Morocco is a low-middle income country in North Africa with a population of over 35 million (2017). Moroccan healthcare system has four layers: primary care, provincial hospitals and private clinics, hospitals in major cities, and university hospitals. Moroccans are served through universal public and private healthcare system. Public healthcare system serves around 70% of the population and public hospitals still face huge gaps in doctors, equipment, and medicine. Private practice grows rapidly, which often draws physicians away from public hospitals, including radiologists.
RAD-AID in Morocco
In November 2016, UTHealth McGovern Rad-AID Chapter started a Radiology-Readiness Assessment in Morocco to assess gaps and needs at selected Moroccan hospitals, the Mohamed V University and in the rural setting. Three fields offered opportunities for improvement: education for radiology professionals, workflow and PACS optimization, and mobile health program to reach remote communities. Medical education appears to be also in need of structuration after discussions with the Dean of the University Mohamed V School of Medicine.
The second mission in 2017 consolidated the assessments and, along with local stakeholders, plans for future annual trips were made. RAD-AID’s team and in-country partners plan to enhance training and develop curriculum in interventional, musculoskeletal, and emergency radiology through hands-training during field visits and online conferences. Optimization of the workflow and implementation of quality improvements project led by residents paired with volunteer US residents was discussed. We also provided a disaster preparedness plan for radiology based on our model and adapted to local requirements. The plan was presented at the World Association of Disaster and Emergency Medicine Conference in November 2017.
In 2018, the traveling team included 4 members. Lectures and workshops on residents’ education in radiology and medical writing were provided. Meetings were held with the president of the Moroccan NGO Association Marocaine pour la Protection de la Sante (AMPS) to plan our participation to their future outreach missions. Additionally, the first Morocco-US collaboration in a scholar product was started and led to a presentation at the ARRS 2019. It is in the works for publication.
The 2019 mission involved 14 persons, including 2 interventional attending radiologists, a radiologist in private practice, a family medicine attending, and a physicist.
- Didactic lectures in the topics of Emergency Trauma, Oncologic Emergencies and Abdominal Emergencies were followed by interactive workshops on corresponding IR procedures and hand-son training of basic IR procedures.
- A detailed PACS readiness assessment and workflow optimization seminar provided short and long-term goals for full implementation of PACS system in the hospital, as well as efficacy improvement.
- Our group also joined a local non-profit organization mobile caravan in a medically underserved remote area, which gave us the opportunity to directly participate in patient care, as well as working together and exchanging experiences with a local Moroccan health care team.
- The presence of a physicist group-member was very valuable, as this provided the opportunity for a detailed assessment of the equipment for imaging quality and radiation safety.
For future trips, we are aiming to include imaging technologists to the group for evaluation of imaging quality and assist in more formal technical training. Similarly, nurses could also join the mission to deliver lectures regarding contrast monitoring, contrast material related adverse event management, and code training.