Alternatives to WHIS-RAD units fall short

Providing low-cost, high-quality x-ray units was the goal behind development of the WHO's basic radiology system. The WHIS-RAD isn't the only game in town, however. Several alternatives, along with their drawbacks, are discussed on the Park Ridge, IL, Rotary Club's WHIS-RAD Web site (www.rotarywhis-rad.org).

- Used equipment. Radiology departments due for an upgrade may decide to scratch their philanthropic itch while discarding old equipment. But departments usually upgrade because their old equipment has exhausted most of its usefulness. Also, the original equipment may not be adaptable to power outages or lack of radiological expertise in the developing nations to which it is likely to be donated.

- Inexpensive equipment. Extremely inexpensive x-ray units are available, but the old adage "You get what you pay for" applies. Cheaper units may be based on outmoded technology, lack versatility, and break down frequently. Obviously, areas without funds to purchase state-of-the-art equipment will not have the funds to repair unreliable equipment.

- New and advanced x-ray equipment. Potential donors must consider the conditions in the recipient's hospital and locale. It is not particularly useful to able to diagnose breast cancer, for instance, in a region without the basic healthcare infrastructure to treat breast cancer. Additionally, advanced equipment may be too complex for facilities that lack trained radiologists and radiographers.

"It should be clear that any assistance donations should be adequate and appropriate for a specific situation. MRI, interventional radiology procedures, and even CT may be totally out of place in many countries. What is needed is basic, general-purpose radiology in addition to general-purpose ultrasonography- not even Doppler," said Dr. Harald Ostensen of the WHO.