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Sep 10
2010
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It is true that that Radiology is the ‘backbone’ of any institution. If you have to forecast the success of any medical centre, one must start from the radiology department. And this is not just at local level, its a global phenomenon. Institutions have been catapulted to heights of success by their strong radiology team.
However, Radiology in Africa takes a back seat.
Let us take a closer look into radiology practice in North Africa first.
The countries comprise of Egypt, Libya, Tunisia, Algiers and Morocco.
Radiology practice in Tunisia is at par with Indian standards with ‘cut’ culture. The equipment is ‘state-of-the-art’ only in the capital city of Tunis and the radiology skills are equally good. Elsewhere, the radiology machines are quite old. Most of the radiologists in Tunisia are educated in France which explains the reason for high-standards. There is quackery too, no doubt, as in India. For example, there are quacks with large size refrigerators and tall cupboards claiming ‘miracle’ treatment.
Egypt fairs equally well with a fair mix of ‘good’ and ‘bad’ radiologists. The equipment is both ‘state-of-the-art’and pretty obsolete too in a few centres. One could count good radiologists on finger tips. The best centres are based in Cairo and Mansoura cities along the river Nile. Egyptian radiologists score over all African nations in research publications and scientific presentations in international conferences.
Radiology in Morocco and Algiers is not even worth talking about.
Libyan radiology practice is quite interesting as is the name of the country – “Great Socialist People's Libyan Arab Jamahiriya” or GSPLAJ in short. There is no shortage of ‘state-of-the-art’ equipment and one can see a 16 slice CT scanner even in a remote town amidst Sahara desert! The reason maybe the huge incentives provided by the companies supplying the equipment, as there is no direct representation of manufacturers like GE or Siemens etc.
No one talks about employing a radiologist when a deal to purchase the equipment is finalized. The result is catastrophic. The machines are installed but left unused for long time because of lack of personnel. I know atleast one centre where they installed an expensive digital radiography unit, left uncared and unused for over three years!!
A 64-slice CT scanner machine in another centre is waiting to be used since last three months.
I sometimes wonder why nations prefix “Great” to their names. What is ‘Great’ about Britain?? People are forced to live with an unnecessary delusion of grandeur. Imagine if India was called “GREAT BHARAT” !!
Anyway coming back to radiology, I was amazed to see the high standards in South Africa. There is not enough research activities reported from that country, but the standard of radiology education is at par with international standards, I must say.
There is nothing to say about sub-Saharan Africa except poverty and disease and not to forget, amazing wildlife!
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Reviewed by Anuj Mishra September 15, 2010
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Dr. Sridhar V
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... Thank you Dr Anuj for this interesting piece of information. Your article clearly gives us an insight into what Radiology up to in your part of Africa and rest of Africa. Apart from South Africa, majority of southern African countries have nothing to talk of Radiology per se. One thing heartening to note is that we have got company in alien country ( Tunisia ) as far as 'cut' practice goes.No body can complain back in India about ethics etc.Looks like it is universal phenomenon. AS far as quackery..... I think it can not be eradicated as long as people go on trying alternative medicine in the form of herbal,unani,aurveda,sidda,village witchcraft,wodoo ....you can go on and on... As far as adding Great before the name of the country....just nothing but expression of inferiority complex. Finally the lesson learnt is " saare jahan se accha hindustan hamara " |
Anuj Mishra
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... Thanks dr. sridhar for summarising the article. My experiences into Africa has been a mixed bag of joy and depression. You would be surprised to know that Morocco was the host country for International congress of Radiology before China this year. |
Alok Varshney
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... Quite a traveler you've become Sir,  One can find comparison between many states of India and dark parts of Africa. The reason is simple: economic development will always precede development of good quality medical facilities, including radiology. In general good professionals always flock to the prosperous areas where people (or government) can pay them (although some of them may be ideologically motivated; or simply it becomes a fashion to serve in underprivileged area). |
Anuj Mishra
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... I feel state of radiology practice depends as much on trained personnel as good equipment. Unfortunately, there is a huge 'brain drain' from large parts of Africa as in India. Due to this 'inevitable attrition' of human resource, the states of Africa lag behind. |
Dr. Mohamed Refaey
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... thank you Dr. Anuj for sharing your thoughts, I'm gonna just comment on the part related to me. as Egyptian radiologist, it's true that most of modern scanners are present in Cairo..it's the capital city and holds more than 25% of citizens. but other large cities are also well equipped like alexandria, tanta, zagazig, mansura. it's the same in each country, the capital usually obsessed with more advanced technology. about Egyptian radiologists, no doubt their positions in African and Arab countries mean their abilities..even at Europe and the US, once they got the chance, they prove their profession. it's a statement more than a defense, each country has its brights and dark. |
Anuj Mishra
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... many thanks dr. mohamed for your invaluable input.  The level of healthcare in Egypt is the best in Africa, I admit. And I have quite a few Radiology friends from this country with a glorious past. |
Prashant Bhatt
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... A very interesting read Anuj, seeds of a book How the market expands, and the logic of profits overrides that of human needs is evident. Only yesterday, I was talking to an expatriate surgeon who has recently joined and he was wondering if the same level of indifference to real needs of people exists in advanced countries too. What is your experience/opinion on that? We keep reading about lack of Insurance and Medical bills being the leading cause of bankruptcy. |
Dr. Anuj Mishra
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... Indeed Prashant....can write a book on this. As you have said "the same level of indifference to real needs of people in advanced countries", I would say those so-to-say 'advanced' countries attitude towards people depends on the origins of the person and not on their culture. The attitude shows in their interaction with fellow citizens and foriegners. As far as doctor-patient relationship, I feel that often we tend to forget that we are treating a human being and not just a 'disease'. Indifference exhibited in a physicians' behavior towards his patient 'becomes' logical in such circumstances. And I feel this is more true in the Arab world. |
Alok Varshney
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... # Prashant (good to see u back) Though healthcare is a genuine need, the dilemma remains how to provide healthcare for all, specifically the poor. When one starts examining the question in detail, the debate becomes complex. For example, what is basic healthcare and what is advanced healthcare? Is the use of high tech and high cost equipments like CT and MRI making healthcare expensive and thus inaccessible to the poor? Does having insurance equate to having healthcare? For any service, there has to be a provider willing to provide service. The most consistent motivation for such a provider is economic gain (or profit). State intervention often ends up in situations such as Dr Anuj describes- a 64 slice CT in the middle of desert. |
Dr Manoj
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... sir, how is ZAMBIA as a country to work and stay there. I have got a lucrative offer at one radiology center with 0.2 TESLA MRI. Iam considering it, but afraid due to unknown country. Poor African country with rampant infectious disease and AIDS - about 15% ADULTS with HIV. This is the knowledge gathered through wikepedia. But my radiographer friend portrays good picture of Zambia with many Indians. Expecting ur reply to take this important decision of life |
moneim auod
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... Thank you Dr. Anuj For this valuable information ,I Think most african countries have similar conditions the reasons are many ,poverty and bad mangement of resorces,brain drain form afriica(radiologists and qualified radiographers) to Gulf countries because they are highly paid there and also to most african pliticians( Decision makers) Health is not a priority in my beloved country sudan radiology services enters with Britsh troops in 1989 ,we have advanced machines CT, MRI but in khartoum the capital and only other 2 or 3 cities most of qualified radiologists and radiographer leave to Gulf or UK THANKS |
Dr. Anuj Mishra
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... thanks dr. moneim for your honest comments. As far as Zambia is concerned, never heard or met any radiologist from there. If you are planning to got there for voluntary work Dr. Manoj, its ok. |
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