My inspiration for this post came from knowing that many of the Malawian Poly interns saw Forest Gump for the first time a few days ago. Such a good movie! Tom Hanks’ famous quote: “Life is like a box of chocolates – you never know what you are going to get” is so true, but he forgot to mention one thing. It’s not only about which chocolates you get – it’s about which chocolates in your box of life’s gifts you choose to give.

I have a bag of my most favorite chocolates – Dove Dark Chocolate with Almonds – here that I brought over from the States as part of my comfort food stash. Enjoying a chocolate now and then has reminded me of feelings of home, but I’m actually enjoying giving them away to dear people I meet along the way so much more. Isn’t it unlike anything else – the joy of giving? It’s not actually the act of giving that matters so much as the impact, the empowerment, the ripple effect created by each act of kindness we share with one another, resulting in compounding joy.

This week, we celebrated the tenth anniversary of the Global Health Technologies (GLHT) program as well as the official opening of the beautiful new Chatinkha nursery at Queen’s. I was completely humbled and amazed to realize that the nursery was made possible by a selfless act of giving one of life’s special gifts. Dr. Oden and Dr. Richards-Kortum earned an award from the Lemelson Foundation for their combined work in global innovation, which came with a generous cash prize. Although both women have families to serve, they decided that they wanted to use the money to serve the community and the babies at Queen Elizabeth’s Central Hospital in Blantyre, Malawi. They both have invested so much time, care, and service into Queen’s since the start of the GLHT program ten years ago, working with their students at Rice as well as doctors and nurses in Malawi to actively improve neonatal mortality across the country. Then, they donate proceeds from one of the most prestigious awards in the world for innovation to the renovation of the Chatinkha nursery.

How remarkable it is to witness their passion to serve neonates and give life’s gifts over and over again. I can say on behalf of all of the students involved in the GLHT program that it is a true privilege to have them as strong, encouraging, selfless mentors. It is also a privilege to follow in the footsteps of their work at Chatinkha, now helping to create renovation plans for 22 more hospitals in Malawi. I feel so grateful. I wouldn’t rather be anywhere else than here sharing these warm moments in time and spreading these sweet gifts in life.

 

Today was definitely a learning experience! The morning was spent working on filters and figuring out protocols. It was great; I love that we are trying to do everything (even testing) with local materials. At one point we even took a mini field trip to the Poly’s game center to borrow a ping pong ball for testing airflow. However, the afternoon we ran into a couple road bumps when we started working on the sieve beds.

To give a little background, there are two sieve beds in an oxygen concentrator. They both contain zeolite (aluminum silicate) which binds nitrogen and is used to filter out the nitrogen leaving only oxygen as the output. They work using a valve system with one sieve bed binding nitrogen while the other one is purging it’s contents. The sieve beds work great until they are contaminated with water (which usually happens due to bad or missing filters). Our goal is to figure out a simple and effective way to regenerate the zeolite in the sieve beds. In other words, we want to get rid of the water when the sieve bed has been contaminated.

Before we start to even go through the design process, we decided our first goal was to understand the sieve bed. We did some research on Monday and talked to Matt and found that there is a company that regenerates zeolite by heating it up for a long period of time and then placing the zeolite back into the sieve bed before it has cooled down completely.

Proving that this procedure works is the best place for us to start! Thus, today we decided to try to take apart a sieve bed. This seemed like an easy test, but I have started to learn that things are not always what they seem. Opening the sieve bed involves pushing down a spring and trying to pry open the top. This is done in the machine shop using a press to apply the proper pressure needed. Since there is a spring, potentially hazardous material inside, and we were using a large press: safety definitely came first! We were wearing masks and glasses during the entire process:

It is better to be over safe than sorry. Our first mistake was not applying pressure evenly. This caused the fitting on top of the sieve bed to become slanted and wedged into the cylinder of the sieve bed. Our second mistake was trying to fix the first mistake. We ended up applying too much pressure in a concentrated area which resulted in a broken fitting. The funny thing with the broken piece is that we still could not open the sieve bed and get to the zeolite. As a result, we had to admit our failures and go to Matt for more help. We eventually got the zeolite out! The entire process taught me a lot:

– Things are sometimes easier said than done
– Sometimes you need to experience failure to grow in the end and come out with more knowledge
– Sieve beds are definitely not meant to be opened up in a hospital setting
– Even after breaking something it can be difficult to open
– Just because something has a spring does not mean it will jump out at you  after a fitting is broken
– You get a lot of weird looks when you walk around the poly in a bunch of safety gear

So even though we were not successful at our first attempt to open the sieve bed, I know we will have much better luck next time and we learned way more then we ever would have if we succeeded the first time.

It’s the 4th week! We finally have design projects settled. I am on a team with Theresa, Vincent, and Harvey. We spent the last week trying to figure out project proposals for oxygen concentrators. In the end, we have decided to devote the rest of our summer to filters, sieve beds, and an educational campaign.

Filters are a big focus. In the hospitals, we found that a lot of concentrators would have the first filter missing or it would be replaced with a random piece of foam. Preventative maintenance is key for keeping a concentrator in working condition, so when there is no filter or an ineffective one, the concentrator will fill with dirt and create problems with other parts of the device. Thus, we want to create a low cost filter made out of local material that can be used when a filter is missing. We really think this is a great need. At Mulanje, one of the doctors I talked to really stressed the need for local filters. Also, when random pieces of foam are used as filters, they have not been tested and no one actually knows how good they are. As a result, we will be doing a lot of testing to ensure we find a filter that is close to the current one.

In order to start the brainstorming process we spent all of Monday doing a lot of research on what the current filter is made of. We then made a shopping list of brainstormed materials that could work and decided to go shopping on Tuesday.

Tuesday was very successful! Harvey and Vincent really took the lead with figuring out where to go shopping. They decided to go to Limbe town because there are a ton of hardware stores within walking distance of each other and it’s super close to Blantyre. Once we arrived in Limbe, we started to just walk into a bunch of different hardware stores.

I was hesitant at first and really did not expect to find all the materials we were looking for. I was definitely wrong! We found a lot of foam, sponges, car filters, and various other material we thought could potential work as a new filter. The entire experience was amazing! I loved being able to just walk into stores and find the material that we wanted. This is not the first time that we have wondered around town looking for something specific and ended up finding it. Malawi just seems to be the perfect place for wandering minds.

I cannot wait to test all the material we collected! We spent all of Wednesday morning really going through the design process figuring out design criteria and protocols for testing. It was nice learning how Harvey and Vincent go through the design process and sharing what Theresa and I know about it.

It has taken me time to pop up, but I have blogged anyway. I am a fourth year Mechanical Engineering student from the Malawi Polytechnic. Currently, I’m interning at the Malawi Polytechnic Design Studio with interns from Rice University (Tahir, Leah, Christine and Theresa) and Polytechnic (Brighton, Vincent and Kate). It’s always my pleasure to make new friends. Therefore, this internship has broadened my network of friends. I had a longing for doing something that is health related but was failing to see an entry point. Through this internship I can see my dreams of doing something for the betterment of the humanity especially in the field of medicine coming true. We started this internship on 6^th June of 2016. We are working on two Biomedical Engineering projects at the Malawi Polytechnic namely Oxygen concentrators and Neonatal Hypothermia.The first week involved project and individual introductions.

The second week involved site visits in order to do problem exploration surrounding these project ideas. For oxygen concentrator, we wanted to find the common modes of failure and think of how we as students can help in coming up with long term solutions to address these defects. In neonatal hypothermia, we wanted to find how better to combat it at earliest possible stage by designing technologies that can be used to prevent or treat neonatal hypothermia.

Some of the visited sites are Malamulo, Zomba Central, Mulanje Mission and Kamudzu Central Hospitals. I was in the team that went to Kamudzu Central Hospital (KCH) in Lilongwe. We arrived in Lilongwe on Sunday around 10pm and lodged at college of medicine hostels. We reported for work at KCH on Monday (13/06/2016) and were warmly welcome by PAM officers. The first day involved hospital familiarisation and introduction to different heads of sections /Wards. The next four days involved observations and interviews with different Medical officers and neonates’ mothers/guardians. Our visit was for five days and we returned to Blantyre on Friday (17/06/2016).

In the third week, we were compiling raw data to come up with well- documented data set for future reference. We also prepared presentations to brief the Provost, Marie Lynn Miranda from Rice University about the progress of our project. After presentations on Sunday we went to atmosphere lodge in Blantyre where we had dinner with the Provost. It was awesome!

Numerous to mention are the benefits of this project to me as an individual and the Malawi health sector at large. Apart from the academic benefits, we are sharing different social experiences through which I have learnt some Spanish words like;

¡Buenos días! (Good morning)

¿Cómo estás? (how are you?)

Bien ¿Ytú? (well. And you?)

Bien (well)

Many thanks should go to the organisers of this internship. I’m hoping to share more in the upcoming blogs……………………………………..

On Tuesdays there is diabetes clinic at the hospital. Anywhere from 30-80 people with diabetes, mostly above the age of 65 congregate in a small room of concrete benches. Looking around, you can see the logo of the Diabetes Association of Malawi and old diabetes education posters speckling the walls. Bread, butter, and tea are sold in the back of the room. Soon a scale is brought out to the aisle between the rows of benches and patients line up. One by one they slip off their shoes, hand their health passport to the man in front, and step onto the scale, holding a support pole to minimize unsteady wobbles. Simultaneously a nurse, identified by a small white hat pinned to the crown of her head, came out with a blood pressure cuff and began winding her way down the rows.

At some invisible signal the patients were shooed back onto the concrete rows with a few Chichewa phrases of instruction and mild laughter. Moments later, descending into our crowded room, came suit-clad representatives from the World Diabetes Foundation in Denmark. A Chichewa welcome song rang out received by ten iPhones in front of ten foreign smiles. The “honorable visitors” were instructed to sit in the back row and soon commenced the formal exchange of statements from spokesmen on both sides.

What happened next was the play. The Empires, two Malawian men in their late twenties, emerged at the front. One had wrapped a chtengi around his waist the other sported a pointed hat, like you would see in a rice field, and had stuffed a soccer ball underneath his shirt. Dramatically they acted out a conversation in English that examined the challenge of treating diabetes in a culture where a larger stomach is equated with success.

[Important note, there are many people around the world with diabetes, even type 2, who are not obese. Research however suggests that diabetics who do have a high BMI often find their symptoms lessen if they loose some weight.]

While I’ve been here I’ve reflected on how difficult it is to get very obese without eating processed foods or snacks- even if you’re eating a ton of carbs- rice or nsema (maize) and a fair amount of fat- fried donuts or “chips” aka french fries. It will be interesting to see what happens to the obesity rates as processed bags of chips and other snacks continue to grow in popularity and the types of jobs people do continue to decrease in physicality. Is there a way for a country to develop while avoiding the associated problems of affluence?

This post is about a week late- it’s taken a while to process all of our site visit information.  Also, the Rice University provost, Dr. Richards-Kortum, Dr. Oden, Dr. Leautaud, and some medical doctors interested in the program have come to Malawi for a few days so we’ve spent some time talking to them about our projects and getting great feedback and advice.

The road to Zomba was long.  It took about an hour to get there every morning, and I often found myself drifting into sleep to the sound of BBC radio.  It was strange to hear about the Orlando shooting occurring at home through British broadcasting in a car in Malawi.  A Polytechnic lecturer named Joseph traveled with us every day and was very helpful.  The first morning he described an experience he had in Zomba a few years back when he played football (soccer) for school.  He said the Zomba team had placed a witch doctor behind their goal because they believed it would help them win, jokingly commenting that it must’ve worked because his team lost.

When we reached the hospital, we went straight to the PAM workshop where we met Mr. Khonje, a PAM technician.  At first the sheer number of broken concentrators was overwhelming, but Kate and I just began systematically taking them off shelves and going through our log for each one.  We soon discovered that we needed to reevaluate the questions we planned on asking.  While Mr. Khonje was able to give us details about a concentrator that had broken two weeks prior, the others had been broken at least six months (most about a year) before.  In the absence of newly ordered parts, the technicians had stripped several parts from the broken concentrators in the hopes of using them to repair other broken concentrators.  Without flow meters, oxygen sensors or pressure gauges to pinpoint the issue with a concentrator, the repair protocol used by PAM is to switch out parts until the concentrator operates properly.  However, proper operation can only be gauged by the absence of low output alarm lights, and the presence of flow that can be felt by hand.  For these reasons, we were unable to get details about the other concentrators from the technician, only our own measurements and observations.

Looking at a concentrator in the PAM workshop

          We also looked at concentrators in wards and methods of thermoregulation in the nursery, labor, and KMC wards.  We were able to interview several nurses, three mothers, and a nursing student.  We noticed that the walls were covered in information including the importance of thermoregulation, ideal temperatures of babies,  ideal room temperatures, KMC tips and danger signs to look out for during KMC.  The nurses were very knowledgeable about hypothermia, most problems seemed to arise from lack of equipment like thermometers or working resuscitators which were used to heat babies.  According to a nursery ward nurse, babies weren’t wearing hats due to difficulty affording them (they cost about 1500 kwacha each).

Typical beds in the nursery

Danger signs of KMC posted in the KMC ward

           Overall, it was a great learning experience to be able to assess needs based on my own observations.   I emphasized my role as an engineering student looking for project ideas, not evaluating or “grading” the nurses and other staff in any way.  This was the first time the program included site visits, and I am hopeful that our trips have helped build up the relationship between the Polytechnic (and Rice) and the hospitals we visited.

 

 

 

Malawi never ceases to amaze me. I feel as though everywhere I turn I continue to see the intersection of what I have learned in class and what actually occurs.  This week everyone has returned home after the site visits. I am sad that we are no longer going to hospitals, but I am happy everyone is together again. We are all back to working in the design lab at the Polytechnic and have been focused on compiling all the notes we took from the different hospitals we visited. It is really interesting to share experiences with my fellow interns and see how the hospitals differ. Theresa and Kate were at Zomba District Hospital while Tahir, Harvey, Leah, and Vincent were at Kamuzu Central Hospital in Lilongwe. Both hospitals differed greatly from Malamulo and Mulanje (the two mission hospitals Brighton and I visited). The biggest difference was the absence of technicians at both Mulanje and Malamulo. For Zomba and Kamuzu, the Physical Assets Management (PAM) team is present to repair medical devices that break.

As I look over my notes and go through all the technology pictures from the week, I keep coming back to one device that really stuck with me. At Mulanje I saw a wheelchair that looked very different from the ones I have seen before:

The beginning of Junior year, I took a Needs Finding Class taught by Dr. Ghosn. In this class I learned a lot about how to interview patients and establish the difference between what is needed and what would not be helpful. At the beginning of the class, Dr. Ghosn had us use a wheelchair for a day to show us that there are challenges with the wheelchair we have not thought of before. Being in the wheelchair was definitely an experience; I have such a new found appreciation and respect for people that use wheelchairs. Spring semester of Junior year, I also made a CAD drawing of a wheelchair as practice in my AutoCAD class and we spent a lot of time thinking about ways to change the design. Thus, when I saw an engineered wheelchair I was immediately drawn to it.

Upon further inspection of the chair, I found it was from an organization: Free Wheelchair Mission. This organization provides free wheelchairs for developing nations. I love that they saw a need, like wheelchairs, came up with their own design, and were able to develop a platform for delivering the chairs. Knowing that an organization like this exists makes me even more motivated to continue developing filter designs for oxygen concentrators. I am so lucky to have the opportunity to come to Malawi and see what has been developed already. After all my experience with wheelchairs last year, I never knew about the wheelchair organization and would have never known how many other organizations there are trying to develop technologies for the hospital.

Hello everyone, its Vincent Mbewe. It has taken me a while to have my first blog. I am a student at the University of Malawi The polytechnic studying Mechanical engineering, and one of the poly interns under the biomedical internship together with other students from Rice University (Houston-USA). Initially, I had interest in doing medicine and surgery but odds pushed to mechanical engineering. I did not realise I would have another chance to do a little of medicine before this internship. Now my interest in medicine has been revived and I love the programme and willing to do more about medical health-care even after the internship.
We (interns) are now in our fourth week of the programme but will still talk about my experience in the past weeks. The first week was basically an introduction to the teams and projects to be focused on. I was happy to meet the Rice interns; Tahir, Theresa, Christine and Leah and also reuniting with my fellow interns from poly; Harvey, Kate and Brighton after some months at our respective industrial attachment placements.
We were introduced to our primary projects; oxygen concentrators and Neonatal Hypothermia. Some of the terms were news to me but with the help of the team I familiarised myself with the projects and was ready to do any requirements that were outlined for me.
Site visits took place in the second week and I was in the team that went to Kamuzu Central Hospital in Lilongwe together with Leah, Tahir and Harvey. Whilst at KCH, we did our research on the primary projects and got some information that advanced project ideas. However, we encountered obstacles in the process; for instance being denied access to wards. Nevertheless, in the process of trying to get the admittance into the wards, we managed to boost relationships with some of the people in charge. These relationships will somehow help the progress of the Poly-Rice Biomedical Internship; a blessing in disguise.
The third week was for compiling reports and data finding for assessment to come up different project ideas. I was contented that we were able to come up with project ideas that were presented to the Provost of Rice University. We have now divided into two leading teams in both of the projects. Kate, Tahir, Brighton and Leah form the leading team on Hypothermia and we have Christine, Theresa, Harvey and I as the leading team on Oxygen concentrators.
This week we are trying to come up with the exact solutions of our project ideas and possibly have something that can be appreciated. It’s exciting and we are ready to do more.

Hey Everyone reading this 🙂

Been wanting to blog for a long time and am excited I finally got the chance to do so . As of today we just started our 4th week into the internship.  The past 3 weeks have been enlightening , exciting and inspiring. I will share in more detail In the coming blogs on all the experiences (maybe not all, but i will try ).

For today however I just want to share with you all on where we are at right now. The two primary projects we are working on during this internship are oxygen concentrators and hypothermia. Last week we were compiling all the data that we got from the hospital site visits (will share more on this in the next blog). Leah , Brighton, Tahir and me  were working on compiling  all the data for hypothermia while the other 4 interns were working on compiling data for oxygen concentrators.

Over the weekend the Provost  from Rice and some professors from Rice arrived in the country. On Sunday Me, Kinsey (Rice Intern at Queens) ,Brighton and Leah had Lunch with the provost, it was great talking to her. In the Evening all the interns (Poly, Rice) , the provost and professors had dinner together.

This week we are continuing with our projects and just trying to make sure we get everything planned done in time. So until the next blog, thanks for reading.

P.S. as am writing this i don’t have any pictures on my computer but a friend shared this with me this morning and i’ll just leave it here. I found it inspirational