“Airway, Breathing, Circulation” - thus begins the mantra that doctors use to aid people who are experiencing a life threatening event.   The first two address how air is entering and leaving the body. Looking at circulation, we are concerned about how blood flows to bring nutrients and air and take wastes from the whole body.

Both blood pressure and flow direction are important. Did you know that in the healthy arteries of your legs, the blood flows backwards briefly while the heart relaxes and refills? I didn’t until I started doing ultrasound. Using a portable Doppler flow device allows us to screen for abnormal flow direction and amount of flow while the heart is beating. We also are comparing the blood pressures of the arms and legs. This is called the ankle brachial index (ABI). Together these methods are a powerful early warning system for vessel disease.

In our setting many people have undiagnosed vessel disease. We recently found a woman with a severe blockage of blood flow to her arm using this method, even though she was only fifty. Her pressure in the left arm was only 57% of her right arm, and the flow was abnormal and weak. She will receive further evaluation and treatment. In India, researchers found that this was a good screening test for people who also had heart disease. If they get a concerning result on this test, they had an over 90% chance of having blockages to one or more heart vessels, which could lead to a heart attack. We have also found this to be true here in South Africa with our local people whose ancestors came from India.

After seeing how useful and simple it is to use this non-invasive screening test, we just purchased another unit for health builder use. Now we will be able to have two units operating side by side in our field screening settings. This will enhance service. We envision a nurse or doctor running one unit and an assistant running another unit nearby. If there are abnormal results with the assistant, they will be confirmed. Eventually the assistant will be able to operate more independently. With a diabetes rate of over 25% in 50 year old people here, this test picks up a lot of disease. The people are then encouraged to better care for their arteries, and they are encouraged to have their heart arteries looked into as well.   Our health builders can work with people over the long-term to help them develop healthy eating and exercise habits.

Thank you for supporting our efforts to provide intelligent service to people who need further attention and encouragement.