team of professionals were from the United States, Canada, and El Salvador. Several of us had taught in Bluefields on prior missions. The team included diagnostic radiologists Gale Sisney, M.D., Jean Seely, M.D., and Richard Hirsh, M.D., mammography technologists Linda Corrion, R.T., Janice Guntner, R.T., and Sandra Hanawalt, R.T., engineer John Stanley, and interpreters Emily Loeffler, Andrea Molina, and Jacob Youst. Once again, as in all of RMI's mission projects, we welcomed this opportunity to share our experience, our expertise and our passion to help save lives and to make a difference for the underserved.

Thank you,

Richard N. Hirsh, M.D., FACR

President and Founder Radiology Mammography International

Akron, Ohio

Mammographers Sandra Hanawalt, left, Linda Corrion, center, and Janice Guntner, right, with the Bluefields Hospital's technologists.

Dr. Richard Hirsh and interpreter, Jake Youst.

Dr. Jean Seely and Dra. Magdalena Bello, head radiologist, performing breast ultrasound.

Linda Corrion R.T.RM reviewing Quality Control with the head technologist.

Dr. Gale Sisney (left) and mammography technologist, Sandra Hanawalt (right) discussing positioning protocol with hospital technologists.

John Stanley, engineer, calibrating the new donated mammography machine at Bluefields Hospital.

Dr. Jean Seely teaching Ultrasound guided breast biopsy technique using a turkey breast.  Bluefields, Nicaragua, May 2016.

Dr. Gale Sisney, left, and Janice Guntner, R.T.RM right, positioning a patient.

Interpreter Jake Youst speaking to patients waiting for their mammograms.

Our ride from Bluefields, Nicaragua airport to hotel. May 2016.

Placing the needle using an apple.

Dr. Jean Seely with interpreter Andrea Molina and mammographer Linda Corrion, discussing Preoperative Needle Localization procedure, training with an apple.

Dr. Richard Hirsh (right) with Bluefields surgeon Dr. Ulysses CiFuentes.

Mammography Training Project
Cali, Colombia
April 18 - 25, 2015

From April 18 - 25, 2015, Radiology Mammography International completed another breast cancer training project, this time to the city of Cali, Colombia. We were invited by and partnered with a Baltimore based humanitarian organization called Partners for Cancer Care and Prevention. This organization was founded by Dr. Armando Sardi, a cancer surgeon who was born and raised in Cali. After earning his medical degree there, he came to the United States for his surgical residency and subspecialty training in Surgical Oncology.

During this project, our volunteer teaching team provided hands on training and consultation at three clinical sites, all of whom had recently upgraded their mammography equipment to full field digital. The three local institutions were: Hospital Universitario del Valle, Hospital Canaveralejo, and (IPS) La Rivera.

Our three mammography technologists, Linda Corrion, Tracey Erb, and Sandra Hanawalt, observed and instructed in the mammography suites during the regularly scheduled imaging of patients. Radiologists Dr. Gale Sisney and Dr. Richard Hirsh did image and case review with radiology faculty and residents. Formal lectures were presented by Dr. Sisney. Our interpreters were Rebecca Woodward and Emily Loeffler. Our team field service engineer was Michael Lynde. Kent State University nursing student, Lauren Lynde, assisted in patient throughput in one of the local breast clinics. All elements of this project were expertly organized and coordinated by Mavalynne Orozco, the representative officer of Partners for Cancer Care and Prevention, to whom we are most grateful.

Our humanitarian experience was extremely fulfilling. We were warmly welcomed by the Colombian medical personnel and patients with whom we interacted. This was certainly another memorable adventure for our volunteer medical team.

Thank you,

Richard N. Hirsh, M.D., FACR

President and Founder Radiology Mammography International

Akron, Ohio

Radiology Mammography International
Guatemala Mammography Teaching Project
August 17 - 31, 2013

Radiology Mammography International (RMI) completed its most recent Mammography Teaching Project to Guatemala from August 17 - 31, 2013. We partnered with a non profit organization based in Baltimore, Maryland, called The Healing Hands Foundation, who has been organizing medical/dental missions to Guatemala for many years. A site assessment evaluation visit to the region was performed in December 2012 for the purpose of selecting qualified appropriate clinical sites to receive donated mammography equipment and training.

This mission project included two donated factory refurbished Hologic M IV mammography machines, which were installed at two clinical sites, one at Hospital Roosevelt in Guatemala City and the other at the Women's Breast and Cervical/Uterine Cancer Screening Center in the Municipality of Villa Nueva, a suburb of Guatemala City. Donated mammography cassettes and accessories, quality control test instruments, and biopsy needles and hook wires were provided to all of the clinical sites. RMI's volunteer team provided personalized hands on training to female X-ray technologists and diagnostic radiologists in the proper use of this new equipment. Also, a third clinical site, Hospital San Juan de Dios, which already had relatively modern mammography equipment and a radiology residency program, received enhanced breast imaging training in mammography and breast ultrasound. In addition, a major emphasis of this Guatemala project included an extensive Women's Health Education Program, which provided community outreach to the general lay public including high schools students, as well as focused lectures to health care professionals. Educational hand out literature was available during the various presentations.

Our remarkable and caring volunteer team of professionals, most of whom had served on prior RMI projects, included six mammography technologists, three diagnostic radiologists, a field service engineer, and two women's health educators. Our volunteer mammography technologists included Linda Corrion, Tracey Erb, Janice Guntner, Sandra Hanawalt, Jennie Little, and Wendy Marshall. Our three radiologists included Dr. Bonna Rogers-Neufeld, Dr. Gale Sisney, and Dr. Richard Hirsh. Our engineer was Michael Lynde. And our women's health educators were Kathy Mueller and Terri Bogan. Our in country organizer and Healing Hands Foundation representative was Ingrid Kretzschmar, without whose tremendous efforts and dedication and persistence, this mission would not have taken place.

Our non profit organization reaches out to breast imaging equipment manufacturers for donations and technical support during the initial phases of each mission project. Hologic in Danbury, Connecticut, remains our greatest supporter for our many projects to underserved regions around the world. And as part of Hologic's wonderful donation for this mission to Guatemala, their regional dealer, Medimax-RSI, based in Puerto Rico, generously provided engineers to do the installation and calibration of the two donated mammography machines at no cost/charge to the recipient clinical sites. This collective generosity and devotion to serving the developing world truly reflects the nature of so many individuals who worked together to bring this wonderful humanitarian team effort to fruition.

Thank you,

Richard N. Hirsh, M.D., FACR
President and Founder
Radiology Mammography International
Akron, Ohio

Multidisciplinary Breast Cancer Conference
National Cancer Institute
Hanoi, Vietnam
November 2 – 5, 2010

Radiology Mammography International recently completed a Breast Cancer Conference at the National Cancer Institute in Hanoi. This conference took place at the same hospital where RMI provided a mammography teaching project in 2000 and a follow up mission in 2002. During the 2000 project we provided donated mammography machines and hands on training of technologists and radiologists to hospitals in Hanoi as well as in Ho Chi Minh City (formally Saigon).

Our conference provided formal lectures in multiple disciplines involved in the diagnosis and treatment of breast cancer. These included diagnostic radiology, general surgery, plastic (reconstructive) surgery, radiation therapy/oncology, medical oncology, and palliative care. In addition we did case reviews and patient consultations as part of our teaching efforts.

Our teaching faculty, all of whom were volunteers, included: Nick Bisconti, M.D., surgeon, Nick Papas, M.D., plastic surgeon, Steven Radwany, M.D., palliative care, Sandra Hazra, M.D., medical oncologist, Mitchel Fromm, M.D., radiation therapist, Alda Cossi, M.D., Helen Shi, M.D., and Richard Hirsh, M.D., diagnostic radiologists.

Overall, the conference was a wonderful success. Much useful and applicable information was provided. And the number and quality of the questions from the Vietnamese reflected their involvement and caring.

Thank you,
Richard N. Hirsh, M.D.
 

Kosova Mammography Teaching Project
University Clinical Center of Kosova, Prishtina
Regional Hospital, Peja
August 28 – September 11, 2010

From August 28 – September 11, 2010, Radiology Mammography International organized a Mammography Teaching Project to Kosova. This project provided two donated Hologic M IV mammography machines plus Maxant mammography viewers and X-rite quality control instruments and Kodak mammography film and cassettes for two recipient hospitals in Prishtina and in Peja. Hands on training was provided to female X-ray technologists and to radiologists at both clinical sites. This donated equipment replaced older mammography machines.

This project was coordinated by breast surgeon, Dr. Elvis Ahmedi, who worked diligently with local officials and doctors in both cities as well as Dr. Bujar Bukoshi, the Minister of Health of Kosova. Our teaching team included radiologists and mammography technologists plus a surgeon and a palliative care physician. Our team also included two women's health educators who travelled around the country giving talks to women's groups and to primary care physicians about breast cancer and other topics of women's health. Several hundred mammograms were performed, and at least six suspicious lesions were identified resulting in surgical procedures.

The volunteer medical team included: radiologists Dr. Richard Hirsh, Dr. Karen Lindfors, and Dr. Cheryl Schwalm, surgeon Dr. Dean Mayors, palliative care physician Dr. Robert Taylor, mammography technologists Tracey Erb, R.T., Jennie Little, R.T., Trudy Crabtree, R.T., and Sandra Hanawalt, R.T., Carolyn Keegan, R.T., and Lesley Ewen-Foster, R.T., engineer Mike Lynde, and women's health educators Kathy Mueller, R.N. and Kathy Pardew, and administrative assistant Hilary Taylor.

I consider this project a strong success in that it established good breast imaging techniques and provided widespread community outreach throughout the country. It is my expectation that RMI will return to Kosova in about one year to do a follow up mission to bring the trained radiology staff up to a new level of expertise building upon their experience.

Thank you,
Richard N. Hirsh, M.D.
September 14, 2010

MAMMOGRAPHY TEACHING PROJECT TO AMMAN, JORDAN, AL AMAL MATERNITY HOSPITAL and RED CRESCENT HOSPITAL
APRIL 26 - MAY 7, 2010

From April 26 - May 7, 2010 Radiology Mammography International conducted an intensive breast imaging training program for Jordanian mammography technologists and diagnostic radiologists. We worked in partnership with the non profit organization, the Jordan Breast Cancer Program based in Amman. All of our trainees were hand picked for their high levels of enthusiasm and their desire to learn how to perform mammography and breast ultrasound at the highest performance levels. All had previous experience. But our job was to add additional expertise to their individual skills, so that these trainees would be prepared and feel
comfortable training other mammography specialists. We referred to this
training program as, "Train the Trainers" or "Teach the Teachers".

This two week project offered didactic lectures and hands on mammography training first with models and then with patients. Individual instruction and guidance was provided to about twelve Jordanian mammography technologists. For the approximate ten radiologists there were daily film reviews and ultrasound guided breast biopsy training. In addition, our volunteer team field engineer visited multiple mammography sites at several nearby hospitals critiquing the mammography equipment with the assistance of Jordanian engineers and radiation physicists.

The volunteer team members included radiologists Dr. Richard Hirsh, Dr.
Michael Linver, Dr. Heather MacNaughton, mammography technologists Louise Miller, Linda Corrion, Susan Cross, Janice Guntner, Laura Hatfield, and
field engineer John Stanley.

The project goals were accomplished: Advanced hands on training was provided to Jordanian mammography technologists and diagnostic radiologists. It is our hope to return to Jordan to provide follow up training in breast imaging.

Thank you,
Richard N. Hirsh, M.D., FACR
President, Radiology Mammography International Akron, Ohio
May 2010

Mammography Teaching Project Follow-up, Macedonia
October 10 – 24, 2009

From October 10 – 24, 2009, Radiology Mammography International coordinated the second Mammography Teaching Project to Macedonia. This project was a follow up to the 2007 Mission to the General Hospital in Strumica. The 2007 mission brought a new donated Hologic/Lorad M IV mammography machine plus quality control instruments and mammography x-ray film and cassettes. Training was provided to female X-ray technologists and to diagnostic radiologists.

This recent project focused on observation at the original site and providing more advanced training for those same technologists and radiologists. RMI also had two additional teams, one offering focused training in breast imaging at the Radiology Institute in Skopje, and the other, a “mobile” team, which traveled around the country providing consultation in improving mammography service/quality at many regional hospitals. All sites visited were by invitation from the individual local hospital radiologists and administrators. Community Outreach/Education was taken to multiple cities around the country. This project was coordinated by the Boris Trajkovski International Foundation in Skopje.

At the primary site in Strumica, the overall quality of the mammograms was excellent. Not only were they performing outstanding images (including proper film techniques and breast positioning), but they were also actively training technologists and radiologists from other hospitals. Our former pupils had now become the “new” teachers. Remember that, “If you give a man a fish, he eats for a day. But if you teach a man how to fish, he eats for a lifetime”.

The volunteer medical team included: radiologists Dr. Richard Hirsh, Dr. Nancy Wadden, Dr. Karen Lindfors, and Dr. Cheryl Schwalm, mammography technologists Linda Corrion, R.T., Jennie Little, R.T., Tracey Erb, R.T., and Josephine Raimondi, R.T., engineer John Stanley, and women’s health educators Kathy Mueller and Kathy Pardew.

I consider this follow up project a definite success in that it reinforced good breast imaging techniques. But more importantly this mission observed the establishment of a local independent site now providing quality training in breast imaging.

Thank you,
Richard N. Hirsh, M.D.
President
Radiology Mammography International
October 26, 2009

Mammography Teaching Project to Nairobi, Kenya
Kenyatta National Hospital
May 2 - 17, 2009

From May 2 - 17, 2009 Radiology Mammography International conducted a mammography teaching project to the Kenyatta National Hospital in Nairobi, Kenya. This project included the donation of a Hologic/Lorad M IV mammography machine. This quality equipment was installed by Vertec Scientific SA out of South Africa, who is a regional representative of Hologic. Vertec generously provided this service as a donation. The Kenyatta National Hospital is a major teaching hospital which has a radiology residency training program. The timing of this donation followed and replaced the hospital's prior very old mammography machine, which just one month before our arrival had stopped functioning "for the last time".

The new mammography machine was installed and calibrated. During the next two weeks we trained four of the hospital's female X-ray technologists in the proper use of this new equipment. Our training also included Quality Control techniques. Appropriate QC test instruments were also donated for this purpose. The RMI volunteer team included three diagnostic radiologists, one surgeon, four mammography technologists, one engineer, and two women's health educators. Close to one hundred mammograms were performed. Training in ultrasound guided biopsy procedures was provided to the hospital's radiologists. We provided numerous lectures to the radiology and surgery staff focusing on breast disease. Our surgeon participated in numerous surgical operations as part of our teaching/training process. Women's Health talks focusing on breast disease were provided in remote villages and outlying towns and cities during the two week mission.

The team members included, Dr. Richard Hirsh, Dr. Alda Cossi, and Dr. Heather MacNaughton, radiologists, Dr. Nick Bisconti, surgeon, Jacquie Barber, Janice Guntner, Linda Lindeman, and Anita Lee, mammography technologists, John Gallagher, engineer, and Kathy Mueller and Flo Higgins, women's health educators.

The mission goals were successfully completed: Quality donated equipment was installed and the radiology and surgery staff were trained. Women's health education focusing on breast disease was provided. The Kenyatta National Hospital's radiologists will keep me advised as to the ongoing use of this new equipment including the numbers of newly diagnosed cases of breast cancer. It is my hope to return in about two years to do a follow up Mammography Teaching Mission to Kenya.

Thank you,
Richard N. Hirsh, M.D.
President
Radiology Mammography International
May, 2009

Mammography Teaching Project To Jinotepe, Nicaragua
October 25 - November 9, 2008

Radiology Mammography International recently completed a successful teaching project to the Regional Hospital Santiago in Jinotepe, Nicaragua, about a one hour and twenty minute drive south from Managua.

This entirely new mission delivered quality donated equipment including a Hologic/Lorad M IV mammography machine as well as Maxant Technologies mammoviewers. Also donated were quality assurance instruments and mammography X-ray film and cassettes as well as biopsy instruments and localization hook wires/needles. The local radiology staff was trained in the proper performance of mammography and in film interpretation. Our American team trained a total of four female Nicaraguan X-ray technologists plus the hospital's diagnostic radiologist. We taught
mammography including preoperative wire needle localizations as well as ultrasound guided breast biopsy techniques. The local staff was extremely focused on learning these new modalities.

Our volunteer medical team included three radiologists; Dr. Bonna Rogers-Neufeld, Dr. Cheryl Schwalm, and Dr. Richard Hirsh. Our three mammographers were Janice Guntner, Linda Corrion, and Maria Fabrega. The teams Spanish language interpreters were Maribel Sanchez, Kelly Washbourne, Camelly Cruz Martes, Chris Mellinger, and Betsy Pierce. Our two engineers who did the installation and calibration of the mammography machine were Gary Harris and John Stanley. Several of these wonderful volunteers have served on previous missions. For some, it was their first project with RMI.

The seed has been planted and watered. The tools have been provided and the basic training has been completed. The spirit of the project has been passed to our Nicaraguan colleagues. We will plan on a follow up visit in about two years to evaluate their progress and to add new techniques to their skills. We all consider this mission to represent the focus of our commitment to serve and to make a difference.

Thank you,
Richard N. Hirsh, M.D.
President
Radiology Mammography International
November 10, 2008

Radiology Mammography International
Mammography Teaching Project To Bluefields, Nicaragua
March 1 – 16, 2008

From March 1 – 16, 2008, Radiology Mammography International coordinated the third Mammography Teaching Project to Bluefields, Nicaragua. This project was a follow up to the 2005 and 2007 Missions to the Regional Hospital in the Southern Autonomous Region on the Caribbean Coast of Nicaragua. The 2005 mission brought a new donated Affinity Model Hologic/Lorad mammography machine and a Hologic/Aloka ultrasound machine plus quality control instruments and mammography x-ray film. Training was provided to female X-ray technologists and to diagnostic radiologist, Dr. Magdalena Bello.

This recent project was preceded by a two month regional breast cancer screening of over 600 women, compared to last year’s mission which included 400 screening mammograms. This was an enormous accomplishment, considering that practically all the women had to travel great distances for many hours by open boat to the city of Bluefields. There are no roads on the Caribbean coast.

The volunteer medical team consisted of two diagnostic radiologists, one surgeon, three radiological technologists, one field service engineer, and four interpreters. In addition to interpreting hundreds of mammograms and diagnostic breast ultrasounds, we performed numerous ultrasound guided biopsies and open surgical biopsies. All of these procedures were performed with our Nicaraguan colleagues, thus strengthening the hands on teaching approach employed during all of RMI’s missions.

The team members included: Dr. Richard Hirsh and Dr. Michael Linver, radiologists, Dr. Nick Bisconti, surgeon, Linda Lindeman, Janice Guntner and Lesley Ewen Foster, mammography technologists, Robert Warner, engineer, and Peg Haas, Rebecca Woodward, Andrea Loomis and Coert Ambrosino, interpreters.

I consider this follow up project a definite success as it reinforced good breast imaging technique and surgical skills with our Nicaraguan radiological and surgical colleagues. But mostly this mission has stimulated an ongoing commitment from the hospital and from the Ministry of Health to offer breast cancer mammography screening for all the women of the region.

Thank you,
Richard N. Hirsh, M.D.
March 17, 2008