Linda Arnold, a specialist research echocardiographer in the Oxford Cardiovascular Clinical Research Facility (CCRF), recently spent a week volunteering for Echo in Africa, a humanitarian project based in Cape Town, South Africa. Here Linda shares her experiences with us.
“During the autumn of 2014, I spent a week volunteering for the Echo in Africa humanitarian project. The project is run jointly by the UK-based British Society of Echocardiography (BSE) and the cardiac care team at the Tygerberg Hospital in Cape Town, South Africa.
Initially, this is a two-year project, which started in autumn 2014, with the aim of screening 2000 secondary school age children for the early stages of rheumatic heart disease (RHD). Funding for the project, which includes all necessary machinery and a purpose-built facility was provided by the BSE and SUNHEART cardiology care, based at Stellenbosch University in South Africa.
RHD affects 15 million people worldwide and is the third most common cause of heart failure in Africa. The burden of this disease disproportionately falls on children in the developing world, especially where poverty is widespread. Consequently, the children taking part in our screening programme come from low socio-economic rural communities within the townships of Cape Town. If detected early, RHD disease is both treatable and preventable with the intervention of antibiotics and careful clinical follow-up. As RHD predominantly affects the mitral valve within the heart, we used an everyday, accessible diagnostic technique known as echocardiography, as a screening tool to detect early rheumatic changes to the valve.
The Echo in Africa project aims to develop and validate echocardiographic protocols to facilitate future roll-out and screening in the community. As screening services in these communities are generally poor or non-existent, this project gives local children much needed early access to diagnosis and the necessary local aftercare.
As a volunteer scanner on the project I really stepped out of my comfort zone and experienced working within a completely different culture and population. I gained insight into the local health provision, medical practices and facilities in South Africa. The facilities on site, both in terms of working environment and equipment, were very good. The South African medical team were friendly, approachable and organised trips on our behalf, so we saw some amazing scenery and took part in many interesting activities the country has to offer. Most importantly, the children were engaging, multilingual and not averse to telling many a joke (and playing a few practical ones)! I hope our small contribution goes some way to helping treat a population who are poorly resourced and less fortunate than ours here in the UK.
On a professional level, the knowledge and experience gained during my short time in South Africa can be directly applied to my work here in CCRF.
From a clinical perspective, I gained in-depth knowledge from local experts in both the diagnosis of mitral valve disease and the more unusual presentations of cardiac pathology. As we rarely see either acute or chronic cases of RHD in this country, an increased awareness of MV anatomy, pathology and how to specifically identify it will help in everyday scanning and reporting.
The ability to be flexible, adaptable and communicate effectively was essential, in order to work well as part of a completely new team and across cultural boundaries. Finally, on a more personal level it brought into sharp focus just how fortunate we are, having access to such excellent research facilities, equipment and diversity of expertise.”
The Echo in Africa project has many secondary aims to take forward:
- Continue screening in an area with a high risk of RHD
- Compare and contrast hand-held echocardiography devices against a substantive machine
- Help train the local South African healthcare professionals in the use of hand-held devices
- Assess whether the WHF criteria for RHD can be refined and updated
- Screen for other types of heart disease that may be present
- Continue the fight against this disease!
For further information on this project, please contact: