Alicia Armour, MA, BS, RDCS, FASE

Most of us have thought about doing mission work; some of us have taken the time, energy, interest, and made the fiscal and personal investment in it. There are many questions to be answered: how does it affect the people we serve, what clinical impact does it hold, and how can it be maintained?

Over 250 million dollars and thousands of volunteer hours are spent every year on medical mission trips (MMT) across the globe covering all aspects of healthcare. Mission work has helped identify the prevalence of Rheumatic Heart Disease (RHD), the ability to undertake small scale research and apply it to local disease prevention programs, orthopedic and cardiovascular surgical intervention needs, and more. This mission work brings hope and opportunity to developing countries where it could be years before some patients receive necessary treatment.

RHD, a disease more prevalent in developing countries, is estimated to affect more than 15 million people worldwide, with over 250,000 new cases annually. Numerous MMT groups spend their efforts in these developing countries trying to identify these patients, and educate local healthcare workers about the initial stages of the disease and screening tools to evaluate patients who have been affected. One particular MMT group evaluated the prevalence of RHD in León, Nicaragua based on criteria developed by the World Health Organization (WHO) and National Institute of Health (NIH). In this area, they found that 48 out of 1,000 children were affected by RHD and 22 out of 1000 adults. While these numbers are relatively small on a global level, they exceeded the predicted rate and highlight the need for preventative care in developing areas such as León, Nicaragua. Identifying these cases early enough can help reduce recurrent issues and prevent valvular heart disease later in life, a role where echocardiography is key in detection.

New tools to track quality have been created and utilized for MMT. One group created an evaluation tool assessing major and minor quality factors of importance to MMT including cost, efficiency, impact, preparedness, education, and sustainability. The tool identified strengths in cost and impact (mean score of 86% and 84%, respectively) and lower performance in education (64%). Tools similar to this one can be used and applied for MMT not only to assess quality, but also to enhance and improve future MMT.

Recent groups have made effort to educate local healthcare workers to carry out similar screenings, examinations and work in their area. Focused education to continue care, such as echocardiography exams, has been implemented through MMT teams. These increased efforts along with the aforementioned tools will bring new perspectives, goals, and possibly guidelines for future MMT. To learn more about involvement with MMT through the American Society of Echocardiography’s Foundation visit www.asefoundation.org .

Alicia Armour, MA, BS, RDCS, FASE is a Cardiovascular Sonographer III at the Duke Cardiac Diagnostic Unit. Alicia currently serves on the ASE Council on Cardiovascular Sonography Steering Committee as the Guidelines and Standards Committee Representative and is on the ASE Workflow and Lab Management Task Force.