What does medical physics mean for a small, lesser developed nation; the case of Paraguay

Paraguay is in many ways a typical example of the small, relatively undeveloped nation of the world. It is centrally located in the South American continent, with an area the size of California and a population of five million. The political, financial and industrial center of gravity is the capital city of Asuncion with a population of 1.2 million. Major health problems include a high infant mortality rate and goiter. However, as is the case in most industrialized nations, cancer is the second leading cause of death behind cardiovascular disorders. Adequate medical diagnostics capability exists, but only in Asuncion, and then only in the private sector. Available equipment includes two high field, superconducting MRI units, 11 CT scanners of which 3 are helical, 6 planar gamma cameras, 2 SPECT units and two DSA units. Therapy equipment includes 2 cobalt units and two 6 MeV photon linear accelerators. No simulator or computerized treatment planning equipment exists. Calibration of the therapy machines is performed at acceptable international standards. There are only 3 practising, licensed medical physicists in the country, and the role of the medical physicist is still poorly understood by health officials, the medical community and the general public. Clearly however, the type of equipment being used and the number of procedures being performed establish the need for many more qualified medical physicists. The Physics Department at the National University is considering the possibility of opening a training course in this field in the near future. The Ministry of Health and the International Atomic Energy Agency (IAEA) would be potential financial sponsors. The IAEA has provided crucial assistance in establishing, and gaining recognition for, the role of the medical physicist in Paraguay. This assistance has taken many forms including fellowships for local physicists, the donation of dosimetry and health physics apparatus, and a vigorous foreign expert exchange program. Based mostly on personal travel and other information, the author concludes that this picture may be representative of the situation in many small and lesser developed nations of the world