Inside the daily reality, challenges and hopes of radiographers across Ghana

Eight hours on the road for an MRI scan that may take less than one.

For some patients in Ghana, medical imaging is not just an appointment.

It is a journey — often starting before sunrise, from a northern region to a hospital in Kumasi or Accra, with the hope of finally getting answers.

By Anita Nsiah Donkor — Diagnostic Radiographer (Actual View Diagnostics), Research/Teaching Assistant (University for Development Studies, Tamale, Ghana). Part of the Fourier Crew & Volunteer Everything MRI.

By the time patients reach the radiology department, they and their families may already be tired, anxious, and facing additional costs. And still, one uncertainty remains: Will the scanner be available when they arrive?

For radiographers in Ghana, situations like this are part of a daily reality shaped by high patient demand, limited resources, unpredictable equipment availability, and the constant responsibility to keep care moving — even when circumstances are far from ideal.

Radiology in Ghana is about much more than operating imaging equipment. It means adapting quickly, reassuring anxious patients and relatives, making decisions under pressure, and providing essential diagnostic information for people who may have travelled hours in search of answers.

In this article, we take a closer look at the everyday work of radiographers in Ghana. From ultrasound, CT, and MRI to equipment downtime, patient positioning, radiation protection, and the growing opportunities ahead, this field report offers an inside perspective on the challenges, resilience, and hope shaping medical imaging across the country.

Content

1. GENERAL OVERVIEW OF RADIOLOGY IN GHANA

A "Normal" Work Day

ULTRASOUND

COMPUTED TOMOGRAPHY (CT)

MAGNETIC RESONANCE IMAGING (MRI)

2. SPECIAL CHALLENGES IN DAILY PRACTICE

3. RESOURCE-LIMITED SETTINGS : POSITIONING, PATIENT EXPERIENCE AND RADIATION PROTECTION

4. OUTLOOK: OPPORTUNITIES AND GROWTH IN RADIOLOGY IN GHANA

REFERENCES

1. General Overview of Radiology in Ghana

Medical imaging in Ghana has developed significantly over the years, driven by a growing demand for accurate diagnosis and better clinical decision-making. As healthcare needs continue to rise, radiology professionals are taking on an increasingly important role in supporting patient care, often while working under high pressure and with limited resources.

Today, the country’s imaging landscape includes a broad range of modalities such as general radiography (X-ray), dental imaging, mammography, Computed Tomography (CT), fluoroscopy, interventional radiology, Magnetic Resonance Imaging (MRI), ultrasound, and nuclear medicine. While modern technologies are available, access is not evenly distributed across the country. Advanced systems are more commonly found in larger cities, while many regional areas still face limited imaging options. (Bour et al., 2022)

In everyday practice, ultrasound and conventional X-ray remain the most widely used modalities in both public and private healthcare facilities. Their affordability, accessibility, and versatility make them essential tools for daily diagnosis. From obstetric examinations to trauma imaging, these systems often form the backbone of radiology services across Ghana.

Image 1: Rad.Ahmed positioning a patient for a Chest X-ray at Living waters hospital, Kumasi, Ghana. Courtesy of Anita Nsiah Donkor.

MRI, by contrast, remains one of the least accessible imaging modalities. Limited scanner availability means that many patients must travel long distances to reach facilities offering MRI services, often in urban centers such as Accra or Kumasi. For some patients, this can mean additional cost, delays in diagnosis, and longer waiting times before treatment can begin.

This contrast between growing medical demand and uneven access defines much of radiology in Ghana today. Yet despite these challenges, imaging professionals continue to deliver essential diagnostic services with resilience, adaptability, and commitment every single day.

A “Normal” Work Day

A normal shift in radiology may begin early in the morning and continue into the evening, depending on staffing levels, patient demand, and emergency workload. In my experience, shifts are often dynamic, especially in busy facilities where patient flow is unpredictable.

On some days, I move between different imaging modalities, while on others, a structured schedule can quickly change within minutes when emergency cases arise. There have been instances where a calm day suddenly turned into a series of urgent cases. At times, unexpected challenges such as equipment breakdowns or power outages further complicate workflow, requiring quick adaptation and teamwork.

Ultrasound

Ultrasound is one of the most widely used imaging modalities in Ghana due to its affordability, portability, and safety. It plays an essential role in obstetrics, pelvic imaging, abdominal, doppler examinations, and emergency care. In many hospitals and diagnostic centers, ultrasound is often one of the first imaging tools available to support fast clinical décisions. If a patient complains of abdominal or pelvic pain it does not look surprising if they are referred to the ultrasonography unit first.

What makes ultrasound especially important in Ghana is its flexibility. In both urban and rural settings, radiographers frequently take an active role in performing examinations, particularly where sonographers or radiologists are limited in number, this is because most radiographers are taught ultrasonography as part of their courses at the university, others like myself go as far as learning the practical aspect to standout, this means you can have a radiographer who can operate almost all equipments available at a facility.

Image 2: Rad. Anita Nsiah Donkor performing a Doppler usg on a patient at Actual View Diagnostics, Kumasi, Ghana. Courtesy of Anita Nsiah Donkor.

Most mornings in my facility begin with obstetric and anomaly scans, followed by pelvic examinations or emergency cases arriving without notice.

On one occasion, I managed multiple urgent cases at the same time, including patients with severe abdominal pain and complications from unsafe procedures. As the only imaging professional on duty, I had to quickly prioritize cases, calm anxious relatives, and work closely with nurses to stabilize patients before completing the scans.

In another instance, a patient lost consciousness during an examination, which required immediate attention before the scan could continue. Situations like this highlight how unpredictable and demanding ultrasound practice can be.

At the same time, ultrasound offers some of the most rewarding moments. I remember a couple who had struggled with fertility for years. During the scan, we discovered a multiple pregnancy. The room quickly filled with emotion as they realized what this meant for them. Moments like these remind us of the human impact behind every image

Computed Tomography (CT)

Computed Tomography (CT) plays a critical role in emergency and trauma imaging in Ghana, particularly in larger urban hospitals. It is widely used for the rapid assessment of head injuries, stroke, fractures, and internal bleeding, where speed can make a life-changing difference.

In many departments, CT is one of the busiest areas. A radiographer may scan accident victims, suspected stroke patients, oncology follow-ups, and routine outpatient referrals all within the same shift. Balancing high patient volumes with precise image acquisition and radiation dose optimization requires constant focus and efficiency.

Image 3: Rad. Ahmed Yakukubu, positioning a patient for a Head CT scan at Living waters hospital, Kumasi, Ghana. Courtesy of Anita Nsiah Donkor.

Access to CT is still limited in most peri-urban and rural regions. Patients are often referred to urban facilities in regions like Kumasi, Accra or Tamale which can mean long travel times and delayed care. It is not uncommon for patients to arrive after traveling several hours (3-7) for a single examination. There have been instances where patients travel several hours for a CT scan, only to face delays due to equipment challenges. In one case during my clinical training, a patient required urgent imaging, but the scanner developed a fault mid-process. The patient had to be transferred immediately to another facility, highlighting how critical equipment reliability is in emergency care.

Experiences like this reflect the real impact of limited resources on patient outcomes and the difficult situations healthcare professionals sometimes face.

Certain injury patterns may also reflect local realities. Road traffic accidents, motorcycle injuries, and untreated conditions presenting at a later stage can create imaging cases that radiographers in Ghana encounter. Most patients in Northern Ghana prefer, their injuries to be treated locally, this increases their risk of infection, some come to the imaging center after the situation gets out of hands and mount pressure on imaging professionals and healthcare professionals as a whole.

Another challenge comes when a scanner is temporarily unavailable. If CT downtime occurs, pressure rises immediately, referrals increase elsewhere, and urgent patients may need to wait or be transferred. I had an experience when the power went out during a critical examination of a boy whose abscess was being drained from his brain at the CT unit, the patient was immediately transferred to a different unit for the examination to proceed, luckily he is alive.

Magnetic Resonance Imaging (MRI)

Magnetic Resonance Imaging (MRI) remains one of the least accessible imaging modalities in Ghana due to high acquisition costs, maintenance demands, and limited scanner numbers. Yet despite these barriers, MRI is indispensable for evaluating neurological, musculoskeletal, and soft tissue conditions.

Image 4: A functioning MRI machine at the Okomfo Anokye Teaching Hospital, Kumasi, Ghana. Courtesy of Anita Nsiah Donkor.

Because MRI availability is limited, appointment schedules are often full and waiting lists can be long. Some patients travel long distances for MRI examinations that may take less than an hour but require an entire day of planning and transport. I have encountered patients who traveled over eight hours from northern regions to access MRI services in Kumasi. These long journeys can delay diagnosis and treatment, especially when combined with waiting times and transportation challenges.

MRI work also requires strong communication skills. Many patients experience anxiety due to the noise, long scan times, or claustrophobia. Radiographers must often calm nervous patients, explain the process clearly, and create trust before the examination even begins.

In a typical MRI shift, patient care goes far beyond pressing buttons. It includes positioning, safety screening, monitoring comfort, reducing movement, and helping patients remain calm enough to complete the scan successfully. In settings where scanner time is precious, every successful examination matters.

2. Special Challenges in Daily Practice

When the Scanner Stops: Equipment Downtime and Its Impact

One of the most significant challenges in radiology practice in Ghana is the frequent downtime of imaging equipment. When a scanner is unavailable, the effects are felt immediately: appointments are delayed, urgent cases become more difficult to manage, and pressure on healthcare staff rises quickly.

In many cases, downtime is not caused by a single issue, but by a combination of systemic challenges. Preventive maintenance programs are often limited, meaning some machines are repaired only after a breakdown has already occurred. A shortage of biomedical engineers and technical specialists can further delay servicing, especially as the number of imaging systems continues to grow (Asamoah et al., 2025).

Another common difficulty is access to spare parts. Many facilities rely on international suppliers, which can lead to long waiting times, high import costs, and uncertainty around repair schedules. Limited maintenance budgets may also force hospitals to postpone servicing until a problem becomes critical.

For patients, the consequences can be serious. If a CT or MRI scanner is down, they may need to travel to another city or private facility, often at significant personal cost. For trauma, stroke, or oncology patients, even short delays can affect diagnosis and treatment pathways:

From my own experience, I have seen this impact directly. Our MRI scanner has been out of service for years, which means patients are often referred to private health facilities in southern Ghana when public-sector MRI access is unavailable. Whenever our CT scanner breaks down, which happens frequently, we usually have to refer patients to different private facilities. This increases costs and waiting times, and in urgent cases, can affect a patient’s chance of survival.

For radiographers, downtime often means adapting quickly. Workloads shift, frustrated patients need reassurance, schedules must be reorganized, and alternative imaging options may need to be considered. Over time, repeated equipment failures can affect morale and place additional strain on already busy departments.

Despite these difficulties, radiology professionals across Ghana continue to keep services running through flexibility, teamwork, and determination.

3. Resource-Limited Settings : Positioning, Patient Experience and Radiation Protection

Radiology practice in Ghana is often carried out in resource-limited settings, where challenges related to patient positioning, patient experience, and radiation protection can significantly influence the quality of care. Despite these limitations, radiographers continue to provide essential diagnostic services every day with adaptability and professionalism.

Image 5: Rad. Ahmed Yakubu positioning a patient for a head X-ray examination at Living Waters Hospital, Kumasi, Ghana. Courtesy of Anita Nsiah Donkor.

Proper patient positioning is critical for accurate diagnosis, but it can be difficult to achieve in many facilities. The limited availability of immobilization devices and positioning aids makes it more challenging to position patients effectively, particularly in trauma, pediatric, or unstable cases. As a result, radiographers often need to improvise in order to obtain the required images. In some situations, this may lead to repeat exposures and increased radiation dose to patients.

Patient cooperation is another important factor. Discomfort during positioning, long waiting times, pain, or anxiety during procedures can all affect how well patients are able to follow instructions. In busy departments, this can make image acquisition more difficult and place additional pressure on workflow.

Radiation protection also remains a critical concern. While many radiographers demonstrate good knowledge of radiation safety principles, consistent implementation can be challenging in practice. Factors such as workload, departmental routines, institutional policies, and the availability of protective equipment all play a role (Abubakari et al., 2026).

Basic protective devices such as lead aprons are commonly available in many facilities. However, other important items including thyroid shields, lead gloves, and protective goggles may be limited in supply. In addition, personal monitoring devices such as thermoluminescent dosimeter (TLD) badges are not always used consistently.

These gaps can affect both patient and staff safety. Medical radiation protection is an important aspect of quality care, and limited access to protective equipment, combined with occasional repeat exposures, may increase the risk of unnecessary radiation exposure. Continued training, improved equipment availability, and stronger enforcement of safety protocols would help further strengthen radiology practice across Ghana (Antwi & Kyei, 2015).

4. Outlook: Opportunities and Growth in Radiology in Ghana

Despite the challenges facing radiology in Ghana, the field continues to evolve with clear opportunities for growth. Demand for diagnostic imaging is steadily increasing, driven by population growth, expanding healthcare needs, and greater awareness of the importance of early diagnosis. This creates a strong foundation for the continued expansion of radiology services across the country.

Encouraging progress is also being seen in education and professional training. Universities and training institutions continue to develop qualified radiographers and sonographers, while ongoing professional development helps practitioners build expertise in specialized areas (Antwi et al., 2015). A strong and well-trained workforce will remain one of the most important pillars of future progress.

Technology offers another major opportunity. The continued adoption of digital imaging, teleradiology, and emerging tools such as artificial intelligence could significantly improve workflow efficiency, reduce pressure on healthcare professionals, and expand access to imaging services in both urban and rural communities. These developments have the potential to narrow long-standing gaps in healthcare access.

Investment will also play a key role. Increased support from both the public and private sectors can improve access to modern equipment while ensuring better maintenance of existing systems. In addition, partnerships with international organizations may contribute to training, knowledge exchange, and infrastructure development.

Improving radiation safety practices remains equally important. Continued education, better access to protective equipment, and stronger implementation of safety standards will help protect both patients and healthcare workers while raising the overall quality of care.

Radiology in Ghana has already come a long way. With continued investment, education, innovation, and the dedication of its healthcare professionals, the future holds strong potential. The profession is well positioned to play an even greater role in improving healthcare outcomes across the country in the years ahead.

Image 6: An image of Medical Imaging Students graduating from the University for Development Studies, Tamale, Ghana. Courtesy of Anita Nsiah Donkor.

References

Abubakari, I.-D. O. M., Asasu, I. M., Tigbee, I., Awortwe, A., Addai, D., & Mumuni, A. N. (2026). Knowledge Level and Radiation Protection Practices Among Radiographers in Northern Ghana. https://doi.org/10.21203/rs.3.rs-8633408/v1

Antwi WK, K. K. (2015). Evidence-Based Practice in Radiography: Attitudes, Beliefs, Knowledge and Practices of Radiographers in Ghana. OMICS Journal of Radiology, 04(01). https://doi.org/10.4172/2167-7964.1000176

Asamoah, R. A., Dzreke, C., Dzreke, E., & Kanzin, D. (2025). The silent epidemic: Equipment maintenance failures and patient outcomes in Ghana’s healthcare system. Advanced Research Journal, 10(1). https://doi.org/10.71350/3062192586

Bour, B. K., Sosu, E. K., Hasford, F., Gyekye, P. K., Achel, D. G., Faanu, A., Amoako, J. K., & Pitcher, R. D. (2022). National inventory of authorized diagnostic imaging equipment in Ghana: data as of September 2020. Pan African Medical Journal, 41. https://doi.org/10.11604/pamj.2022.41.301.30635

W. K., A. (2015). The Need for Good Radiation Protection in Diagnostic Imaging in Ghana. Clinical Medicine Research, 4(3), 42. https://doi.org/10.11648/j.cmr.s.2015040301.19