In Santa Catarina Ixtahuacan, 10,000 feet up in the mountains of Guatamala, treatable illness kills villagers who would rather die than make the five-hour trip by horseback over the rocky, dangerous terrain between them and the most basic medical care. This story staggered Michigan Engineering students, who take technology wherever it’s needed. Of late, they’ve made remote regions of Guatemala the recipients of wind turbines, water pumps and, most recently, a sophisticated digital stethoscope that can record the vital signs of people in largely inaccessible villages and transmit the information to specialists in Guatemala City. The instrument is a prototype at the moment, but with improvements it will help diagnose conditions such as congenital heart disease in infants who otherwise would go untreated.

The students are members of Michigan’s Health Engineered for All Lives (M-HEAL), an organization that’s working to create sustainable, low-cost medical technology for developing regions of the world. The remote stethoscope and the trip to Guatemala are good examples of what engineering, passports and students with heart can do.

Michigan and Guatemala, face to face

Michigan Engineering students on the M-HEAL team met Dr. Cristian Barrios (above, far right) and the staff of a clinic in Nueva Santa Catarina Ixtahuacán to get a grasp of the obstacles they’ll face in refining the remote stethoscope. M-HEAL collaborated with Ann Arbor-based Appropriate Technologies Collaborative (ATC), an organization that creates new sustainable technologies which promote economic growth and improve the quality of life for low income people worldwide.

Need drives technology

Each year, about 1,600 infants in Guatemala are born with malformed hearts. Without surgical treatment, these conditions can cause permanent brain, lung or heart damage — they might even prove fatal. These are the facts that drive the remote stethoscope team, led by Nathaniel Skinner, a PhD student in mechanical engineering. Skinner said that an easy-to-use screening tool, accessible to those in rural areas, “will help get those who need surgery into the hands of those who can provide it.” He sees the development of the remote stethoscope as a multi-year project that currently is far from being a solution, but he’s confident that the next generation of the device will come much closer to being a successful interface between doctors and patients like 15-month-old Wilson Irael Mendez (above). Mendez has tetralogy of Fallot, an anatomic misalignment of the heart. The abnormality is genetic and quite complex, requiring open-heart surgery either soon after birth or later in infancy.

The remote stethoscope, which is still under development, will become a basic instrument in telemedicine, a discipline that uses technology to help diagnose and sometimes treat medical conditions over long distances. The remote stethoscope has three main components: a pickup mechanism to collect heartbeats, an encoder that digitizes the sound from the pickup and a transport engine that sends the digitized signal to another location where it can be decoded and heard.

Jeremy Koehler was one of seven Michigan Engineering students who traveled to the Castañeda Foundation and five rural clinics to meet with midwives, nurses and doctors to learn about the daily practices and environments of the stethoscope’s potential end users. (Right: Nurse Angela Rosales explains some of the challenges that Koehler and the M-HEAL team will face.) The trip also involved a study of Guatemala’s health system, and the cultural and social obstacles that complicate the stethoscope’s implementation. The students did find time to sightsee and partake of the country’s hospitality.