A Trip to Brazil

As a recap, my implementation project, the personal “mini-thesis” project that is the first of two large GMI program deliverables, involves Teledermatology in mobile travel clinics within Brazil. Earlier this week, Erica and I travelled to Brazil where, among a few other things, I was able to do a bit more background research on this project, its requirement, its current standing, and the limitations and barriers it may face. While the trip itself was non-stop and incredibly exhausting, actually being in the community was so beneficial to the understanding of my project and the appreciation I have for its source and need. Let me begin by saying a bit about Brazil, Barretos, and the Cancer Hospital…

Public healthcare in Brazil, a country currently struggling both politically and economically, is not strong, well-supported, or widely available to the general population. Much of the country has limited or no access to an adequate medical system and doctors in the public system are undertrained and underpaid, creating further treatment gaps. In addition to this, a number of people live in places (the Amazon for example) that simply do not have trained medical professionals. The combination of political corruption, dangerous drug- and gang-based crime, and a poor system of care creates a terrible environment for the establishment of prosperous public hospitals.  This is what makes Barretos and the Cancer Hospital so amazing.

Tucked away in the midst of a sugar cane field a few hundred miles from Sao Paulo or Rio, Barretos seems a quaint city of 100,000 people. It’s relatively safe, humble in its handful of restaurants and hotels, and at first glance does not seem to have much to its name. There isn’t much truth to this, however, as the city is renowned throughout Brazil as having two great things: (1) the Rodeo which effectively doubles the size of the city every August, and (2) the best cancer hospital in Brazil, if not Latin America, and this is no exaggeration.

This Hospital is advanced, having some of the latest technologies, methods, and tools. It is undoubtedly comparable to first world hospitals and, as far as I am concerned, maintains some of the highest standards of care I have seen. But that’s not what makes this hospital system amazing, rather it is the dedication to treating the nation’s poor and underserved that lifts this facility and its staff above and beyond compare. The lengths this hospital goes to diagnose and treat those who have before had no option is, to say the least, heart-warming and inspirational. From the universal treatment to the free meals served to those receiving treatment and their families, the transportation for patients into the town (there is no public airport within a 50-mile radius) to the trucks and vans that travel hundreds of miles to provide care, it seems there is no length this hospital is not willing to go to change how people in Brazil are treated.

One of the most mind-blowing services proimg_2965vided by this hospital is the mobile clinics that travel thousands of miles, reaching across most of Brazil, to bring first class and first world care to the country’s general population. Vans and semi-trucks (including two that have full MRI and CT machines in them to give you an idea of their size) travel with a physician, nurse staff, and support staff to the under-served. And this is just a part of the hospital’s attempts to spread high quality care. Another, one directly related to my project, is the training of 200 nurses a year to identify cancerous skin lesions.

My implementation project is the construction of a low cost dermatoscope that provides high quality photos of moles and lesions when attached to a smart phone camera. This scope will then be provided to the trained nurse staff and, if effective, be used across the country. The research trip to Brazil was incredibly useful in determining both the hardware and software needs of the staff and hospital.  I am much clearer on where I need to head with my project and, hopefully, I’ll have a few pretty pictures of prototypes for you by the next check in.

Until then,

Jeannette Nelson


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