Guat Day is it Again?

This morning the team said adiós to the avocado trees at Casa del Angel and headed out promptly to Antigua. We marvelled at the greenery and volcanoes visible out our bus windows, as well as the skill of our driver Evi as we winded upwards. Traversing the cobblestone streets, we arrived at Obras Sociales del Hermano Pedro, where we were greeted by a friendly group of administrators and doctors who introduced us to our project: a large storage room filled with equipment. We promptly got to work!

At Obras Sociales, Christia and Noah worked on testing and repairing foot pedals for use with electrosurgical units. These foot pedals are used by surgeons to switch between cut, coagulation, and bipolar settings when performing electrosurgery. This makes switching between these settings much easier for the surgeons, increasing surgical efficiency. They tested the functionality of seven different foot pedals by using a multimeter to detect the changes in resistance that occurs in the pins of the connectors when various pedals are pushed. Of the seven pedals, four were fully functional after initial testing, and the remaining three needed repairs. 

Christia and Noah working on an ESU foot pedal

One of these pedals had a connector that was fully disconnected from the wire. Noah and Christia spent the entire morning attempting to solder the wire back into the connector, but the pins in the connector were so frayed that they were unable to make a reliable connector. Concerned about the reliability of their repair, they unfortunately decided that it would be safer to dispose of the pedal. Another of the pedals needed to be taken apart to diagnose the problem. Christia and Noah discovered that the piece of metal that makes an electrical connection with the switch when the pedal is pushed was not reaching the switch. They made a quick fix by wedging an adhesive shim underneath the metal piece to raise it enough to click on the switch. The newly-repaired foot pedal is now deemed functional for use in the hospital!

Stephanie and Katie testing an automatic tourniquet system

Performing electrosurgery on a banana

Grinding the cocoa beans

After a quick stop at our new hotel, we made our way to the Museum of Chocolate. We learned about the history of chocolate, working through the Maya to the Aztecs to the Spanish and tasting chocolate drinks from each culture along the way. We learned to shell and grind cocoa beans and to mix a traditional Mayan drink with chocolate powder, chili, honey, and vanilla. Finally, we made our own dark chocolate bars with diverse combinations of cocoa nibs, coffee beans, ground coffee, cinnamon, chili, and other ingredients!

Pouring the chocolate bar

We found all the colors

As the sun set behind Volcan de Agua, we took the opportunity to take photos of the beautiful, ancient architecture and ruins of Antigua. We wound our way through the cobblestone streets, awed by the history and culture around us. We briefly visited a local artisan market before heading off to dinner at La Cuantía de Los Urquizu where we enjoyed traditional Guatemalan dishes. Satisfied, we explored the streets of Antigua, especially taking time to take in the main square and the works of art around it. Exhausted from a busy day of travel, work, and exploration, we headed back to the hotel to chat and recuperate for another fulfilling day tomorrow!

The team at El Arco de Santa Catalina in the heart of Antigua 

Goofy team selfie with Volcan de Agua

Making Amigos all over Guatemala City

Another beautiful morning in Guatemala started with a morning run for a few of us, then breakfast in Casa de Angel Hotel with preparation and discussion for the day over pancakes!

Exhausted but happy at the top of the hill on the morning run

We wove through the busy streets of Guatemala City in our big beige bus back to Juan Pablo II where we worked for the first half of the day. We finished up the medical equipment we had left from yesterday, then presented our results to the hospital administration. We sorted through 33 pieces of equipment and were able to fix, calibrate, or test 23 devices that will now be operational for the hospital.

Stephanie presents our finished monitors
to hospital administration

Antonio picked up where he left off on Monday, trying to test and potentially repair the 7 “defective” ECG units. None of the units had leads to connect to the electrodes on a patient’s body, so Antonio, with the aid of Noah and Cerie, made makeshift electrodes using stranded wires that wound around the ECG module and were delicately embedded in gel electrodes. This initial design worked and produced a functional ECG when placed on the body; however, the group quickly developed a better prototype by winding solid core wire around solder wire to form a solenoid-like wire that could quickly slide on and off of the ECG modules. This design allowed the team, now aided by Hunter, Rhett, Michael and Stephanie, to rapidly test the functionality of the remaining ECG systems. The group assessed the different leads of the ECG units, the printing capability, and the general settings. The team was able to recommend much-needed accessories, clean and inventory the modules, and confirm that many of the previously “defective” ECG modules were functional with minimal limitations. The collaboration during this endeavor is what enabled its success and epitomized what it means to be engineers in the field--solving problems through communication and teamwork. 

After leaving Juan Pablo II, we stopped at INCAN Cancer Hospital to meet with leadership, learn about the hospital’s mission, and look at some of the devices in the labs. INCAN is the only nonprofit hospital providing cancer care in Guatemala. We were inspired by INCAN’s work to provide care to cancer patients despite limited and occasional lack of funding. We met with INCAN leadership and Dr. Carlos Esquit from Universidad del Valle, hopefully establishing connections for future collaboration between these two admirable institutions.

Rhett, Aidan, and Christia present at Universidad del Valle

Our next stop for the day was Universidad del Valle de Guatemala (UVG) where Prof. Carlos Esquit described the many great things that they do in engineering there.   Guatemala's first satellite was developed at UVG and is about to be launched this Friday. Two of Prof. Esquit's engineering teams presented their projects, one of which involved printing 3D models of hearts defined by segmented cardiac CT images and the other involved integrated circuit design.  Dr. P. described Vanderbilt and the School of Engineering, encouraging UVG students to consider VU for graduate school. Then Christia Victoriano described her research about a point-of-care low flu diagnostic tool for low resource settings, Rhett Britton presented his microfluidic device to support a cancer-organoid for testing chemotherapeutics, and Aidan Pace described his work with Engineering World Health.

Rhett and Noah conversing with Universidad del Valle students

While our three students showed Vanderbilt academics in the strongest of lights, the rest of the students had the opportunity to mingle with the Guatemalan students and leave a unique impression on the individual level. However, none mingled quite as uniquely as Rhett and Noah. The two bee-lined straight for the back of the lecture hall where “all the rowdy students must be.” They immediately made friends with a group of students despite their broken Spanish. Noah quickly proceeded to become the loudest individual in the room, and Rhett’s witty sarcasm had everyone rolling on the floor in a few short exchanges. Whether it was talking to the students about classes where neither group understood a lick of the other group's technical terms or requesting a Spanish translation of “Aidan is a hunk of a man,” the two of them had a wonderful time laughing with the local students. This exchange culminated when Rhett finished giving a presentation and Noah stood up to ask a question in front of the whole group. Noah, intending to tell Rhett what a good job he did, tried to tell him how handsome he looked up on stage. Unfortunately, a stray dog has a better grasp of the Spanish language, and he accidentally told the whole lecture hall that he himself was very handsome. This of course elicited a roar of laughter which was completely lost on him. When he sat back down, the girl next to him leaned over and asked if all Americans “had as much energy as our group.” To which he replied, “no that’s kinda just me.” He then proceeded to consume half of the free buffet.

Antonio talking with Universidad del Valle students

We ended the day with a satisfying dinner and turned in late. Tomorrow we will be on to Antigua to work with Obras Sociales del Hermano Pedro!

Anticipating the arrival of the other half of our dinner

Building Momentum at Juan Pablo II

The morning started early with reflection questions for the day posed over a bright breakfast of eggs and toast. Dr. Adams led the group in considering the purpose of the trip and what we hoped to accomplish.

Breakfast at Casa del Angel Hostal

After planting seeds for reflection, we packed up, jumped in the bus, and headed through the packed Guatemala streets towards Hospital Materno Infantil de Juan Pablo II!

When they tell you the traffic will take another hour

Hospital Materno Infantil de Juan Pablo II serves low-income mothers and children in Guatemala City. They had accumulated many pieces of malfunctioning or broken medical equipment over the past two years, so the room we carried the pieces to was packed in no time. With plenty of work on our hands, we partnered up, grabbed a device, and set to work on repairing items!  

Getting to work!

Dr. P making use of her resources

Jorie, Cerie, and Katie worked together on a set of three autoclaves, instruments that build up high temperatures and pressures to sterilize medical equipment. They got two of them up and running! The third had a few more problems… it was found in a large container soaked in water. After fixing the water drain and wiping off the significant rust that enveloped the interior, we decided it was time to plug it in and...

The autoclave team

Rhett working on a new pointer for a broken scale

Calibrating and balancing infant scales turned out to be a taller task than expected when Rhett discovered that one of the scales was missing the indicator on the large weight. Instead of letting the scale go to waste he decided to make a new one! We bent a few pieces of scrap metal into shape and then epoxied the new pointer onto the weight. After calibration, the scale worked like a charm!

Overhead view of the internal workings of the ESU

Hunter spent the entire day fighting to revive an electrosurgical unit that was determined to stay dead. The machine is commonly used to perform delicate surgical procedures, and this item in particular was a major priority to the JPII staff, and they were really hoping we could get it up and running for them while we were here! Despite knowing that it wouldn’t turn on, when we first arrived we were very hopeful that we would be able to get it working since we had trained on this exact model of electrosurgical unit. However we quickly realized that it would be trickier than we first expected. The fuses, cable and power switch were all working fine when tested using a multimeter, which indicated that the issue with the unit was somewhere inside the electronic components of the machine. After doing a deep dive into both the service manual and the circuit schematics, he narrowed down the issue to the power supply board at the back of the device, which wasn’t providing the power that the unit needed to operate. Upon this discovery, Hunter along with Rhett removed this board, replaced it with our DC power supply, and SUCCESS! The unit was able to turn on! This victory however was short-lived, as the unit’s interface still wouldn’t respond to inputs, and indicated much more complex problems associated with the logic board. After struggling with the zombie electrosurgical unit for awhile longer, Hunter and Rhett unfortunately had to declare it dead, but not before the device decided to give them some not so kind parting words for disturbing it’s rest.

Parting words from the ESU

Hungry from our first day of medical equipment repairs, we headed off to dinner where we enjoyed delicious Guatemalan cuisine before retreating to Casa de Angel Hotel for journaling and relaxing! It’s been a full day and given us a lot to consider from the equipment we tested and repaired to the Guatemalans we observed going about their day. Time for a recharge and a reboot to be on top of our game for tomorrow. Happy 21st birthday to Stephanie!!

Showing off her engineering and gymnastics skills

¡Hola Guatemala!

Hello Everyone!

The first day of our trip started early! The BME Guatemala students gathered at Kirkland Circle at 3:40 am to catch our 6:00 am flight to Miami. Sleeping from one plane to the next, we swapped planes at the Miami airport at headed towards Guatemala city!

Perks of waking up for a 6:00 AM flight

Arriving in Guatemala, we took off our sweatshirts in the bright sunshine and mid-70's temperatures. We loaded the bus and made our way through narrow, busy streets towards our hotel. Exploring our new home, we loved the cute atmosphere and the avocado trees growing near the back patio.

On the bus downtown for a late lunch

Heading out into Guatemala City, Dr. P. guided us towards Saul Bistro where we enjoyed a refreshing late lunch. Our restaurant featured wonderful ensaladas and a variety of familiar and new dishes!

Enjoying fresh Guatemalan avocados

Chilling with our new friend at Saul Bistro

After saying goodbye to our new zebra friend, we wove in an out of the crowds towards Plaza de la Constitucion. The people of the city flowed around the plaza in bright colors - we had just missed a huge parade festival. On the square, clothing and street food markets dotted the corners of the space while locals streamed in and out of the stands.

Cathedral Metropolitan Basilica of Santiago de Guatemala

Soon, the sun started sinking behind the presidential palace and it was time to head back to the hotel for a night of preparation, reflection, and fun. Dr. P and Dr. Adams started the night off by directing the students in preparing our equipment and communication devices for tomorrow.

Post-late-night wings back at home

¡Estamos Listos! Preparation for Guatemala 2020

The VU BME Guatemala team is back at it in 2020! In a few short days our crew of 12 engineering undergraduates and our esteemed leaders, Dr. Cynthia Paschal and Dr. Nick Adams, will depart to Guatemala for a packed week of testing and repairing medical equipment. Meet the team below!

The 2020 BME Service Learning in Guatemala Team

Front: (left to right) Antonio Glenn, Aidan Pace, Cerie Ock, Christia Victoriano, Katie Stoehr, Stephanie Nolen, and Prof. Cynthia Paschal

Back: (left to right) Hunter Spivey, Michael Jindia, Rhett Britton, Prof. Nick Adams, Noah Mallory, Jorie Budzikowski, and Zach Eidman

To prepare for our trip, we have spent the past two months developing our medical equipment sleuthing skills. We have learned about and worked with electrosurgical units, sequential compression devices, defibrillators, vital signs monitors, and more. Many thanks to Project C.U.R.E. for lending us devices for practice! 

Troubleshooting the ECG on the defibrillator

Will he survive at 5000 ft? The SpO2 sensor thinks so.

Bet you've never had a Dean of Engineering take your blood pressure

We depart bright and early Sunday morning for Guatemala! The team will spend the first three days in Guatemala City working with Hospital Materno Infantil de Juan Pablo II and visiting Universidad del Valle. We are thrilled to have the opportunity to collaborate with Universidad del Valle engineering students throughout the week. On Wednesday, we will move on to the city of Antigua, where we will work with Obras Sociales del Hermano Pedro and Hospital Nacional Pedro de Bethancourt.

We will be keeping in touch daily here with stories, progress updates, and photos. Please check back often to share the journey with us!

Alive, well, and ready for Guatemala!

Behind the Scenes

This trip was made possible through the hard work, coordination, and benevolence of many people. From fielding teams and evaluating hospital needs to supplying vital support and logistics, the services provided by these individuals were invaluable to our mission. All of you have our sincerest gratitude.

Project C.U.R.E.
Karen Bice
Danielle Rand

Vanderbilt University Department of Biomedical Engineering
Prof. Mike King
Prof. Amanda Lowery 
Matty Sevilla
Amanda King
Meagan Crawford
John Dunbar
Willy Reichert 

Vanderbilt University Center for Latin American Studies
Prof. Ted Fischer
Dr. Avery Dickins de Girón

Vanderbilt University School of Engineering
Prof. Chris Rowe
Prof. Tim Holman
Brenda Ellis
Pam Coyle
Michele Cedzich

Vanderbilt University Staff
Juliana Staples -- Office of Admissions
John Fellenstein -- VU Physics Machine Shop
Bob Patchin – VU Physics Machine Shop

Dr. Shari Green -- -- VU Zerfoss Student Health Center
Penny Meek -- VU Zerfoss Student Health Center
Craig Self – VUMC Department of Histopathology

VU Athletics

Hospital Infantil Juan Pablo II
Dra. Maritza Quex
Lic. Rudy Marroquin

INCAN
Dr. Eddie Gharzouzi
Dra. Sylvia Blijidenstein
Julio Valdez

Hospital Nacional Pedro de Bethancourt
Dr. Miguel Soto
Dra. Carmen Cifuentes 

Obras Sociales del Hermano Pedro
Sergio Morales
Anabela Morales
Dra. Julissa Piñeda
Bryan Valle

Guatemala Support Team
Ben Kessler - Logistics Coordinator
Andres Gonzalez -- Translator
Estuardo Mendoza -- Translator
Evi Perez -- Driver

Clara Chacon -- Antigua Community Volunteer (and Dr. P.’s awesome Spanish teacher)

Universidad del Valle de Guatemala

Prof. Luis Pedro Montenegro – for tireless leadership, coordination, and instruction

Prof. Carlos Esquit – for years of partnership in this collaboration

Profesor Miguel Zea

Prof. José Eduardo Morales

Prof. José Antonio Bagur

Prof. Pablo Oliva

Universidad del Valle de Guatemala Students
Ana Bartra 
André Rodas
Andrés Lainfiesta
Arturo García
Cecilia Marsicovetere
Christopher Chiroy Miranda
Dan Álvarez
Darwin Rivas
Delbert Custodio'
Diego Alejandro Juárez Lossi
Edwin Fernando Coronado Roche
Guillermo de León Archila
Jonathan Aguirre Orantes
José Alejandro Rivera García
José Ramón Corona Boch
José Roberto Ruano
Juan José Tzun
Julio Ronaldo Diéguez Ochoa
Luis Ralón
Luis Ruano
Marcos Benedict
María Belén Hernández
María Gabriela López Castellan
María José López Ayala
Marlon Josué Castillo Martínez
Michel Ramírez
Miguel Godoy Garín
Mynor Franco
Pedro Joaquín Castillo

Spring 2018 Service Learning in Guatemala Team
Prof. Cynthia Paschal
Prof. Nick Adams
Nicole Budgell
Leah Fassinger
Candace Grisham
Austin Hardcastle
Seiver Jorgensen
Chad Keller
Sheng-Yau Lim
Ariana Nicol
Tori Qualls
Nicholas Wigginton
Anna Word

Sophie Xie

Leaving Paradise

Our last day of the trip cannot be described with words. Some of us started the day with a walk back up to the cross overlooking Antigua and a morning coffee near the central square. After a quick breakfast, we took off for our first adventure at Finca Filadelphia.

During our tour of the coffee plantation, we were able to see the complete process of coffee from the plants to the roast. At the end, we tried fresh coffee right from the plantation. This provided the perfect boost of energy for the next excursion... zip lining. If you are a fan of flying over the trees while simultaneously feeling like you may fall hundreds of feet, zip lining is for you! We were able to take in the amazing view of the volcanoes and Antigua from above the trees (after you got over the fear aspect).

We wrapped up our time at Finca Filadelphia with lunch (including coffee cake) and gift shopping for authentic Guatemalan coffee. We returned to the city of Antigua and meandered through the Artisan market for souvenirs. After our last exploration through Antigua, we settled in for our last dinner in Guatemala at Las Palmas. Immediately after dinner, we returned to Guatemala city for 6 short hours before heading to the airport.

A 3 AM wake up call has never felt so refreshing.... just kidding. Most of us slept on the first flight from Guatemala to Dallas. Luckily, customs in Dallas was very peaceful and allowed for a smooth transition to our connecting flight. We picked up our first American meal in a week. Ironically, some of us chose a hispanic restaurant. Our last flight to Nashville flew by (pun is absolutely intended). We are now peacefully in our dorms unwinding and preparing for this upcoming week.

We want to express our sincerest gratitude for being able to go on this service trip and impact not only the hospitals but also the students and faculty we worked with from UVG.  We hope they can continue their awesome work until we return next time. Thanks for following us through our journey!