Today is our final day of training in Angoteros. We moved all the VSI imaging devices from the smaller maternity house into the main clinic. This required interchanging equipment and furniture between rooms within the clinic so that everything would fit, as well as for proximity to the hard-wire internet cable.
The irony was that when we connected the ethernet cable, there was no signal, so we went back to using wifi – …with upload and download speeds of approximately 0.18 Mbps. At times, I thought it would be faster to hand carry the one’s and zero’s from one location to another.
This and many other challenges remain. Hopefully, we can raise some funds or add sponsors over these coming months to cover expenses required to improve this system. We will consider Starlink as an option, but that adds monthly “overhead” (both literally and figuratively) to the project costs.
As we arrived at the maternity house, there was already an expectant mother waiting to be seen. We felt our students were now ready to perform full scans on actual patients, so Bryan stepped up to the plate and began scanning. We only gave him the smallest of suggestions for improvement.
Unfortunately, an unexpected complication arose almost immediately…the portable electricity generator had run out of gas. Since it was still early morning, there would be no electricity in the village until 6:00pm. The ultrasound system’s emergency power supply (UPS) kicked in and started beeping. Undeterred, Bryan continued the study. One of his sweeps did not go perfectly, but he calmly deleted it and redid the sweep. I anxiously followed the imaging system’s battery status bar rapidly contracting, worried that Bryan would run out of power before he finished. As a UPS is about to crash, it starts to beep more and more rapidly. We knew he had less than a minute or so to go, but Bryan finished the last sweep, hitting the final button needed to complete the study “James Bond-style”, seconds before the power went out. Remarkable.
We had to wait until more gas for the generator could be found. This experience has made it clear that one of this project’s future needs is to stabilize power delivery, which mirrors a similar challenge we faced in Uganda with Imaging the World (ITW). In the meantime, without power, the students practiced using the system while disconnected. Hours later, we resumed imaging after a few gallons of gasoline arrived.
Shortly after lunchtime, the heavens opened up with rain. I have included a video so that you can see what it’s like to be in a hut during a heavy rainstorm in the Amazon.
In the latter part of the afternoon, I gave the students a “review” test. It was designed more to emphasize the critical points I want them to remember, rather than to assess what they have learned. I felt like I could see what they had learned by watching the sweeps they performed and by reviewing the stored scans afterwards. Like most students, they wanted to get everything correct, and kept wanting more information. They of course all passed.
I wrote up a “cheat sheet” of key concepts, standards, and practices to remember, to be posted on the wall. OK – more precisely, I wrote up a draft in English and Leslie translated it to Spanish. We printed certificates for the four students to indicate that we now expected they would be able to perform sweeps on real patients, and that those sweeps would be directed to physicians in Santa Clotilde and/or in Iquitos for interpretation and feedback once this study is in full swing.
We were supposed to be finished training and over to Dommi’s house for snacks at 7:00 pm, but we did not finish until around 7:30pm. In celebration, we opened two cans of Italian tuna which we ate with Ritz-style crackers. That was an unexpected treat.
Walking in the dark towards Dommi’s house, we were pretty elated having survived the heat, humidity, bugs, bats, cold showers, lack of power, lack of internet, and limited food selection. Dommi was waiting for us, crying out a rowdy greeting – what an unbelievable spirit this woman has.
We again met Baptiste, along with another young man named Paul. Paul is extremely tall and has a mop of curly hair flopping above his head. He, like Gabriela and Dommi, is originally from Poland. Paul is a PhD and a professor in computer science. He has been motorcycling through Ecuador and just arrived by boat this morning. Apparently, he has known Dommi for many years. He comes periodically to assist with software projects to help her and the Vicariate, and to replenish her supplies. Today he carried a large canister of gas for cooking as well as giant bags of limes, herbs, and other provisions.
We formed a very eclectic group. At our table of six people, I believe there were over 10 languages that could be spoken. Of course, only a few would be recognized by anyone else at the table – but still it was interesting to have such a diverse group come together in the middle of one of the most remote parts of the world.
Dommi lit some candles – partly for effect and partly to keep the bugs away. In the center of the table, she had a single red candle. She then handed out palm husks, one to each of us. She started by praying and then each person was to state something for which they were grateful. Once that person finished, she would sing a song of praise. Then that person placed their husk near the center candle, ultimately producing what looked like a flower. Baptiste made a pitcher of basil-infused Mojitos – using bottled water so that we would not become ill. When that pitcher was finished, he made a second batch using the more conventional mint. (I think I know why Dommi likes having him around now.) Dommi also had fixed a plate of olives, some plantain chips, and a tuna fish salad with crackers. We sat in the candle light eating, joking, and laughing. Hard to imagine there is another world out there when you are so isolated and living in the moment.
At 9:45pm, everyone hastily departed, so we would get back to our rooms before the power went out. We had already mostly packed for the boat ride for tomorrow; we just had to get ready for bed. We made it back to the maternity house just minutes before the electricity went down. A very long but a very good day overall.
Our plan for tomorrow is to finalize a few things at the clinic, eat a quick breakfast, and head down to the riverbank to begin our boat ride back to Santa Clotilde.
Thank you for sharing this journey with me. Look for my next installment soon. Below are hyperlinks to the prior blogs on Bringing VSI Imaging to the Amazon of Peru:
BRINGING VSI IMAGING to the AMAZON of PERU (Intro/Chapter 1)
BRINGING VSI IMAGING to the AMAZON of PERU (Chapter 2)
BRINGING VSI IMAGING to the AMAZON of PERU (Chapter 3)
BRINGING VSI IMAGING to the AMAZON of PERU (Chapter 4)
BRINGING VSI IMAGING to the AMAZON of PERU (Chapter 5)
BRINGING VSI IMAGING to the AMAZON of PERU (Chapter 6)
BRINGING VSI IMAGING to the AMAZON of PERU (Chapter 7)
BRINGING VSI IMAGING to the AMAZON of PERU (Chapter 8)
BRINGING VSI IMAGING to the AMAZON of PERU (Chapter 9)
Frank Miele, MSEE , President of Pegasus Lectures, Inc. Frank graduated cum laude from Dartmouth College with a triple major in physics, mathematics, and engineering. While at Dartmouth, he was a Proctor Scholar and received citations for academic excellence in comparative literature, atomic physics and quantum mechanics, and real analysis. Frank was a research and design engineer and project leader, designing ultrasound equipment and electronics for more than ten years at Hewlett Packard Company. As a designer of ultrasound, he has lectured across the country to sonographers, physicians, engineers and students on myriad topics.
