Imaging's training supremo proves a tough act to follow

October 1, 2007

It was always going to be hard to find a replacement for Dr. Harald Ostensen, who was in charge of diagnostic imaging at the Geneva-based World Health Organization between February 1998 and his retirement in July 2007. Very few people are suited to spending more than half of their time on the road, operating on their own under often-grueling conditions in impoverished nations, surviving on a tight budget, and working within a bureaucratic organization. Furthermore, the best person for the job is probably a radiologist, but very little incentive exists to leave clinical practice for such a challenging post.

It was always going to be hard to find a replacement for Dr. Harald Ostensen, who was in charge of diagnostic imaging at the Geneva-based World Health Organization between February 1998 and his retirement in July 2007. Very few people are suited to spending more than half of their time on the road, operating on their own under often-grueling conditions in impoverished nations, surviving on a tight budget, and working within a bureaucratic organization. Furthermore, the best person for the job is probably a radiologist, but very little incentive exists to leave clinical practice for such a challenging post.

Faced with this dilemma, senior managers at WHO appear to have taken the easy option and decided not to replace Ostensen. They have not yet advertised the vacancy for a coordinator of the Diagnostic Imaging and Laboratory Technology Branch, and unless they respond to growing external pressure, the resources may be redeployed to other medical device projects.

The International Society of Radiology is leading the campaign to ensure that WHO does not abandon its imaging-related activities. The European Society of Radiology, RSNA, American College of Radiology, and other bodies have already given their support. In his letter of 22 June to WHO director general Margaret Chan, ISR president Prof. Claude Manelfe encouraged Chan to recruit a successor to Ostensen and carry on the training scheme he championed.

"We write as the world organization of diagnostic radiologists to urge the continuation of a program on medical education. Your program has been vital to so many worldwide programs, and any diminution or loss would be catastrophic for efforts to improve medical imaging in most parts of Africa and Southeast Asia," he wrote.

If the post remains vacant indefinitely, patients in developing countries will suffer. A huge education gap still exists among radiologists and radiographers, and without WHO's practical and inexpensive courses and training manuals, their needs will not be met. If there is no support from Geneva, the four centers of excellence established by Ostensen in Cameroon, Fiji, Kenya, and Tanzania may well disintegrate, and valuable momentum will be lost.

The fact remains, however, that there is no obvious successor to Ostensen. Given the demanding nature of the work and the unique set of qualities required for the appointee, it is perhaps understandable why WHO has been so reluctant to start the recruitment process, but this is not a legitimate reason for failing to look for suitable individuals. Failing to even advertise the post during the past few months appears inexcusable.

Please contact me at di-europe@btconnect.com with your thoughts or suggestions on this important matter. In the meantime, the November edition of DI Europe will include a feature article about Ostensen's achievements.