There are days and trips that can alter the course of your life, or at the least leave such an impression that you want to adapt and change – to become better, to make a difference, to give more than you thought possible and to change even what others may say you never can or never will.
My trip to Honduras, February 17-22 was one of those trips. It is perhaps for this reason that this blog entry has been so hard to write, and now comes (because it has to!) as I prepare to speak about our experience at the SIIM conference in Minneapolis, and the documentary of the trip premieres... (this brief documentary is available at http://www.itnonline.net/node/36993)
It is always a struggle to put into words the sights, sounds, smells, feelings and emotions that arise when you leave your comfort zone and go to a place that knows true need. How can you write about the people that you encounter that leave you humbled by their dedication and compassion for a people less fortunate, with no regard for personal or financial gain and do any justice at all to what they do and who they are? How do you write about the people you meet who you would expect, and quite frankly DESERVE, to be crying out in hopelessness and despair, but greet you instead with smiles, love and a desire to share?
The reality is – there are no words. So I’m simply going to write what I can and hope that as you read, you can dig deep down and imagine your most powerful moments – moments when you have been touched beyond belief by someone who took time to believe in you, to inspire you, or a memory and feeling so powerful that YOU were moved beyond words, and then read on with that feeling and perhaps together we can bring these oh-so surface-skimming words to life.
Life is really a circle and one thing leads to another. Chance encounters in one area often lead to profound opportunities in another if you are open to experiencing them. Such is the case with how Medweb got involved with Shoulder-to-Shoulder/Hombro a Hombro (S2S). It started with a chance meeting with a philanthropic-minded radiologist, Dr. Phillip Silberberg, at the Radiological Society of North America (RSNA) conference in November 2009. On January 14, Dr. Silberberg contacted us to ask if we would donate a PACS (Picture Archiving & Communications System) for the Roy y Melanie Sanders Regional Medical Clinic in Concepcion, Honduras – nearly 8-10 hours from the capital of Tegucigalpa (depending upon the roads) set to open on February 20th. We tend to get several inquires so at first it was just a “sure, we can do that using virtualPACS™, not an issue.” Done, next issue and back to Haiti relief and grant writing for Afghanistan and Pakistan – Or so I thought! Turns out, not with this group…
Impassioned and well-entrenched in the country for the past 20 years through grassroots volunteer efforts and a lot of “blood, sweat and tears,” I came to realize that this is no ordinary organization on any level. Their style of service and mission lead to a level of sustainability that is truly remarkable, and accordingly, they get results far beyond what their balance sheets say they can do. And so, a 5069 to Cincinnati Medical Center, virtualPACS for use in Honduras, and a plane ticket to Honduras for the final clinic set-up and grand opening later, and we were a part of this great effort.
Joining me in Honduras was an incredible team from S2S, as well as several other representatives from private organizations who Dr. Silberberg had also reached out to solicit donations for the clinic. To say that these individuals were amazing would be an understatement. Dedicated, sincere, knowledgeable and willing to pitch in anywhere – inspiring to the core.
Monte, our Senior Engineer, and a true genius was set to go with me, for as much as I would love to learn to be technical, I have just come to terms with the fact that I just am not. So instead I look up to and depend upon the true talents and genius of Medweb’s “Geek Power Corps” (or at least that’s what I’ll call them for now).
Upon landing in Tegucigalpa, however, I received a call from Monte that he had not been able to board the plane because his passport had been warped after he had gotten it wet during a philanthropic trip to Antigua the week before. Since getting to Concepcion would not be characterized as “easy”, there was really no way to get him there on time for the clinic opening in the next 36 hours. As a cold weight settled in my stomach, I sought to reassure the others that had traveled from near and far from this great assembled team that Suuurrreee... I can totally handle this. Absolutely under control. Ay yi yi.
Working on our side once we got to Concepcion, however, was the fact that the engineering machinations of a dedicated volunteer and all-around “MacGyver” of the highest order, Art Ranz, we had bandwidth. Hallelujah! I was saved! Monte was able to tunnel into the virtualPACS and set up the parameters needed, as well as help when some of the other partners needed assistance in integration. There IS a benefit to doing this all over the world – you learn to integrate and work with what you have under intense time pressures because lives are literally at stake. And
Monte really is one of the “best of the best.” He did things remotely that even folks on the ground could not make happen, for products that were not even ours, and literally worked around the clock to make it happen. Again, no words for the depth of respect and admiration I have for him! Good for me as well, was learning that I CAN do this and I know our stuff much better than I thought. It’s amazing what you realize and can do when you have to.
Realization #1: How Art managed to get the bandwidth he did, from a satellite at the price he got, should be recognized. While the solution needs more permanence (and some serious benefactors) it really shows the vision of what IS possible when people come together. Bandwidth does not have to be unattainable and it doesn’t have to be priced at blinding prices that aren’t sustainable, or place undue financial burden, in the long-term. Bandwidth = access to information and communications which means access to education, health, business opportunities and overall growth and stability. Calling all Power Geeks and philanthropic minded folks from the public and private sectors… Let’s find a way to get sustainable bandwidth here and in other places.
Realization #2 & Whole Bunch More: You can’t go into a place expecting to be “sustainable” right away. S2S has been “in country” for more than 20 years, and started with a single individual dedicated to making a difference – Dr. Jeffrey Heck – Founding Director of S2S. Dr. Heck’s legacy will last more than a lifetime, or even 3 or 4 lifetimes. His work, dedication and the dedication of his family is beyond inspiring. The model that S2S/HaH has built is ground-up. It incorporates a local organization that drives the day-to-day operations of the organization, and is focused and built on relationships with individuals. They also constantly strive to do more (build a clinic, build a school, provide supplies, support the local economy through job creation, etc. etc. etc.) S2S though is also realistic. They KNOW what can be done, what should be done, and how to get it done – and they know how to take it in stride when things go sideways, up and down or boomerang back and hit you over the head when you least expect it.
I was blessed to see the fruits of all their labor and love at this point. You could FEEL the energy as people poured in from all over the countryside to sit in the chairs and on the dirt hills surrounding the clinic. This was no ordinary day. The clinic opening represented more than just a medical center and that energy was palpable. The dream became a reality on that special day as the extraordinary efforts of so many were recognized, while still others who gave more than anyone thought possible stood quiet in the background – content to just FEEL the power of the place, without the need for recognition.
Concepcion, Honduras – this tiny impoverished area, neglected for so many years, now has a telemedicine and teleradiology program that rivals anything you will see anywhere – and at a price tag that is unbelievable – approaching zero cost to the organization (not including staff time). Donations from numerous private sector partners in addition to Medweb, public support (from the Honduran government), paid and volunteer leadership and effort at its finest, ongoing services and consultations from more than 20 medical institutions and universities throughout the U.S. – the impact is staggering. This is what you talk about in aid/humanitarian work – the dream you pursue and hope, but more often than not never achieve. THEY DID IT HERE. IT IS POSSIBLE. This is a MODEL for how to do it elsewhere, and best of all it is simple.
In saying this, I realize that I keep throwing the world “simple” around as if everything is easy. Let me make it clear that simple is not easy and simple does not mean that hard work is not involved. What it means is that sometimes we try to make things so horribly complex (guilty!) and think there is a magic bullet we just haven’t invented yet. The reality is hard work + dedication to the long haul + recognizing and seizing opportunities as they come + more hard work + more dedication + patience + attitude of love, compassion, and selflessness = Success. When people come together and feel a cause together, and commit to that cause – big or small – it will be resolved, change WILL happen. And it really is that simple.
I truly feel as if greatness was achieved in this corner of the world and beyond on this trip, and we were an ever-so-small piece of this. It was just that each small piece, each small contributor, led to a greater whole, better than any imagination or dream. And if it is achievable here, then it is achievable elsewhere – including war-torn and ravaged places such as Afghanistan, in countries ravaged by AIDS and famine in Africa, Asia and the Caribbean, to even places in the U.S. and Europe where poverty still exists (maybe not to the extent that we see in other areas – but there are still children who starve every day and we can do better).
We were privileged enough before we left to see the first two patients arrive at the clinic for treatment… The first was a 26 year-old male who had been injured in a motorcycle accident 9 months prior. Lucky to be alive, he had considerable pain and had lost the use of his left arm. Having heard about the clinic he and his family had traveled more than 10 hours overnight to get to the clinic – we were his last hope. He had been through a string of doctors who were not sure what to do. At first glance, it appeared that with some fundraising he could be sent to the U.S. for a “miracle surgery” to restore use of his arm. Using the portable X-ray donated by MinXray and the CR by iCRCo, the studies were sent through the Medweb virtualPACS to a neurospecialist in Miami. Unfortunately, sad news came back, and we were moved to tears as this man collapsed in his brother’s arms sobbing... Due to the length of time that had elapsed from the date of the accident, the recommendation was to amputate the arm above the elbow (which also meant that a prosthetic hand/arm would not be possible with current prosthetic technology). NEXT TIME we said though, it will not be the same here in this corner of the world… NEXT TIME, they will now have what they need to diagnose and treat – that is/was the positive. We may have been too late for him, but it will not be too late for someone else.
Our second case was a premature baby who had been born with a club foot. Lucky to have survived at all, they had been trying non-surgical options, such as casting to fix the foot, and really needed a true measure of the progress before contemplating surgical options that would strain the systems of this tiny infant. There were also concerns about other possible heart and organ defects and in addition to the x-ray on this precious little one, he was also given a pediatric ultrasound by volunteer ultrasound and PACS technicians/administrators from Kosair Children’s Hospital in Louisville, Kentucky. In this case, we had good news… no apparent defects AND the casting and current treatment strategy was working. One day, this little one would be running and playing and jumping just like all the others.
We really can do more. It is possible. It is attainable. And it’s not hard when we come together.
As most who know me know, one of my most favorite quotes and sources of inspiration is by Mother Teresa… “If you can’t feed a hundred people, then feed just one.” If all that can (and even many that think they can’t) “fed just one”, the waves would reverberate around the world, creating a sea of lasting change, health, prosperity and peace.
Thursday, July 8, 2010
Friday, February 19, 2010
Making a difference in Haiti...
Guest entry by Jeffrey Henry, Medweb Engineer in Port-a-Prince, Haiti (Tuesday, February 16, 2010)
I’m about to change someone’s world by printing them a 180 page X-ray user manual. He will be an X-ray tech the rest of his life, and probably be able to provide a much better home for his wife and child because of it.
In my not so humble opinion, this trip has been a resounding success. Ever since I set up the view station right next to the Medweb, the doctors have been running back and forth non stop from their patient to the PACS view station. It was awesome to see this. The Medweb PACS has truly helped people get their studies read in a timely fashion; it has enabled them to compare old X-rays to new ones, determine the rate at which people are healing, and decide if they can be discharged. I’m confident Medweb’s donation has helped reduce the length of time people are suffering, and has helped save some peoples lives.
I helped my new Haitian friend Fetner send all the old studies needed by the doctors one image at a time for review.
Before I leave, I am going to print out 1 copy of the Medweb plug-in user manual and staple it together and leave it near the View station for incoming doctors when I am not here. Come to think of it, I should train Fetner to train the Haitian docs. I love how things work out sometimes.
I definitely miss my home, friends and coworkers. If we are coming here on another trip, I will help make a drive to get donations. I cannot stress to you enough how much is needed here.
-Jeffery Henry
I’m about to change someone’s world by printing them a 180 page X-ray user manual. He will be an X-ray tech the rest of his life, and probably be able to provide a much better home for his wife and child because of it.
In my not so humble opinion, this trip has been a resounding success. Ever since I set up the view station right next to the Medweb, the doctors have been running back and forth non stop from their patient to the PACS view station. It was awesome to see this. The Medweb PACS has truly helped people get their studies read in a timely fashion; it has enabled them to compare old X-rays to new ones, determine the rate at which people are healing, and decide if they can be discharged. I’m confident Medweb’s donation has helped reduce the length of time people are suffering, and has helped save some peoples lives.
I helped my new Haitian friend Fetner send all the old studies needed by the doctors one image at a time for review.
Before I leave, I am going to print out 1 copy of the Medweb plug-in user manual and staple it together and leave it near the View station for incoming doctors when I am not here. Come to think of it, I should train Fetner to train the Haitian docs. I love how things work out sometimes.
I definitely miss my home, friends and coworkers. If we are coming here on another trip, I will help make a drive to get donations. I cannot stress to you enough how much is needed here.
-Jeffery Henry
PACS up and running in Haiti!
A Guest Entry from Jeffrey Henry, Medweb Engineer in Haiti (Monday, February 15, 2010)
The Univ. of Miami Medishare hospital has been running X-rays non-stop. I was able to get a view station set-up next the X-ray station in the adult tent. A local arrived who was trained in the machine and can take the X-rays and scan in the cartridges. The traffic here at the hospital has picked up. We are full; the massive rain last night caused schools to collapse and some people came in with major issues.
I have to say, the trip thru town was atrocious; the city is non-stop rubble with a lot of people living in tents made of bed sheets. The international response is everywhere, but at the same time, seemingly minimal. Every country with the capability to do so has sent something, but nothing comes close to the US presence.
I also got some great intel on how the medical efforts are going and where the needs are most vital and how this Medweb server in particular could be used most efficiently.
When I got back to the Miami Medishare facility, one of my laptops had been liberated and hooked up to a projector in the kids' tent to show a French version of Peter Pan. You just can't get "mad" though - these poor kids just tug at your heart and if a little bit of relief in a movie that tells them it's ok to not have to grow up overnight - then that's a part of why we are here, too. There is still another view station in this room. I will leave my tough book here with a user account for Medweb viewing and I will give the password to the docs who need it.
Tonight my to-do list is to send 37 studies from X-ray to PACS so they can compare priors and secure view station, setup near X-ray machine so the doctors can read NEAR the X-ray machine for faster reads.
As I was writing, I was interrupted by a doc who needed to read. Patient had a femur fracture that they patched up and put a cast on and were ready to discharge. They were very happy.
The Univ. of Miami Medishare hospital has been running X-rays non-stop. I was able to get a view station set-up next the X-ray station in the adult tent. A local arrived who was trained in the machine and can take the X-rays and scan in the cartridges. The traffic here at the hospital has picked up. We are full; the massive rain last night caused schools to collapse and some people came in with major issues.
I have to say, the trip thru town was atrocious; the city is non-stop rubble with a lot of people living in tents made of bed sheets. The international response is everywhere, but at the same time, seemingly minimal. Every country with the capability to do so has sent something, but nothing comes close to the US presence.
I also got some great intel on how the medical efforts are going and where the needs are most vital and how this Medweb server in particular could be used most efficiently.
When I got back to the Miami Medishare facility, one of my laptops had been liberated and hooked up to a projector in the kids' tent to show a French version of Peter Pan. You just can't get "mad" though - these poor kids just tug at your heart and if a little bit of relief in a movie that tells them it's ok to not have to grow up overnight - then that's a part of why we are here, too. There is still another view station in this room. I will leave my tough book here with a user account for Medweb viewing and I will give the password to the docs who need it.
Tonight my to-do list is to send 37 studies from X-ray to PACS so they can compare priors and secure view station, setup near X-ray machine so the doctors can read NEAR the X-ray machine for faster reads.
As I was writing, I was interrupted by a doc who needed to read. Patient had a femur fracture that they patched up and put a cast on and were ready to discharge. They were very happy.
Tuesday, February 16, 2010
Our Hearts Go Out to Haiti: Medweb Team & Technology in Port-a-Prince
The stories and images tug at our hearts. Today, news reports called the Haitian earthquake of January 2010 the worst natural disaster in world history - per capita, it has killed more people than the tragic Indonesian Tsumani of five years ago - which laid claim to the not-so-desirable title previously. As the media presence begins to wane, the need will go on for decades. For one of the world's poorest countries, recovery will be long and slow, but maybe, just maybe with enough help from the outside, we can help the people of Haiti to rebuild better, stronger and more resilient communities.
Jeff Henry, one of our engineers, is currently returning from a one week initial deployment and assessment in Haiti. While there he was touched, moved and saddened by all that he saw. His words are vivid, and as such, I invited him to do a guest blog. Here are his words regarding the Medweb PACS supporting University of Miami's/Medishare 240-bed Expeditionary Medical Facility (EMF) at the Port-a-Prince airport.
SATURDAY, FEB 13
Last night I got in and it was chaos. The airport here isn’t really functional; luckily the US military was there with hummers and big guns to keep people in line, literally. :-)
I was able to unload the servers from the plane myself. I asked, "Is there a conveyor belt at the airport?" The military guy laughed at me and told me that I was the conveyor belt. I was so pleased when I got the servers to my sleeping quarters, opened them up and found them to be fully intact.
As soon as I got here they needed an OB and delivered 2 babies last night. There are about 150 patients here with a support staff of about 50.
I went to all the [hospital compound] tents and saw their c-arm, X-ray machine and ultrasound. I am so glad that they all have Ethernet ports. The CT at Heart Check America sent fiber. I need to get both modalities networked, then get them sending to the Medweb. We have spools of cat6 to facilitate this.
If you wanted to send these people something useful, send boxes of carnation instant breakfast, you couldn’t send enough. A couple thousand packets should do.
We could use tablet computers to help doctors do their charts. A decent high speed scanner would be awesome for scanning in charts. We need a badge maker, we need to track patients, if we could get the barcode arm band things that would be a miracle.
Need more blankets, need more tents, need more sleeping mats and sleeping bags.
We could really, really use more mosquito nets. People are actually getting malaria around me, I am so glad I am on the malaria prevention pill.
Something that would be incredibly useful for the supply room and OR are NSF shelves, the big metal shelves you can buy at Costco for around 70 dollars.
We need a scale, a rectal thermometer, infinite fans, otoscope speculums, LFT (liver function test), troponin, B-natriuretic peptide. We need a DENGE test.
I got to sleep last night really late, I walked the grounds with Dave, head of logistics and a pastor handing out blankets and just helping anyone who looked like they needed it -- a family member of a patient sleeping on a bench outside a medical tent. We went and got blankets and water and tucked them in.
I met with Sam, head of IT here. He is 150% awesome. This guy lives excellence. We ran around looking for the best place to put the Medweb server. We chose the main ops tent, which is air conditioned and has good network infrastructure. We ran cat6 cable around the tent to their switch and put the Medweb out of the way on the floor. I installed it and setup a UPS for the Medweb and them to use.
I booted up the Medweb servers and logged in and checked the raids and everything is fine. So the Medweb is up, on their LAN.
I walked around with Sam and his coworker Eric who helped me run cat cable to the Medweb, analyzing their modalities and discussing how we are going to get them networked. Currently they are not networked.
They have an X-ray machine in the pediatric tent, it clearly has an Ethernet port and a super easy interface, I am confident it will be sending to the Medweb server in a couple of hours.
I got to walk into the OR while they were operating. I focused on the C-arm, they have two; one is turned on and plugged in. It has a dual monitor viewing station built on. I saw no Ethernet port, no way to network it. It did have a support contact number and serial number and all that good stuff, so I am merely going to call support, explain the situation and then hope they can assist me in getting this machine networked.
Then I walked over to their ultrasound, it looks like an awesome ultrasound, it has multiple different kinds of US devices, ones for gastro, ones for abdomen, ones I don’t even recognize. I also could not find a network port on that device, bit it also had the support number for the ultrasound and I will call them and ask them how to network it.
We are about to network the X-ray machine, it should be easy it is the closest machine to the Medweb server. It is in another tent, we may put another switch in there.
The c-arm and Ultrasound are on the other side of camp. They will be the biggest challenge. In my opinion, those devices are not as important to get hooked up with the Medweb because they are for more immediate need. I.E. they are literally in the O.R. they are used in a quick fashion like, for instance, if a patient is on the table, and they need a quick scan, they wheel over the C-arm and look inside the patient and then instantly make a diagnosis, rather than the X-ray which will have the studies sent.
I just got approached by a doctor asking to help make the X-ray machine itself work. I ran over there, having never inserted a cartridge before, I copied the support info, and then rebooted the WinXP side of the machine, no dice.
I called support. He told me to reboot the scanner part of the machine and that I needed a physical key to switch it, I ran and got the key and used it to reset the scanner device. It took forever to warm up and then it began working seamlessly.
There was literally a little girl on a table just waiting to be scanned. It’s hard to describe the feeling I got when everyone was relieved that the machine was scanning plates again and they could continue. That moment alone made this whole trip worth it for me. At the doctors’ request I called back the support guy and requested documentation, he emailed it to me and I am getting it printed out now. He also gave me verbal directions on configuring the X-ray to send to the Medweb. X-ray is up and sending, everything that gets accepted by the X-ray machine automatically sends to the Medweb server, the Medweb totally received it and it all works great. We are pumped! Everyone is shaking my hand. So awesome.
In the meantime I fixed a regular old printer for a nurse here. No big deal. They are keeping me busy and I love it. It’s great seeing people work together. The volunteers here just instantly work together on any problem until it’s fixed.
We need viewing stations. Send us the cheapest dell laptops with the widest screens. So, weak processors, minimal hard disk space and wide screens would be 100% awesome.
-- Jeffery Henry, Medweb
Jeff Henry, one of our engineers, is currently returning from a one week initial deployment and assessment in Haiti. While there he was touched, moved and saddened by all that he saw. His words are vivid, and as such, I invited him to do a guest blog. Here are his words regarding the Medweb PACS supporting University of Miami's/Medishare 240-bed Expeditionary Medical Facility (EMF) at the Port-a-Prince airport.
SATURDAY, FEB 13
Last night I got in and it was chaos. The airport here isn’t really functional; luckily the US military was there with hummers and big guns to keep people in line, literally. :-)
I was able to unload the servers from the plane myself. I asked, "Is there a conveyor belt at the airport?" The military guy laughed at me and told me that I was the conveyor belt. I was so pleased when I got the servers to my sleeping quarters, opened them up and found them to be fully intact.
As soon as I got here they needed an OB and delivered 2 babies last night. There are about 150 patients here with a support staff of about 50.
I went to all the [hospital compound] tents and saw their c-arm, X-ray machine and ultrasound. I am so glad that they all have Ethernet ports. The CT at Heart Check America sent fiber. I need to get both modalities networked, then get them sending to the Medweb. We have spools of cat6 to facilitate this.
If you wanted to send these people something useful, send boxes of carnation instant breakfast, you couldn’t send enough. A couple thousand packets should do.
We could use tablet computers to help doctors do their charts. A decent high speed scanner would be awesome for scanning in charts. We need a badge maker, we need to track patients, if we could get the barcode arm band things that would be a miracle.
Need more blankets, need more tents, need more sleeping mats and sleeping bags.
We could really, really use more mosquito nets. People are actually getting malaria around me, I am so glad I am on the malaria prevention pill.
Something that would be incredibly useful for the supply room and OR are NSF shelves, the big metal shelves you can buy at Costco for around 70 dollars.
We need a scale, a rectal thermometer, infinite fans, otoscope speculums, LFT (liver function test), troponin, B-natriuretic peptide. We need a DENGE test.
I got to sleep last night really late, I walked the grounds with Dave, head of logistics and a pastor handing out blankets and just helping anyone who looked like they needed it -- a family member of a patient sleeping on a bench outside a medical tent. We went and got blankets and water and tucked them in.
I met with Sam, head of IT here. He is 150% awesome. This guy lives excellence. We ran around looking for the best place to put the Medweb server. We chose the main ops tent, which is air conditioned and has good network infrastructure. We ran cat6 cable around the tent to their switch and put the Medweb out of the way on the floor. I installed it and setup a UPS for the Medweb and them to use.
I booted up the Medweb servers and logged in and checked the raids and everything is fine. So the Medweb is up, on their LAN.
I walked around with Sam and his coworker Eric who helped me run cat cable to the Medweb, analyzing their modalities and discussing how we are going to get them networked. Currently they are not networked.
They have an X-ray machine in the pediatric tent, it clearly has an Ethernet port and a super easy interface, I am confident it will be sending to the Medweb server in a couple of hours.
I got to walk into the OR while they were operating. I focused on the C-arm, they have two; one is turned on and plugged in. It has a dual monitor viewing station built on. I saw no Ethernet port, no way to network it. It did have a support contact number and serial number and all that good stuff, so I am merely going to call support, explain the situation and then hope they can assist me in getting this machine networked.
Then I walked over to their ultrasound, it looks like an awesome ultrasound, it has multiple different kinds of US devices, ones for gastro, ones for abdomen, ones I don’t even recognize. I also could not find a network port on that device, bit it also had the support number for the ultrasound and I will call them and ask them how to network it.
We are about to network the X-ray machine, it should be easy it is the closest machine to the Medweb server. It is in another tent, we may put another switch in there.
The c-arm and Ultrasound are on the other side of camp. They will be the biggest challenge. In my opinion, those devices are not as important to get hooked up with the Medweb because they are for more immediate need. I.E. they are literally in the O.R. they are used in a quick fashion like, for instance, if a patient is on the table, and they need a quick scan, they wheel over the C-arm and look inside the patient and then instantly make a diagnosis, rather than the X-ray which will have the studies sent.
I just got approached by a doctor asking to help make the X-ray machine itself work. I ran over there, having never inserted a cartridge before, I copied the support info, and then rebooted the WinXP side of the machine, no dice.
I called support. He told me to reboot the scanner part of the machine and that I needed a physical key to switch it, I ran and got the key and used it to reset the scanner device. It took forever to warm up and then it began working seamlessly.
There was literally a little girl on a table just waiting to be scanned. It’s hard to describe the feeling I got when everyone was relieved that the machine was scanning plates again and they could continue. That moment alone made this whole trip worth it for me. At the doctors’ request I called back the support guy and requested documentation, he emailed it to me and I am getting it printed out now. He also gave me verbal directions on configuring the X-ray to send to the Medweb. X-ray is up and sending, everything that gets accepted by the X-ray machine automatically sends to the Medweb server, the Medweb totally received it and it all works great. We are pumped! Everyone is shaking my hand. So awesome.
In the meantime I fixed a regular old printer for a nurse here. No big deal. They are keeping me busy and I love it. It’s great seeing people work together. The volunteers here just instantly work together on any problem until it’s fixed.
We need viewing stations. Send us the cheapest dell laptops with the widest screens. So, weak processors, minimal hard disk space and wide screens would be 100% awesome.
-- Jeffery Henry, Medweb
Saturday, November 14, 2009
Life you just can’t make up…
In addition to meetings and surveys and project analysis and set-up, we’ve also had quite a few adventures in the past 24 hours. Politics have stalled the bridge building process across the Kabul River to the Kuchi village that Sister City/Rotary/Mindtel have been assisting for the past few years, and so makeshift rafts (inner tubes with rope and some wood) are still the way to get across. The plan was to donate some rubber rafts to replace these and then head over for a visit. Reality, on the other hand… presented quite a different experience…
First, we got hung up on a rock in our SUV in the middle of the river. After 10 minutes of attempting to get the car off the rock, and realizing it wasn’t going to happen anytime soon, Dave decided to inflate the raft – on the roof of the car through the sunroof using the foot pump with his hands. Part of the crowd gathered on the near shore of the river came out to assist and try to push us off again – no luck so we got into the raft. (I have to say chivalry is not dead as Meggin and I were the first in, and we were oh-so-carefully handed into the raft – actually quite charming and we were grateful as the water temperature is near freezing.) With Dave and I paddling and Meggin carefully photo documenting we pushed ourselves off and over the rocks and through the rapids – trying to maintain some semblance of control and not tip over. I can only imagine what the picture of this looked like to the villagers! Thankfully, they are friends, and were just excited to have us make it over rather than laughing at us – although I REALLY need to learn Pashto because there was quite a lot of smiling and pointing as we climbed out of the raft – particularly by the boys. (They did, however, immediately jump into the raft (way more than it should really hold) and started paddling around. Albeit, one boy asked Dave – why’d you bring us this cheap thing? We need a wood bottom one. LOL. Point taken and sorry was the best luggage would allow!)
Due to the elapsed time and the pure spectacle we created, there was now quite a crowd gathered to welcome us. The kids know one word in English – “Picture”. With multiple cameras and willing “shooters” – they were in absolute heaven. They’ve become quite the little posers, I must say. Finally we had to begin the hike up to the village, and we did so to the chant of “Picture, Picture” the entire way. The kids are endearing and the parade up the hill with all their brightly colored clothes and beautiful, dirty faces was full of laughter.
Upon arrival at the village there were more pictures (naturally), and then Dave went to go talk to the elders about the situation with the wells. Meggin and I were surrounded as the women came out to talk to us (again, gotta learn Pashto…) and we were invited into one of the huts. While we sat on their carpet, we were surrounded by more than 30 women in children in a semi-circle around us (in a not large space I might add) they asked for our socks. After handing them over, however, a fight broke out among some of the children over the INDIVIDUAL socks, so the eldest woman gestured for us to take them back. So, now we are of course on a sock mission – among other things… For starters, the village has never seen a doctor or dentist. There seems to be some sort of spreading fungus on the kids and lice were literally jumping off their heads.
As we rejoined Dave and the men, and were invited in for chai, we learned that due to flooding they had lost their access to fresh water several months ago. As I drank my second cup of tea, not wanting to be rude as they generously gave us the only gift they had to offer – sugar, I was gently reminded by others in our party that the water we were drinking was the contaminated, barely filtered river water. I needed a stronger immune system anyway… As for them, it is just unacceptable and a complete travesty that they don’t have access to clean water. We found out that it is $500 to put in a new bore hole and give them access. Needless to say this WILL happen in the next couple of days.
This morning, our adventures continued as we made our way to the Public Health Hospital to add a more reliable relay for the sat comms hosted at the Taj and providing access to the hospital. Ryan is of course our comms/sat/tech guru (who is my hero as well after fixing my computer twice in as many days), but no way us non-techies (e.g. Meggin and I) were going to be left behind as we climbed to the top of the water tower. After admiring the FabFi antennas (Google it) at the top that have been providing the link to date, we stopped to look out at the view from this incredible vantage point – snow capped mountains surrounding the valley, bustling activity on the streets below… Tomorrow morning Pete and Ryan will return to complete the last step to get the antenna up and running. For now, as I sit at the Taj writing this, I am just thankful beyond words to be back here, for our friends new and old, for all we have accomplished, and simply for the day.
First, we got hung up on a rock in our SUV in the middle of the river. After 10 minutes of attempting to get the car off the rock, and realizing it wasn’t going to happen anytime soon, Dave decided to inflate the raft – on the roof of the car through the sunroof using the foot pump with his hands. Part of the crowd gathered on the near shore of the river came out to assist and try to push us off again – no luck so we got into the raft. (I have to say chivalry is not dead as Meggin and I were the first in, and we were oh-so-carefully handed into the raft – actually quite charming and we were grateful as the water temperature is near freezing.) With Dave and I paddling and Meggin carefully photo documenting we pushed ourselves off and over the rocks and through the rapids – trying to maintain some semblance of control and not tip over. I can only imagine what the picture of this looked like to the villagers! Thankfully, they are friends, and were just excited to have us make it over rather than laughing at us – although I REALLY need to learn Pashto because there was quite a lot of smiling and pointing as we climbed out of the raft – particularly by the boys. (They did, however, immediately jump into the raft (way more than it should really hold) and started paddling around. Albeit, one boy asked Dave – why’d you bring us this cheap thing? We need a wood bottom one. LOL. Point taken and sorry was the best luggage would allow!)
Due to the elapsed time and the pure spectacle we created, there was now quite a crowd gathered to welcome us. The kids know one word in English – “Picture”. With multiple cameras and willing “shooters” – they were in absolute heaven. They’ve become quite the little posers, I must say. Finally we had to begin the hike up to the village, and we did so to the chant of “Picture, Picture” the entire way. The kids are endearing and the parade up the hill with all their brightly colored clothes and beautiful, dirty faces was full of laughter.
Upon arrival at the village there were more pictures (naturally), and then Dave went to go talk to the elders about the situation with the wells. Meggin and I were surrounded as the women came out to talk to us (again, gotta learn Pashto…) and we were invited into one of the huts. While we sat on their carpet, we were surrounded by more than 30 women in children in a semi-circle around us (in a not large space I might add) they asked for our socks. After handing them over, however, a fight broke out among some of the children over the INDIVIDUAL socks, so the eldest woman gestured for us to take them back. So, now we are of course on a sock mission – among other things… For starters, the village has never seen a doctor or dentist. There seems to be some sort of spreading fungus on the kids and lice were literally jumping off their heads.
As we rejoined Dave and the men, and were invited in for chai, we learned that due to flooding they had lost their access to fresh water several months ago. As I drank my second cup of tea, not wanting to be rude as they generously gave us the only gift they had to offer – sugar, I was gently reminded by others in our party that the water we were drinking was the contaminated, barely filtered river water. I needed a stronger immune system anyway… As for them, it is just unacceptable and a complete travesty that they don’t have access to clean water. We found out that it is $500 to put in a new bore hole and give them access. Needless to say this WILL happen in the next couple of days.
This morning, our adventures continued as we made our way to the Public Health Hospital to add a more reliable relay for the sat comms hosted at the Taj and providing access to the hospital. Ryan is of course our comms/sat/tech guru (who is my hero as well after fixing my computer twice in as many days), but no way us non-techies (e.g. Meggin and I) were going to be left behind as we climbed to the top of the water tower. After admiring the FabFi antennas (Google it) at the top that have been providing the link to date, we stopped to look out at the view from this incredible vantage point – snow capped mountains surrounding the valley, bustling activity on the streets below… Tomorrow morning Pete and Ryan will return to complete the last step to get the antenna up and running. For now, as I sit at the Taj writing this, I am just thankful beyond words to be back here, for our friends new and old, for all we have accomplished, and simply for the day.
"Never doubt that a small group of thoughtful committed citizens can change the world. Indeed, it is the only thing that ever has." ~ Margaret Mead
We arrived in Jalalabad three days ago and have managed to visit the three primary hospitals we had on our agenda. The Teaching Hospital (see entry below with the IV bags hanging from trees, etc.) was our first stop. I’m sad to say that not much (if anything) has changed in 6 months. The smells are still rancid and basic supplies (clean water, soap) are in short supply. As promised many months ago we had planned to fix their “broken” anesthesia machine. Turns out, that the machine had never been taken off the pallet (bolts rusted on) and by simply plugging it in – it worked. However, no one is trained to use it, so instead it sits there while they use a bag-valve mask (BVM) to administer anesthesia – which we might add is not constant and patients frequently wake up in the middle of surgery. In so many ways everything comes back to training and dedicated PEOPLE to make it happen – the technology and equipment pieces are the easy pieces. The human factor is the imperative as Dr. Dave Warner likes to say.
It’s so true. We have the potential resources and ability to install a large telemedicine network here, but there are basic training elements that are lacking and must be met first. So we draw up plans, revise them, and revise them again and again – trying to find a solution that can be sustainable in the long term even if we are not involved. Initially we’ll focus on training because there is such a vital need by establishing a Telemedicine and Medical Distance Education Center. We have a site, excitement about the idea, and it looks like the funding to make it happen within the next 6 months.
At the Jalalabad Public Hospital today, too, we saw a “friend” (no names) from our last trip here who recently was almost prey to a suicide bomber attack. We see a slight resignation in him now versus the near boundless energy from before the attack, the elections and political wrangling and change of the past several months, yet there still remains hope and a light in his eyes and a determined resolve to help his people.
All the kids tug at our hearts everyday as we see them in the halls of the hospitals and the banks of the river, but there was something equally powerful and moving sitting across the conference table today looking at this powerful man oh so humbly and graciously—with no pretension—express his appreciation for the fact that we came back, ask us to not leave and help him to help his people. We are humbled to be around such incredible people who do so much for little more than love. It is a lesson also in resilience – quitting is not on option…
It’s so true. We have the potential resources and ability to install a large telemedicine network here, but there are basic training elements that are lacking and must be met first. So we draw up plans, revise them, and revise them again and again – trying to find a solution that can be sustainable in the long term even if we are not involved. Initially we’ll focus on training because there is such a vital need by establishing a Telemedicine and Medical Distance Education Center. We have a site, excitement about the idea, and it looks like the funding to make it happen within the next 6 months.
At the Jalalabad Public Hospital today, too, we saw a “friend” (no names) from our last trip here who recently was almost prey to a suicide bomber attack. We see a slight resignation in him now versus the near boundless energy from before the attack, the elections and political wrangling and change of the past several months, yet there still remains hope and a light in his eyes and a determined resolve to help his people.
All the kids tug at our hearts everyday as we see them in the halls of the hospitals and the banks of the river, but there was something equally powerful and moving sitting across the conference table today looking at this powerful man oh so humbly and graciously—with no pretension—express his appreciation for the fact that we came back, ask us to not leave and help him to help his people. We are humbled to be around such incredible people who do so much for little more than love. It is a lesson also in resilience – quitting is not on option…
Friday, November 13, 2009
Afghanistan Return - Fall 2009
Compared with our last trip here to Afghanistan in March, which can only be described as a whirlwind, this trip, which began on November 6, has been at a totally different pace—Slower and quieter, but still powerful. A lot has changed in six months, and certainly the media has done a “great” job of sensationalizing some of the security and political issues, but there is still an amazing hope and energy that is palpable, and I would be sadly remiss if I didn’t mention it and try to convince others to feel it and care about it, too.
We spent several days in Kabul on this trip due to travel issues, but everything happens for a reason and I’m so happy we did. Having not spent much time in Kabul previously, it was a whole new adventure – from the tranquil serenity of our guest house to the bustling and crazy traffic that rivals anything LA or New York can throw at it – just add some donkey carts, bicycles and lanes that aren’t really lanes so much as “guidelines” – to the French restaurant tucked away off dirt side streets with good friends. At one point, we set out to pick up our air tickets from the UN travel office thinking it would be 45 minutes max roundtrip and over 3 hours later we had success. Little bit of lost driver time in there, too, but the upside was that we (Meggin & I) got to see parts of Kabul we’d never seen before. Also, got to ride in the back of the car (trunk really), as in true Afghan style, we crammed 8 people into a car meant for 5. All part of the adventure.
That’s kind of been the flow of this whole trip – start with a plan, have it change, redirect, etc. and go with it – which is often far better than the original plan. We were able to meet again with Afshar Hospital, which is now open and functioning – great to see the changes and the use of the facility. Our meeting was delayed by a couple of days as they prepared for and then conducted their first outreach clinic on the outskirts of town along the Jalalabad-Kabul road. They saw over 200 patients (men, women, children) in the space of 4 hours – impressive to say the least. We brought along a 3.5 MHz portable USB ultrasound, which we donated and they will use for their upcoming clinic this weekend and in the weeks that follow. While we were there, their IT Tech was able to load it onto one of their laptops (after first conducting a virus check of our ultrasound AND the laptop!), so it is ready to go and they were excited to use it. There is just such a great feeling about being able to give something that you KNOW will be put to good use and immediately.
Our next stop was the privately funded and run Acomet Hospital – associated with Kabul Medical University. Another great facility – and completely dedicated to a qualitative standard of care. They offer no patronage, rather services are provided on a first come-first serve (or urgent need) basis – period. The two brothers that run it are incredible. We’ve now had the good fortune to meet both, and their dedication (which includes living at the hospital), energy, and commitment to forward progress and quality are truly inspiring. As but one small example, in a couple of weeks the 64-slice CT (impressive technology) they ordered will arrive at the hospital. We were able to donate a Medweb server and get it up and running for their Radiology Department. After our return from Jalalabad, we’ll head back to the hospital and Meggin and Ryan will provide some additional training and ensure they know where to go for support.
As I sit here in the sun in Jalalabad reflecting back on the week, I just can’t help but smile. It’s REALLY good to be back here in Afghanistan.
Up next… Our Jalalabad adventures… including today’s planned excursion in a couple of hours which involves rafting across the Kabul River to visit the Kuchi village…
We spent several days in Kabul on this trip due to travel issues, but everything happens for a reason and I’m so happy we did. Having not spent much time in Kabul previously, it was a whole new adventure – from the tranquil serenity of our guest house to the bustling and crazy traffic that rivals anything LA or New York can throw at it – just add some donkey carts, bicycles and lanes that aren’t really lanes so much as “guidelines” – to the French restaurant tucked away off dirt side streets with good friends. At one point, we set out to pick up our air tickets from the UN travel office thinking it would be 45 minutes max roundtrip and over 3 hours later we had success. Little bit of lost driver time in there, too, but the upside was that we (Meggin & I) got to see parts of Kabul we’d never seen before. Also, got to ride in the back of the car (trunk really), as in true Afghan style, we crammed 8 people into a car meant for 5. All part of the adventure.
That’s kind of been the flow of this whole trip – start with a plan, have it change, redirect, etc. and go with it – which is often far better than the original plan. We were able to meet again with Afshar Hospital, which is now open and functioning – great to see the changes and the use of the facility. Our meeting was delayed by a couple of days as they prepared for and then conducted their first outreach clinic on the outskirts of town along the Jalalabad-Kabul road. They saw over 200 patients (men, women, children) in the space of 4 hours – impressive to say the least. We brought along a 3.5 MHz portable USB ultrasound, which we donated and they will use for their upcoming clinic this weekend and in the weeks that follow. While we were there, their IT Tech was able to load it onto one of their laptops (after first conducting a virus check of our ultrasound AND the laptop!), so it is ready to go and they were excited to use it. There is just such a great feeling about being able to give something that you KNOW will be put to good use and immediately.
Our next stop was the privately funded and run Acomet Hospital – associated with Kabul Medical University. Another great facility – and completely dedicated to a qualitative standard of care. They offer no patronage, rather services are provided on a first come-first serve (or urgent need) basis – period. The two brothers that run it are incredible. We’ve now had the good fortune to meet both, and their dedication (which includes living at the hospital), energy, and commitment to forward progress and quality are truly inspiring. As but one small example, in a couple of weeks the 64-slice CT (impressive technology) they ordered will arrive at the hospital. We were able to donate a Medweb server and get it up and running for their Radiology Department. After our return from Jalalabad, we’ll head back to the hospital and Meggin and Ryan will provide some additional training and ensure they know where to go for support.
As I sit here in the sun in Jalalabad reflecting back on the week, I just can’t help but smile. It’s REALLY good to be back here in Afghanistan.
Up next… Our Jalalabad adventures… including today’s planned excursion in a couple of hours which involves rafting across the Kabul River to visit the Kuchi village…
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