As an engineer I guess it’s in my nature to quantify things. Over the past summer I have waited 26 hours in an airport, been on 3 continents, and spent 47 nights under a mosquito net. I have traveled to 5 different hospitals, worked around 180 hours on my project, and have unsuccessfully pitched over 20 alternative names for the PneumaShoe. I’ve have been to both the highest point at 3002 meters and the lowest point at 37 meters in Malawi. But most importantly I have met 15 amazing, intelligent, and dedicated individuals (14 engineers and 1 economist) who have made this internship better than I could have ever expected over the course of 7 fulfilling weeks.

I am really grateful to have been able to work with my fellow peers to have been given an opportunity to work on something with potential for real world impact. When I first became interested in global health technologies my primary focus was unsurprisingly on designing point of care medical devices. But being able to observe firsthand on different challenges faced in developing nations designing applicable devices may be important, matters of public policy, community adoption, and continued support and maintenance are in some cases more important than the idea or the device itself. As someone interested in both medicine and engineering, these experiences have really come to change my perspective on how problems can be solved. In order to tackle such a complicated problem, say how to prevent oxygen concentrators from breaking, it takes a team to come up with an applicable answer. And I am glad I was able to work with such a great team this summer.

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.

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.

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.

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.

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.

The celebrations during the summer are always my favorite part of the season. Because the days are longer and school is out, summer, especially when I was younger with less responsibilities, was always spent around the barbecue in our backyard with friends and family. The past week was double the fun since both American Independence Day (July 4th) and Malawian Independence Day (July 6th) happened around the same time. And if that isn’t enough Madonna visited the week after to open up a new hospital! However in spite of all the excitement our project still continues; this week we will have another round of tests which will hopefully yield useful results, exciting in a different way.

With the data collected from the previous preliminary testing conducted on the different filtering materials as well as determining possible entry points of dust into the machine we have developed 3 prototypes with attempt to address the problem. The first is simply placing the filter behind the external sponge. While cheap and easy to implement it may not be the best solution since it may block too much air which is used to cool the machine. The second design is a baffled filter box. The folded filter paper has a larger surface area so more air is able to pass through. Finally the last design is an active filter box which uses an external fan to pull air across filtering material into the machine. This design can channel air exclusively from a single area and prevent dust from entering through other vents due to a zone of positive pressure being formed inside the machine as well as force more air into the machine which can be used for cooling. These designs will soon be tested on one of the concentrators hopefully providing good data on which prototype is most effective at allowing proper airflow; internal compressor temperature will be measured after 4 hours of filter testing for each prototype. The results will supplement the week long tests conducted at the end of the week on which proposed solution allows the least amount of dust to enter.

But even with all the fun and festivities around us, as with most great celebrations, they will eventually end. with only a few weeks left we are nearing the end of the testing and the internship. But even though I am feeling homesick right now I have a feeling once I go I’ll be sad to leave this picturesque nation behind. On one hand, I will be happy to spend time with family and friends in the states again, but on the other hand, I’ll miss the new friends I’ve made here at the Polytechnic, Kabula Lodge (the place we are staying), and even the fellow Rice interns which I’ve had the pleasure to get to know better. I’ll just have to make the most of the remaining weeks, making memories and hopefully producing a prototype that will outlive my time here.

Something I have noticed about myself is that I have a very singular focus; I tend to do a lot is devote all my time and focus to analyzing either an idea or an activity, unable to pay attention to other things while this is happening. When I was little I would frequently read books in one sitting, unable to put them down even to go to bed. Although I’ve gotten better at multitasking, this still tends to happen at times. This is sometimes useful; I have been very grateful the night before an organic chemistry exam or before an important presentation. But by redirecting your focus in this way some pretty unanticipated things can happen, often times helping me refocus on the big picture rather than the nitty gritty.

This has been especially applicable for the project, I am currently working on. If you told me right after my previous post that I would continue my initial project, skepticism would be an understatement. I had already begun to internalize what the technicians said and began to focus on other aspects of the concentrator: airflow, ventilation, etc. But what I had ignored was the big picture. Compressors break unnaturally early and something must be causing it. With helpful input from George, a veteran technician employed by the Rice CPAP office for the nationwide implementation of Pumani bCPAP (a low cost medical respiratory device designed to help babies begin breathing), and Matt Petney, the Polytechnic Design Studio director, I was able to refocus on the issue at hand and re-examine the different components that may fail in order to find the problem.

After extensive investigations my partner and I found that the external gross particle filter on oxygen concentrators is wholly inadequate at stopping dust from entering. We ran a battery of tests on the concentrator for this including measuring internal temperatures at different time points, placing concentrators against walls to see if ventilation may be an issue, taking out the compressor and mapping the airflow route of the cooling and compressed air, and of course the extent filtering in the machine. Most of these tests returned normal results except for the filter tests.

In order to test filtering, we designed a airflow detection system and a dust retention system in order to see what types of filtering materials would both allow a lot of airflow into the device and also retain to most amount of dust that can be picked up from the surrounding environment. The airflow test device consisted of two tubes that were separated by a filter with air being pushed across with a fan that could be monitored by a air pressure sensor hooked up to a Arduino processing unit. The dust tension device used a fan in reverse to pull dust from one side of a filter to the other side into a collection container. As expected, the gross particle filter preformed the best at allowing airflow but just as George mentioned it did nothing to stop the dust. (The fan didn’t even be needed to turn on to see this happen). Other materials we had previously acquired were tested as well in order to cover the bases and determine which filter material would be the best should we chose to replace the filter.

But in the meantime we have been sorting through different ideas we had for other ways to solve the problem. After a sorting the weighing the different solutions, we came up with creating a an external filter box which can either passively take in air or actively force air in through the help of another fan attached the the concentrator. Currently we are in the process of making prototypes of these devices to determine which system is better at solving the problem. We will test them over the course of this week; hopefully they will yield positive results.

Besides conceptually reconsidering my project problem statement, this week has also forced me to refocus in a much more concrete (and unfortunate) way. Because of this project, I have been spending my free time trying to learn how to use Inkscape, a free graphics design software, to make containers for the filters as well as brush up on other design software. My computer literally had to die in order to stop me from using Inkscape. Currently I’m typing this blog post on my phone which is an experience I would definitely not recommend. However maybe this unexpected incident will help me rethink the big picture instead of pigeonholing me into designing a filter box. While this is our current avenue of approach we do have other ideas that potentially may be better. Who knows?

Growing up, I was really interested in scientific pursuits and enamored to be a research scientist, solving a problem and furthering the frontier of knowledge in a field. While my interested have shifted somewhat, I have always enjoyed using a logical and methodical method to solve problems systematically; this is one of the reasons I am pursuing an engineering degree and want to continue on to medical school after university. This week however, I realized before that stage can even be reached, there is an arguably more crucial step that I had never considered: needs finding and problem definition. When I have conducted research or even worked on a project in college and in high school, I have always taken the problem at face value. Problem? Cancer affects millions of people. What’s next? Theorize and research. Problem? I don’t get enough sleep everyday. What’s next? Theorize and research. But what if the problem is not a problem?

Sometimes problems change, are ill defined, or are problems in principle but are not common or just don’t happen. While the two problems I have listed above are indeed valid and reasonable problems (and obviously the former is much more important and pressing than the latter), for others it’s not as simple. This is the case for my Rice 360 project, which is finding a solution to protect the compressor seals in an oxygen concentrator from the accumulation of abrasive dust particles. While touring neighboring hospitals in other districts around Malawi and interviewing nurses, engineering technicians, and the matrons of the ward, the majority verdict was while dust can build up and wear down the seals, this just doesn’t happen. Furthermore at three of the four hospitals we visited maintenance is done frequently enough that other parts of the concentrator usually fail first, whether it is needing to replace the disposable bacteria and dust filter, burst tubing, or electrical problems caused by electrical surges. Issues with the compressor seals really do not occur until after 5 years of almost continuous use, and even then overworking and overheating usually are much larger causes for this failure.

It is entirely possible that this still is a problem; technicians speak from what they have seen or heard while working at the hospital and something like dust in the compressor can easily contribute to overheating by increasing the frictional forces or be misdiagnosed as other problems, especially since this only occurs in very old concentrators. Furthermore, another group working on a similar project received conflicting answers about dust from the same technicians. But what I have gathered over the course of the past week is that the only way to know if a problem exists is to personally determine it. Tomorrow my group will travel to Queen Elizabeth Central Hospital (Queens) and discuss with more engineers in order to definitely determine whether my problem truly is a problem. Only then can I go back to what I know best, theorize and research.

While thinking about what to write for this blog post, I am surprised at how many mosquitos I have swatted at and how many times I have slapped my self in the face doing so. Arriving in Blantyre for a week now I have finally gotten my bearings in this unfamiliar place. It feels weird to wake up as my friends and family back home are going to bed and going to work everyday in such a bustling city. Work may have the wrong connotation; what I am doing at the polytechnic, learning how to use different design software and tools and improving my foundation in electronics, prototyping, and basic device knowledge and repairs feels too fun to be called work. Currently I am brushing up on my Autodesk Inventor skills while trying to learn how to use a laser cutter while messing around with Inkscape, a software for rendering digital graphics. This crash course of sorts is all in preparation for our team projects that we will be focusing on over the next month. My project will be geared towards protecting the compressor of an oxygen concentrator from dust and other debris, which can cause wear and tear in the machine over time. Hopefully the skills and knowledge I have picked up on during my time working on my Rice GLHT 360 project will be of some use with this real world problem.

In addition to the work done at the Polytechnic we have also had time to get to know the Malawi Interns better outside of the classroom. Last Saturday was one of the intern’s birthdays so we all got together in order to throw an impromptu party for him. Having a cookout (or braii as it is called here) and dancing to a combination of South African, Malawi, and American music, it is interesting how easy it is to get accustom to a new place when only a week before I did not know what to expect. Apparently it is a tradition here to dump water on the person whose birthday we were celebrating, very similar to celebrating birthdays at Duncan College at Rice (we usually toss people into a tank of water we have by the commons). If not for the mosquitos and the constant reapplications of bug spray, I feel almost at home here.

This week we will be visiting the hospitals across Southern Malawi in order to better understand to the problems we were tasked with and to gain hands on experience on how the hospital system here operates and what role we as students and engineers can provide. It will be interesting to see if the rest of the hospitals are like Queen Elizabeth Central Hospital here in Blantyre and what nurses and technicians do in order to solve some of the problems they face here. Hopefully this can give us more insight to what needs to be done and what we can do to address it.

 

I have no idea what I am doing.

This thought hits me as I sit at the gate waiting for my plane to arrive to bring me to South Africa and then to Malawi. Having already travelled overnight and still with another day to go I feel a pit in my stomach as I write this post. Maybe it was the airline food I had ate hours ago (some sort of BBQ chicken concoction made by the chefs at United Airlines), but more likely it was finally realizing that my internship, spending seven weeks in Blantyre working at the Malawi Polytechnic University with fellow Rice Interns, has finally begun.

Before I continue any further I want to focus a little more on what I will be doing over this summer and what to expect from this blog post. Over the course of this trip I will be working on improving projects that were brought from Rice University, partnering with local students at the polytechnic to discover solutions to major problems here, and conducting needs finding to discover more issues that can be worked on in the Rice 360 class in the coming years. Personally I have brought anti-fog silica gel eyewear attachments that my team and I have worked on over the past semester but we have also brought a breast cancer training model and an ostomy bag train model among others. This blog should chronicle my experiences with these projects along with anything else we do over the course of trip, ranging from places we have visited to hardships and frustrations we will encounter.

I have travelled in the past before, but this was the first time I have travelled alone overnight. In addition I will have visited Europe and Africa for the first time by this time tomorrow. This experience almost has a surreal quality to it, especially since I am traveling alone until I reach Johannesburg where I will meet up with the rest of the interns. If anything I think traveling like this is fitting; although I may not know exactly what I have in store for me (though if you are reading this in the future you will), I will say that I am definitely being pushed out of my comfort zone. I never expected to do something like this. In fact, I never really considered traveling abroad in any capacity in college. But now sitting in the airport having returned from visiting the city of Frankfurt holding a Rindswurst in one hand (I have no idea what that is; a local recommended that I get one while in the city) and typing this with the other, it strikes me that I will be learning so much more than just what I had signed up for. I came because I wanted to see how other countries dealt with regional health issues and to explore the different solutions that ingenious people around the world come up with, but even though I haven’t arrived yet I have already learned a lot about myself. I am not a huge fan of figs, I can’t sleep on planes for the life of me, and mustard in Germany is the most amazing thing I have had in a long while. These may seem super trivial but I think they underscore a larger point; living abroad hopefully I will be able to learn as much about myself while magnifying my passions for bioengineering, specifically in a global health setting.