Sharing knowledge and shaping practice: Dev’s volunteering experience in Malawi

At Worldwide Radiology, we believe that developing global radiology capacity starts with the building of long term collaborations and ongoing exchange of expertise. 

Our programme in Malawi, based at Queen Elizabeth Central Hospital (QECH) and Kamuzu University of Health and Science in Blantyre, is a key example of this approach. Led on the ground by radiologist and project lead Dr Karen Chetcuti, the programme contributes to the training of a new generation of radiology professionals in a setting where resources are limited but the need is immense.

This year, UK based radiologist Dr Derfel ap Dafydd, also known as Dev, travelled to Blantyre as a volunteer with Worldwide Radiology, after previously supporting the programme through remote teaching sessions. 

His on site assignment focused on subspecialist training in head and neck and uro-radiology, clinical service support, and mentoring.

Strengthening training in underserved areas

A central goal of Dev’s visit was to address gaps in access to subspecialist training. As Karen explains, “Lack of diversity and number of on site radiology educational faculty includes lack of dedicated head and neck tumour radiology expertise, addressed with Dev’s assignment.”

Head and neck cancer is a major health burden in Malawi. “Our registrars really do need to be competent in recognising and characterising head and neck cancer to make an accurate diagnosis,” she says, adding that this enables appropriate referrals to surgery, chemo/radiotherapy or palliative care.

Dev was able to deliver teaching on these topics through hands-on clinical work, case discussions, and ultrasound sessions. “This traditional apprentice style of training is my preference, and I felt it worked very well with the interns,” he shared. 

He also noted that the radiology residents - Chisomo, Olive, Emily, Dama, Rashid, and John -  were “motivated, enquiring, and refreshingly reliable attendees at teaching sessions.”

Karen observed that Dev’s contribution went beyond education: “Dev’s objective on this occasion was primarily to focus on the radiology educational aspect, however while here his opinions have also impacted greatly on several head and neck and urinary tract cancer scan interpretations… thus also impacting patient care through service delivery.”

From teaching to teamwork

The volunteer placement also offered the opportunity to work with the radiology team on improvements to diagnostic imaging scan practice at QECH. 

The hospital had recently installed a new MRI scanner, and Dev, whose clinical practice in the UK is MRI-heavy, was able to offer feedback and input on optimising local imaging protocols.

“My first impressions are that the quality of MRI radiography at QECH is already good,” Dev noted. “I am hopeful that further refinements to protocols and parameters are very achievable, and dialogue with clinicians can balance local referral practice with available capacity.”

In addition to working with the residents, Dev also exchanged knowledge with radiographers and medical officers who regularly visit the radiology department for clinical input. 

Karen also highlighted his work in “constructive discussions on working together to further optimise quality radiology image acquisition,” which she sees as vital to the department’s growth.

Lasting partnerships and looking ahead

At Worldwide Radiology, volunteer placements are designed to ensure mutual benefit and learning. With assignments tailored to achieve broad outcomes relevant to the healthcare needs of our hosts.

For QECH this means, “The aim is to work towards every activity having benefit on both the clinical service aspect as well as the educational aspect ” Karen explained. Volunteers also gain valuable exposure to a healthcare setting very different from their own and to “challenging and markedly diverse disease types and presentations….”

Dev found the experience both professionally and personally enriching. “The clinical work is challenging, but also very interesting, and very educational for me,” he said. “The resourcefulness, resilience, commitment and decency exemplified by Karen in particular is beyond that of anyone I’ve encountered in my career before.”

Following his visit, Dev has committed to ongoing support in several areas. He is already leading monthly case review sessions remotely via the Collective Minds Cloud PACS solution and plans to take up a  mentorship role for  radiology registrars in writing academic abstracts and preparing conference presentations. 

He has also continued to contribute to the refinement of CT and MRI scan protocols at QECH. Looking ahead, Dev hopes to return to Malawi for a second visit and is exploring the possibility of creating overseas training opportunities for UK radiology registrars to engage with the programme on site.

Karen sees these partnerships as key to strengthening the department and broadening learning opportunities for both Malawian and international radiology health workers: “I hope to work with Dev and of course WWR in, for example, creating structured educational opportunities for international radiology registrars to spend some time in Malawi.”

Reflecting on Dev’s time in Malawi, she shared: “Dev has been an inspiration to our residents and in my opinion been a fantastic volunteer. His relaxed and flexible approach, his ability to balance his needs assessment while also being incredibly proactive has been remarkable. I am incredibly thrilled to have him join the WWR volunteer family.”

Stories like this remind us of the power of collaboration and how shared learning across borders can help move us closer to equity in access to radiology around the world.

Dev shared that the experience gave him perspective: “A population of twenty one million people served by a handful of radiologists and scanners puts into perspective the demands of radiology at home and the looming evolution that preoccupies us. Managing uncertainty and unfamiliarity is (or surely will be) common to us all, and this experience was a reminder of the importance of being adaptable and collaborative, regardless of the setting.”

For others considering similar work, Dev offered some advice: “I expect many radiologists could learn a great deal from the spectrum of referrals in Blantyre, and how to address a consecutive list of such complex scans, as well as how to manage resources in a genuinely mindful way. My advice to volunteers is to make the most of it and engage as much as possible with the department’s activities; the opportunity to work with a team so inclusive and welcoming is a rare privilege.”