Seeing Clearly with Dr. William Marks

After several blood transfusions—many from his own staff—and hours of surgical repair, the surgeon packed 50 meters of gauze inside Minata's abdominal area and closed her up for the night. A baby had begun to grow outside the mother’s womb, causing severe internal bleeding. The next day, hospital staff gathered in prayer and song, in hope that the bleeding would stop. The hours following would be critical to her survival.

When Minata arrived at Koutiala Hospital for Women and Children in Mali with severe cramping and internal bleeding, surgeons used a new ultrasound machine provided by Medical Teams International. They determined that she had an ectopic pregnancy—a baby growing outside the uterus. Dr. Dan Nesselroade, the hospital’s lead OB/GYN, and four other residents began operating immediately. Nearly a day and seven blood transfusions later, including a transfusion from Medical Teams International volunteer Dr. William Marks, Minata emerged from her ordeal. "Just a few days later I watched her walk out of the hospital," says Dr. Marks, who says these types of emergencies are quite rare and has seen only one case in his 30-year medical career. "Having access to ultrasound will allow earlier and more accurate diagnoses of ectopic pregnancies," he says.

Dr. Marks works as a radiologist in Seattle, Washington, and recently took a month off to volunteer with Medical Teams International in southern Mali. He spent his time training hospital staff to use a portable ultrasound machine the size of a laptop computer that will be used at the N'Torosso health clinic . Medical Teams International purchased the refurbished machine from SonoSite, using funds from generous donors. "The machine is generations better than the equipment they had at the hospital," says Dr. Marks.

Thousands of Malian women and babies die of obstetric-related causes every year. “It is hard to get the statistics,” says Dr. Marks, but women who do encounter complications during their pregnancy often cannot reach care before they bleed to death. Access to an ultrasound during the third trimester will help the N’Torosso clinic staff diagnose problematic pregnancies and refer the patients to larger hospitals equipped to manage their complications. Conversely, a proper diagnosis at the clinic-level ensures that patients will not have to spend a month’s wages or more to travel to the capital for a diagnosis. "I saw one newborn with a soft spot on his head and the staff wanted to refer him to the capital, more than five hours away, because they thought he had hydrocephalus," Dr. Marks says. "I performed an ultrasound and didn’t find a hydrocephalus, but normal cranial anatomy. The ultrasound ultimately saved the family days of travel time; and in their estimation, the equivalent of three month’s wages."

Using a solar panel on the roof of the N'Torosso health clinic, staff will be able to power the portable ultrasound machine. The ultrasound machine can be powered using conventional electricity, batteries and even solar energy. An electrical engineer helped the team set up solar panels on the roof of one of the hospital’s six outlying health clinics—and the team proceeded to conduct a solar-powered ultrasound on a pregnant woman. This N’Torosso clinic is several miles from any formal power source and has never before had access to a piece of diagnostic equipment. "We explained to the people that the initial ultrasound was a pilot and that Dr. Pierre Kamate, whom I spent time training, would be back to the clinic with the equipment soon," says Dr. Marks.

In addition to performing more than 140 ultrasounds on patients and providing training for the hospital staff on the use of the machine itself, Dr. Marks also held 10 lectures for the physicians and surgical residents. He covered ultrasound topics ranging from basic physics and obstetrics to fetal malformations, to breast, neck and hernia diagnosis, and liver, gallbladder and renal scanning. "While a number of individuals received help, the most important part was the training," says Dr. Marks. "My experience was just great…and it is very cool to see the impact we are having firsthand."