8. Michiru to Mulanje (July 24th 2017)

A visual representation of how we felt after summiting Mulanje

There is something about hiking for 6+ hours and eating cold oats and canned beans for 3 days straight that makes you long for civilization. But in all seriousness in order to end with a bang, we decided to climb the tallest mountain in the country, the Mulanje Massif or Mt. Mulanje. Rising 3002 meters above sea level, the peak named Sapitwa literally translates as “Don’t Go”. Not being an avid hiker or remotely outdoorsy, my experience reaching the peak was a struggle to say the least. In fact the only other mountain I have hiked in earnest is Michiru at the beginning of the trip. But with the suffering and pain I learned a valuable lesson in desirable difficulties and what it means to persevere. 

In cognitive psychology, desirable difficulties is a method of effective learning that was pioneered by Robert A Bjork. The basic concept is that putting yourself through challenging situations helps you better learn concepts and improve long term performance. While climbing a sheer rock faces with no training and equating this to my life is a quite literal (and very inaccurate) interpretation of this, nevertheless it provided valuable insight into the field of engineering helping me learn more about myself and my limitations both physically and mentally.

Much like hiking, the prototyping process needs to be done one step at a time. Whether brainstorming, choosing the best solution, or even prototyping, everything can be broken down into manageable sized chunks. I remember that when the project was first announced I selected protecting cup seals from dust in oxygen concentrators specifically because I did not know where to start with this project. One of my previous blog posts even detailed how hard it was to find the source of the problem when talking to technicians. But with guidance and by progressing slowly and purposefully, eventually my partner and I were able to build filter box prototypes and test them. More tests need to be done (some where inconclusive) and by no means is our solution the best or only solution, but at least it was a good start in my opinion. Now that my project, and by extension the internship is over, just like reflecting on the mountain it is amazing how much we’ve all accomplished in such a short time. Just like starting the internship by climbing a mountain and ending it by climbing a mountain everything has made full circle. Hopefully my project (either the improved internal or improved external air filter) will be continued after I go and can demonstrate a measurable impact. But for now what I am really looking forward to is a long shower, a hot meal, and a warm bed to sleep in.

7. How to Succeed as an Entrepreneur Without Really Trying (July 18th 2017)

Celebration after the RICE 360 Facebook live event

To say that today is a big day for Rice 360 is an understatement. For the past year this program has been applying for the 100&change grant from the MacArthur which from the foundation website would provide 100 million dollars to “fund a single proposal that promises real and measurable progress in solving a critical problem of our time.” The Rice 360 Institute of Global Health is currently one of the 8 semifinalists; the proposal is to deploy a 16 piece Newborn Essential Solutions and Technologies (NEST) package prevent 85% of neonatal deaths in Malawi and to reduce newborn mortality by 50% in 10 years. Much more information can be found on the MacArthur Foundation website and the Rice 360 Nest 360 page, but being able to intern during this pivotal time, I’ve been lucky to see the parts of the process behind the scenes and talk to some of the very accomplished professors, doctors, and entrepreneurs.

One of the people I’ve been privileged to get a chance to talk to was Professor Kara Palamountain, a research associate professor and global health lecturer at the Northwestern Kellogg School of Management with extensive experience in entrepreneurship and industry. An expert on technology adoption, talking with her was illuminating to see what happens after the engineering design and next steps for successful implementation. This is especially relevant in developing areas where needed technology already exists, but distribution is challenging preventing widespread access. As a result many companies focus their resources in areas that are already well connected which creates an even greater disparity. An comparison she gave was to think of a lemonade stand selling drinks in on a certain street. If the stand earns enough money to expand their business they can either choose to sell other goods like sugar cookies or open up new stands in other areas. But because more people are needed to run the stand and relationships with the new neighbors need to be established many times it’s much easier to build up rather than build out. RICE 360, in addition to tailoring technologies for these developing regions, endeavors to build out and establish a roadmap for implementation, increasing both access and opportunities for more companies to follow.

So with such a daunting task ahead, what makes someone suited to undertake such an endeavor? More generally, what makes someone a good entrepreneur? Connections? Charisma? Determination? Interestingly enough Professor Palamountain immediately answered knowing when to quit. Rather than persevering, picking and choosing your battles can help sort out great ideas from lackluster ones. This is especially relevant to me in the context of GLHT 360; the silica goggles I worked on may be useful but upon conferring with medical professionals there are many other issues here especially like fixing oxygen concentrators that are more pressing. While it is disheartening it is better to understand that this is just part of the process and move on. But this advice will be definitely something to consider in the years to come where things will have much less structure than university.

6. 80% productive, but 120% efficient (July 14th 2017)

What does a Swiss Army knife, Cholula Hot Sauce, and a portable phone charger have in common? First and foremost these are all things I am thankful to have brought with me on this trip. More relevant, these items all started out as concepts or ideas waiting to be realized. As an engineer, when testing solutions and building a prototype, a lot of the time is spent on optimization or improving on existing ideas. However, an arguably more critical step is brainstorming. A good idea determines whether a product or solution even has a chance to be implemented and will literally make or break a project. But even though it’s so important, this is probably the least structured step of the engineering design process and the hardest to define. So with that in mind, where does an good idea come from?

I am certainly not qualified to answer a question like that but I will say to me the best way to generate ideas that have merit is a combination of identifying needs and unstructured personal time. The former is pretty straightforward, but the latter are where some of the craziest ideas are generated. At the design studio in order to facilitate innovation and boost productivity we are given time to find and work on our own personal projects; this time is called 20% time. Pioneered by Google , this freedom is responsible for gmail and Adsense among others. It is supposed to be 20% of the working day but due to time constraints this usually happens on Friday afternoons. Since my main project here is currently entering its final stages I wanted to use this space to talk about some of the other projects I have been working on.

Improved Internal Air Filter

The first and most impressive project I have worked on is creating a reusable internal air filter which can be cleaned and can be used across different concentrator models. With all the experience and knowledge I’ve gained, I decided to apply this to internal air filtering in order to solve another common problem. The prototype consists of HEPA filter paper that is sandwiched between two sides of a box which allows for natural baffling of the material, an air tight seal and a mechanism to open and close the device should the paper need to be washed. Currently it is held together by two rubber bands which is easily replaceable but a latch mechanism can be developed to reduce the amount of parts associated with the device. The two green attachment ports fit in both the new life and the devil bliss machines and the different port lengths are to prevent excess blockage of airflow. Preliminary testing demonstrates that concentrator output is the same as the regular filter, but since this is still very early on in the prototyping process more testing needs to be done on efficiency and comparability across different concentrator models.

CSA logo worked on in the first couple of weeks drawn by hand on Inkscape

Other projects I have worked on including learning how to better use Inkscape, designing a logo for the Chinese Student Association and making souvenirs for friends and family back home. But the most valuable lessons learned from 20% time was how to use the different devices and the seemingly random ideas generated from these passion pursuits. Brainstorming is such an organic process; Friday afternoons really helped kick-start the process, better preparing me for my main project.

Six Weeks in the Polytechnic Design Studio

Hi. Chikondi Kanama over here. Sorry that I have not blogged for so long that this is my second and last blog about the 2017 Lemelson Internship at Poly. Thanks to Veronica and Emily who made me feel obliged to take the responsibility to update everyone on what I have been doing.

As elicited in my earlier blog, Serena Agrawal and I have been working on the project aimed at designing and manufacturing stands for 40 bili-lights available in the studio so that the devices can be safely and effectively used in Malawian hospitals.

In the second week of the internship week we visited two Central and two District Hospitals, trying to collect data necessary for the respective projects we were assigned.

With respect to our project, we got the following feedback in summary:

  •     Nurses expressed dire need for the bili-lights for phototherapy against jaundice
  • Nurses wanted the light to swivel side ways  to create more space when they need to access the baby in the cot
  • The hospitals have different kinds of cots (plastic cots, wooden cots and the hot cot, which is basically a wooden plastic cot with a top transparent cover)

In response to the feedback and considering engineering constraints, we brainstormed possible designs and then exploited the resources generously provided in the studio to go through a number of prototype iterations before arriving at the final version we have. However, considering that we are dealing with a weight suspended over the body of a neonate, we have been much concerned with safety tests, thereby pushing mass manufacturing beyond the time scope of the internship.

Nevertheless, the internship has been a wonderful experience. I have acquired practical skills that have helped cement the engineering theory I have so that I have been part of a team that addressed real life health problems. Thank God for the wonderful workmate Serena Agrawal; may she become the great engineer as she wishes. Gratitude also to all 2017 Lemelson Polytechnic interns and Matthew Petney as well as the entire Poly Design Studio staff for always being there for us: we appeared great because great people were in the background.

Finally, may Rice University, the Malawi Polytechnic and Lemelson foundation feel it that their efforts shall perpetually transform engineering students as well as the Malawian Health Sector for the better.

Presentations & Progress

This Wednesday I had a chance to visit everyone at the Polytechnic and watch their presentations. It was a wonderful opportunity to see how far everyone has come since the projects were proposed last month. Everyone has worked with their partners to find solutions and bring those to life. Although I’m sure the other interns have elaborated on the details of their designs, I’ve listed out the basics of each group (for those at home who might be a little lost).

One element that I’ve realized is integral in the Rice 360 model of designing solutions is the smooth continuation from group to group. Due to the nature of undergraduate coursework and summer internships, each project is usually worked on by numerous groups of students. One semester it’s a group of students in the global health design course, the following semester it could be an individual’s personal study, and the next summer it could go to Malawi with a team of interns! While this sounds like it might get confusing, I actually think there are lots of benefits to this process. Instead of being limited to one group of students, each project gets multiple sets of eyes and brains working and reworking how it could best benefit the intended users. For example, Millie and Kelvin’s work on the PneumaShoe has taken this two year project and completely changed some integral components. If the original group of students in Houston said, “we’re done!” and then we gave their device to a hospital in Malawi- it would not had nearly the impact it could have now that Millie and Kelvin are redesigning it.

As a lot of these solutions and devices are created for very niche settings, it’s very important to get feedback on them before trying to implement. As I’m sure you’ve read in other blogs- medical equipment graveyards are a real problem because there is no continuity between donated machines. However, not only are there these problems when the devices break, there is also the issue of devices that are working but unused. For example, one of the days that I was shadowing Prince, a study nurse in Chatinka, he pointed out a few very fancy looking incubators. He didn’t know whether or not they were still working but assumed that at least one was entirely functional. However, these incubators are only used as transportation trolleys. Why weren’t they being used to warm babies? These incubators were designed for high resource settings where the nurses have time to check on the babies through specially designed holes in the device and only one baby is on the cot at a time. In Queens it’s just not practical or possible for the nurses there. They need easy access to the baby so they can check on them quickly. If the bays are full or they want to keep a close watch on several babies, then those infants are sharing mattresses. It’s simply doesn’t make sense to try and integrate these fancy incubators into the system they have. This proves how important it is to gather as much feedback on the device as possible before trying to give it to a hospital. The solutions we are creating should be useful to those you are trying to help. I’m glad to see that process in motion with all of the engineers working at Polytechnic this summer.

Here’s a quick list of the projects!

  • Serena and Chikondi have designed a final prototype stand for the bililight, a phototherapy device used to treat neonatal jaundice.
  • Millie and Kelvin have adjusted the PneumaShoe (now called MwaziFlow (mwazi means blood in Chichewa)) to be a pneumatic compression device for bedridden patients. The cuff now goes around the calf, thigh, or arm instead of the foot.
  • Vin and Mpha have designed the graphical user interface (GUI) for a Nurse Alert system so that patients can call the attention of a nurse from their bedside.
  • Erik and Alinaya have redesigned the external filter for the oxygen concentrators to prevent the damage caused by dust.
  • Naod and Webster were able to find a process to manufacture cup seals for the oxygen concentrators locally so that replacement parts are not so expensive.
  • TK and Bernadette fixed several oxygen concentrators and wrote a novice training manual to teach how to fix broken equipment.

Time (5)

Reading the short story Story of Your Life by Ted Chiang (the basis for the movie Arrival) I became preoccupied with the notion of time and how culture morphs the elusive concept. In the short story we learn- through the perspective of a linguistics professor-of humanity trying to communicate with extraterrestrial visitors who understand time very differently. The more she learns their language the more she begins to experience time as they do. From an scientific background time’s arrow is the result of entropy (caveat: after reading Story of Your Life this may just be an anthropocentric conclusion). Time’s one-directionality is a notion that I can safely assume ALL humans experience and understand. If not please contact me, I’d love to talk! This lead me to question whether culture impacts humanity’s understanding of time.

My time in Malawi has really showed me how culture truly warps time. Forewarning, I’m not saying that culture influences “scientific time” but instead that our perception and anthropomorphism of time. For example, in the States we have a saying that time is money and money is time. This causes us to be more sparing with our free time. Our culture on one hand stresses timeliness and scheduling which makes for an efficient workforce on the other hand workaholic-ism is also stressed.

Busyness is worn as a badge of honor, pervading every nook and cranny of American culture. From hospitals to college campuses, an inordinate workload has become our national pastime. Our cultural perception of time as limited and commercially valuable causes us to value this workload hysteria even with its exhaustive consequences. Using time to its fullest extent and more is a sign of maturity, success, righteousness, and modernity.

Here in Malawi time marches at a slower pace. There doesn’t seem to be a culture obsession with time. This is evident in what is playfully known as Malawian time. Wether it’s waiting to be served at a restaurant to scheduling meetings, time is negotiable. As a visitor I was at first taken aback by the long waits at restaurants, the tardiness, and the disregard for set meeting times. However, after taking a step back and realizing that I was projecting a Western understanding I was able to see the beauty in the slower pace and learned how to implement in my life.

Our cultural understanding of time is unnecessarily stressful and even though some of us may believe we work better in this stressful environment our mental health and health records show otherwise. In Malawi a lassie-fair approach does indeed make the work day and people more enjoyable (earning them the title Warm heart of Africa). I believe that both Malawian and Americans could learn so much from this difference. We know that valuing time does indeed create a more efficient society but at the same time commodifying time harms said society.

The more time I spend in Malawi the more I learn to value time with all of its paradoxes and abstractions. Time isn’t money, time is something much more special and profound. So let’s not waste it on our cultural obsession with success. Instead let’s learn to use it efficiently and meaningfully. Also who doesn’t love longer lunch breaks!

Dizzying Data!

Reporting live from the office, it’s me, your favorite non-engineer in this internship! (by default as the only one) Unlike everyone at the design studio, I have no exciting photos of the device I’m working on. Instead I thought it was more realistic to have a picture of some of the data I’m working with. As exciting as over 200,000 data points sounds, it can be a slight pain to manage! Here’s a spreadsheet of some of the ambient temperature data collected from the nurseries at different hospitals.

Essentially, each time our CPAP team visits a district hospital to check on equipment and ensure proper maintenance on CPAP devices, they gather temperature information from sensors that run 24/7. Unfortunately, they usually end up putting these txt files into a dropbox folder and then don’t get a chance to organize them. Now that our CPAP office has a handy dandy intern (oh hi, that’s me) we now get a little more analysis and insight into how hospitals are managing their temperatures! I took aaalllllll of that information and condensed and compiled and sorted and added until we could look at all these numbers and actually understand what was going on. As a result we can now compare night vs. day temperatures, Northern vs. Central vs. Southern hospitals, summer and winter temperatures, District vs. Central hospitals, etc. The graph below managed to provide a very interesting insight on this last comparison.

On this graph the warm colored lines demonstrate Central hospitals (yellow line is daytime, orange line is nighttime) and the blue colored lines show District hospitals (lighter line is day, darker line is night). What we can see is that the larger, better funded Central hospitals manage to keep relatively consistent temperatures throughout the year, only dipping slightly during the colder month. However, the District hospitals show a huge drop in ambient temperature in the nurseries.

You might be wondering – why do we care about the air temperature anyways? Newborn infants, especially those who are premature, often struggle to maintain body temperature. Hypothermia kills lots of neonates each year because when so much energy is spent trying to maintain temperature, their bodies have a harder time fighting infection, breathing, or absorbing nutrients. One discovery when analyzing CPAP data was that below a certain threshold temperature, it doesn’t matter if the infant is put on CPAP or not, they usually don’t make it. This knowledge energized efforts to keep neonates warm through all means possible. While kangaroo mother care (where the baby is wrapped tightly to the mother with skin to skin contact and radiant warmers/ hot cots are very useful tools, often they are not enough by themselves. All hospitals are strongly encouraged to use any available space heaters and warming lamps to keep the entire nursery at a higher temperature. This way babies are better supported  while being fed, moved, or adjusted. As a result of organizing this ambient temperature data we now have more insight when looking at mortality rates month by month. It might be able to help explain differences between Central and District hospitals throughout the year. It’s great to see that the Rice 360 program and our CPAP team here in Malawi are not just focused on one device. Instead they are dedicated to determining each element of essential neonatal care so that the support and technology we provide is comprehensive and focused holistically on the health outcomes of the babies.

 

techn-engineer

To be an electrical engineer doesn’t only mean designing and implementing the design but you should also be able to diagnose, troubleshoot and fix some faults in electrical devices. For the past 4 weeks that’s what I have been doing. We (with my partner) call ourselves TEAM ReMeDe (REpairing MEdical Devices).

Our main focus was on the oxygen concentrator; we learnt how they operate, some common faults encountered and basic procedures on how to fix them. The job wasn’t that easy as to all of us it was our first time working on that machine but with the help of the service manual and some advice from our supervisor George we managed to fix all the machines that were brought to us to us.

So basically the common faults with the oxygen concentrators that we worked on were the wearing out of the compresser kits, contaminated sieve beds, blown out fuses and constricted pipes. All these problems could cause the oxygen concentrator to produce no or less oxygen concentration.

One thing I have learnt through this internship is that lessons learned from mistakes are of great worth. I remember  when  we were trying to fix the first oxygen concentrator and burnt the sensor the other teams started laughing us they even  changed our team name to burmede (burning medical devices).it was so discouraging coz that moment I felt like we couldn’t do it anymore, I felt like a failure. But that pushed me forward coz since that incident we tried to follow the necessary procedures so we could not damage other components again. The most challenging task I faced during the repairing was the replacement of the cup seals to the compressor. It wasn’t an easy task to try fitting the cup seals on the cup. But all in all it was really fun….

Adios amigo…….

Cup Seals To Coding

Its been while without posting but work was still the order of the day. Soon after completion of hospital visits, more research on our project was done.  We had to understand the properties of the material that we were to use  for producing the compressor cup seal. The material is called the PTFE and its a self lubricating material.  We thereafter  had to come up with CAD drawing to use for laser cutting. At our disposal, we had three types of the PTFE material but we worked only with two. The difference mainly is the infill.  Cup seals then had to be tested to compare the performance  and the rate of wearing of the two materials.


The testing of cup seals required us to collect pressure readings for a period of 3 days. why pressure? its because the  function of cup seals  is to prevent air leakages during compression in the compressor. low air pressure than the recommended range of 10 to 30 psi would mean something is wrong with the compression process; more likely air leakages in the cylinder.  Collection of this data had to be done as often as every minute.   pressure analyse was not an option hence we had to come up with an Arduion data logger.   This was another interesting part of the project as we had to learn more coding and pressure sensors.

We tested one material so far (white one) and it turns out to wear out more rapidly than we imagined. Now looking forward to see the results of the green material which is under testing.

The Nitty-Gritty Begins

During the first week that we spent focusing on our assigned project (repairing medical devices), that Monday was Eid ul-Fitr so we had a holiday. Happy Eid Mubarak my brothers and sisters.

During that week we began by focusing on the Oxygen Concentrator. We read about replacing/fixing the compressor, sieve beds, solenoid valves and circuit board in the service manual, with a plan to read about the other components at a later stage. What I took away from the whole process is that the repairing procedure involves identifying which component or components on the concentrator are malfunctioning and replacing that or those components. This is because basically, the Oxygen concentrator is built modularly.

Working on the Oxygen ConcentratorOur supervisor walked us through the troubleshooting process he uses and we were able to identify the obvious problems that might occur with the device but are left out of the troubleshooting section in the service manual. These are the things that we wrote about in the guidelines for novices.

We learnt how to do the standard diagnostic tests on the oxygen concentrator during the week. There are precautions to be taken with some of the test that we did not adhere to very well some there were some mishaps but the problems caused were rectified.

For my personal project during the Friday afternoon period I decided to refresh my Arduino programming skills. I started reading through the notes I had written from my last internship on Arduinos and build up my knowledge there. What I took away from reading back is that practice is very important. Having to go through all the steps in programming that I have forgotten is annoying and with practice I could have avoided it.