Today was a long day, but we are very pleased.  It is nearly 9 pm, and I finally had a chance to take a shower and cool off.  Arose before dawn and got some of my own work done as well as a little work for MIMAs.  We headed over to breakfast after sunrise, where we had hard boiled eggs and a large meatball-shaped starch made primarily of unsweet plantain.  

As I referenced a couple weeks ago, Geordano’s family is hosting our meals here in Angoteros, with his wife Lizabetta in charge of the cooking.  This next picture shows their oldest daughter in front of the indoor cooking fire-pit.  And here is her captivating younger sister, who loves to play on the floor. 

We got back to the maternity house to set up, expecting our pregnant volunteers to arrive around 11 am for the VSI OB protocols.  I think they may have been eager to have ultrasound evaluations performed to confirm their babies were healthy and doing well, because they arrived two hours early.  So, we switched up our training plans and dove into training specific to the OB sweeps for VSI.  My team was on top of their game and really shined, so we quickly moved to testing the trainees’ comprehension, where I conducted VSI sweeps and made intentional mistakes – some more obvious, and some very difficult to spot.  They really enjoyed learning this way, and I think it helped train them to collaborate and assist each other once we are no longer with them.  From there, we began training on how to use the MIT capture and transmit box. 

Once we completed the training, Brian (Dr. Garra) performed actual pre-natal imaging sweeps for evaluation.  Once Dr. Garra had completed his examinations, we went back to reviewing and redoing the right upper quadrant VSI protocols that we had trained on the day before.  By this point, everyone was mentally exhausted and hungry.  Here are three of the four trainees taking a mental break.

After breaking for lunch, we stopped at the tiendita for some treats for the students.  You can see Leslie’s excitement at finding something with chocolate – I think her happiness is self-evident. 

As we continued the training, this time using the transducer connected to the ultrasound system and the MIT box, our trainees were immediately energized once they saw actual ultrasound images appearing on the screens, and understood that the protocols were actually working.   

It rained during the afternoon, cooling the day off…probably in the low 80’s for a while, but by late afternoon, the temperature had crept back up with high humidity.  The result of the storm was very beautiful skies as evening came on.  These pictures show the skies from the area right outside the maternity house, and where we sleep at night.  

Lizabetta had washed some of our clothes earlier that day, but I think they got caught out in the rain.  With the humidity so high, clothes certainly do not dry well – but I think these were a little beyond the dampness we expected.  Still – the clothes were clean – so we hung them up all around the clinic, stretched over chairs, beds, broom handles, and anything else we could find. 

Today we trained only the four clinicians who will be doing the day-to-day scanning – this includes Bryan, Beatrice, and Geordano from here at Angoteros, and Jens from Santa Clotilde (three of whom are pictured above).  I would have loved to get to know their stories better – but communication is somewhat limited between us with my limited Spanish and their non-existent English.  

We finally finished scanning about 7:30 pm.  After cleaning up and setting up the system for data transmission, we went over to dinner.  Fried eggs and fried plantains.  Our hunger tonight was particularly intense.  Like the other night, there was a group of kids which included some neighbor children watching television.  I think the youngsters are getting more used to seeing us – and not as much as scary novelties.  They actually smile now and seemed happy to interact with us.  

Tomorrow, we move into the clinic with the equipment and begin transmitting cases using the standard, normal workflow.  I think they are ready – which as I stated in the opening, makes us very pleased.  

After the long day, and not sleeping too well last night, I am ready for the power to go out, forcing the day into a state of closure.  It is amazing to hear.  The moment the power turns off, all artificial humming of fan motors and lights, music from the distant houses, and (our) typing sounds cease.  The result is a quiet that allows us to hear nature’s symphony of various insects chirping in the night. There are definitely a few advantages to being so far removed from “the grid.”

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) 

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.