Eating the Elephant

Ashoka Fellow Andrés Martínez Fernández’s organization, Enlace Hispano Americano de Salud (EHAS), is group of brilliant engineers committed to using technology to improve health outcomes for people in very remote parts of Latin America.  I have spent the better part of my first month tying to understand exactly how they do that.  This means playing with circuit boards, looking at schematics, and trying to understand how internet protocol could possibly relate to mothers and babies.  My experience thus far has felt more like my days as an engineering student trying to understand complex systems than as a social entrepreneur working to make motherhood safer.   I am not yet totally overwhelmed, but am definitely drinking from the fire hose.  

The EHAS office sits in the engineering labs under the main library of Universidad Rey Juan Carlos in Madrid, Spain.  The flickering fluorescent light keeping the piped ceilings of basement from absolute darkness is the only thing even remotely reminiscent of the developing world.  But the work happening here in one of Europe’s most vibrant capitals is reverberating to very far away places.

Not only has EHAS built several wireless networks around the Amazonian rain forest, the group has also worked to connect many diagnostic devices to these wireless networks.  Let’s start with the networks. 

Phone companies will only build mobile phone networks in places where the economics make sense.  If there is not enough profit potential or population density, no network gets built.  EHAS’ research has shown that communications alone can drastically enhance the quality of healthcare at the most remote health posts.  So the Spanish NGO goes into a country and finds a strong local technical partner, usually within the national engineering university, and starts to train them on the design and construction of wireless networks in rural settings.  These wireless networks are WiFi networks – the same type of network you use to connect your computer to the wireless network at your house or Starbucks, but they exist over massively longer distances.

Once the network is in place, EHAS works with their local partner to “turn on” health posts.  Many health posts don’t have electricity so the first step is to install a solar power system.  Once the health post has power, EHAS hooks up computers, an internet phone and an antenna that connects the hospital to the wireless network.  With a hospital now connected wirelessly to the internet, the possibilities start to grow.   

EHAS engineers are digitizing the signals of several diagnostic tools and making them into internet devices.  For example, EHAS has turned a regular stethoscope into a digital stethoscope that turns the sounds it collects into digital signals (like what you hear on your iPod) and then sends these signals over the air to the internet where any doctor in the world can hear when a patient inhale or exhale.  The team has digitized an EKG monitor and the output from old ultrasound machines and they are working on a connected microscope.  This concept has significant implications for telemedicine by allowing doctors, most of who live in the cities, to serve patients hundreds of miles deep in the Amazon.

Besides learning about all the exciting technologies that EHAS is using, I have spent a fair amount of time trying to get my living situation settled.  In such an exciting city, I really hoped to find a great place in the middle of everything.  But I am way too picky.  I am still living out of a suitcase in an expensive temporary place where I can touch every wall with my hands while standing in the middle of the room.  Yes, it’s that tiny.  I am about to give up hope and move to a dorm room at the university on the outskirts of town just for the sake of stability and closet space.

In the mean time, I will keep eating that big technology elephant one bite at a time and figuring out how to orient all this amazing technology towards mothers.