Maternal and newborn mortality are important issues in Uganda. While maternal mortality has improved considerably between 2011 and 2017 (from 438 to 336 deaths per 100,000 live births), infant mortality has remained steady for the past ten years. However, neonatal mortality has not improved since 2006. In addition, there are high disparities in healthcare access between rural and urban areas. Urban women are twice as likely as rural women to receive antenatal care, and births in rural areas are less likely to occur in a health facility than births in urban areas (Uganda Bureau of Statistics & ICF international Inc, 2018; UNICEF, 2016). Access to ultrasound technology can make a difference in improving care for pregnant women.

Imaging the World (ITW) is a nonprofit organization founded in Burlington, Vermont in 2010. They work with clinics in rural Uganda to implement low-cost, portable ultrasound technology and conduct ultrasound training for nurses and midwives. Their mission is to strengthen rural healthcare systems and decrease maternal and child mortality. The United States team is based out of the University of Vermont Medical Center. Dr. Kristen DeStigter, the founder of ITW, is a Professor and Chair of Radiology at the Larner College of Medicine. In addition to their team of doctors in the US, ITW has a permanent staff at their office in Kampala, Uganda as well as Ugandan public health experts.

Some of the major goals of ITW are to increase attendance of prenatal visits at health centers, train clinical officers, nurses and midwives to use obstetric scans, and train ultrasound teachers (Imaging the World, n.d.). Imaging the World works primarily in Uganda, although it has recently expanded to Malawi as well. Their model consists of three parts. Their first focus is strengthening infrastructure with ultrasound equipment. The second component is workforce development through ultrasound training programs. In addition to training nurses and midwives in ultrasound technology, they also train Ugandan ultrasound teachers to keep the ultrasound program sustainable and cost-efficient. Third, they provide telemedicine radiology services to ensure quality care. During the training period, images are sent to radiologists at the University of Vermont for consultation and peer review. The ultrasound program was started to identify high-risk pregnancies in rural Uganda. However, it has expanded to the detection of breast cancer, evaluation of liver, kidney, and thyroid disease as well as rheumatic heart disease.

The ITW team travels to Uganda multiple times throughout the year. During past summers, they have brought a few local high school students who are interested in public health on one of their two-week trips to visit the clinics and observe trainings. I was a participant in this program in high school. Then, in the summer of 2019, I worked for ITW. My job was to create a more organized curriculum for the student volunteers to have them learn about Uganda and the roles of ITW. This project took the form of a 60-page “Field Guide” for the students to use as a resource before, during, and after their time in Uganda, giving students the opportunity to be more informed when they arrived and to reflect on their experiences. I compiled resources into chapters about the geography, people, and history of Uganda as well as information about the Ugandan healthcare system and ultrasound technology. In each section, I created activities and questions for the students to answer. A major component of the Field Guide was focused on the United Nations Sustainable Development Goals (SDGs) and how they related to Uganda. The goal was to have the students learn more about how development issues and projects are intertwined and how ITW fits into the bigger picture. After writing the Field Guide, I traveled to Uganda with the ITW team for two weeks. The focus of this trip was the implementation of a new shoulder ultrasound program as well as training for kidney and bladder ultrasound. In Uganda, my role was to guide the students through the field guide and facilitate discussions about public health, the SDGs, and the environmental impacts of NGOs working in rural sub Saharan Africa.

Creating the Field Guide was a way to improve the experience for student volunteers and give them a more active role outside of shadowing the ITW team. During the process of writing it, I learned much more about Uganda that I had not known the first time I was there in high school. I was also able to bring some knowledge from courses at Macalester. For example, one of the main focuses of the Field Guide was the United Nations Sustainable Development Goals. During the previous semester, I had written a paper analyzing these goals, and I really enjoyed applying that research to something outside of Macalester.

Through informal conversations with the founder of Imaging the World and the Ugandan team, I learned more about how NGOs work and how they expand their projects. I also learned about how ITW engages with clinics and communities to assess their needs and the feasibility of implementing an ultrasound program. Working with Imaging the World has confirmed my interest in global public health and working in the non-profit sector