My comments are NOT intended to denigrate or criticize the worthwhile efforts of the people on this group. However, they are intended to provoke conversation. Unfortunately, I am leaving for Nigeria on Thursday, and so I will not be able to attend this seminar. I do however wish to congratulate Mr. Brunette on his work thus far. My undergraduate degree was in Electrical Engineering and I have an MBA. I have worked in software and telecommunications for over 15 years. I have also launched a non-profit organization and a for-profit business during that time. Most importantly, I am an African and I am acutely aware of the situation in African countries. I share all this, because my background gives me an opportunity to address some potential pitfalls that I see with all the technological solutions to Developing World problems. First of all, why are our efforts always focused on the rural users? Even in the urban areas, most of the population does not have access to ultrasound. Yes, even in the General Hospitals, the access to technological resources is limited. The clinicians are relying on experience and skill to save patients. Most patients by far utilize the public health facilities in the urban areas. Their quality of care is heavily influenced by the experience and skill level of the clinician. The bigger need is developing or modifying existing devices to work in those urban settings. Ultrasounds are designed to work with constant electricity. How can we adapt these devices to a battery-operated solution that requires one hour or less to charge? Secondly, where are the students from the Foster School of Business? As engineers and scientists, we cannot work in silos. We must work within inter-disciplinary environments in order to actually get our products into the hands of users. Microsoft was Paul Allen, Bill Gates and Steve Ballmer. Allen focused strictly on technology, Ballmer focused on Sales, Marketing and Business Strategy. Gates straddled both worlds. The same with Steve Wozniak and Steve Jobs. There is no enterprise that has thrived solely on technology. That’s a major problem I see with all these wonderful technological solutions that come across this group. There is no one focused on Sales or Marketing. The products have to be sold or the end-users will never see them. In my opinion, none of these efforts should be solo-efforts. >From the minute a project is proposed, an inter-disciplinary team should be formed to bring the product to market. Thirdly, it is a fundamental flaw to believe that we can drop technology into the hands of a user and the user will begin to use it. Think back to the days before computers, people had to attend secretarial school to learn how to type. There are very few people in this world that can learn to operate a computer or any other technological device right out of the box. In my experience donating computers to schools in Nigeria, we discovered that the schools that ultimately took advantage of the computers were the more affluent schools that had support infrastructure in place such as computer teachers. Handing a device to a midwife who is working in the field and expecting her to learn how to use the device on her own is a recipe for failure. The midwife is a member of that community, probably faced with the same challenges that the patients are facing. She has to get home and ensure that dinner is prepared before it becomes too dark. She has to ensure that school uniforms are washed for the next day and all the other mundane activities that is life in Africa. She’s not going to have time to self-study, and it’s not at the point of care that she’s going to scan through the integrated teaching help system. Ask yourself, how many times you click on “help”? Most developers will post a question to a Developer Forum or contact someone directly for help. In both instances, we’re looking for a human response to our questions. Again, I’m stressing the fact, that our technical solutions require human support systems or they will not have any mass adoption. Let me reiterate that I am not discounting the earnest desires of the scientists and engineers on this forum to address the world’s problems. I applaud your efforts and creative technological solutions. But, I must stress the obvious. Scientists and Engineers working alone cannot solve the Developing World’s problems. We need inter-disciplinary teams from the conception of the project in order to effect the kinds of dramatic change that we hope to achieve. There is an erroneous belief that we can solve the Developing World’s problems by addressing the needs of the rural communities. This is not the case. Most of the Developing World’s populations are congregated around urban areas and this is where we can have the biggest bang. One last thought. In the Western World, hospitals do not pay for medical equipment in full. Just as we always have to apply for a loan in order to purchase big-ticket items like cars and houses, hospitals have a financing plan that enables them to purchase all their medical equipment. Without a Credit Monitoring\Collection system in place, hospitals here would face the same challenges of Developing World health facilities. These Health Systems do not have the up-front cash to purchase Capital Equipment, no matter how cheap. The technological solution that may truly revolutionize the Developing World’s problems would be to develop technology that allows these devices to work on a pre-paid basis. Mobile phones were able to penetrate all reaches of Africa in a relatively short period of time, because they provided a pre-paid solution. The Mobile Broadband infrastructure already exists. Our technological solutions should leverage the existing communication and payment platforms to get these devices into the hands of the end-users. Kunle 515-771-6775 (cell) ________________________________ From: Nicola Dell <nixdell@cs.washington.edu> To: change@change.washington.edu Sent: Monday, March 26, 2012 9:39 AM Subject: [change] CORRECTION: Waylon Brunette on portable antenatal ultrasound for village midwifes. Sorry, the Change seminar is in CSE 203 (not 205 as I said before). On Mon, Mar 26, 2012 at 9:38 AM, Nicola Dell <nixdell@cs.washington.edu> wrote: This Thursday at Change Waylon Brunette will speak about his research on a portable antenatal ultrasound platform for village midwifes. Please note that the seminar will be in the Allen center, CSE 205. The room currently listed on the MyUW website (MOR 225) is incorrect.
While ultrasound imaging is an effective tool for identifying maternal mortality risk factors, it is nearly absent in many rural healthcare facilities in developing regions. The high costs of both equipment and required training are major barriers to adopting ultrasound; to address these barriers we designed an inexpensive ultrasound system composed of off-the-shelf hardware and custom software. To leverage existing healthcare systems commonly found in these contexts, we focused our efforts on increasing the diagnostic capabilities of midwives - often central medical figures in rural and low-income communities. To enable local midwives to identify high-risk conditions for referral to a better-equipped health care facility, we developed a low-cost, portable, easy-to-use ultrasound system. Compared to currently available ultrasound devices, we simplified the user workflow and interface while maintaining adequate functionality to allow midwives to detect three common obstetrical conditions: placenta previa, multiple gestations, and breech presentation. Specifically, the midwife's ultrasound system is designed to: support a solitary work environment, balance cost and features, present a minimal interface, enable easy customization through a modular design, provide appropriate scaffolding to assist the user, and include an integrated teaching help system. Complicated and expensive medical technologies are unlikely to meet the needs of users with limited opportunities for formal training and continuing education, so we created an appropriate integrated help system to supplement a midwife's conceptual and operational knowledge of diagnostic ultrasound. Through our fieldwork in Uganda and preliminary evaluations, we have found that in addition to the contextual reference material accessible during an exam, midwives need in-depth learning materials that can be accessed outside of a medical exam scenario. To evaluate whether or system was appropriate for identifying the three conditions, we tested the accuracy of ultrasound measurements, image quality, and the usability of our system by Ugandan midwives. The midwife's ultrasound system is designed to utilize existing local healthcare resources in order to create a sustainable solution that does not depend on telemedicine or other continuous foreign assistance. Waylon Brunette is a PhD student in the Department of Computer Science and Engineering at the University of Washington advised by Professor Gaetano Borriello. His research interests include mobile systems, leveraging smartphones and sensors to solve problems in healthcare, and designing systems that improve the lives of underserved populations in low-income regions. What: Waylon Brunette on portable antenatal ultrasound for village midwifes. Where: The Allen Center, CSE 203. When: Thursday, March 29th at 12 noon.
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