Chanel Fischetti assists a nurse colleague at a remote clinic in Lebakeng, Lesotho, in using point-of-care ultrasound for fetal scanning.

Brigham emergency physician Chanel Fischetti, MD, has been passionate about point-of-care ultrasound (POCUS) since she was introduced to the practice in medical school. Inexpensive and portable, the versatile technology enables patients to undergo an ultrasound wherever they are being treated — whether that is in a hospital bed or a rural village.

In the U.S., the technology is common — often found in emergency rooms and obstetrical clinics — because training opportunities are plentiful. But in resource-poor areas of the world, where POCUS has the potential to make an even broader impact, its use is far less prevalent. That is partly because training programs are far less accessible.

This inequity has motivated Fischetti to bring POCUS training to areas of the world with some of the greatest need — most recently in Lesotho, a small, land-locked country in Southern Africa where the disease burden is high and average life expectancy is just 52 years for men and women.

“CT scanners and MRIs are incredibly uncommon and also very expensive,” Fischetti said. “But ultrasound is one of the most affordable and ubiquitous imaging modalities, both therapeutically and diagnostically, and it forwards no radiation. I deeply believe in the power of ultrasound to transform, start to democratize and even the playing field for health care.”

Supported by a Fulbright Specialist Scholarship, which pairs academics and professionals with a host institution for a two to six-week experience abroad to share their expertise, Fischetti traveled to Lesotho from Jan. 16 to Jan. 31 in collaboration with Partners In Health, a global health and social justice organization that provides quality health care to the world’s most impoverished and marginalized people. Together, they conducted a needs assessment on the country and developed a curated POCUS curriculum for providers there.

The project was ambitious. Supporting 10 sites throughout the country over just two weeks, Fischetti would sometimes find herself teaching three lectures in a day.

“Some of the sites are so rural that it takes five to seven hours just to drive to them,” Fischetti said. “We worked with the Lesotho Defense Force, which flew us out on their military helicopters just to go to these sites, which was terrifying but amazing.”

Despite the demands of her work, Fischetti found her time in Lesotho as an educator humbling and took away several lessons herself. She reflected on how rewarding it was to work alongside colleagues from all over the continent. Lesotho is one of the 11 countries in Africa without any medical schools.

“I never take my education for granted,” Fischetti said. “This kind of experience certainly makes you aware of the system that you work in and the opportunities that you have even just to have a ‘normal’ family unit or a job in the country you want to be in.”

As someone who has previously done global health work, Fischetti said was very conscious about making sure the work she was doing in Lesotho wasn’t a “Band-Aid” but a lasting solution to the lack of training programs in country.

“You never want to leave a country and be like, ‘OK, well, they have to wait until next year for me to come back,’” Fischetti said, “The goal is long-term sustainability and accountability, and Partners In Health is an organization that really does what they say. They have long-term roots and relationships in these countries.”

While her time in Lesotho was short, Fischetti was able to accomplish her goal of enabling long-term proficiency with POCUS.

“The doctors’ confidence grew so much in the two weeks I was there with things like how to hold the probe, where to find the kidney and how to look at the heart,” she said. “I even have a few colleagues who have reached out to me after my trip who want to go and continue to build on the work that I’ve started, which is amazing.”