Canadian doc brings ultrasound to rural Africa

MARKHAM, Ont. – Ultrasound is an easy-to-access test for patients in Canada and the United States. Not so in much of the developing world, such as rural Uganda. But a Canadian physician is now using portable ultrasound to deliver U/S exams to patients in remote areas of Uganda, spotting life-threatening illnesses like pneumonia, the number one killer of children under the age of five.

Dr. William Cherniak (pictured), an emergency room doctor at Markham Stouffville Hospital, is using a portable ultrasound probe called Butterfly IQ, which attaches to a smartphone to provide on-the-spot diagnostic imaging.

The Butterfly is about the size of an electric shaver. It is battery-powered and contains microchips rather than piezoelectric crystals, so it usually won’t break if dropped. (That was accidentally tested a few times during a week that a New York Times reporter spent in rural Uganda with Dr. Cherniak’s team.)

For Butterfly Network, the Connecticut company that makes it, the profitable target customers are doctors and nurses who can afford a $2,000 device that fits in a coat pocket and is as portable as a stethoscope.

“That was my real motivation for making it,” said Jonathan Rothberg, Butterfly’s founder, who initially pursued the goal because one of his daughters had a disease that caused kidney cysts needing regular scans.

“Two-thirds of the world’s population gets no imaging at all,” he added. “When you put something on a chip, the price goes down and you democratize it.”

The Bill and Melinda Gates Foundation is one of his backers, as are the investment arms of other family philanthropies.

He has donated scanners to medical charities working in 13 low-income countries, seven of them in Africa. Several went to Bridge to Health, a Canadian charity that Dr. Cherniak founded six years ago; it works closely with Kihefo, a medical charity based in western Uganda.

Through Bridge to Health Medical and Dental, Cherniak and his team are training frontline workers in Uganda to use the device to diagnose conditions like pneumonia. The team consulted with frontline workers in different communities to see how they could use diagnostic imaging. The overwhelming response was to help diagnose pneumonia cases.

“Most patients in a low resource setting don’t get access to really good diagnostic imaging,” Cherniak told CTV News.

“You can basically bring it with you anywhere into a really remote rural area … It plugs into the device, you pop it on the patient and it’s a single probe rather than three, so it makes it that much easier to diagnose.”

Bridge to Health Medical and Dental partners with local health services to conduct HIV screenings, physical and dental exams, eye checkups, and provides training to local healthcare workers.

“The reason why they wanted us to focus on pediatric pneumonia is because it’s the most common cause of death in children in low resource settings,” Cherniak explained.

“Many children come with cough, cold, flu-like symptoms, but it’s very challenging to get access to chest x-rays so it’s really hard to know if they have pneumonia.”

Dr. Michelle Lee, pediatric emergency physician at Toronto’s Hospital for Sick Children and lead trainer for the Bridge to Health program, says that because many pneumonia cases go undiagnosed, delays in treatment are often fatal.

“We do have effective treatment for pneumonia if it’s delivered in a timely fashion,” Lee told CTV News. “So we believe tools like this can save lives.”

Ultrasound images can be uploaded to specialists in Canada and the U.S. who can double check the diagnosis.

Bridge to Health currently operates in communities in Uganda and Kenya.