Society of Diagnostic Medical Sonography

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Sonography Fulfills Needs in E. Africa and the Dream of an SDMS Member

by Michelle Hopkins, SDMS Writer/Editor

Cheryl Boodt International Assistance

Cheryl L. Boodt, BS, RDMS, RVT, was wedged into the front seat of an old, battered ambulance with her husband, Tom, and their driver. Leaving behind the shimmer of Kenya’s sleek capital, Nairobi, the driver sped over unpaved roads pocked with holes, occasionally careening sidelong to avoid a mélange of vehicles and wayward cows and goats. With no traffic lights, safe travel was truly a shot in the dark.

Two hours of white-knuckle bouncing, swerving, and jolting might not be everyone’s idea of a good time. But, for Cheryl, taking this road has made all the difference – bringing sonography education and equipment to the land of the Kalenji, eight east-central African groups related by culture and tribal language, who also speak Swahili and English.

In four years and four trips, Cheryl, through her sonographic knowledge, and Tom, through his construction and organizational skills, aided by a grant from the SDMS Foundation’s International Assistance Program and the prayers of their church family and friends, have made an indelible impact for multitudes 7,700 miles from their home.

Cheryl Boodt International Trips

Dreams don’t die. They just take an alternate route.
“When I was four or five years old, we had a family friend who was a medical missionary to Africa. I wanted to become a nurse and a medical missionary, but Africa sounded scary,” Cheryl says. “Since I don’t do well at the sight of blood, I gave up plans to be a nurse and became a dental hygienist instead.” 

One day in her 20-year dental hygiene career, between curette scrapes and instructions to rinse and spit, Cheryl got an unexpected change of course from a dental patient. “We have an ultrasound machine but no one knows how to use it,” he said, speaking of a health facility in Kalamazoo, Michigan, where he worked. “Why don’t you go back to school, learn how to use it, and come work with me?” Three years later, Cheryl graduated as a credentialed sonographer. At age 42, she was ready to launch her second career, unaware this would be the first of two critical steps in her serendipitous journey to Kenya.

“My dad died in 2017 and left a major donation to Samaritan’s Purse. I searched online and learned that this faith-based 501(c)3 organization supports 50 hospitals worldwide,” she says. One thing led to another and Cheryl, now 60ish, asked Stacey, a Samaritan’s Purse employee, “Do any of the hospitals need ultrasound help?” In fact, 10 to 15 hospitals did. Ultimately, Cheryl chose the hospital in Kapsowar, Kenya because English was spoken and the climate was mild. On February 27, 2019, two days after she retired from her job at Holland Hospital, Cheryl and Tom boarded a plane to Nairobi, Kenya.

Through her eyes, assessing the need
Cheryl was devoted to healthcare and teaching sonographers long before her first medical mission trip in 2019. From 2007 to 2014, she was an adjunct professor in diagnostic sonography at Grand Valley State University, where she earned her credentials in vascular sonography in 2008. While teaching part time at Grand Valley State University, Cheryl worked full time in three, 12-hour Holland Hospital shifts weekly. She served as the main presenter in a sonography study group she started at Holland Hospital. 

Both of these institutions would prove to be valuable partners in her mission work. Grand Valley State University helped fast-track echocardiography training for her to apply in Kapsowar and Litein. The head of the university’s echo department read sonographic images she uploaded to the cloud, a workaround to overcome shortages of modern equipment in mission locations. Holland Hospital welcomed Cheryl as a student in their echo department in the fall of 2019. 

“In Kapsowar, two basic needs were to teach physicians how to order scans with more precision and to create protocols and a more systematic approach for the sonographers. Taking a singular image, as they did, was inadequate in searching for pathology,” says Cheryl. Students there are taught a full range of imaging modalities over three years with only three to four months devoted to ultrasound. 

The Boodts’ first trip in March 2019 revealed a panorama of ways they could help. Their commitment grew. They would return to Kapsowar in January 2020, and this time plan for a three-month visit.   

Security threat reveals a “busier, needier hospital”
Uncanny forces blew through Cheryl’s life. Unexpected or unpleasant occurrences had a way of giving her the means to do good and follow her medical mission dream. “Serendipity” is the word given to events like these. The first was the “swish-and-spit” invitation to a new sonography career. Next, her father’s passing introduced her to the charitable organization that would convey her to Kenya.

Two-and-a-half weeks into their return trip to Kapsowar Hospital in January 2020, serendipity would make a third appearance, this time more frightening. From another African country came a threat against the “mzungu.” This Swahili word (“mzungu”) today can mean anyone who speaks English. The threat was intended for the Canadians and Americans who ran the Kapsowar Hospital, including 15 full-time staff and seven volunteers, Cheryl and Tom among them. 

Some volunteers flew back to the U.S. within 24 hours of the threat but Cheryl thought otherwise. “We planned to be in Kenya for three months. We wanted to stay. So, Samaritans Purse called A.I.C. Hospital in Litein and asked if they could take in ‘two old people,’” she laughs. They did. This turn of events would bring the Boodts to an even “busier, needier hospital,” says Cheryl.  

Litein welcome mat is lined with dogs
Despite rattled nerves that led some volunteers to leave Kenya, Cheryl felt reinforced in their decision to stay. She got “a sign,” she says, upon arrival in Litein, even before going to the hospital.

“I’m a major dog lover. Before we left Michigan, I hopefully, but naively, prayed to find a dog in Kenya. Most dogs are feral here, not domesticated. In Litein, our new quarters had only sporadic water, electricity, and internet. When I was unpacking, we lost electricity, so I opened the window coverings to let in the light. Outside the bedroom window was a tame mama dog and her litter – seven nursing puppies. I got my prayer times seven!” says Cheryl. “This is where we were supposed to be.”

“A.I.C. Litein Hospital has 220 beds and six or seven radiographers and sonographers. They were all using an outdated 2002 ultrasound machine with an abdomen probe only – no matter the scan or organ and with grayscale only, no color flow,” recalls Cheryl, who flew into action. “I arranged to have a Butterfly IQ (a device designed for point of care ultrasound that plugs into a smartphone) temporarily transported from Kapsowar Hospital. I told the Litein Hospital administrator that I would provide the down payment for a new Siemens ultrasound machine, if they could get it quickly so I could train the sonographers before we left at the end of March.”

Cheryl Boodt International Assistance 2021

The new Siemens NX machine with four transducers – curved linear for abdomen, pelvis, and OB; transvaginal probe, cardiac phased array, high frequency linear for small parts and vascular systems – arrived and the training began.

“Echo training was vital. Heart problems that would be repaired in the U.S. linger for children and teens in Kenya due to a lack of resources,” says Cheryl. “I saw two cases of ventricular septal defects –  congenital holes in the heart – in a five-year-old and a 19-year-old. Also, rheumatic fever is common here, as in other tropical countries, sometimes causing mitral valve damage to the heart.”

Cheryl paid $1,000 tuition for Eva, a Litein sonographer, to receive echo training in Nairobi. While the support was appreciated, doctors insisted that Cheryl conduct scans of the heart, too. Cheryl consented, as the need was desperate. She received training in Holland Hospital’s echo department in 2019 before returning to Kapsowar on her second mission trip to Kenya in 2020. “With only one X-ray machine and one ultrasound machine for imaging, I had to give it a try, she says. “Ultrasound was the best option”

Cheryl Boodt International Assistance 6

“I worked with the hospital administrator in Litein to get a second ultrasound machine for echo because sonographers were trying to do 20 exams a day with one machine,” she says.

In addition to enhancing electrocardiography services at the hospital, Cheryl also updated the hospital’s list of ultrasound exams, what they included, and appropriate indications. She taught the physicians how to order exams over the full gamut. She also instructed the medical staff on vascular ultrasound, protocols for exams, and proper ultrasound techniques.

Expanding her scope of service to Rwanda
In the first quarter of 2022, Cheryl and Tom returned to Kapsowar and Litein and ventured a new direction, their first trip to Rwanda. Rwanda is a landlocked country about the size of the state of Maryland (much smaller than Kenya, which is about the size of Texas). It’s home to five volcanoes and numerous lakes and rivers. Lake Victoria and a stretch of Tanzania lie between Kenya and Rwanda.

Once again, Cheryl packed her own enhanced sonography education for her fourth trip to the African continent. “In the fall of 2021, I stood in for a Grand Valley professor on sabbatical and taught advanced abdominal sonography, which encompassed ultrasound of the lungs, salivary glands, and musculoskeletal system. My knowledge was limited so I worked hard researching and designing my instruction. What a gift this turned out to be for my mission work in Rwanda,” says Cheryl.

While Rwanda and Kenya suffer a shortage of doctors, equipment, and financial resources for residents to get the care they need, there is no shortage of knowledge, skill, and finesse among these African people. “I am basically a one language and one modality gal,” says Cheryl. “Many of my African colleagues are trilingual, do X-rays and ultrasounds, build their own dwellings by hand, and have mastered much in their lives. I am humbled by them.”

Cheryl Boodt International Assistance 2

Cheryl and Tom worked at Kibogora Hospital, a 280-bed facility, from January 11 to February 4, alongside the single radiographer. Next, their itinerary called for a month in Kapsowar and a month in Litein before returning to the U.S. in early April.

Cheryl Boodt International Assistance 4

Cheryl hopes her story will inspire all sonographers and sonography students to pursue international service, with its profuse kaleidoscope of value and vitality added to their careers. In ways she never could have predicted, sonography and sonographic learning are transforming people who were once worlds apart but now deeply invested in each other’s lives and future.

And, so, ends chapter four for Cheryl in a story that likely will go on, as long as healthcare partners nurture the dream, serendipity opens doors, and puppies magically appear.