{"id":2538,"date":"2023-05-03T13:40:06","date_gmt":"2023-05-03T18:40:06","guid":{"rendered":"http:\/\/test.pegasuslectures.com\/blog\/?p=2538"},"modified":"2023-08-15T18:07:11","modified_gmt":"2023-08-15T18:07:11","slug":"bringing-vsi-imaging-to-the-amazon-of-peru-chapter-4","status":"publish","type":"post","link":"https:\/\/www.pegasuslectures.com\/blog\/index.php\/2023\/05\/03\/bringing-vsi-imaging-to-the-amazon-of-peru-chapter-4\/","title":{"rendered":"BRINGING VSI IMAGING to the AMAZON of PERU (Chapter 4)"},"content":{"rendered":"

Not sure anyone really enjoys early-morning flights, especially when they allow for only four hours of sleep.\u00a0 Today we flew to Iquitos <\/a>, the capital of Peru\u2019s northernmost region (Loreto<\/a>), which incorporates their equatorial forests.\u00a0 We are meeting administration at Hospital Regional De Loreto \\”Felipe Santiago Arriola Iglesias\\”<\/a>, a few doctors within their staff, and an official with the Ministry of Health of Peru<\/a> (MINSA) to outline our initiative and goals.<\/p>\n

Our purpose in meeting was to persuade the hospital administration and staff to participate in a correlative study, similar to those conducted in our prior mission in Uganda. \u00a0In Uganda, we completed a \u201cConcordance Study\u201d and an \u201cOutcome Study.\u201d\u00a0 The concordance study is a comparative assessment of VSI sweeps<\/a> against conventional ultrasound evaluations.\u00a0 In this study, we would need both \u201cnormal\u201d and \u201cabnormal\u201d patient surveys to validate the VSI protocols<\/a> and process.\u00a0 For the outcomes study, we would need to access post-procedure patient data to evaluate VSI\u2019s efficacy<\/a>.<\/p>\n

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At the airport, we received an impromptu cardiac stress-test when baggage check-in flagged some of our luggage as over-weight.\u00a0 Despite our frantic efforts to reapportion the suitcases, mixing out clothing, the ultrasound system, the UPS (backup power supply), gallons of gel, video capture devices, MIT boxes, various cables, and personal items, we still ended up with one over-weight bag.\u00a0 Airport staff redirected us to the opposite end of the terminal to pay an added fee, lacking the commerce equipment to take payment right there.\u00a0 Our flight was nearing departure as we stood in line to make payment, but mercifully a kind-hearted supervisor, perceiving our distress, waived the fee so that we could get going.\u00a0 We made our flight with five minutes to spare.<\/p>\n

Rushing back through, I noted a sign: \u201cComienza Aqu\u00ed\u201d, which seemed perfect as an obvious metaphor for the journey on which we were embarking.<\/p>\n

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With the moments we had to spare, we grabbed a sandwich at the little store in front of our gate \u2013 and boarded the plane to Iquitos<\/a>.
\nWhen we landed, we disembarked onto the tarmac. I felt like reciting the line from the Wizard of OZ \u2013 \u201cI’ve a feeling we’re not in Kansas anymore.<\/a>\u201d<\/p>\n

There was great excitement and relief when we saw our side-tracked, over-weight bag on the luggage carousel, as we had left it marooned, across the airport from our departure gate.\u00a0 We were not sure that bag would make it!<\/p>\n\n\n\n
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From the airport, we took a car over to the hotel to drop off our luggage.\u00a0 (You can see a picture of the front door and also the view from my room) in the associated pics.)\u00a0 It was, not surprisingly, very warm and humid.\u00a0 The roads are congested with what are called moto-taxis, which are basically motorcycles with the back wheel removed and instead attached to the axle of a two-wheel cart behind.\u00a0 They make a fair amount of noise and the drivers seem fearless as they dart in and out of traffic.\u00a0 From the hotel, we took our trip to Hospital Regional De Loreto <\/a> in a moto-taxi (an experience everyone should have at least
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Upon our arrival, we were welcomed by Gabriella, the Santa Clotilde hospital\u2019s administrator, and Dr. Norberto, from its hospital staff.\u00a0 As I referenced in my Introductory blog<\/a>, our journey would tomorrow continue by 8+ hour boat ride to Santa Clotilde<\/a>, and then another 8-hour boat-trip up the Rio Napo<\/a> to the rural village of Angoteros.\u00a0 This was our first meeting with Gabriella in a non-Zoom conference setting.\u00a0 You will hear a lot more about Gabriella in the upcoming blogs.\u00a0 She is an effective and dynamic powerhouse with an obvious ability to make things happen.<\/p>\n

We later met Alex, the Hospital Regional De Loreto\u2019s<\/a> administrator.\u00a0 Once we began our presentation, it became very clear that Alex was excited about what he was hearing.\u00a0 His enthusiasm was encouraging and uplifting.\u00a0 Charlie, the MINSA<\/a> official arrived a short time later.\u00a0 He also very quickly grasped the benefits our program could offer.<\/p>\n

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Our discussion expanded to an explanation of the logistical challenges specific to Iquitos<\/a> and the region of Loreto<\/a>.\u00a0 Iquitos is bounded on three sides by the Amazon<\/a> and two tributaries, the Rio Nanay<\/a> and the Rio Itaya <\/a>.\u00a0 Consequently, Iquitos is functionally more like an island than a connected land mass.\u00a0 Transportation to and from Iquitos is by air or by river transport.\u00a0 In the Loreto region, many places have access only by river or by foot.\u00a0 So, when someone becomes ill in the remote areas of the region, it is extremely challenging to get them to Iquitos<\/a> or Santa Clotilde<\/a> where they can be treated.<\/p>\n

Transportation of the sickest patients is done by water taxis, or in extreme cases, by sea planes that can take off and land on the rivers.\u00a0 Because of the expense, potential patients will often wait until their condition is so grave that they cannot be treated successfully or cured.<\/p>\n

Another efficiency concern surrounds when patients are flown in for a condition that causes pain but is not life threatening (like a cyst).\u00a0 The possibility of reducing these unnecessary flights seemed to excite Charlie, because if they could reduce unneeded transportation costs, these funds could be used elsewhere.<\/p>\n

In the picture below, my left hand is pointing at Iquitos<\/a>.\u00a0 My right hand shows how far up the Rio Napo<\/a> we need to travel to Santa Clotilde<\/a>.\u00a0 Brian\u2019s<\/a> left hand is pointing at the village of Angoteros.\u00a0 You can see how close we will be to the border of Ecuador.\u00a0 It sure looks like a long trip.\u00a0 You are probably asking \u2013 \u201cWhy are we smiling?\u201d<\/p>\n

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As we left, Alex suggested that we could meet with some of the Hospital Regional De Loreto\u2019s<\/a> doctors after returning from our training sessions in Angoteros and Santa Clotilde<\/a>.\u00a0 We had accomplished our first goal and were very pleased.\u00a0 Success on the first of many phases.\u00a0 By the way, did I mention that the room was air conditioned? \u2013 it felt like heaven.<\/p>\n

We took another moto -taxi back to the hotel.\u00a0 Each of us had work to take care of so we spent the next few hours on our laptops \u2013 aided by the fact that we had internet access.\u00a0 We walked to dinner around 7:30 pm, after which we saw the hotspots of Iquitos<\/a>.\u00a0 Along the Rio Itaya<\/a>, there are many restaurants, dance clubs, bars, and ice cream shops.\u00a0 Throngs of people were out in the very humid air, enjoying the start to the weekend.\u00a0 Young people were dressed up and obviously involved in their courting rituals.\u00a0 The place was very alive.<\/p>\n

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We headed back to the hotel, knowing that we had an early morning to get to the boats to travel nearly eight hours to Santa Clotilde<\/a>.<\/p>\n

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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)<\/a><\/em><\/strong>
BRINGING VSI IMAGING to the AMAZON of PERU (Chapter 2)<\/a><\/em><\/strong>
BRINGING VSI IMAGING to the AMAZON of PERU (Chapter 3)<\/a><\/em><\/strong>
<\/p>\n

Frank Miele, MSEE , President of Pegasus Lectures, Inc.<\/a> Frank graduated cum laude from Dartmouth College<\/a> 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<\/a>. As a designer of ultrasound, he has lectured across the country to sonographers, physicians, engineers and students on myriad topics.<\/p>\n","protected":false},"excerpt":{"rendered":"

Not sure anyone really enjoys early-morning flights, especially when they allow for only four hours of sleep.\u00a0 Today we flew to Iquitos , the capital of Peru\u2019s northernmost region (Loreto), which incorporates their equatorial forests.\u00a0 We are meeting administration at … Continue reading →<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/www.pegasuslectures.com\/blog\/index.php\/wp-json\/wp\/v2\/posts\/2538"}],"collection":[{"href":"https:\/\/www.pegasuslectures.com\/blog\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.pegasuslectures.com\/blog\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.pegasuslectures.com\/blog\/index.php\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pegasuslectures.com\/blog\/index.php\/wp-json\/wp\/v2\/comments?post=2538"}],"version-history":[{"count":27,"href":"https:\/\/www.pegasuslectures.com\/blog\/index.php\/wp-json\/wp\/v2\/posts\/2538\/revisions"}],"predecessor-version":[{"id":2726,"href":"https:\/\/www.pegasuslectures.com\/blog\/index.php\/wp-json\/wp\/v2\/posts\/2538\/revisions\/2726"}],"wp:attachment":[{"href":"https:\/\/www.pegasuslectures.com\/blog\/index.php\/wp-json\/wp\/v2\/media?parent=2538"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.pegasuslectures.com\/blog\/index.php\/wp-json\/wp\/v2\/categories?post=2538"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pegasuslectures.com\/blog\/index.php\/wp-json\/wp\/v2\/tags?post=2538"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}