<p begin="00:00:00.082" end="00:00:03.415">(upbeat rhythmic music)</p>
<p begin="00:00:14.370" end="00:00:17.110" tts:origin="0% 0%">- It's always hard for me to<br />pick my most memorable moments</p>
<p begin="00:00:17.110" end="00:00:19.736" tts:origin="0% 0%">cause they're so many<br />interesting pieces I guess.</p>
<p begin="00:00:19.736" end="00:00:22.903">(upbeat driven music)</p>
<p begin="00:00:24.610" end="00:00:27.140">We focus on the most rural,</p>
<p begin="00:00:27.140" end="00:00:29.650">under-serviced parts of the population,</p>
<p begin="00:00:29.650" end="00:00:32.820">and so those are the people<br />that are often forgotten.</p>
<p begin="00:00:32.820" end="00:00:35.110">And so what we're trying<br />to do is come up with</p>
<p begin="00:00:35.110" end="00:00:39.260">an innovative solution to<br />bring an accurate diagnosis</p>
<p begin="00:00:39.260" end="00:00:41.200">and health care in general to those people</p>
<p begin="00:00:41.200" end="00:00:43.711">in those rural areas where<br />getting access to good medicine</p>
<p begin="00:00:43.711" end="00:00:45.500">is just impossible.</p>
<p begin="00:00:45.500" end="00:00:47.200" tts:origin="0% 0%">- For the people we're working with</p>
<p begin="00:00:47.200" end="00:00:49.930" tts:origin="0% 0%">in rural Uganda and rural Kenya, it's--</p>
<p begin="00:00:49.930" end="00:00:52.730">They don't really have the<br />choice between ultrasound</p>
<p begin="00:00:52.730" end="00:00:57.307">or another diagnostic imaging<br />technology like CT or MRI.</p>
<p begin="00:00:58.400" end="00:01:00.180">It's really ultrasound or nothing.</p>
<p begin="00:01:00.180" end="00:01:02.520">Just being able to have<br />an ultrasound machine</p>
<p begin="00:01:02.520" end="00:01:05.729">that can be brought out<br />to them is life-changing.</p>
<p begin="00:01:05.729" end="00:01:09.062">(energetic piano music)</p>

<p begin="00:00:00.531" end="00:00:03.031">(piano music)</p>
<p begin="00:00:08.890" end="00:00:10.900" tts:origin="0% 0%">- My name is Ilana Greenwald.</p>
<p begin="00:00:10.900" end="00:00:13.813" tts:origin="0% 0%">I'm an emergency doctor from Toronto.</p>
<p begin="00:00:13.813" end="00:00:16.790">I'm doing an ultrasound<br />fellowship there as well</p>
<p begin="00:00:16.790" end="00:00:20.461">and I came to Kabale with Bridge to Health</p>
<p begin="00:00:20.461" end="00:00:23.200">to be the medical director this year</p>
<p begin="00:00:23.200" end="00:00:25.050">of the program in the field</p>
<p begin="00:00:25.050" end="00:00:27.640">and I'm trying to use my ultrasound skills</p>
<p begin="00:00:27.640" end="00:00:31.680">to bring ultrasound to<br />the clinical officers</p>
<p begin="00:00:31.680" end="00:00:33.380">and the mid-level providers here</p>
<p begin="00:00:33.380" end="00:00:37.130">so that we can improve<br />treatment, expedite treatment,</p>
<p begin="00:00:37.130" end="00:00:39.440">and make things a little<br />bit easier for that</p>
<p begin="00:00:39.440" end="00:00:40.640">when we're not here as well.</p>
<p begin="00:00:40.640" end="00:00:45.640">So we are in a rural<br />community just a few days ago</p>
<p begin="00:00:45.870" end="00:00:48.420">and there was a two-year-old<br />baby that came in</p>
<p begin="00:00:48.420" end="00:00:50.600">that had fever and vomiting for two days,</p>
<p begin="00:00:50.600" end="00:00:53.220">wasn't able to hold anything<br />down, was really dehydrated,</p>
<p begin="00:00:53.220" end="00:00:57.730">looked really bad, really<br />wasn't opening their eyes much</p>
<p begin="00:00:57.730" end="00:01:02.730">and we thought the baby maybe<br />had some gastroenteritis</p>
<p begin="00:01:07.311" end="00:01:11.000">but the baby was also coughing,<br />so we wanted to make sure</p>
<p begin="00:01:11.000" end="00:01:14.290">the baby didn't have pneumonia as well.</p>
<p begin="00:01:14.290" end="00:01:19.290">The baby was febrile so we<br />started the baby on some fluids,</p>
<p begin="00:01:20.440" end="00:01:21.310">which is what we were gonna do.</p>
<p begin="00:01:21.310" end="00:01:23.410">We gave him some anti-nausea medication,</p>
<p begin="00:01:23.410" end="00:01:25.718">but I took the ultrasound<br />machine to the bedside</p>
<p begin="00:01:25.718" end="00:01:28.690">in the middle of the<br />school in a small room</p>
<p begin="00:01:28.690" end="00:01:30.920">at the end of the day, and<br />I ultrasounded the baby's</p>
<p begin="00:01:30.920" end="00:01:33.540">lungs to see if the baby<br />had a pneumonia as well</p>
<p begin="00:01:33.540" end="00:01:34.690">that we needed to treat,</p>
<p begin="00:01:34.690" end="00:01:39.240">which would really make an<br />impact on what we did for him.</p>
<p begin="00:01:39.240" end="00:01:40.240">So I did an ultrasound.</p>
<p begin="00:01:40.240" end="00:01:42.320">The ultrasound was negative.</p>
<p begin="00:01:42.320" end="00:01:44.480">I didn't see any consolidation<br />on the ultrasound</p>
<p begin="00:01:44.480" end="00:01:46.560">and I was showing some<br />of the clinical officers</p>
<p begin="00:01:46.560" end="00:01:50.320">and Dr. Alan, the doctor<br />that works here, in KIHEFO,</p>
<p begin="00:01:50.320" end="00:01:52.390">how to do the ultrasound<br />and what things looked like,</p>
<p begin="00:01:52.390" end="00:01:54.860">and we kind of looked together<br />and worked through the case</p>
<p begin="00:01:54.860" end="00:01:56.510">and we saw that there<br />was no consolidation.</p>
<p begin="00:01:56.510" end="00:01:58.582">As such, we just treated<br />the baby with some fluids,</p>
<p begin="00:01:58.582" end="00:02:01.230">some anti-nausea medications.</p>
<p begin="00:02:01.230" end="00:02:05.920">We did not put the baby on<br />antibiotics, which was great,</p>
<p begin="00:02:05.920" end="00:02:07.640">because that also has some side effects</p>
<p begin="00:02:07.640" end="00:02:09.300">and we were just able<br />to quickly diagnose them</p>
<p begin="00:02:09.300" end="00:02:10.750">and we brought them back here.</p>
<p begin="00:02:10.750" end="00:02:14.010">And within 24 hours the<br />baby was doing really well,</p>
<p begin="00:02:14.010" end="00:02:17.991">smiling, up and about<br />like usual, rehydated,</p>
<p begin="00:02:17.991" end="00:02:20.493">and went home, which was great.</p>

<p begin="00:00:00.078" end="00:00:02.828">(peaceful music)</p>
<p begin="00:00:06.200" end="00:00:09.310" tts:origin="0% 0%">- So, we had a patient in the field</p>
<p begin="00:00:09.310" end="00:00:11.770" tts:origin="0% 0%">who came to one of our outreach programs</p>
<p begin="00:00:11.770" end="00:00:13.320" tts:origin="0% 0%">who was extremely sick.</p>
<p begin="00:00:13.320" end="00:00:16.442">He had a fever, was coughing for a good,</p>
<p begin="00:00:16.442" end="00:00:18.973">probably two weeks, and<br />developed chest pain,</p>
<p begin="00:00:18.973" end="00:00:21.500">and was in and out of different hospitals,</p>
<p begin="00:00:21.500" end="00:00:22.910">not really getting better in spite of</p>
<p begin="00:00:22.910" end="00:00:24.630">different types of treatments.</p>
<p begin="00:00:24.630" end="00:00:26.050">So when he came to our clinic,</p>
<p begin="00:00:26.050" end="00:00:27.120">his blood pressure was low</p>
<p begin="00:00:27.120" end="00:00:29.010">and he was breathing really hard</p>
<p begin="00:00:29.010" end="00:00:30.510">and so he actually sort of fell down</p>
<p begin="00:00:30.510" end="00:00:31.910">in the middle of our tents.</p>
<p begin="00:00:31.910" end="00:00:34.120">So we started giving him IV fluids</p>
<p begin="00:00:34.120" end="00:00:35.930">and then we got an initial ultrasound</p>
<p begin="00:00:35.930" end="00:00:37.460">to look at his heart.</p>
<p begin="00:00:37.460" end="00:00:39.540">We found out that the heart looked okay.</p>
<p begin="00:00:39.540" end="00:00:40.900">Because he was having the chest pain,</p>
<p begin="00:00:40.900" end="00:00:42.690">we were worried maybe he had a more rare</p>
<p begin="00:00:42.690" end="00:00:44.140">infection of the heart.</p>
<p begin="00:00:44.140" end="00:00:45.410">Then we looked at the lungs and we went,</p>
<p begin="00:00:45.410" end="00:00:49.070">oh my god, his lungs are<br />full of pneumonia bacteria.</p>
<p begin="00:00:49.070" end="00:00:51.780">So we started him on<br />intravenous antibiotics</p>
<p begin="00:00:51.780" end="00:00:53.793">and we actually brought<br />him back to KIHEFO.</p>
<p begin="00:00:55.370" end="00:00:57.560">Then, basically once<br />he got back to KIHEFO.</p>
<p begin="00:00:57.560" end="00:01:00.340">he wasn't quite getting<br />better after the first day</p>
<p begin="00:01:00.340" end="00:01:04.210">so then we did another scan<br />of his lungs at that point</p>
<p begin="00:01:04.210" end="00:01:08.200">and we realized that there<br />was really bad infection</p>
<p begin="00:01:08.200" end="00:01:10.370">all the way from top to bottom</p>
<p begin="00:01:10.370" end="00:01:11.860">and then we were trying<br />to figure out, you know,</p>
<p begin="00:01:11.860" end="00:01:13.490">could he have fluid on the lung</p>
<p begin="00:01:13.490" end="00:01:15.960">and unfortunately, it<br />wasn't really possible</p>
<p begin="00:01:15.960" end="00:01:17.909">to get any sort of x-ray<br />to figure that out,</p>
<p begin="00:01:17.909" end="00:01:19.700">but because we had the ultrasound,</p>
<p begin="00:01:19.700" end="00:01:21.190">we were able to make a decision</p>
<p begin="00:01:21.190" end="00:01:22.850">that he did not need to have a tube</p>
<p begin="00:01:22.850" end="00:01:26.020">put into his lung to bring<br />fluid that wasn't there</p>
<p begin="00:01:26.020" end="00:01:27.340">because we couldn't hear any noises</p>
<p begin="00:01:27.340" end="00:01:29.420">when we were listening<br />with our stethoscopes.</p>
<p begin="00:01:29.420" end="00:01:31.360">So, had we not had the ultrasound,</p>
<p begin="00:01:31.360" end="00:01:32.860">we might have ended up doing a procedure</p>
<p begin="00:01:32.860" end="00:01:34.053">unnecessarily for him.</p>
<p begin="00:01:35.714" end="00:01:38.464" tts:origin="0% 0%">(peaceful music)</p>