Helping everyone, everywhere in the world benefit from advances in MRI technology

 

Prof. Derek Jones, Director of CUBRIC (Cardiff University Brain Research Imaging Centre, in Cardiff, Wales UK) and MRI legend, is currently Vice-President of ISMRM, which means he will become President at the Business Meeting in Toronto. In this interview, he tells us about the newest, most exciting initiative from our Society’s leadership: an unprecedented effort to improve the accessibility of MR hardware, education and knowledge on a global basis, starting with Africa. Dr. Udunna Anazodo, Assistant Professor in the Department of Neurology and Neurosurgery, and also a member of the Neuroimaging and Neuroinformatics research group at The Neuro, in Montreal, also gives an overview of the events that eventually led to the birth of the ISMRM African Chapter.

 

MRMH: Had you ever been to Africa before undertaking this new adventure?

Derek: Yes, I was lucky enough to first go to Kenya when I won a TV competition as a teenager. I’d been to Egypt as a student, and South Africa on honeymoon, but I never would have imagined that I’d come back one day in any official capacity, helping our Society to democratise MRI.

MRMH: How did it all start? Derek: I remember it well. It was about 7 am on the 9th May in London, and I was attending the 31st ISMRM Annual Meeting. In the ISMRM’s EDI forum “Axes of Inclusion”, I heard Prof. Udunna Anazodo and Prof. Godwin Ogbole discussing magnetic resonance in Africa and what they felt was needed. I was struck by a comment that it wasn’t more MRI hardware that African countries needed to progress in the field. MRMH: What else do they need then? Derek: The speakers emphasised the importance of proper training in order to effectively utilise machinery, particularly in the medical field. A lack of structured training programs has led to a scarcity of trained personnel in Africa, causing a ‘brain drain’ as talented individuals seek education and opportunities abroad, often never returning. This has created a cycle of fewer experts and training centres, perpetuating the problem. However, they also shared their dream of having skilled personnel, teachers, and experts in Africa to exchange knowledge with local users. I was totally captivated by what they were saying. This is definitely a complex issue, but we’re a Society of around 8000 members who can pull together to help out. For the next few mornings at breakfast in the hotel, I eagerly recounted the forum and how we could help with early-risers like Andrew Webb, a crucial founder of CAMERA (https://www.cameramriafrica.org/) and Jim Pipe, a former President and AMPC Chair, and I was grateful for their patience and willingness to hear me out as we discussed potential solutions

MRMH: What’s the matter?

Derek: The ISMRM community is acutely aware that the geographical distribution of its membership is heavily skewed towards North America and Europe, which make up the majority of what is often referred to as ‘The Global North’. Access to MR hardware and MR education across the globe is similarly imbalanced, meaning that a significant proportion of the world’s population continues to miss out. I guess this bias might influence the implicit assumptions our members make when considering new MR projects. These might have a significant impact on where, and how, these ideas are tested, and the speed at which new solutions and discoveries can be applied for the benefit of the global population. As an aside, I love the anecdote that Andrew Webb shared with me. Andrew had designed a portable low field MRI scanner in Leiden in the Netherlands and then went to Uganda to collaborate with engineers in Mbarara. They soon discovered that the soil in Mbarara has a much higher percentage of iron ore than the local soil in Leiden! Who knew soil could be so ‘attractive’? We’ve got to approach our work with a global perspective and consider its implications and benefits for all communities, not just those in our immediate vicinity. To quote Udunna at the first EDI Forum at the Annual Meeting in 2019, “MRI is W.E.I.R.D.” (i.e., found mostly in Western, Educated, Industrialised, Rich and Democratic countries).

MRMH: So you want to maintain one part of MRI’s weirdness? Just the “D” and go W.I.L.D. (Working In-Unison, Leading to Democratization)?

Derek: Ha! I love that! But to go truly W.I.L.D, we need a full Society effort and we need people driving the initiative from within Africa. This is one of the main reasons I went to Cape Town in January, to join a roundtable discussion about the formation of an African Chapter of the ISMRM. Prof. Udunna Anazodo flew in from Montreal, Prof. Johnes Obungoloch from Mbarara, Uganda, Prof. Godwin Ogbole flew from Nigeria, and ‘locals’ Prof. Leon van Rensburg from the University of the Western Cape and Prof Ernesta Meintjes from the University of Cape Town, joined Roberta Kravitz (our Executive Director), Anne-Marie Kahrovic (our Associate Executive Director), and Scott Reeder (our current President) for a very productive roundtable discussion about bringing the African ISMRM Chapter to fruition, with Johnes Obungoloch as the Chair (I pronounce my last name the same way Johnes pronounces his first name, or is it vice-versa?). The Cape Town meeting was successful and, to conclude, the Toronto Annual Meeting will be the first one for the African ISMRM Chapter!

MRMH: You may not be among the first proponents of the African Chapter, but you are definitely a protagonist of what comes next. Can you tell us more? Derek: You’re right. I definitely shouldn’t take any credit for the African Chapter. The process for that started way before I got involved. But, when I agreed to go on the ballot as President, I said I wanted to put the “I” into ‘ISMRM’ and make the Society truly international. This means starting with the Annual Meeting. While the formation of the African Chapter is going to build community and strength across Africa, we need to get more people from the Global South participating in our Annual Meeting, contributing new perspectives and benefiting from, and contributing to, the excellent educational content of the meeting. Going back to that EDI Forum in London, it was humbling to recognize the privilege that attending the Annual Scientific Meeting represents for only a small handful of Africans, who often face significant obstacles in accessing opportunities for education and career advancement. Flying to the other side of the world is a luxury that puts our Annual Meeting quite literally out of reach. Yet, participating fully in an international community of MR users offers tangible benefits beyond the warm feeling of belonging to something larger. Unfortunately, in regions such as Africa, parts of Asia, and South America, this level of engagement was not occurring. So it was time for a change.

MRMH: So what did you do?

Derek: I was keen to see what could be done to make our annual meeting more accessible and to expand our membership, and this led to a ‘two-pronged’ attack. First, as you’ll have seen in the ‘twin blogs’ from Scott Reeder and me back in April, we’re going to be holding our first ever Annual Meeting in Africa, in Cape Town in 2026! The founders of the African Chapter have confirmed that this will massively increase accessibility for people in Africa. We visited the conference centre during our visit in January, and it’s a beautiful facility in a stunningly beautiful location. I know the entire membership is going to love going there. But 2026 is a long way off, and I’m impatient. So I’m even more excited that the Bill and Melinda Gates Foundation (BMGF) agreed to enter into a Strategic Partnership with the ISMRM for a multi-phase approach to democratizing MRI. Under the ‘UNITY’ programme, BMGF are already very active in Africa (as well as Pakistan, India and Bangladesh), in supporting the use of lowfield MRI to understand the first 1000 day of life. While we were in Cape Town, we visited our colleagues in ‘CUBIC’ who are using both low-field and high-field (3T) MRI to study development. Back to the Partnership. In Phase 1, the BMGF are going to fully sponsor a diverse group of 100 people, who come from all across Africa, working in different domains (such as: radiologists, radiographers, physicists, and engineers), and balanced across genders and senior and junior status, to come to our Annual Meeting for the first time in Toronto this June. We will welcome them at the Newbie Reception on the Saturday night, where each will be paired with a mentor for the duration of the meeting and the following year. We’ll then have a full-day meeting after the ISMRM to hear from our invitees, getting advice on the next phase in democratising MRI.

MRMH: How do you put the plan to “democratise MRI” into action?

Derek: Well that leads nicely into Phase 2. It would be so easy to sit in my office chair in Cardiff and say “I know what’s best there”, but that’s obviously not true. We needed to hear the voices and the opinions of those with ‘the lived experience’ of working in Africa, and this could only be done by visiting the countries involved. So in April, I formed part of an “Africa tour” comprising ISMRM members and BMGF staff, visiting 5 sites in 3 countries over 2 weeks, visiting existing MRI sites and meeting groups in Blantyre and Zomba (Malawi), Kampala and Mbarara (Uganda), Kisumu (Kenya) with the team going on to Accra and Kintampo (Ghana), and this has helped us put plans in place for after Toronto.

MRMH: What will happen after Toronto then?

Derek: A second thing was said in the EDI forum in London: “It is not effective to take somebody out of a country and pop them in a different context to be trained. What would be really effective is to provide training and support in situ”, and that’s what will keep us busy in the coming year! We have set the challenge to break the barriers that prevent us so far to provide training, knowledge exchange and education in situ. That’s where Phase 2 comes in. With support from BMGF, in the next year we’re going to pilot some ‘Knowledge Exchange Fellowships’. These will support people from the sites we visited in Africa in April to spend time training in high income settings, but CRITICALLY – they will also support our members from HIC settings to spend time in Africa, at those sites, exchanging knowledge and helping to improve MRI, whether it’s the hardware, data acquisition, image processing or interpretation. Working closely with BMGF, and following the Fellowship pilots in 2023/2024, I hope to announce the next phase in our journey at the 32nd ISMRM Annual meeting in Singapore 2024 - stay tuned!! Administering this is going to take some work, but I’m part of a fellowship of truly motivated people including Roberta Kravitz (Executive Director of the ISMRM Central Office), Scott Reeder (current ISMRM President) and Anne-Marie Kahrovic (Associate Executive Director of the ISMRM Central Office). We’ve got excellent leadership and experience from the African ISMRM Chapter, a Partnership with the Bill and Melinda Gates Foundation, and a commitment from the ISMRM Central Office to help administer the Fellowship scheme. But we will need more help – and this is where the volunteerism of the members of the ISMRM Society that we know and love will come to the fore! We strongly believe that this is just the first step for the ISMRM community. Our hope is not only to have created momentum in Africa, but to have established a blueprint of a model that can be applied to democratize MRI technology in other parts of the world. As the President for only a year, I recognize that I can only do so much. However, my ambition is to inspire and motivate others to think about what can be done in other parts of the world, including Latin America and Southeast Asia. This is my vision, and I am confident that through our collective efforts we can make a significant impact in increasing access to MRI technology worldwide.

MRMH: A final message from the incoming President to the ISMRM members:

Derek: We’re an amazing Society. The ISMRM thrives on people’s ideas and time for volunteering, and that’s what makes our Society flourish and evolve year after year. To anybody who is reading the interview, and who has an idea but is unsure about proposing it, I would say: you’re completely encouraged to get in touch with me to discuss it! I can’t guarantee to be able to implement and support every proposal, but I’m always ready to listen.

 

See original document HERE, on Page 7-10 of 64.