Bringing prenatal diagnostics to life

The large heads of human infants combined with a narrow and twisted birth canal — presumably an evolutionary compromise to enable our upright walking — makes childbirth extremely painful and also risky for both mother and child, Stacy Otieno knows. She works as a Research Associate sonographer with the Aga Khan University under the AIMIX Study based in Rabai sub-county hospital, part of Kenya’s Center of Woman and Child Care. 

During her studies, the 26 year old specialized in diagnostic radiography with a focus on obstetric ultrasound. While rarely known in the rural area northwest of Mombasa, this discipline significantly improves maternal health and prenatal care. 

The World Health Organization estimates that about 800 women worldwide die from pregnancy and childbirth complications every day, or roughly one maternal death every two minutes. Although global maternal mortality rates have steadily decreased in the past 20 years, the situation remains complicated in low and middle-income countries, where nearly 95% of these deaths occur.[2] 

Kenya especially has a very high maternal mortality ratio (MMR) of 594 deaths per 100,000 live births, more than double the global average of 223 and fourth highest in Africa, underlining an urgent need for action.[3] Complications in pregnancy and childbirth could be mostly preventable in low-income countries, but they aren’t. Otieno wanted to make a difference for her community by becoming a radiographer.

“There's a phrase in Kenya that you learn most of the things on the ground instead of learning them in class,” Otieno says. This means only a small part of knowledge can be conveyed through books, and experts must impart sustainable knowledge. But licensed radiographers are rare with fewer than 150 licensed radiographers for more than 50 million people. [4]

Rural areas are particularly underrepresented, not only in terms of specialists but also in devices. Systems like CT scanners or MRI machines are concentrated primarily in the private sector of urban areas. This means patients must travel long distances, sometimes several hours, for medical help. “Being in a setup where radiographers and radiologists are not so many, you have to go a notch higher to get the education elsewhere. That's why I chose Radiology Across Borders,” recalls the 26 year old.

'Saving lives through education' began in 2010 as a global vision at Radiology Across Borders (RAB) and has benefited countless patients ever since. The Australian nonprofit organization promotes the education and training of radiologists and medical professionals for underserved communities worldwide with a special focus on developing courses tailored to the needs of emerging nations.

RAB collaborates with strong partners such as the University of British Columbia (UBC). While RAB initiates projects, designs courses, and maintains regional contacts, a University of British Columbia team supports with academic expertise. Together, they’ve established high-quality, multimedia-based training programs with international impact. Siemens Healthineers joined RAB as a Foundation Partner in 2016 and provides essential financial support to help it expand its reach.

Otieno completed one of the most comprehensive trainings – the ‘International Certificate of Radiology Fundamentals’. The year-long program lays the foundation for covering all major areas of radiology. The training is intense, says Otieno, but it's not just about the mere transmission of standardized knowledge.

Some of the mothers who come to Otieno as research participants have already had several pregnancies without ever receiving a prenatal checkup. "Many of the women believe a fetus is only fully formed after six months. When they see their baby for the first time a few weeks into pregnancy on the ultrasound, they are fascinated to see that it already has a head, two small hands, legs, and a heartbeat," explains Otieno.

Ultrasound scans often are compared to X-rays, leading some to believe the sound waves might pose a risk to the developing fetus. This perception can lead to concerns, especially among family members such as mothers-in-law and husbands who may fear potential harm. "One of the big challenges of the job is debunking myths about scans. But once that happens, the momentum builds, and patients start sharing their positive experiences with other women," Otieno says with a smile.