Francisco Arredondo supports radiology in Central America

Latin America is usually portrayed as a troubled region with gaps between rich and poor as wide as the Amazon basin; an area where only a few have access to the latest technology. The situation is far more complex, however. Although Latin America is not rich in infrastructure or technological resources, it does have a wealth of outstanding, resourceful people. Dr. Francisco Arredondo Mendoza is one of them.

"Francisco is clearly a force in Latin American radiology politics," said Dr. William G. Bradley Jr., chair of radiology at the University of California, San Diego.

Arredondo is charismatic; people want to follow him or simply be around him. But much of his influence results from his force of character and the fact that he "gets it," Bradley said.

Arredondo's charm stems from his humility and empathy. Intellectual curiosity, a strong work ethic, and adaptability have helped him along the way, and a number of early challenges refined his character.

Soon after graduation from medical school in Guatemala in 1975, he began a residency in the U.S. That February, a major earthquake shook his country. Arredondo decided to return home and work as a volunteer resident at Roosevelt Hospital in Guatemala City. Amid disaster and misery, he began to hear the call of radiology.

"When I got back, radiology was the area where they needed the most help. There was a huge need to take and read film of injured people. Despite the chaos, I started to like what I was doing," he said.

As Arredondo worked in Guatemala for the remainder of that year, he made the decision to return to the U.S. to study radiology. But just as the quake revealed his vocation, another devastating shock tested his will to pursue it. His father died shortly before he was to leave for interviews at U.S. radiology departments.

"My family was very small-my parents, my younger brother, and myself-and I thought I just couldn't leave my family like that," he said. "My mother, who had always been a reserved and calm person, said, 'Your father wanted you to become a resident and get a postgraduate degree. You have to fulfill his wishes.' My heart was split in two. My mother was the key. She always pushed me forward."

OPTIMIZING RESOURCES

When Arredondo returned to Guatemala in the early 1980s, there were no radiology residency programs in the country, so he started the first one. Now his professional life revolves around three issues: educating residents, lobbying for radiologists' rights, and organizing and developing local and regional radiological societies.

"We need to continue to work so our local programs are well equipped, with access to books, communications systems on a par with today's technologies, and most important, with improved, specialized training," he said.

Raising awareness about the training programs abroad, getting students to apply, and bringing in qualified specialists from around the world are among his goals. But protecting radiologists' jobs is just as important as education. Until recently, for instance, it was not unusual for a person without medical training to hold a government job intended for a radiologist. Arredondo has been working closely with local political institutions to change that situation.

Integrating the Central American radiological societies has become a lifetime ambition. Arredondo is currently working to create the Central American Radiological Federation extending from Guatemala to Panama. Vendor support for Central American countries' radiological meetings or symposia has historically been sparse, since such support is generally based on a country's profit-making potential, he said. Bringing these countries together in a federation should give them more clout to negotiate collectively and benefit equally from vendors' largesse.

Arredondo's level of involvement is impressive. He is the president-elect of the International Society of Radiology and of the Guatemalan radiological society, a member of the RSNA's Committee on International Relations and Education and the Radiology Outreach Foundation, and a member of the European Congress of Radiology's International Scientific Committee. He has also chaired or joined a long list of local, regional, and international radiological and medical organizations, including the Interamerican College of Radiology (CIR) and the World Health Organization.

His motivation to participate actively in so many organizations is driven by a desire to channel attention and resources to where they are most needed. He is also eager to develop bonds of friendship and trust among intercontinental organizations.

"He worked intensely as a CIR executive and later as its president to bring Western Hemisphere radiologists closer together," said Dr. Francisco Quiroz, director of ultrasound at the Medical College of Wisconsin, where Arrendondo studied.

A key link within the RSNA, Arredondo will likely extend his influence even further when he becomes the ISR's president and will benefit Latin American radiology and radiologists, Quiroz said.

Despite the improvements his efforts have engendered, the region's economic realities and the technological gap between developed and underdeveloped countries haunt Arredondo. Acquiring new technology is often economically painful for radiologists in the region, particularly when new developments quickly make the technology obsolete.

"We can't keep up," he said. "On the other hand, this is stimulating. So I tell my students that even though we can't have the latest technology, we can't feel like underdogs all the time. We need to learn to use well what we have."