Africa’s Regional Coordinator’s Report Elizabeth Balogun

Africa’s Regional Coordinator’s Report Elizabeth Balogun 


RADIATION PROTECTION TRAINING THE TRAINERS WORKSHOP IN AFRICA (LAGOS AND TOGO)


Radiation protection has been in the front burner of medical imaging practice globally in the past few decades with the ISRRT playing a critical role. Around the world people are living longer and often with too many diseases that require quality and safe care. Too many people are not informed about the benefits and risks of the care they receive. Only 1 in 3 persons have the risks of their procedure explained to them with 1 in 5 people undergoing an unnecessary examination. It is estimated that 3.6 billion persons are exposed to ionizing radiation from medical sources worldwide annually. Against this background the Bonn call for action which also has the endorsement of the ISRRT with a position statement to that effect has been striving to advance and strengthen the practice of radiation protection in medicine in order to achieve change in practice globally including the African sub-region.

Togo hosted in December the 2019 edition of the regional training the trainer’s workshop in radiation protection for French speaking African radiographers. It brought together 40 participants from 7 (Togo, Benin, Ivory coast, Cameroun, Mali, Guinea Conakry, Burkina Faso) countries and had presentations on several themes of medical radiation protection and practical works hands on exposure and dose measurement in the radiography room. Radiographers were also equipped with teaching methods and pedagogy. They undertook to impact the practices of radiation protection in their countries, as well as to lobby the authorities of their countries for the application of the principles of radiation protection.

The Lagos venue had 90 participants in attendance from all the six geopolitical zones of Nigeria and 4 (Kenya, Rwanda, Tanzania and Uganda) other countries

Training and re-training of radiographers and radiologic technologists has been ongoing with expert support from the ISRRT and the IAEA. The training sessions were facilitated by  Dr. Mohammed Mogaadi who is Radiographer and Medical Physicist trainer with the IAEA.

In view of the level of commitment shown by the ISRRT and the IAEA, Radiographers in both English and French speaking Africa had the Train the trainers’ workshop in November and December 2019 in Lagos and Togo respectively. There were some interactive peer-review breakout sessions, comprising eight (8) different groups in Lagos which identified common challenges of radiation protection across the region and also made a declaration tagged the “Lagos Declaration on Radiation Protection”. 


Common challenges
While several challenges were identified during the session with representatives from various countries: Kenya, Tanzania, Uganda, Rwanda, and Nigeria. Most challenges were similar across countries in the region. These challenges were grouped under 3 thematic areas based on the principles of radiation protection viz; Justification, optimization and dose limitations. 


Delegates at the training of the trainer’s workshop were optimistic that these common challenges facing the African sub-region is surmountable with political will from the relevant heads of governments with their respective ministries of health making radiation protection of patients, staff and the public a priority consistent with the recommendations of the international basic safety standards of the international atomic energy agency. Further support in terms of funding, training of radiographers alongside other health professionals to enhance justification and the use of referral guidelines in the region is strongly recommended with requisite support from the ISRRT, IAEA, WHO, AU, WAHO among others, this is possible. 

 

Group of delegates at the Togo workshop

 

Group photograph of some of the participants in Lagos, Nigeria

 

Blog 7 -  ISRRT News and Views – April 2020 edition
ISRRT Professional Practice Director’s Report – Stewart Whitley
News from the IAEA and WHO Medical Devices section of WHO
Some important pieces of news reported in the IAEA’s Radiation Protection of Patients (RPOP) E-newsletters (RPOP RPoP.Contact-Point@iaea.org) for December 2019, January and February 2020 include:-

1. More Resources are Needed for Developing and Using Diagnostic Reference Levels
Concluded at the ICTP-IAEA workshop held from 18 to 22 November 2019
2. ICRP publications free to access from 1 January 2020 - Every ICRP publication up to and including Publication 137 will be free to access on this link
3. HERCA Position Paper Published  - Clinical audit in medical radiological practices 
4. New E-learning Course for Radiographers - Improving Radiation Protection through Reject/Repeat Analysis Programs (RAPs)
5. Webinar: Managing Radiation Protection in Fluoroscopy Guided Interventions: How We Do It - Recording Now Available Online
6. A New Module on Therapeutic Nuclear Medicine in Safety in Radiation Oncology (SAFRON) - Voluntary reporting and learning system for medical professionals
7. Call for Translations of Posters in Paediatric Imaging - Help The Image Gently Alliance by translating posters
8. Patients in Focus: The IAEA’s First Training in Safety Culture in Medicine - 25 participants discussed the future training material to be launched in May 2020
9. CT Protocols and Radiation Doses for Hematuria and Urinary Stones: Comparing Practices in 20 Countries - A new article published in the European Journal of Radiology
10. DEADLINE EXTENDED TO 15 APRIL: Call for Papers for the IAEA International Conference on Radiation Safety - Including also topics from medical area
11. Radiation Safety of X Ray Generators and Other Radiation Sources Used for Inspection Purposes and for Non-medical Human Imaging - New IAEA Specific Safety Guide
12. Free Lecture by ESR: Novel Coronavirus Outbreak: Experience and Challenges in Imaging and Beyond - ACE2 – a rational frontline therapy for COVID-19
Note - Just click on these links for further information

Some important pieces of news reported in the WHO Medical Devices Newsletter for December 2019, January and February 2020 include: -

New publication: Decommissioning Medical Devices

Health technology is an indispensable component of effective health care. Of these technologies, medical devices provide the foundation for prevention, diagnosis and treatment of illness and disease and rehabilitation. 

This new publication, to which as previously reported that ISRRT had made valuable input, addresses the decommissioning as the removal of medical devices from their originally intended use in a health care facility to an alternative use or disposal. It further explains the options to eliminate or reuse and the notion of disinvestment decision. WHO developed this guide, with support from experts, as part of the WHO Medical device technical series.
 

The book is available at:
https://apps.who.int/iris/bitstream/handle/10665/330095/9789241517041-en...

Consultations still open: 

Information to Update Country profiles - Global atlas of medical devices 

Global Atlas of medical devices book provides the global, regional and country data particularly on the availability of specific medical devices, policies, guidelines, standards and services.

Related links:
- WHO Global Atlas of medical devices , 2017 [pdf, 11.63mb]
- WORD DOCUMENT TO UPDATE YOUR COUNTRY PROFILE
- Country profiles - Medical devices regulatory systems at country level
- Global Health Observatory (GHO) interactive maps on medical devices
- Global health observatory, data repository

Action requested: 
We kindly request your help to bring-up-to-date the figures of each country. Each request for edition needs to be sent to medicaldevices@who.int

Information to know about the need and use of nomenclature for medical devices 

If you use naming , classification, coding, nomenclature of any kind of medical devices including in vitro diagnostics,  WHO will welcome your  input in the following SURVEY. 

Technical specifications for procurement of assistive technologies

The consultation opens until 12th January 2020.   https://www.who.int/phi/implementation/assistive_technology/aps_open_con...

Coronavirus 2019-nCov 

Technical guidance: WHO is updating technical guidance every day, please find it here:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technica...

Daily Situation reports, can be found:  
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situatio...

Research and Development Blue print  -  to accelerate  vaccines, diagnostics and therapeutics for Novel Coronavirus - https://www.who.int/blueprint/en/

Ongoing Professional Issues

As stated previously I’m pleased to say that, as part of our commitment to the WHO which enables ISRRT to function as a ‘Non-State Actor’ (formerly non-government organisation NGO) we have now finalised and published general guidance on several quality control documents relating to:- Mammography, General radiography and Computed Tomography.

We are grateful for the feedback received from colleagues – please visit the ISRRT website.  

Additionally, all the ISRRT Position statements are in the process of being standardised and these can be found on the ISRRT website. Don’t forget to look for the respective Tabs with relevant dropdowns to find what you are looking for.    
ISRRT is committed to continuing to raise the profile and importance of implementing the Bonn Call for Action Joint Position Statement by the IAEA and WHO - Setting the Scene for the Next Decade following the meeting in Bonn, Germany, in December 2012, with the specific purpose of identifying and addressing issues arising in radiation protection in medicine. To this end the ISRRT board have updated its action plan at the ISRRT Board meeting in Paris January 2019. Various tasks have been allocated and we will continue to engage with many stakeholders and sister organisations in raising the profile of the Bonn Call for Actions.

As indicated previously one of those Actions is Action 2 which calls for the establishment, use of, and regular update of diagnostic reference levels for radiological procedures, including interventional procedures, in particular for children. Hence the development of a Position Statement on Diagnostic Reference levels (DRLs).

Readers are encouraged to use following IAEA and ICRP links to gain information on the use and establishment of DRLs. 

IAEA – About Diagnostic Reference Levels (DRLs)
https://www.iaea.org/resources/rpop/health-professionals/radiology/diagn...

IAEA – Diagnostic Reference Levels (DRLs) in medical imaging 
https://www.iaea.org/resources/rpop/health-professionals/nuclear-medicin...

Diagnostic reference Levels in Medical Imaging - ICRP Publication 135
http://www.icrp.org/publication.asp?id=ICRP%20Publication%20135

We plan to develop a DRL guidance document once the DRL position statement is approved.

 

Keeping our eyes and ears open


As ever it is the ISRRT’S objective in advancing the science and practice of radiography and radiotherapy and allied subjects by the promotion of improved standards of education and of research in the technical aspects of radiation medicine and radiation protection. This means that we all need to keep abreast of developments and advancements promoted by the various Regional and World agencies such as the WHO and the IAEA. 

We must be diligent as we see developments such as the introduction of ‘Artificial Intelligence (Ai)’ being introduced into many aspects of the patient journey and imaging process.

The ISRRT Board will be working with the EFRS to prepare a joint paper on the radiographers/technologists’ role in the application of Ai. More to come on this subject.    

 All of us have a professional responsibility to maintain clinical competence and knowledge. To aid in this resolve the IAEA has a wealth of information on radiation protection including online training courses in radiation protection. Available courses and information packs include: -

Medical Imaging: The Right Test at the Right Time - A new short video on justification of medical procedures

Webinar: Computed Tomography simulator

E-learning: Radiation Dose Management in Computed Tomography (CT) -  Now available in Spanish

Tips & Tricks: Radiation Protection in Radiography

Safety and Quality in Radiotherapy

New Cases Mapped in SEVRRA-SAFRON - 583 probabilistic safety analyses added in IAEA online tool: Safety in Radiation Oncology


For further information clink on https://www.iaea.org/resources/rpop/resources/online-training


Additionally there are free posters and leaflets which available at the IAEA website https://www.iaea.org/resources/rpop/resources/posters-and-leaflets.

These include with their respective links the following: 

Poster - Building awareness in pregnancy →
Trifold - Delivering Safe Radiotherapy is in your Hands →
Poster - 10 Pearls: Radiation protection of patients in CT →
Poster - 10 Pearls: Appropriate referral for CT examinations →
Poster: 10 Pearls: Radiation protection for children in interventional procedures →
Poster - 10 Pearls: Radiation protection of patients in fluoroscopy →
Poster - 10 Pearls: Radiation protection of staff in fluoroscopy →

To benefit from the vast IAEA resource why not sign up to receive the IAEA to receive the Weekly News and the IAEA Radiation Protection of Patients (RPOP) for their monthly E-Newsletter – for further information look up (www.iaea.org/newsletter and the (www.iaea.org/resources/rpop/newsletter

We continue to encourage suggestions and ideas for position statements so please forward your suggestions to Stewart Whitley at aswhitley@msn.com.

Stewart Whitley – 10.3.2020