Catching up on photos

 

I’ve been a little behind in keeping up with posting photos in my blogs. I thought I would make a post that has some photos I’ve been meaning to upload, so that you can have a visual as to who and what I’m talking about in my posts. My apologies for the resolution of some of the photos, and for not making this kind of post sooner.

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The team discussing the ergonomics of our phototherapy dosing meter from a simulated nurse’s perspective.
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Andrew describing what he envisions for the exterior of the phototherapy dosing meter.
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A broken oxygen concentrator in the PAM warehouse.
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A series of donated syringe pumps laid to waste at PAM- these devices can’t be used because they weren’t donated with power adaptors, user manuals, or disposables like syringes.
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Sarah, Charles, Alysha and Andrew fixing broken bCPAPs in the bCPAP office.
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Christina, Andrew, Francis and Sarah working together on moving a circuit into housing.
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Jacaranda school, where we gave a talk to primary and secondary school students about going to college and being an engineer.
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Christina and a student from Jacaranda.
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Dr. Saterbak and myself walking at Satemwa Tea Plantation.
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The Poly and QECH interns halfway up Mt. Mulanje- the tallest mountain in central Africa
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An elephant seen on our boat safari in Liwonde
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Christina and myself at Lake Malawi.

 

(Mostly) Low-resource design

A large focus of BTB’s design projects is that they can be created from parts locally sourced in the setting they are being delivered to. Having locally available materials ensures potential for production of the device without Rice’s participation or intervention. As BTB’s first design-centered interns in Blantyre, Catherine, Sarah and I have an opportunity to observe firsthand what is and isn’t available here and to shape our design on local materials. Doing this makes it easier for BTB to deliver our technology to QECH with assembly instructions, so that PAM or some other qualified personell could build more without our help.

For the Poly interns, this internship offers a different opportunity. The students at Poly are normally limited in their designs and prototypes to resources that can be found in Blantrye. If electrical parts are hard to come by or very expensive here, students have to design around those components. Therefore, for Charles, Christina, Andrew and Francis, having American friends who can bring materials with them serves as a unique opportunity. They have a chance to exercise their circuit design expertise using parts they may not have access to at other times. Parts from the US are tools for practical experience that makes them better engineers in the long run, and the ten weeks we are in Malawi is a window of time during which they can use those tools.

In practice, our designs have partially been locally sourced and also included some hard-to-find parts that we had sent from the US with other Rice visitors. We kept the circuit for our dosing meter on a prototyping breadboard as opposed to soldering the components so that future Poly design teams could use the components. We sourced everything but wire for our chitenje warmer device from Blantyre, but we had to order the wire online in the US and have it shipped. Our suction pump has a pretty complicated circuit, so a lot of our parts had to be brought from the US, although or initial prototypes used infrared sensors and diodes taken from VCRs and remote controls found in the local market.

Trying to find a balance between local sourcing and bringing supplies comes back to the question of the most important goals of our internship, and how we are trying to accomplish them. We are expected to design prototypes that can be continued into real interventions in a hospital, so that our work makes a tangible impact on the community. That impact is a goal of BTB’s and it is part of the beauty of the program; as undergraduate students we still get a chance to design and build devices that will actually go to patients, as opposed to theoretical problems being solved simply for the sake of our education. When we use locally available materials we are ensuring that our designs have a greater potential to reach the point of patient use.

However, this internship is also a learning opportunity. We are expected to get something out of this summer that will make us better engineers and further our education. Our group of seven is gaining a lot of knowledge on design and iteration, on scoping problems, on working on a team, and on working independently without continual due dates or deadlines to keep us in check. Working with a variety of parts- even those we can’t find in Blantyre- is part of that education. In the long run, the lessons we learn from this internship should help us to become more capable at doing the same kind of work later in our career. It has been interesting to notice the way these two goals intersect and sometimes conflict, as in the example of finding parts. I believe that our team has done a pretty good job of balancing our interests, and I hope that finding our balance will result at the end of the summer with a few strong designs to show for our work.

Rice and the Poly

As Sarah, Catherine and I have gotten to know Christina, Andrew, Francis and Charles better, we have had more opportunities to compare our lives at university and our different cultures. Our friendship has given me an opportunity to learn a lot about Malawi, and it has made me much more appreciative of the place and people I’m visiting. Here are a few cultural differences and similarities that we have discovered that I think are particularly interesting:

Differences:

Getting in to University

In most schools in the US, you apply to the university as a whole, or maybe to a particular school such as the school of engineering or social sciences. If you are accepted, you have the flexibility of choosing your major within the university or school to which you applied. If you decide to switch majors under that domain, it is relatively easy to do so. 

When I was accepted to Rice, I first got an email with my acceptance and some information about what to expect. A few days later I received a letter in the mail, with confetti, a letter of acceptance, and congratulations. I remember getting the email and later the letter and being ecstatic about the prospect of starting a Rice career.

When applying to a university in Malawi, you rank the top three major programs you are interested in pursuing. Admissions staff will compare your test scores and performance in secondary school, and you will be accepted into one of the three choices. If you wish to change majors or schools, you must reapply and qualify for the new choice separately.

Acceptance to different university programs are announced over the radio. Secondary students will tune in at a certain date and time, and the broadcaster will announce the university and the program for which they are naming the accepted students. They will then say the names of the students and the secondary schools they come from. Using the radio would allow students who may not have a mailing address or consistent access to the internet to find out whether or not they got in to college. Our friends at the Poly have told us that when they got in to the electrical engineering program at the Poly, they were equally as thrilled as I was when I got into Rice.

Perceptions of Malaria

In Malawi, Malaria is an extremely common disease. Much like the flu in the US, it is understood to be dangerous but also seen every year. Francis, Christina, Charles and Andrew told me that getting Malaria happens at least every few years for each of them, and that it’s not that big a deal when it happens. If they get malaria, they go to the health clinic to get medicine and they try to get more sleep and just wait it out. Christina said that the worst time is the very first time you get sick, because your body has no immunity to the virus. After that, your body becomes better at responding when you are infected, and typically you may have to miss a few days or maybe a couple weeks of school before you’re back on your feet. I was told that everyone sleeps under a mosquito net every night preventatively, and that the government even provides a mosquito net to babies when they are born in the clinics.

I’m sure it’s needless to say that Sarah, Catherine and I have a very different understanding of Malaria. This is largely because it doesn’t exist in the US, and because it’s a very popular conversation topic among global health workers and development agencies. We learned in our global health classes that malaria is one of the top killers in developing nations around the world, including Malawi. Although we weren’t wrong in being concerned about the severity of the disease, It was an interesting difference between Malawian and American perspectives to learn how malaria is also a part of everyday life. Malaria is dangerous, but it doesn’t inspire nearly as much fear in my Malawian friends as it does in Sarah, Catherine and myself.

Similarities:

Girls in Engineering

Things are changing in the US, but there is still a large unbalance between the number of women who pursue careers in engineering as opposed to the number of men. According to the National Science Foundation, women made up only 18.6% of the enrolled undergraduate population pursuing an engineering discipline in 2011. At Rice, there’s evidence that the problems still exist, but things are moving in the right direction; Sarah told us that there are only six out of nearly forty rising juniors in the electrical engineering department that are girls, although my year of in the bioengineering department is Rice’s first class with more women than men.

At the Poly, the gender gap is also pretty apparent. Christina says she’s one of three girls that started in first year and will continue to complete their fifth years in electrical engineering, out of about forty students. Most of the engineering faculty we’ve met are men. However, Christina also told us about outreach programs she’s involved in that goes to local secondary schools and inspires girls to pursue engineering and other STEM fields. When we visited Jacaranda primary and secondary school, Christina delivered some very inspirational words to the girls in the audience about working hard towards dreams of careers in math and science.

Social Media

One of the biggest similarities between Rice students and Poly students that I’ve seen is the use of social media. Andrew told me that Facebook is pretty common among his friends and classmates, along with Instagram and WhatsApp. Social media is very essential during the year at Rice, and it’s been my tool the past six weeks to let me keep in touch with family and friends. The happiest part about our shared habitual usage of social media is that it will allow Sarah, Catherine and me to keep in contact with Charles, Francis, Andrew and Christina when we leave. If pursued smartly, social media connections could be a great way to facilitate communication between Rice and Poly students in the future, especially since the common practice of daily use is already set in place.

The start of something new

This fall, the Polytechnic is starting a new biomedical engineering (BME) program. It will be the third university in Africa to offer BME, and the first in Malawi. The Poly will offer two different paths- one is a three-year technical program that provides training relevant to technicians, and the other is a five-year degree program that graduates higher-skilled engineers. The two programs are comparable to education for electricians versus electrical engineers, or auto mechanics versus mechanical engineers. The five-year program is similar to Rice’s bioengineering program, although it is more specifically focused on device design as opposed to cellular or tissue engineering, and it is affiliated closely with the electrical engineering department. 

As a bioengineer, it is very exciting for me to be at the Poly during the final preparation for the new program. It is a chance for me to observe how a engineering degree program is structured, and also to get to play a role in BME’s first introduction. One of the biggest ways that Sarah, Catherine and I are contributing is with the orientation week for new BME students. Because it is a new program, we have a lot of flexibility in our planning and a valuable opportunity to bring some great qualities of Rice’s O-Week and their bioe program to the Poly.

The orientation week we are planning is designed for the forty or so new students to the Poly that have been accepted into the BME program. The students will be coming from secondary schools all over Malawi, so they will bring with them a range of experience with medicine and engineering. Some of the students may have finished a program in a technical college, and are now seeking a five-year degree that would offer more opportunity. In our plans we are trying to offer the fundamentals of BME and engineering design, so that even the students with little previous engineering experience are prepared for the next five years at the Poly.

With four weeks left before our orientation week takes place, Sarah, Catherine and I have started thinking of lectures and lesson plans for activities that we hope to offer the students. We have been trying to align the entire agenda with three goals; to introduce students to the Polytechnic, to show them what skills are necessary to be a biomedical engineer, and to give them an understanding of what the career of a biomedical engineer can look like. We are collaborating with wards at Queen Elizabeth Central Hospital and Physical Assets Management (PAM) at the hospital, who oversees the repair of medical devices used in the hospital. Hopefully with these connections we can expose the incoming students to real-world BME, so that they can have a more tangible context to the work they will be doing at the University. We are also planning a week-long team design project, so that the students will be exposed to the design process and also get experience in collaboration and working on a team. Both of these skills are absolutely necessary in any type of engineering, and we hope that by providing an early exposure to both we can help the students use these skills in their future coursework.

With no precedent to the program or to the orientation week, it is difficult to predict what exactly our activities will look like or how they will play out. Nonetheless, our combined experience of bioe, global health, and general engineering design classes are a huge asset and a resource that I’m sure will be put to use as we draw closer to the event.  I look forward to facilitating the orientation, and getting to see the BME program unfold in real time.

Some Observations

Nearly every night after dinner, Sarah, Catherine, Tanya and Karen and I sit for what can sometimes be hours and discuss the work we’re doing and what it means. It is one of my favorite times of day, because the conversation helps direct me to be mindful of the place I’m in and the way we interact with the community.

It appears that the Poly may have a less direct connection to those global health challenges so apparent in Queens, because we’re tucked away in our lab building prototypes instead of witnessing sickness or death firsthand. In reality, our team is working towards solving the same problems that you can see so clearly in the hospital, and therefore the problems and underlying challenges in the clinic are actually very relevant to our work. Even beyond the direct problems of global health, it is important for me to remember that themes of development and outreach are still related to me, even if they don’t always feel entirely tangible in the lab. With that logic, the observations I’ve had about common misperceptions within the development community around Blantyre may not be prevalent in my daily interactions but they are a fibre of my work. Here are the two largest misconceptions I have started thinking about from our dinner conversations and my general observations:

Misconception #1: Sustainability = education.

A large focus of groups intending to provide medical or public health interventions is to be sustainable in whatever service they supply. Leaving medical supplies is a short-term intervention. People don’t want to simply drop off materials or donations and leave; they want to ensure that the things they bring to the community have impact after they leave. The trouble is when that sustainability is equated wholly to education.

It is often true that educating people about a new health practice or educating healthcare workers about device maintenance can go a long way towards really helping a community. Education often has a long half life, so if you can effectively teach a new skill to someone it is unlikely that their new knowledge will deteriorate much over time. But oftentimes the largest obstacles to an intervention in global health aren’t as straightforward as a lack of education. Maybe it’s not worth teaching a community how important it is to wash their hands if they don’t have consistent access to clean water. Knowing how to repair a device can only go so far if the clinic you work at cannot afford replacement parts. These may seem like obvious examples, but in my experience it is much harder to make these kinds of observations when you aren’t removed from the setting. Sometimes frustration about an unexpected condition or excitement about a new project can impair vision about what the real issues are.

To avoid falling into this misconception it is absolutely essential to have a solid understanding of the environment you are working in. In engineering terms, the process of understanding the problem and forming theoretical design criteria for every educational service or new skill you try to offer is one of the most important steps in the process. In my case, I am lucky to have six other interns that I work with who can help ground my judgement and come to a more complete understanding of the global health problems we are trying to address. Staying conscious about my own perceptions helps me self-regulate and stay diligent about getting all the facts straight.

Misconception #2: There is only one type of solution that works.

This one came mostly from some of the books I’ve been reading on health and economic development interventions in Africa in the past. A lot of experts will argue either entirely in favor or completely against some kind of program- either aid cripples an economy and it must be stopped, or it is necessary to prevent countless deaths and cannot be stopped in the near future. Either hospitals must indefinitely depend on supplies from the US and other foreign entities to keep patients alive, or they should try an immediate reduction in dependance on donations of supplies to stimulate their own medical markets. One article will say that low-resource settings cannot develop without the help of others, and the next will argue that they never can develop while being handicapped by others’ interventions.

In my experience, these macroeconomic assumptions hold less water when tested on the ground. Malawian mortality rates and disease prevalence cannot be attacked with a straightforward, unidimensional approach. The best strategy is different for each circumstance, and it depends on the long-term goals and the urgency of the need being addressed.

As an example, consider the need for pulse oximeters in many of the wards I visited this year and last year. The lack of available pulse oximeters is and has been a large problem in Queens and I’m sure in other healthcare facilities in the area. An all-or-nothing approach from some of the authors I’ve read may be to not intervene in any way in order to supply these devices to the clinics. The lack of adequate technology would spurn the start of a market to locally manufacture or find pulse oximeters. If the need is present, eventually healthcare workers and government officials will find a solution, and because that solution won’t have depended on outside entities it will be much more self-sufficient than any other kind of intervention. However, this kind of sustainability is achieved at the expense of the patients in the wards today, those who are in conditions critical enough to where they cannot wait for the needs to drive the market. There’s no way of knowing how long it would take before the pulse oximeters started appearing sustainably, and in the meantime there is still suffering and mortality.

The other extreme is to look more at the short-term needs in a setting. Pulse oximeters tend to be extremely expensive, especially the type that are small enough to be used on infant patients. They’re also relatively delicate- they require maintenance and repair, as well as a periodical battery change. If an NGO delivered one hundred pulse oximeters to the nurseries at QECH, immediate patient care would improve. However, as those pulse oximeters slowly deteriorated over time, as more and more broke or were lost or ran out of battery power, the intervention would become less effective. In a few years, the hospital may be back in the same situation of not having all the tools necessary to deliver a high standard of care. Therefore the approach of indiscriminate aid or donations is also impractical, because it fails to attack the heart of the problem.

Pulse oximetry is a unique example because it highlights an area where neither method of international involvement is ideal. Other strategies like BTB’s to deliver pulse oximeters that are affordable by the hospitals try to straddle the opposing issues of providing a service while also encouraging local sustainability. There are also many other areas where one side of the argument may be better for the community than the other. The point I want to make is that the underlying issues faced in global health are multifaceted, dynamic and deeply rooted in history, economics, culture, and geography. Because of their complexity, it is impossible to make blanket statements about whether or not interventions in low-resource settings are good or bad. Each circumstance must be observed with respect to the unique setting and context that defines it.

Looking ahead: Things that should suck and other things that shouldn’t

This next week looks like it’s going to be pretty busy. One of the big things we’ll be starting is the design of some supplementary component to add to Queens hospital’s suction pumps, which break often. Suction pumps are used to drain fluids from the patient’s lungs, stomach, and throat. The problem we’re going to be solving occurs because nurses don’t have time to constantly monitor the suction pumps when in use. The pumps drain all waste into a large container, but when the container fills up beyond it’s capacity the fluids will start to enter the tubing that connects to the main device and motor. If the fluids get into the motor, the device breaks.  Our team of electrical, biomedical, and mechanical engineers wants to create something that can be added on to an existing pump, so that either the fluids don’t have access to the motor, an alarm sounds to alert the nurse when the container is full, or both. I’m very excited about this challenge because it’s a unique one; we aren’t designing something completely from scratch, but instead we must lend our design to absolute compatibility with any suction pump found in Queens. We’ve started doing some basic research, and I think by the middle of the week we’ll have enough background on the issue to start thinking of design.

The other project we intend to get a good start on this week is a website that can be used for communication between Rice and Poly design teams. Sarah, Catherine and I were in such awe when we brought the Rice design projects in to show Charles, Christina, Andrew and Francis, and they immediately had great feedback about all the technology. Having a platform for direct contact between students would be valuable for design teams to have other perspectives on their devices. If communication was sustained, it would be personally valuable for each side because they would have a better understanding of what engineering is like across the globe. Francis and Sarah both have a lot of interest in starting this project off, and I have a little bit of background in website design that I hope will be helpful to them. We’ve set some pretty ambitious goals for this week, but I think there is so much enthusiasm and passion for the work that achieving them is well within our power.

Some thoughts

With the dosing meter nearly completed, the seven of us have started to look forward into what projects to tackle next. There are so many opportunities for ways to spend the next seven weeks, and a lot of different interests. We have a variety of ideas for new design projects, and if we spent the next eight weeks doing them we could probably finish at least a few first generation prototypes. However, we also have some ideas more related to Poly-Rice relations or the new bioengineering program, and if we jump start some of these we may have to be a little more selective with how we spend our time.

One of the design projects we are most interested in is a thermoregulator for babies at home. Neonates tend to have trouble regulating temperature, and it is not uncommon for infants to suffer hypothermia at home, especially in the winter. We were given the idea of building a feedback system that could monitor a baby’s temperature and set off a beeper if hypothermia is reached. The device would be wrapped around the infant before going to bed, so if the mother or father is asleep when the baby gets cold the would be awoken. Because it would be intended for home use, this device would have to be very inexpensive and made largely of local materials.

Another idea we had was some sort of addition to the suction pump machine used in the nursery that would prevent some of the common breaks in the device that put it out of use. The suction pumps are used to drain excess fluid from the patent’s lungs and throat. Right now, the use of a suction pump requires constant monitoring by a nurse or clinician to turn the pump off when the waste containers fill up. If the pump is neglected, it will overflow and fluid can get into mechanical or electrical parts of the machine, clogging the system and damaging important components. The Poly interns and Sarah, Catherine and I have started talking about some sort of addition to the pump that would stop suction when the waste containers are full. We have discussed both electric and mechanical mechanisms that would provide this function, but we haven’t set any of our plans in stone yet.

One of our biggest objectives for this internship is to collaborate on design projects with the Poly students, and the consensus is definitely still in favor of pursuing at least one more design. However, as the first BTB students to pilot this kind of internship that works directly and fully with the Poly, Sarah, Catherine and I also want to find a way to give the Poly something sustainable that would enhance some facet of their engineering program. The bioengineering orientation week we are helping to plan is an example of this; we are contributing something to the bioengineering program that uses our specific skills and that could be continued after we leave. We’ve also had thoughts about creating some kind of forum for communication between Rice students and Poly students, or helping build more connections for the Poly to Queens Hospital and other members of the Blantyre community, so that their new bioengineering program has a local network to work with and build off of. All of these ideas are still in the works, and we’re trying to sort out our priorities and strongest interests.

Personally, I have two main objectives that I want to pursue in choosing our next project. Of course, one of the most important things to keep in mind is how to choose projects that are guaranteed to be sustainable. If our designs cannot be improved and tested, or if our other projects are never used by Rice or the Poly, it defeats the purpose of why we’re here. We have all talked about ways to ensure that the projects we’re picking up have some kind of lasting impact on our schools or the greater community.

The other thing that I have been thinking a lot about is how to make our project unique to our internship. A lot of the design projects we have are really interesting, but there’s no reason for other students in BTB or at the Poly shouldn’t work on them later, back at the OEDK or here but without the American student’s help. I’m sure it would help the fledgling bioengineering program here to start making connections with PAM and fortifying their relationship with Queens, but I also feel that those are goals that are already being pursued by Poly faculty with BTB’s help. Some things like a website to facilitate communication between Rice and Poly design teams, or a design project that involves a replacement part to an already existent device that breaks often would be tasks that benefit from the Rice-Poly team that we have right now. I would like to think that our team dynamic and the way we were able to work together on the dosing meter would provide a unique asset to some of our ideas in a way that will be hard to replicate until next year’s interns fly out. I know that we will be keeping these thoughts in mind as we pick our new projects, and I’m really looking forward to seeing what we decide.

Designing a Photodosing Meter

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A view of the Polytechnic with Mt. Soche in the background.

This past week was very busy, as the other interns and myself have started settling in and getting to work on our projects. The project of the week that took the most of our time was the bilirubin dosing meter, which measures the amount of blue light given to a patient with jaundice. Most jaundiced patients are neonatal and tend to be in a fairly fragile state, so delivering the right amount of light is necessary to ensure the baby is being adequately treated without any risk of over-exposure. 

The prototype we are building is inspired by a few designs that have proliferated the global health domain. Students in last year’s GLHT 360 course had created a design based off of a design from Engineering World Health, which included a solar cell and an analog ammeter to give dosage information. A design by students at the Poly used an Arduino to display light intensity on an LCD screen, and measurements were taken with a photo-dependent resistor. It was our job to come up with a prototype based off of those that already existed that was cheap, accurate, and easy to use by healthcare workers.

Some of the decisions made in our new design were fairly easy; we chose an Arduino and digital display like the Poly’s prototype because of the inaccuracies of an analog reading, and we decided a solar cell because they had a wider resolution and were cheaper than alternatives. Other decisions though, like the shape of the device or how to ensure optimal placement, required more deliberation and creativity. It was these decisions through which our team dynamic and the diversity in our way of thinking shone through. I brought Catherine, Christina, Charles and Andrew to meet some of my acquaintances in Chathinka so we could get from them some feedback on how they normally deliver blue light therapy in the nursery, and whether they would prefer a single device containing sensor and display or whether it would be optimal to separate the two to have a display component attached to a sensor probe. This kind of feedback was so valuable because it directed our design decisions; although we had many ideas on what nurses and doctors may like best about different designs, we couldn’t really know the answer to any of our usability questions without asking the potential users themselves. 

Another area that offered us some creativity in this domain was deciding how to ensure the healthcare worker was positioning the device properly. The photocell is very sensitive to minute changes in angle and positioning under the blue light. It is essential for healthcare workers to be able to easily place the device under the blue light while keeping the solar cell parallel to the ground and as close to the patient as possible. 

After some brainstorming, the team decided the best way to ensure parallel angling was to include mechanical levels on the surface of the device, like those you would use to would use to hang a picture on a wall. Thinking about how to best ensure that the sensor was placed close to the patient sent us back to the drawing board for design of the device housing. Because of the addition of the mechanical levels, the idea of a probe attaching to a display was discarded. We went through a few iterations before deciding on a design that would be an elongated rectangle, with the sensor on one end and the display on the other. The length of the box allows us to keep the width fairly thin while still housing all the components, and it also gives the nurse or doctor a good view of the display while keeping the sensor close to the patient.

I really enjoyed working on the photo dosing meter with the group because it taught me so much about designing in the context of user needs, and because the creative outlets in the design process gave me insight about our team dynamic. The seven of us are very diverse, in nationality but also in engineering background and in the way we think. I thought it was very interesting to see how our differences played into the way we approached the design, and then from there to get to build our ideas and turn out an actual device that could serve a clinical purpose. I am really looking forward to the other projects we will start to now pick up.

A case study of our first week

Sarah, Catherine and I came to Malawi with a lot of different medical device prototypes and ideas. Some of them were products of global health and senior design classes that need feedback for further modifications. A lot of space in our suitcases was occupied by parts of theoretical designs that we anticipated prototyping with our Poly friends during our internship. We also carried a significant amount of general prototyping materials, so that if we discovered any particular opportunities for completely new designs, we would have what we needed to build our ideas.

On our very first day in the lab, Christina, Andrew, Francis and Charles had a ton of great feedback about the prototypes we already had built. One of the first devices we demonstrated was a heating system for the bCPAP device. The bCPAP is used for patients who are premature and have difficulty keeping their lungs open to breathe. The device uses positive pressure to deliver air to the patient’s lungs, but the air is not warm which can be a problem as patients this fragile also often have trouble with thermoregulation. The device we showed to the Poly interns was designed by Sarah and some other students at Rice this past semester. A large nylon sleeve containing resistance wires is snapped around the bCPAP tubing, and is attached at one end to a small circuit box. With the flip of a switch on the circuit box, the resistance wires in the sleeve heat up, and the air in the bCPAP tubing is also heated. By the time the air in the tubing reaches the patient, it has been warmed to body temperature. A temperature sensor at the patient end of the tubing acts as a feedback system to ensure that the device is maintaining body temperature and not overheating the patient. 

Anjrew drawing up a circuit schematic for the bCPAP heater

Andrew explaining a modification to the bCPAP circuit

Immediately after Sarah explained to us the specifications of the heater, the Poly interns had a number of ideas for improvements. The first one was an additional safety component of the circuit, which restricted the total possible amount of voltage that the resistance wires would receive. This ensured that even during a power surge or a short in the circuit, the patient would not be exposed to extreme heat. The second was a method of adapting the wall power in Malawi to a level that the circuit would be able to handle. This would reduce the cost of the device and make it more adaptable by eliminating the need for a special power cord. Instead, any power cord with the right connection to the circuit box and a plug that fits in a Malawian outlet can be used. To be honest, a lot of the electrical engineering components of this internship so far have been a little bit out of my realm of expertise. I’m lucky that Christina, Francis, Andrew and Sarah- the electrical engineers on the team- are so willing to slow down and help to explain things to me. I have been receiving an excellent education so far in circuit design and function, which is something I’m sure will come in handy in the future.

The things I’ve learned in the past week aren’t just restricted to prototyping and circuits. I have worked on a number of different engineering teams during my time at Rice, and I have experienced exposure to a new culture before, but this trip is the first time for be to do both in tandem. Our intern team can be much more creative in our ideas for modifications to devices or future design projects because of our different backgrounds. And working together as partners with the Poly students has given me so much more insight into Malawian life and culture. Working with fellow students allows us to use shared experiences such as life in college or our passion for engineering as a platform on which we can understand one another, and with this foundation we have a much better perspective about how our personal and cultural differences define us. I have high expectations for the next two months ahead of me, and I hope that by the end of them I can bring back with me a real understanding of the lives of my new friends.

So I guess I’m doing it all over again

The University of Malawi Polytechnic
A view of Blantyre taken from the top of Mt. Soche taken last year
A view of Blantyre taken from the top of Mt. Soche last year

My last blog post from my internship in 2014 was answering the question of whether or not I would consider returning to Blantyre with BTB again. Apparently the post was less of a reflection and more of a prophecy for this coming summer. I am beyond excited to return to Malawi, but I know that this trip will be very different than my two months last year. I look forward to being in the same city, to seeing some of the same people, and to have the chance to brush up on my Chichewa, but I have been working to keep in mind that my work for this year will be a whole new experience of its own.

This year I will be working at the Polytechnic Institute of Malawi, which is a branch of the national University of Malawi. There are around 7,000 students in the University of Malawi spread among five colleges. The Polytechnic houses the business, accounting, architecture, mathematics, communications, and engineering schools, among others. Currently the engineering department offers degrees in mechanical, electrical, and civil engineering, and they are initiating a bioengineering degree program. The Poly is also working with partners at Rice to create a space similar to Rice’s OEDK that would be used for student engineering design projects and classes. The Poly is already collecting design software and mechanical tools that will be necessary for future students’ prototyping. I look forward to getting to be a witness and a participant in that development.

Sarah, Catherine and I have a few specific projects we expect to complete in our eleven weeks. Firstly, we will be working with students and faculty at the Poly on a variety of design projects. Some of them will be continuations of projects started by Rice and Poly students and some are new projects that we have been assigned or will identify while we’re there. We are hoping for all of the projects to be able to source a lot of the materials locally, instead of carrying them from home and therefore making the projects harder to sustain in Malawi. A second task is to develop a sort of engineering O-week, in which incoming students at the Poly can get some exposure to what it means to be an engineer, in all senses of the word. In our preparation, the other interns and myself have brainstormed some ways that would show incoming students how to think like engineers, how to approach a design project, and what different engineering careers can look like around Blantyre. Once we get on site and have some more specifics about our space and the number of students, we will be able to hash out some details. Along with these tasks we will be helping Dr. Saterbak and Dr. Wettergreen with an engineering workshop for the Poly faculty, identifying potential future design projects for Poly and Rice students, and helping the Poly faculty network in any way necessary to prepare the bioengineering curriculum and the engineering design space. 

So yes, I will be in the same city under the same program that I traveled with last year. I feel the same passion for the place, for the goals I’m pursuing, and for the work I’ll be doing as I did a year ago. But the new experience and knowledge I bring to the table, the projects I will work on, and the people I will be collaborating with make this internship an entirely new experience from last year. I’m so excited to be going back to Blantyre, and I hope that the work I do and the connections that I form with the Poly students and faculty can help me become a better engineer, a better ambassador of the Global Health program, and a better world citizen.