Rotary WHIS-RAD Project

The WHIS-RAD system

The development of WHIS-RAD began in 1975 at A Primary Care Radiological System meeting held by the Pan American Health Organization (PAHO). Because two-thirds of the world’s population does not have access to basic X-ray services, the objective of the session was to develop a way to deliver a low-cost, safe, reliable, easy-to-use X-ray system that would produce high quality images.

The result was the creation of a battery-operated X-ray unit with stepped mAs, kVp and fixed source-to-film distance. It was extensively clinically tested by the World Health Organization’s (WHO) for General and Continuing Education under the direction of Dr. Holger Pettersson at Lund University Hospital, Sweden previously headed by Dr. Thure Holm who oversaw the initial development and testing of the unit. Coordination of the program is provided by Dr. Harald Ostensen, Coordinator of Diagnostic Imaging and Laboratory Technology for , Switzerland who was preceded by Dr. Gerald P. Hansson who provided initial support for the program.

An outstanding set of manuals accompany each unit that describe how to perform procedures, interpret the results and process the film. These were written by Dr. Philip E.S. Palmer, the recipient of Radiological Society of North America’s (RSNA) Special Presidential Award in 2000 and Professor Emeritus of Radiology at the University of California. Dr. Palmer also is a WHO consultant and a primary advocate of the WHIS-RAD concept based on his years in, beginning in 1954 as an assistant radiologist in Bulawayo.

Today, three companies provide the WHIS-RAD unit to the specifications approved by the WHO: Philips Medical with its MRS system, and IMS of Bologna, Italy, with its Wizard system, and General Electric Medical with its BRX system. Costs are about $40,000 including installation and shipping.

Approximately 80,000 units are needed worldwide. Since 1975, about 1,500 units have been installed with fewer than half in operation today. WHO cites obstacles as capital cost; lack of revenues to fund maintenance, training, film and chemicals; and government/medical politics and corruption.

For qualified programs, matching fund grants are available from the Rotary International Foundation as well as most Rotary Districts.

WHY WHIS-RAD?

Rotarians have provided X-ray systems from a wide variety of sources over a number of years. Why should it be any different in the future?

WHIS-RAD was developed specifically for undeveloped and underserved areas of the world which have special requirements. The equipment has to provide high quality images, be safe to use, be reliable, easy to learn and simple. Additionally, it has to operate where power is unreliable and unavailable for periods of time. WHIS-RAD meets those requirements and has been successfully tested, deployed and clinically proven in a wide variety of situations. Training of medical personnel with the help and consultation of radiologists has to be simple and easy to understand.

Used Equipment-Frequently used equipment is available from  wealthier countries which is often shipped to under developed or underserved areas of the world. The difficulty with this solution is that the equipment has usually seen most of its useful life and is being sent to areas where service is hard to find and expensive. The equipment is likely more complex to meet the unique clinical demands of a more affluent and older patient base and training is not readily available nor the expertise available locally to run the equipment. There is likely no way to deal with power outages.

Inexpensive Equipment-Medical X-ray equipment can be purchased for as low as five thousand dollars. This equipment is usually based on decades old technology, has very limited application or versatility, is built cheaply and is therefore unreliable and the company providing it has little or no service or support capability. In addition, because of the design and application compromises made, the equipment can be dangerous for both patients and the operator. Training support is virtually non-existent.

New and/or advanced X-ray equipment. In most cases, the newer, more advanced X-ray equipment is designed for the large markets of the industrialized countries. This equipment usually is more complex with more features covering more applications. As a result, it requires special training, excellent service support, a cadre of experienced technologists and radiologists and an understanding of where and how to use the technology most effectively by both radiologist and clinician. It is expensive to acquire and the design does not anticipate power failures

While contributions based on these alternatives are well meaning, the gift can be of little or no value to the recipient and a real head ache beside.

WHIS-RAD is the best way to supply X-ray services for up to 50,000 people where no such service now exists.