Images Bring Hope

In a corner of Rebecca Ludwig's office is a growing tower of donated books, lead aprons, and other radiologic supplies destined for areas where they might be needed. Ludwig is an assistant professor of radiologic technology and a doctoral candidate in health sciences technology at the University of Arkansas for Medical Sciences (UAMS) in Little Rock. She also volunteers in countries where electricity and running water are recent or hoped-for innovations, and radiologic education is desperately needed.

A Long Road to Learning

In the mid-1990s, a colleague recommended Ludwig to International Aid, a non-profit organization that offers medical care to developing countries. The organization was interested in Ludwig because of her teaching credentials: she had been teaching since 1988 and had been performing diagnostic imaging procedures since 1975.

When International Aid first asked Ludwig to go to Taxila, Pakistan, she declined. "I was a single mom, working full-time, with two boys in school, and I was running a bed-and-breakfast," she says. Six months later, in 1996, International Aid asked again, and, this time, a friend urged her to go – promising to care for her children and for her bed-and-breakfast.

The six-week experience changed her in ways she could not have imagined. "It opened a new sense of the world for me," says Ludwig. "People in Pakistan don't come to the doctor until it's almost too late and their conditions are far advanced." The hospital's facilities were also a shock. Patients have to rent their hospital beds, are made to sleep in huge wards, and – if they cannot pay for medical services – are turned away.

Frequently, several patients undergo X-ray procedures in the same room, at the same time. "Family members stay in the X-ray room. I had them go to the far side of the room, but then I had to let it go. It hit me that their dose was much less than ours because it was so seldom that they or anyone in their family had a radiologic procedure," she explains. Family members accompany each other in most situations in Pakistan: "It's a cultural expectation. It means they care about each other."

When Ludwig first arrived, her primary objective was to train four men who had no previous formal education in radiology. Word soon spread that an X-ray teacher had come, and many more people came to learn from her. "It was a humbling experience. People traveled by foot, oxen cart, bus, and train. People traveled longer to come to the seminar than it took me to fly to Taxila – one man traveled for 36 hours."

"I love this X-ray!"

The next time International Aid called (in 2000), they wanted Ludwig to go to the mountain village of La Union, Lempura, in Honduras – a difficult six-hour drive from the capital, Tegucigalpa. The region is home to 27,000 Hondurans with some of the lowest per capita incomes in the country; there is only one medical facility in the area. By this time, Ludwig's children were now adults living on their own, and Ludwig had completed a Master's degree in education and was remarried. Her husband decided to accompany her to Honduras. His presence proved to be almost as useful as Ludwig's. A practical man, he fixed almost anything, from gas refrigerators to centrifuges. The people from the clinic did not want to let him go. "They told me they hoped I would come back. They told him they weren't going to let him leave."

"The people were very poor. But every day as we walked down the road to the clinic, people would come out of their homes and offer us something – a boiled egg, an orange, or a pineapple drink," she says. "They were sharing with us all they had."

The clinic recently had the good fortune of receiving a donated, refurbished Toshiba capacitor discharge mobile unit, but no one knew how to use it. For the first time since the ravages of Hurricane Mitch in 1998, Lempura would have electricity and the ability to produce diagnostic images. It was Ludwig's task to teach all five of the clinic's staff, including the physician, the basic principles of radiography.

The first time the equipment was put to the test was during a patient's difficult labor. "I was hand-tanking the film and praying like crazy that I was going to have an image – that it was going to turn out. When I came out of the darkroom, I held up the X-ray, and we could see the position of the baby. The doctor shouted, 'I love this X-ray!'"

Researching Radiology

Joseph Bittengle, Ludwig's department chair at UAMS, says her international accomplishments are an asset to the program because they help set diagnostic imaging into a dramatic perspective for students. Ludwig is looking forward to another overseas assignment, but she will wait until after she finishes her doctoral dissertation.

Ludwig is happy to share her experiences with other students. "I love this profession because it requires lifelong learning to stay current with the technology. It never gets boring. What we are teaching our students now is night and day from what we taught them 10 years ago," she says. "I tell students they won't leave the program knowing everything they need to know, but they will know how to find the answers."

For an updated story about Rebecca Ludwig, see: Respect the Techs.

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