I recently had the privilege to listen to a presentation by members of the World Health Imaging Alliance (WHIA), a non-profit organization with a charter to deploy digital imaging technologies in developing countries. They noted that two-thirds of the world's population does not have access to basic radiology services, something those of us in the developed world often take for granted.
The WHIA shared that the state of the radiology systems deployed in developing countries is deplorable—an estimated 30 percent of all radiology equipment there is not functioning. In addition, even if the equipment is properly maintained, there is often no money available to pay for the consumables (film and chemicals). The cost of these items is the equivalent—or more—of an average day’s pay, and there can be tremendous logistical hurdles to bring the supplies to remote areas. Imagine having to regularly transport film and chemistry to a remote village in a jungle, or over a steep mountain path in the Andes.
The advantage of deploying digital imaging technologies in developing countries is obvious. A simple CR or low-cost DR system would be a great solution. Combine this with a battery-operated WHIS-RAD device—an X-ray unit with stepped mAs, kVp and fixed source-to-film distance specially created for developing countries—and it is possible to deploy a complete system, including a computer for QA and two diagnostic viewing stations, for less than $100,000 (U.S.).
However, there are many challenges to the use of these systems in remote areas that involve logistics, training, maintenance and on-going support. That is why the WHIA, in cooperation with the Rotary International, has embarked on an exciting project to deploy a pair of pilot sites utilizing this technology configuration. The first one is being deployed in South Africa and the second one will be set up in Guatemala this summer.
It will be interesting to track the progress of these projects. Often, solutions deployed in the developing world are modified for use in developed countries—proving that less can be more. Maybe it is time that we start simplifying and consider that more is not always better. There is a large market for simple devices and in many cases it requires starting from scratch. That is what Tata accomplished in India with its development of a $2,000 car.
Who knows, the next generation CR or DR device may well be created in a country such as India. Perhaps it is time for the established medical device manufacturers to start developing simplified versions of their devices, too; or risk going down the same route as the U.S. auto industry.