By Scott Harris
According to the medics, the lines seemed to stretch on forever. At clinics in towns just across the Ukrainian border in Poland, countless Ukrainian refugees who were injured defending or fleeing their homes now stood in queues for hours hoping to receive medical care. Back home, many had loved ones experiencing exactly the same thing in the country under Russian attack.
As the patients arrived one after another, clinicians, some fresh out of school, were forced to make life-altering decisions for their patients at a rapid pace. Making matters worse, they had only a fraction of the clinical materials and tech that much of the world takes for granted, like CT scans that offer detailed images of inside the body. But a fresh view recently changed that — and it’s making a dramatic difference for Ukrainians in harm’s way.
Nahreen Ahmed, MD, MPH, a physician with Penn Medicine, is an expert in training physicians and other care providers around the world in using ultrasound machines to assess injuries and other health concerns. Widely known as the technology that allows pregnant women and obstetric teams to see a developing baby inside the womb, ultrasounds can help clinicians gain insight into just about any area of the body.
“Ultrasound interventions go a long way,” said Ahmed, an assistant professor of clinical medicine at the Perelman School of Medicine at the University of Pennsylvania and a scholar with the school’s Center for Global Health. “You can see the heart, the liver, the stomach, the blood vessels, the list goes on. You can see what’s going on without needing a more intensive test which is often not available in the first place.”
Through training both in-person and virtually, Ahmed has taught hundreds of clinicians how to use ultrasound equipment in emergency areas, conflict zones, refugee settlements, and many other places with few resources. She has also provided training in acute and critical care for patients in dangerous and unstable settings around the world. Trainees include many who are currently working in Ukraine, in addition to others in areas of Asia, the Middle East, and South America. For these efforts, she recently received the Robert Suskind and Leslie Lewinter-Suskind Faculty Global Health Award, which honors a Perelman School of Medicine faculty member who exemplifies a lifelong commitment to improving global health and access to care through training partnerships.
“There is no question that Nahreen’s energy, foresight, enthusiasm, and creativity make her more than deserving of this award,” said Robert Suskind, MD, who has served as a dean of three medical schools and in 1963 graduated from Penn’s school of medicine. “Leslie and I are so happy to congratulate Nahreen on this accomplishment. Through her activities in Ukraine and Bangladesh and so many other places, she has made a difference in critical care and as an expert in the use of ultrasound at the bedside.”
Ahmed’s current career trajectory began in 2018 in the city of Dhaka, Bangladesh, a South Asian nation with a population of roughly 165 million. A second-generation Bangladeshi-American, Ahmed created the Bangladesh Ultrasound Initiative, which has now provided ultrasound training to more than 150 physicians working in resource-limited settings.
Ultrasound is a good fit for these settings, Ahmed said, because the technology is accurate, versatile, and highly portable.
“Ultrasound machines are so small now that you can carry one in your pocket,” she said. “These days, pretty much any clinician can conduct an ultrasound, if trained properly, and use it to identify some of the pathology in the body and make a clinical decision.”
While in Bangladesh, Ahmed traveled to the Kutupalong refugee camp, comprised mainly of Rohingya Muslims, an ethnic group brutally persecuted for their religious beliefs and displaced from their native home of Myanmar. Upon seeing the conditions, Ahmed transferred to the refugee camp — the world’s largest, numbering more than 700,000 Rohingya — to care directly for the people there.
“There was a lot of dirt, a lot of tents and tin homes, all of which could be destroyed in a mudslide during Bangladesh’s monsoon season,” she recalled. “I was concerned about clean water and the damage to infrastructure that could occur during storm season.”
Working on a dirt floor in a tiny clinic made of bamboo, Ahmed and her fellow clinicians distributed medication and key services to refugees living in squalid conditions.
“Dysentery and diarrheal diseases were huge problems,” Ahmed said. “Another major problem was PTSD, based on what they’d experienced. But they said they would rather stay in the camp — would rather die, in fact — than go back to Myanmar. This was all quite overwhelming to me as someone who was new to seeing the effects of conflict, that human beings could be treated this way just because of their religion and background.”
Since then, the training Ahmed provides in ultrasound and in acute and critical care have taken her work to global conflict zones and mass-migration areas all over the world, including in Yemen, Gaza, Syria, Sierra Leone, Colombia, and Venezuela. The impact she provides, and her motivation to serve in unstable and dangerous areas, have left an impression on her colleagues.
“Dr. Ahmed is a consummate clinician and educator,” said Penn Medicine pulmonologist Jason Christie, MD, who nominated Ahmed for the award. “She bravely dives into a crisis and has maximal impact at key times, such as teaching point-of-care ultrasound diagnostics to medics in the Ukraine war. I firmly believe that her work has saved many lives.”