Sprawls helps developing
countries achieve healthy images
Seeing is believing-and in medicine, "seeing" can mean the
difference between life and death. X-rays and all sorts of other imaging
procedures are allowing doctors to "see" from without more clearly
and diagnose more accurately what ails within.
But doctors in less developed areas of the world often lack the training
and equipment to properly image patients and make complete diagnoses. Helping
these doctors "see" more clearly has become a life's passion for
After 36 years as a medical physicist in the School of Medicine, in 1997
Sprawls requested a half-time appointment so he could concentrate more fully
on improving the practice of medicine in developing nations. Patients, doctors
and scientists in India, China, Brazil, Estonia, Panama and Malaysia have
already benefited from Sprawls' determined efforts.
During his years as a full-time professor in the department of radiology
and as director of the department's division of radiological sciences, Sprawls
became an internationally recognized authority in the field of medical imaging.
His renown in diagnostic quality improvement in radiology was the reason
health care agencies and institutions from around the world began seeking
He now works to help health care systems in developing countries put
in place programs and procedures to improve the quality of medical imaging.
This often involves the training of medical personnel, creating quality
assurance programs and developing infrastructures to support quality improvements.
The ultimate goal is to help doctors make the best diagnoses.
"An effective diagnosis is one that can detect a disease, such as
cancer, at an early stage-when there is the best chance of effective treatment
and patient survival," Sprawls said. "This is very dependent on
the quality of the diagnostic imaging process."
Sprawls has found that approaches to imaging improvement vary in developing
countries according to national economy, organization of the health care
delivery system, types of medical and medical science education and political
factors. In Estonia, for example, the health care system has been emerging
from Soviet domination since the country's independence in 1991.
"In the former Soviet Union we are trying to develop a new approach
to the concept of quality," Sprawls said. "We are trying to foster
the notion that quality is less a bureaucratic requirement and more a professional
and social responsibility. This is a paradigm shift that takes time to develop
in some societies.
"There are advantages to working with smaller countries such as
Estonia, Panama and Malaysia, in that we have a better chance of affecting
national policy and programs with respect to quality issues. The larger
and more populous countries such as India and China, however, offer the
opportunity to reach more people. Still, the full implementation of quality
improvement procedures will require extensive national efforts. In the larger
countries, we are working more toward the development of pilot programs
and demonstration projects in selected areas."
Sprawls' most ambitious program to date is in China at Xian Medical University.
Several years ago he worked with the university president and faculty to
identify needs that might be met through cooperative efforts with Emory;
one of those specific needs was for physicians trained in medical imaging
diagnostic procedures. This resulted in the development of the Emory University-Xian
Medical University Cooperative Program in Medical Imaging Education, a unique
model in which about 12 top Chinese students are selected to pursue intensive
training in radiology during their final year of medical study.
Two classes have graduated and a third will graduate in July. According
to a recent report by Ren Humin, president of Xian University and a major
supporter of the program, graduates are in high demand throughout China.
Sprawls personally teaches each class in Xian, and several of his Emory
colleagues have taught in Xian and provided special training for Xian faculty
who have visited Emory.
Sprawls is involved in three other projects aimed at improving the quality
of medical care around the world. He directs the College of Medical Physics
at an intensive training institute in Trieste, Italy, sponsored by UNESCO
(United Nations Educational, Scientific and Cultural Organization). Physicians
and medical scientists gather at the institute for special training that
allows them to update their skills and bring new knowledge back to colleagues
in their home countries.
In addition, the family-sponsored Sprawls Educational Foundation makes
grants to provide educational materials, instructional media and equipment
for programs in developing countries-all to support training in contemporary
diagnostic imaging methods and quality improvement techniques. The foundation
has planted seeds for future growth in more than 20 countries.
Several years ago Sprawls developed a partnership program in which medical
scientists in the United States partner with a developing nation to provide
resources and collaborative support. About 25 active partnerships are now
in existence. Sprawls has also begun traveling on the information superhighway-he
is developing an Internet-based program to support the personal on-site
work he is pursuing in remote and not-so-remote corners of the world.
to May 4, 1998 Contents Page