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 <[email protected]>
To: change at 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 at 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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