Building CT confidence in Vanuatu

Recognising the limited resources Port Vila Central Hospital had, I ensured my training was ultimately a sustainable tool for better healthcare for the country. To support them beyond my visit, I created a CT protocol handbook tailored to their equipment, environment, patient demographic and clinical needs. It included images of positioning, scanning parameters and reconstruction settings – something tangible and practical that they could reference long after I had left. I also implemented a quality assurance programme to help maintain the safe operation of the CT scanner. Additionally, I developed a ‘referral to CT’ pathway, approved by the radiologist, which enables MITs to ensure all CT scans are appropriately justified according to the clinical question.

One of the main challenges I faced on my trip was the emotional reality of limited healthcare access in Vanuatu. A large proportion of patients requiring CT presented with advanced disease. Because of the local geography, people often need to travel long distances by boat or plane from remote islands, and therefore only seek care when their symptoms become impossible to ignore. Moreover, there is a strong cultural belief in traditional medical practices and reluctance to visit hospitals. As a result, I was often confronted by patients with late-stage, potentially treatable conditions, who hadn’t had the chance to be diagnosed earlier.

On top of that, CT scans aren’t free in Vanuatu. In a country where many people live on subsistence farming, paying for a scan isn’t always possible. For example, a CT of a chest, abdomen and pelvis costs the equivalent of £150 for a local or £250 for a ‘non-citizen’. The harsh reality was that a CT scan in Vanuatu was often financially out of reach for those who needed it most.

Despite the challenges, this experience was easily the most rewarding thing I’ve ever done. The MITs were so responsive and receptive to the training and had been eagerly anticipating my visit. They felt frustrated that they had been expected to operate the CT scanner without any training. Throughout the two weeks, they were keen to apply theory to practice, try new techniques and optimise pathways to ensure high-quality patient care. Watching their confidence grow over the two weeks was genuinely moving. In the feedback I obtained on the last day of training, a technician wrote: “I can’t believe how much I’ve learned in just two weeks.” Another wrote: “This has positively impacted my operation of CT and patient safety.” For me, the positive feedback validated everything: the weeks of planning, the long-haul flights and the uncertainty of stepping into a brand-new environment.

One of my proudest moments came when we finalised the CT protocol handbook together and I presented it to the allied service manager. We worked on it as a group – it was a symbol of what can be achieved when knowledge is shared with mutual respect and collaboration.

Learning wasn’t limited to the CT department. Every day, the team made me feel like part of the team. They brought in fresh fruit from their gardens – papaya (or ‘popo’), cassava, bananas, avocados and cucumbers. We shared lunches, swapped stories and laughed about the differences in our daily routines (the concept of a 1.5-hour London commute was always a source of entertainment for them, when most had short walks to the hospital). I learned so much about the Ni-Vanuatu people (or ‘ni-Van’) – a term used to refer to the native population of Vanuatu. I was shown the local markets and social spots by the MITs who astounded me with their generosity and laid-back attitudes – something I have endeavoured to bring back with me to the UK. I quickly learned that Vanuatu operates on ‘island time’, where there’s no rush and schedules are more of a guideline than a rule.

Another key lesson I learned was just how transferable radiographic principles are. CT physics, scanning techniques and optimisation strategies are universal. The real challenge is adapting those principles to different settings. This made clear to me that the goal isn’t to transplant a western model of care, it’s to equip local teams with the tools to make radiology work in their context, often just by enabling them to do the best that they can.

The introduction of the CT scanner has already begun to change healthcare in Vanuatu. Previously, patients who needed CT imaging had to travel overseas, usually to Fiji. Now, they can be scanned locally, saving not only money but also time, which is often critical in diagnosis and treatment. While Port Vila is the only site with a scanner, it serves as a central hub. With a PACS system soon to be implemented, images can be shared with radiologists abroad, allowing for remote consultations and faster diagnoses. This digital leap will have a ripple effect across the archipelago, improving access and equity in healthcare delivery.

If you are considering a similar opportunity, I advise you to go prepared, but be ready to let go of your expectations. I brought so many printed materials and resources as I genuinely had no idea what to expect, including whether I would even have wifi! Accept that you may be working alone and embrace that independence. It will be one of the most rewarding things you ever do. Volunteering in Vanuatu stretched me professionally and personally. It reminded me why I chose radiography, and what it means to serve others through healthcare. I kept a diary during the trip – a tip I would now give to anyone considering volunteering. Even now, reading it brings those moments back to life.