Yesterday, our last day at the Polytechnic, Mr. Mafuta taught us a new Chichewa phrase: zikomo kwambiri, muzigona kutali ndimoto. He told us it’s a traditional parting phrase used when you don’t have the words any more to express how grateful you are. Literally, it means “you must sleep far from the fire.” It originates from the practice of using a fire to keep warm during the colder months, which unfortunately causes many accidents. When parting with someone, if you say this phrase, you’re telling them not to sleep too close to the fire, so that they don’t get hurt. It has evolved to mean that you’re telling them not to get hurt because you don’t know what you’d do without them, that they are the cause of a lot of joy in your life.

We found it a very fitting phrase for our last day at the Polytechnic. We expressed the sentiment as we hugged our Poly interns goodbye for the last time (for now), and as we said our goodbyes to the Poly faculty we have been working so closely with. The past ten weeks have been filled with incredible experiences shared with wonderful people in this beautiful country, which makes leaving that much harder.

As is common with all endings, we’ve done a lot of reflecting about the past two months. Our days have been filled with hard work, laughter, and plenty of new lessons, all encouraged by the projects we’ve been working to complete.

We’ve been lucky to spend time working on something we all are so passionate about, which has been a privilege I hadn’t yet experienced. The motivation that grows from being so invested in these projects has fueled us all to finish more than we imagined possible when we first began on June 1, and we are excited to see these projects move to the next step.

However we’ve been even luckier to have gotten to work with such great people along the way. Everyone involved in this process has been inspiring, encouraging, and welcoming, making Blantyre feel like a home I’ve lived in for much longer than these 10 short weeks. So until next time, to all those with Rice who advised us and helped make this possible, to our supervisors at the Poly who helped us along the way (especially Dr. Gamula, Mr. Chadza, Mr. Vweza, and Mr. Mafuta), to those around Blantyre who made us smile every day (Linksone the Banana Man, Henry the Honey Man, Lucia & Aida the security guards, and all those at the cafeteria), to the new BME students we’ve had so much fun getting to know over the past week and see them beginning their time at Poly as we end ours, to Karen, Tanya, Charles, Christina, Francis, Andrew, Emily, and Catherine: zikomo kwambiri, muzigona kutali ndimoto.

Here are a few things I hope you find helpful along the way:

1. Bring many USBs. Access to Wi-fi and Google Drive isn’t reliable; having a method of storing/exchanging information that doesn’t require these luxuries is crucial.
2. Get to know the Poly students. Whether you are lucky to have Polytechnic interns to work with every day or not, find a way to get to know some Poly students—go out to lunch with them, hang out on the weekends, and work with them if possible. They’re likely incredibly smart and have a lot to teach you, will give you a far more genuine perspective of Malawi than is attainable (I think) without getting close to any Malawians, and may be some of the kindest and most enjoyable people to be around that you’ve ever met.
3. Bring all the socks you own. They’re the “limiting reagent” of laundry.
4. Bring small hand sanitizer bottles. Paper soap was also helpful—you eat a lot with your hands here.
5. Learn Chichewa. Learn as much as you can! Not only is it useful and respectful, but it also will bring you closer to those teaching you. Often you’ll be laughed at (in a friendly way) when trying to use your Chichewa, but that just makes the process all the more fun.
6. Don’t make any assumptions. Be open and willing to learn—it will get you much further than trying to teach.
7. Bring a tape measure.
8. Get faculty/clinician feedback on your work, often. They know much better than you do what qualifies as good work and as a good idea, so use them! Work diligently to adapt your communication style away from the aggressive “confidence” of American communication—it won’t get you much honest feedback.
9. Explore the city and the country you are in as best you can. Within the realm of safety and reason, of course.
10. Bring Pepto Bismol.
11. Express your gratitude for those who are helping you. We found that baking did this well; by this point, we’ve probably hand delivered cookies to over a dozen different people, many of whom on multiple occasions. We’ve tried different desserts, and have received feedback on the tastiness of each baked good. The order (from most to least tasty) is as follows: chocolate chip cookies, banana bread with chocolate chips, apple pie, peanut butter cookies, banana bread, snickerdoodle cookies.
12. Bring sturdy shoes. They’ll take a beating. Also, bring tennis shoes or something similar for weekend excursions.
13. Pack a small sewing kit. The total number of holes torn in my pants is currently at 5.
14. Listen more than you speak. Listen to what those around you (who know better than you) deem as important needs to be addressed, and how they (faculty, Poly students, QECH staff) understand the problem and think it best be solved.
15. Bring duct tape.
16. Be thankful and humble. We received a loving, warm welcome from all those we met when we first arrived in Malawi—the Poly faculty, the Poly interns, the produce sellers, the security guards, the cleaning lady on our floor, and on and on. From what we’re told (and definitely from what we’ve observed), making all feel comfortable, happy, and welcome is an important aspect of Malawian culture. Don’t take this for granted!
17. Read some relevant books before you go/while in Malawi. It helps get the most out of the experience; Renata recently wrote a blog full of great recommendations.
18. Don’t expect to solve a huge problem. It’s silly to think doing so is possible in only ten weeks. Instead, be open to helping those around you in whatever way they need help, or solving a piece of a problem if that’s where you fit best. Keeping your mind open in order to help with whatever need presents itself allows you to utilize your own self effectively, and most likely learn the most as well.
19. Spend time in the hospital. Even a half day can provide you with critical knowledge for both current and future pursuits.
20. 10 weeks goes by too fast. Enjoy your time, and always be present—don’t let your mind get stuck anywhere else.

I remember before I left, I was trying to get an idea of what an average day would look like during the internship; looking back, my expectation was way off. So, for all the future interns who are curious about the average day in the life of a Poly intern or for anyone else who is wondering, here is a brief summary.

Monday-Friday

Mornings here are exactly what you’d expect—we wake up, get ready for the day, and eat breakfast. The lodge we live at provides tea and toast in the mornings, so we’ll walk down the dusty road in the mornings over to the main building. At breakfast, we are spoiled with a beautiful view of the hills in Blantyre, which rise up in the distance through the fog; in addition to the toast and tea, we’ll bring down our own coffee from a nearby plantation, fresh bananas or apples, peanut butter (made in Malawi!), jams, and fresh honey from the villages around Blantyre. One thing I didn’t know to expect is just how gorgeous Malawi is. We are here during the winter, but we experience daily temperatures in the mid-70s, and the sun is almost always shining. There are flowers blooming all around, and mountains surround us in the distance (Blantyre is circled by mountains).

The lodge we live at is located about an hour walk away from the Polytechnic, but luckily there is a bus (driven by the lodge owner) that travels from the lodge to the hospital every day at 7:30am. There are many expatriate doctors who live at our lodge, so we all load up into our bus every day to take the 15 minute drive to Queens. The roads are busy in the mornings, filled with both cars and people walking to work. There’s always plenty to view out the windows of our bus on the way to work, as so many people here walk to their destinations, women sell fresh mandasi on the side of the road, men roam the sidewalks with stacks of the day’s newspapers, people set up their airtime stands to settle in for the day, children scurry to school with their backpacks tightened over their shoulders, and the market stalls are opened and carefully set up to display their goods; the streets here are alive with people.

From there, Emily, Catherine, and I walk up the street to the Polytechnic, which takes about 10 minutes (record time is 6 minutes, which is done about once a week when we’re running late). We pass more vendors laying out their goods (fruits, candies, shoes, jackets) in the small market besides Queens, push through the line of minibus drivers shouting their rates to those passing, and join the throngs of people heading to work. We meet Christina, Francis, Andrew, and Charles outside the Poly, bask in the sun for a moment or two, then all head upstairs to our room to work.

We’ve been stationed in the same room our entire internship. It’s used as a classroom during the school year, though we’ve transformed it into a prototyping room over the past nine weeks. We keep all of our supplies and projects in there, and have stocked up tools like soldering irons, small saws, and hammers to work with. Our activities during the day vary greatly depending on what project we’re focusing on. Sometimes we all sit around the white board to brainstorm design ideas; other times half of us crowd around a circuit board while the others fit together wood pieces; one or two people may be at their computers, completing documentation or working on orientation week lectures. If we need internet, we head over to the library or outside on the porch, where there’s a mystery hotspot with some quality wifi.

For lunch, we head downstairs to the school cafeteria, where we’ve made good friends with all the cooks. If we’re lucky, the air smells faintly of fresh mandasi (freshly fried sweet dough) in addition to the expected smell of beans, meats, and veggies that they cook in the back room. I’ve about memorized everyone’s standard meal, and while ordering we function as a well-oiled machine (unlike the first few weeks of our internship, when ordering lunch for 7 caused a lot of confusion and misunderstood Chichewa).

During the afternoons, we continue to make progress on our projects. About once a week we’ll need to go out and buy some materials, which requires an enjoyable trip to the shops downtown or to Blantyre market. Blantyre market is filled with people and goods; voices of those negotiating prices, laughter between friends, short shouts between coworkers, and music fill the air. There’s a portion of the market outside, which mostly sells clothes, shoes, and produce, then a labyrinth of tightly packed stalls inside the market.

We’ll stay at the Polytechnic until around 4:45pm, when we head back to Queens to catch our 5:00 ride back home. If we need to do grocery shopping, we’ll head out around 4:00 so we can buy our food and get home before dark. There’s a great grocery store called Chipiku right across the street from the Polytechnic, where we buy pasta, rice, peanut butter (which we consume at a rate of 1kg/5days), jams, juices, etc. If we’re looking for produce, we head back to Blantyre market, where dozens of vendors watch over their ample stacks of fresh fruits, vegetables, spices, and meats.

On the bus ride home, we are always lucky to enjoy a beautiful view of the setting sun. After getting home around 5:30 (and after our routine snack of toast + peanut butter), we spend some time finishing up work for the day and blogging, or reading one of the many books we all brought with us. Around 6:30, all five of us crowd into the kitchen to make dinner. Three of the five of us are vegetarians, so we usually make some tasty dish with our fresh produce and rice. There’s no light in our dining room and it gets dark by 6pm here, so we always enjoy a cozy, candlelit dinner.

Weekends

Weekends vary a lot! Sometimes we simply stay at home to get ahead (or catch up on) work; sometimes we go explore Blantyre’s restaurants, shops, churches and weddings which are excitingly busy on weekend mornings; other times we are lucky to go out and see the beauty of Malawi.

I’ve mentioned the orientation week that we are planning a few times on this blog, and have decided it’s time to go a bit more in depth on what the week is all about—especially since it’s starting tomorrow.

The Polytechnic will be offering a degree in biomedical engineering (BME) for the first time starting this coming year, so the incoming 2015 BME students are the pioneer class. At the Polytechnic, all first year students attend a week long orientation (grouped my major) their first week of classes. The orientation is intended to introduce them to resources at the Polytechnic, and help lay the necessary groundwork before they begin their schooling; their orientation lasts a few hours every day, for five days. At Rice, first year students also attend a week long orientation, but it is a bit different from the Poly’s. We are grouped by dormitory, it lasts 10-12+ hours a day for five days, and orients us to Rice campus, college life, and academics.

One of our tasks this internship was to create an orientation week for the incoming BME students at the Poly, that lay somewhere in the middle between Rice’s and the Poly’s existing orientation weeks. Since the Poly students attend the orientation week activities with their majors, we were able to focus exclusively on the incoming BME students and work with the BME faculty; this was helpful, as we learned from the faculty that they wanted an orientation to being an engineer, not just an orientation to being a student. Throughout the past nine weeks, we’ve been meeting with different faculty members at the Poly, consulting Rice faculty, and talking to upperclassmen Polytechnic students to understand the need and objectives for this orientation week.

We’ve focused the week to four main objectives: help the students understand the skills necessary to be a successful BME student, understand the resources at the Polytechnic, build a network of peers, and understand the job of a BME. Using these objectives, we constructed a weeklong schedule of activities and lectures to get our main points across. Choosing and scheduling the events was the most difficult part of this planning process, as we wanted to ensure the week felt cohesive and the information digestible, while maintaining student interest and getting our points across.

We then constructed the lectures and gathered materials for the activities we had planned. While this task at first seemed overwhelming, we had a lot of help from Dr. Saterbak (a Rice bioengineering professor), Dr. Wettergreen (a Rice design professor), Mr. Vweza, and Mr. Mafuta (both Polytechnic electrical engineering faculty).

After all of our planning, the orientation week finally begins tomorrow! We will have 42 incoming BME students throughout the week, and we are excited to get started. Our week will consist of events that…

• Introduce student life at the Polytechnic. This includes a tour of the Polytechnic, a lecture on student skills, faculty introduction, “tips and tricks” for success at the Poly, library and resource introduction, academic rules and regulations, and things like paying fees/getting IDs made.
• Teach basic engineering concepts and skills. This is done primarily through a week-long explanation and execution of the design process through tacking a real engineering problem. This process will include things like brainstorming, decision making, and a materials workshop.
• Increase understanding of biomedical engineering. Activities will include a lecture on the BME curriculum, BME career paths, talks from industry workers in the field of BME, a visit to PAM and QECH, and stories of various successful biomedical technologies.
• Form a community among the BME students. This includes welcoming activities and icebreakers, a huge scavenger hunt, working closely in a team of 6 throughout the week, team formation activities, and a matriculation ceremony.

Two weeks ago, I wrote about how important it is to get a good understanding of the context a design will be implemented in, and the user of a device. This past week on my blog, I was more focused on what qualities of a device this understanding changes. Now, I’m going to focus down even more and use a device I’ve been working on for the past few months to explain with more concrete details the nuances of global health technology design.

I took a Global Health Technology course this past semester at Rice about appropriate design, during which I was part of a four person team tasked with developing a heating sleeve to be used in tandem with Rice’s bCPAP technology. The bCPAP helps babies with underdeveloped lungs to breathe, and right now it supplies the patient with room temperature air; warming the air–which is what our device does–will potentially increase the survival rates of babies treated with bCPAP. Our basic design is a 9 foot long sleeve that snaps around the tubing delivering air from the bCPAP to the baby. The sleeve has heating wire sewed into it, and connects via a plug to a control box that regulates the temperature of the air delivered to the baby to 37C. Essentially the device is a long and skinny custom heating pad, made to heat bCPAP air to body temperature.

We spent about four months working on the device, and this summer two members of the team (Renata and myself) are interns in Malawi. We’ve been able to gain a much more thorough understanding of the context our device will be implemented in, and get feedback from intended users about how best to improve our device over the next year.

Through this experience, it’s become obvious what considerations we didn’t know we had to take so seriously. The thorough research we’ve been able to do has revealed flaws in our design that would bar maximally successful implementation, and has been an interesting reflective process to go through. Here is some of the feedback we’ve received, which I think shows what sorts of concerns are difficult to imagine without having visited the hospitals our device is targeted towards:

• Ability to be cleaned. Our device has current-carrying wires running through the sleeve that heat it up. This makes the device especially difficult to be cleaned, as we don’t want any liquid to make contact with the charged wires while in use. Waterproofing our device, though, is also challenging, as most of the waterproofing materials are not very thermally conductive, which makes temperature control difficult. We decided to sew a layer of nylon as the outermost layer of our sleeve, as this made the sleeve moderately waterproof but still adequately thermally conductive. Since the sleeve doesn’t come into contact with the patient, we thought this moderate waterproofing would be sufficient to allow for spot cleaning as needed. Since being here, I’ve learned that was a pretty unreasonable assumption. The bCPAP babies frequently lay on the same cot as two other babies, without any divider separating them. This means the tubing easily touches the other babies, as well as anything lying in the cot. Many of the program associates for the bCPAP clinical trials have indicated that the tubing often comes into contact with blood, feces, and other bodily fluids while in use at the district hospitals. Additionally, the tubing often is coiled up on the ground between the bCPAP machine and the patient. This not only would cover the sleeve with dirt, dust, and any other mystery liquids that lie on the ground, but also makes it susceptible to being doused with the ample amounts of mop water that is used to clean the wards, or any spilled liquids. However, we don’t want to make cleaning the sleeve a difficult process, as that would be an additional barrier to use; if there are many steps involved in attaching/removing the sleeve from the tubing and cleaning the sleeve, nurses may opt not to use the heating sleeve at all in order to save time. Alternatively, because many of the nurses didn’t grow up with electrical devices, they don’t have the same instincts concerning wires, power, and water; some nurses may submerge the heating sleeve with the electrical wires into the same bleach/water solution used to clean the bCPAP tubing because they don’t understand why not to. Finding a balance between ease of use, sterility, and functionality will be something we have to spend a lot of time with next year.
• Patient/guardian perceptions. One of the difficulties currently facing the bCPAP clinical trials is how the mothers, especially in rural areas, perceive the machine. It can look scary to mothers due to the apparently invasive nasal prongs, and there’s been a lot of talk about how to best get mothers “on board’ with the device. Some have expressed concern that the sleeve covering the bCPAP tubing would make the mothers more wary of the bCPAP, as they cannot see into the tubing delivering air to their child—she wouldn’t know what was in the tubing. The color of the device was also frequently discussed with nurses and the program associates, trying to determine which color is the most comforting to mothers.
• Weight. We were aware of the fragility of the babies treated with bCPAP, and knew this meant our device had to be lightweight. However, we figured that the tubing would be resting on the bed or on a table nearby, so the weight of the entire 9ft tubing + sleeve wouldn’t be tugging at the baby’s face. As a result, we were initially satisfied with our heating sleeve weighing 195g, which is about as much as the tubing weighs. However, being in the wards and watching the device in use has changed that assumption. The babies treated with bCPAP are often resting on beds a meter up from the ground, and the bCPAP tubing I saw often draped directly off the bed towards the ground. This means the weight of 1 meter of the tubing (and possibly in the future, the sleeve) is tugging at the patient. Since the neonates are already so tiny, and their skin so delicate, the added 195 grams of our sleeve would make a significant difference. Over the next year, we will have to work to bring down the weight of this device significantly.
• Other unforeseen difficulties. One medical student had noticed that in the special care ward, there were many bugs that flocked to the oxygen concentrators, as they heat up during use. While bugs aren’t too common in QECH, they are in the district hospitals. Since our entire sleeve gets warm and is often laying on the ground, we realized this may be a big problem. We’ll have to figure out how to heat the air without making the outside of the sleeve warm, so as not to attract any unwanted visitors.

In addition to these notes, I’ve gotten feedback from various doctors about what testing they think is necessary to run before the heating sleeve moves forwards. While these changes and tests will be difficult to navigate, understanding the potential barriers to implementation of our current device while we are still early in the design process has been lucky, and hopefully will significantly improve the chances our device has for long term success.

In my last post, I talked about how the scarcity of resources is arguably the biggest challenge that hospitals in low-resource settings face. There are many different needs pulling hospital funds in various directions, which further increases the need for affordable healthcare technologies; the devices don’t simply need to be low enough cost to fit into the hospital’s budget, but they need to be worth the dollars that as a result won’t be spent on medication, supplies, or human resources. This is part of why the research phase of design (which I talked two about two blogs down) is so crucial: a thorough understanding of what technology attributes will best set a design up for success—and what traits add cost but not practical value—enables the creation of devices that are worth the allocation of hospital funds.

Through my time in the Rice 360 program, conversing with nurses and doctors at QECH and observing a bit of ward practices, and working this summer at the Polytechnic designing new health technologies, I’ve noticed a few common attributes that string together many of the successful devices. Here are a few of those traits:

• General Qualities
  • Low cost. This is perhaps the most obvious quality on this list, but also one of the most important. To give a few examples, the commercial CPAPs in the States can cost $6000, while the Rice bCPAP costs under $400; the States’ gold standard phototherapy dosing meter costs $2000, the one we’ve built costs under $50; commercial phototherapy lights in the US cost over $1500, the Polytechnic BabyLights costs around $100; American commercial ophthalmoscope costs $300, while the one we saw in use at QECH is $4—the list goes on and on. In the meetings I’ve been at with physicians, when we show them technologies in development at Rice to gather feedback, one of the first questions asked is often “how much does it cost?”
  • Durable. In the busy and crowded wards at QECH, devices need to be able to withstand a good bit of wear and tear. Machines tend to be stacked onto one another; tubing is coiled, pinned, and draped into the proper position; power cords and adapters lie in corners and can be splashed with mop water. Without proper storage space, devices and components often must be fit into small spaces on top of cabinets or into cramped packing boxes.
  • No consumables. The continuous cost of consumables is a drain on hospital funds that is difficult to sustain. If a machine requires consumables to run properly, whenever there is a lapse in supply or an inability to purchase new materials, the machine becomes effectively useless.
  • Easy to replace parts. It’s very difficult to get machines fixed once broken (as discussed in a previous PAM blog). Since devices sent off to be repaired often never make it back to the wards, there’s a pretty common of practice of simply setting aside broken equipment, where it sits unattended and unused. In order to mitigate this practice, machines with locally available replacement parts are great; providing a machine with the components that are frequently needed to be replaced is also convenient. For example, if a circuit component blows, supplying an extra circuit that can pop into the broken circuit’s slot requires only a simple few steps that a nurse could execute. As another example, the bCPAP provides a small bag with replacement parts within every device, to ensure broken devices are not so easily discarded.
  • Transportable. High risk patients often must travel a lot within the hospital—from labor to the neonatal ward to the X-Ray machine to the high risk unit and back to the neonatal ward, for example. Making devices, such as incubators, that are small and light enough, or have wheels, to transport with the patient between wards marks them both more attractive to the hospital and more useful.
  • Backup power source. Power can be a bit unreliable in low resource settings. In clinical settings, this can be life-threatening. Making a device capable of running on its own for short periods of time between power outages—or at least provide enough backup power to give nurses time to offer alternative, electricity-free care—can save lives.
  • Easy to clean. Not only does sterilization need to be quick and easy, as the wards are so busy, but thorough as well. Devices can come into contact with a lot of blood, feces, and infectious disease while in use, and with the large number of patients requiring treatment in combination with the often short periods of time between the treatment of different patients, devices must be quickly but methodically sterilized.
  • The simpler, the better. This mentality has been repeated to me many times from professors, doctors, nurses, and other interns. The simpler a device is, the more likely it is to be successful—often because simplicity requires it to have the above attributes. Sometimes as engineers, we get sidetracked by the possibility of designing a really “cool” device with complicated circuitry and fancy features. However, that often decreases the likelihood of long term success for global health technologies. Complicated devices usually require more time to understand and use—time that nurses don’t have free to devote. They also tend to have many parts, which are just more things that can break and cause the device to be discarded. Simple devices with few parts, however, have a greater likelihood to be “figured out” and repaired when necessary. They also tend to not be as “scary” looking, which is a common problem when mothers don’t understand what a device does and is thus afraid of it being used on her baby.
• More Specific Features
  • Solar power. I’ve noticed that solar panels are really well received here, as they require no costly resources and are reliable. There’s a lot more faith in solar panels than in an AC power cord or a battery pack, and healthcare workers I’ve talked to are quickly excited by and convinced to support a technology when it’s powered by solar energy. This is another big benefit to using solar—if the users are already behind it, implementation and sustained use are inherently smaller barriers.
  • Size: wristbands, necklaces, clips, and pockets. This is another attribute I’ve noticed that quickly garners healthcare worker support and generates excitement. The doctors and nurses here are busy; they have many patients to attend to, and their work is very difficult. There are already dozens of machines they must learn how and when to use, so sometimes a new machine can seem like more of a burden than a help (especially in a place where confidence in machines can be pretty low, considering how often they malfunction). Devices need to not only cater to the doctor’s needs, but in some cases also to their convenience. Techs that can easily fit into a pocket, or be slipped around a head in the form of a necklace, help to lessen the load on the healthcare workers. That way, the device is readily available, and has less of a chance to being lost. Of course, this isn’t applicable to all technologies, but for machines commonly used on rounds—respiratory rate calculator, ophthalmoscope, heart rate timers—this can be enormously useful.
  • “On” indicators. While this may not seem like a vital component for a device, it can be very useful for busy doctors. Machines that don’t have an easily visible, bright LED to indicate when the device is and isn’t on (sometimes the switch is on the back, sometimes there is no LED, etc.) make it difficult to know whether a device is still treating a patient when it is supposed to be. If an outlet is accidently switched off or if a battery runs out, the nurse needs to be easily aware of this change in status.
  • Internal transformer. Unfortunately, many commercial machines require specific plugs to adapt the wall voltage to the voltage the device runs off of. The problem with this is that in the case the particular plug is damaged or lost, it’s difficult to replace. New parts straight from the manufacturer are often unreasonably expensive (for example, a manufacturer-provided battery replacement on a machine we were repairing cost $1000, but could be obtained at the market for $20), but finding suitable substitutes requires some electrical background knowledge that the hospital staff often don’t have. The better solution is to put the transformer within the device itself, so that the machine can be connected straight to the AC wall voltage with any old power plug. If the cord is lost or damaged, they’re easily bought at the market for around $10.

There are many features of design that are hard to consider without seeing the context or talking to clinicians directly about what devices they do/don’t need, and what they do/don’t like about existing devices. Designing so close to QECH this internship has given us the opportunity to develop our technologies in line with what the hospital needs, as well as given us a far better foundation from which to design new healthcare technologies in the future.