Hastings Banda: An Interview with our Colleague in Malawi
Melissa Culp, Director of UNC Global Radiology, recently sat down with Mr. Hastings Banda, a radiographer and sonographer at Kamuzu Central Hospital (KCH) in Lilongwe, Malawi. Mr. Banda shared with Mrs. Culp his story of becoming a radiographer and ways he’s sought to advance radiography at KCH. He also described how UNC Global Radiology’s contributing support for ultrasound curriculum training for the hospital’s radiographers has impacted UNC Radiology’s international collaboration with KCH.
Melissa Culp: It’s great to talk with you today. Would you start by telling us about yourself?
Hastings Banda: My name is Hastings Isaac Banda, the 4th born in the family of 8, three men and five ladies. I grew up in the remote area of Kasungu district located within the central region of Malawi; about 124.5 kilometres north of the capital Lilongwe.
I began my school journey in Kasungu at Msawala Primary School. Then, I completed secondary school, like high school in the United States. Due to financial constraints, I completed a four-year course of secondary studies in three years. After secondary school, I attended my first college — Teachers College — and completed initial primary teacher education. Thereafter, joined the Radiography programme at the diploma level, graduating in 2013.
After working as a radiographer for the government from 2014 to 2016, I decided to go back to school for a baccalaureate degree in South Africa during 2017. Additionally, I completed a Point-of-Care Ultrasound Fundamentals Certificate from the Alliance for Physician Certification and Advancement. I have a post-graduate certificate in Leadership and Management in Health from the University of Washington. I completed both in 2019.
MPC: Why did you decide to become a radiographer and a sonographer?
HIB: When I was in secondary school, one of our favourite neighbours died of Kaposi’s sarcoma that started in the foot and was diagnosed at a late stage. That motivated me to be a radiographer.
After joining the radiography degree program, in my final year, I lost my mother due to late diagnosis of cervical cancer. At the time of diagnosis, she had both hepatic and lung metastases despite having multiple ultrasound scans. I believe that my mum’s case serves as a most likely representation of the general occurrences when it comes to diagnosis and prognosis of cancers in Malawi.
I decided to become more proactive. I wanted to be in a position to be able to raise a red flag toward early cancer diagnosis. This experience influenced my decision to pursue further education as a sonographer.
MPC: We met through the collaboration of the UNC Global Radiology, which is partnered with Kamuzu Central Hospital’s (KCH) Department of Radiology, RAD-AID International, and the Malawi Children’s Initiative. What has your role been in the collaboration, and how has the partnership impacted you?
HIB: Having only a few sonographers in the nation does not allow for early diagnosis in our population of around 19 million. It became apparent that more radiographers needed ultrasound training and education. To advance this goal, I volunteered to coordinate an ultrasound interest group with support from UNC Global Radiology, RAD-AID International, and Malawi Children’s Initiative.
To become a strong leader for local advancement of sonography education, I knew that I needed a formal degree in ultrasound, which requires a considerable amount of financial investment. To that end, I am completing a Master’s Degree in Diagnostic Ultrasound, with funding from UNC Global Radiology sponsors via Malawi Children’s Initiative and RAD-AID International.
UNC Global Radiology, RAD-AID International, and Gurnick Academy have been supporting an ultrasound curriculum training for a team of 11 Kamuzu Central Hospital radiographers to learn more about ultrasound. In the radiography diploma, there is no formal introduction to sonography. However, when we start working, we are supposed to perform ultrasound examinations. The training offered right at KCH using our usual machines has been the most needed and successful project to advance patient care improvement.
Once I have completed my formal degree and return to work at KCH, the team and I will continue to refine our protocols and processes so that workflow and standards at KCH are more efficiently higher as compared to the pre-training period.
In June 2021, I was accepted as an inaugural Global Ambassador for the POCUS Certification Academy of Inteleos, which acknowledges my leadership in education and training for healthcare providers in Malawi.
I am very grateful for the support to KCH as an entire department and specifically toward ultrasound team building and my formal degree in sonography. And many thanks to KCH radiology leadership for grooming me through their leadership and exposure.
MPC: Would you be able to share with us about a patient that has benefited already from your participation in formal education in ultrasound?
HIB: There was a 4-year-old boy from far north of the country who was scanned multiple times in the northern district and central hospital with a diagnosis of neuroblastoma with IVC thrombus. There is no functional CT in the north.
When the patient was referred to KCH for chemotherapy only (there is no radiotherapy yet in the country), the reports consistently had been stating an advanced and metastasized neuroblastoma. I did a follow-up, or confirmatory scan, to see if we agreed with the referred diagnosis. Our diagnosis was a large nephroblastoma, or Wilms tumour, with patent and free IVC. There were no hepatic focal lesions or prominent lymph nodes to suggest metastasis. The mass did not cross the midline, had no calcifications, and was well circumscribed with famous the ‘claw sign.’ I was confident that it was a Wilms tumour. Around the same time, we had received a thorough presentation from John Campbell and another one by Heather Jordan on the differences between neuroblastoma and nephroblastoma.
The child went to surgery, and the paediatric surgeon confirmed with us that it was a Wilms tumour. The child is currently well and healthy.
Diagnosis that leads to a change in patient management is critical in Malawi.
MPC: Is there anything else that you would like to share?
HIB: Since joining KCH in 2014, I have served on a number of committees and volunteered for different roles, including being a clinical mentor for students from the Malawi College of Health Sciences and a clinical coordinator for student technologists from UNC.
During 2015 and 2016, I traveled to Haukeland University Hospital in Norway for a six-month exchange program. While at the University of Johannesburg, I was class representative for international students in 2017.
I have a six-year-old daughter and a pet cat. I enjoy studying, leisure driving, following politics and current affairs, and I enjoy jokes in my native language of Chichewa.
My favorite quotes are:
‘The eye sees what the mind knows.’- John W. Budd (chapter title)
‘Tell me and I forget, teach me and I may remember, involve me and I learn.’ – Benjamin Franklin
Thank you to the faculty, staff, and residents of UNC Radiology who volunteer your time and give to support our global and local health equity initiatives! Appreciation to our Malawi collaboration partners—RAD-AID International and Malawi Children’s Initiative.
Best regards,
Melissa Culp, M.Ed., RT(R)(MR)
Director of UNC Global Radiology
UNC Department of Radiology