2. Welcome to Malawi!

June 25, 2023:

Hey everyone, it’s Pranav again! I’m writing to you from Blantyre, Malawi: the Warm Heart of Africa! Our first week in Malawi has been amazing, and I’m finally feeling like I’ve gotten my bearings in Blantyre. 

Our Plane at O.R. Tambo Int’l Airport, Johannesburg

Earlier this week, we departed from Houston on the long, 40+ hour journey to Malawi. After a short stop at Atlanta and a restful overnight layover at Johannesburg, Alex and I finally touched down at Chileka International Airport. There, we met Hillary, Sally, and Waliko, who enthusiastically greeted us and helped us with our luggage. The first thing I noticed about Malawi was the striking mountains surrounding us in all directions. That, and the fact that you drive on the opposite side of the road. We decided to drop all our belongings off at Kabula Lodge before heading to the Design Studio at MUBAS. The rest of the day involved a whirlwind of introductions, a short tour around the city (Hillary showed us a nice place to grab some coffee), and shopping for our stay at Blantyre. 

Meeting Sally, Waliko, and Hillary at the Airport.

The next day, we woke up to a beautiful view of the sunrise while having some breakfast (the pancakes were delicious) at Kabula Lodge. When we arrived at the design studio, we met four other interns—Getrude, Arnold, Joyce, and Nassan—who were doing the MUBAS engineering internship. We then went right into our project work: I was paired with Sally while Alex was paired with Waliko. As a previous team at MUBAS had worked on the IV drip project before, we reviewed their documentation and research in order to understand the scope of the project. Our goal was to build off of the previous team’s work by integrating a drip monitoring system and a flow rate control mechanism with a touch-screen display and the cloud.

View from Kabula Lodge during Breakfast

Front Entrance of MUBAS

On Friday, we took part in a workshop led by one of the design studio technicians about building and printing custom circuit boards. It was my first time ever using circuit boards, so it was intriguing to learn the basics behind circuits and create our own circuit system. The workshop made me excited for all the new techniques and concepts that I would be learning over the next couple of weeks in Malawi.

Printable Circuit Board Workshop

Before we knew it, our first weekend in Malawi was upon us. We spent Saturday exploring nearby sites around town, such as the Blantyre market and the Bean There Coffee Roastery. We also grabbed some lunch at KwaHaraba Café, which had been highly recommended by previous travelers to Malawi. The café was decorated with local artwork and crafts that depicted the beauty of Malawi. On Sunday, we did our first of many road trips—this time to the Zomba Plateau. We went with Sally and Waliko, and met up with one of their classmates, Tom, at Zomba. Tom showed us around town, giving us a tour through the University of Malawi and highlighting the various administrative buildings (Zomba once used to be the capital city). He then took us up to the top of the plateau, passing by many scenic viewpoints with breathtaking views on the way. Driving through Zomba while blasting some African music was an amazing way to get to know Sally, Waliko, and Tom better. 

KwaHaraba Cafe

A Dam at Zomba Plateau

Williams Falls at Zomba Plateau

As the weekend comes to a wrap, I’m looking forward to learning more designing basics for my projects, from learning how to use Arduino IDE to wiring together sensors and motors. 

Until next time!

Pranav

Week 2 & 3: The Warm Heart of Africa

Hey y’all! 

It has been a few weeks since my last post – we have just been so busy since arriving in Malawi! To keep the posts from getting too long, I will be splitting the last 4 weeks into two posts.

Week 2 of the internship was our last week in Houston. We wrapped up orientation with a few more workshops, a networking lunch, and the final preparations for travel. Before our final review together, all of the interns were surprised by a trip to an escape room! Unfortunately, we were unable to escape, but I’d like to think that the team did very well given the technical difficulties we encountered. Finally, we ended the week with a delicious team dinner at Hungry’s in Rice Village. It was quite bittersweet since the end of orientation meant that all of the interns would be splitting up to different parts of the world, but at the same time, we were all so eager to dive into our projects. After a weekend of packing, all of the interns gathered at the BRC on Monday morning for a final sendoff. The long journey to Blantyre had begun!

Team picture after failing to escape );

Forty hours later, with an overnight layover in Johannesburg, Pranav and I touched down in Malawi. The customs process went smoothly, and once we picked up our bags, we met Hillary, Waliko, and Sally in the airport. After we made our introductions, Hillary drove everyone through Blantyre, stopping briefly at the design studio at MUBAS and a few other places in town that would be useful during our stay. My first afternoon in Malawi had been exciting, almost overwhelming, and after almost two days traveling, we finally settled in at Kabula Lodge.

Final sendoff with the interns
Dinner in Johannesburg
Arriving at Chileka International Airport
Meeting Sally, Waliko, and Hillary

The next morning, we woke up early to catch the shuttle from Kabula to Queen Elizabeth Central Hospital (Queens). Since it was our first day, the bus driver, Paul, was so kind and offered to drop us off directly at MUBAS – normally it is about a 10 minute walk. Upon arrival at the design studio, we were introduced to the four other interns, Gertrude, Arnold, Joyce, and Nasson, and the technicians who would be working alongside us throughout the summer. Sally and Waliko also gave us a tour of the campus as well as the nearby shops and places to eat. They were all so friendly and gave us so many tips and tricks for getting around in the city!

Shops near MUBAS

We spent the rest of the week familiarizing ourselves with our projects, and before we knew it, the weekend had arrived! Pranav and I spent Saturday visiting the Blantyre Market, walking through the city to see the Bean There coffee roastery, and stopping by KwaHaraba Art Gallery and Cafe for lunch and some coffee and tea. The main event of the weekend was a trip we had planned with Sally and Waliko to Zomba. Although it was only a day trip, we got to see so much! Once we arrived in Zomba, we met up with one of Sally and Waliko’s classmates, Tom – since MUBAS was on winter break, he was staying at his family’s home in Zomba. He showed us around the beautiful campus of the University of Malawi (formerly called Chancellor College) which is the largest in Malawi. Then, he drove us up the winding road to the top of the plateau soaking in the breathtaking views along the way. Everything was somewhat impromptu, but we had such an amazing first weekend with our new friends!

University of Malawi
Zomba Plateau
Zomba Botanical Gardens
William’s Falls


Several weeks in, it still feels surreal that we are here in Malawi. However, I’ve gradually been adjusting to life in this vibrant country. From the moment of our arrival, the phrase “The Warm Heart of Africa” has echoed in my ears, and I can confidently say that Malawi lives up to its reputation. All of the people I have met have been incredibly kind and welcoming, making me feel at home from the moment I got here. Waking up each morning at Kabula Lodge, I can look out over Blantyre and the mountains in the distance with a warm cup of coffee and a stack of delicious pancakes. At the time of writing this, we are already at the tail-end of the internship, and I have been able to learn so much in just a few weeks. There’s still so much to discover and learn, and I couldn’t be more thrilled about the experiences that lie ahead. Thanks for reading!

Alex

 

Featured Image: View from breakfast at Kabula Lodge

Featured Image

Week 1: Orientation and Setting Goals

Hi y’all!

Since this is my first post of the summer, I wanted to make a brief introduction. My name is Alex David and I am a rising senior from Will Rice College majoring in BioSciences and in Sports Medicine & Exercise Physiology, and I am minoring in Global Health Technologies. Outside of academics, I am the president of the Rice Men’s Club Volleyball team, and I try to find any chance I can get to play, either on the beach or on an indoor court. I also love all things coffee, whether it is trying to brew the perfect cup, exploring local coffee shops, or chatting with other “javaphiles” about our shared love for coffee.

I’m looking forward to this internship in Malawi because of the new perspectives I will engage with and for the opportunity to learn from a low-resource healthcare setting. I hope to make the most of this experience and will be making weekly posts and updates on this blog!

Over the last few weeks, Pranav (the other US intern traveling to Malawi), and I have been getting ready for our departure next Monday. It has been a whirlwind of flight planning, vaccines, VISA applications. This past week was my first week back at Rice, and the other Rice360 interns and I have split our time between the OEDK and the BRC setting goals and making preparations for the rest of the internship.

I will be working with Waliko, an intern from Malawi, on two projects. Our first project is on an infant transport incubator so that babies are kept warm as they are moved around the hospital. This project is still in the early stages, and much of our work will be conducting needs-finding at the Queen Elizabeth Central Hospital. Our second project is a little bit further along in the design process, and we will be working on prototypes for NESTation, a low-cost solution capable of storing, charging, and sanitizing handheld medical devices in low-resource settings.

I have also set some personal goals for myself for the summer. Entering into an unfamiliar environment is often difficult, and I know that sometimes, it is easy to stick to doing what I am comfortable with. I want to keep myself accountable for pushing that boundary, and making connections with the individuals that I will be working alongside. I have so much to learn from this experience and will get the most out of it by adopting an open mindset and by not being afraid to ask questions. Finally, I want to have fun! While my main purpose in Malawi is to work, I will be exposed to a new culture and environment, and chances to immerse myself in a culture different from back home are often rare in a lifetime.

Although we have a long trip ahead of us, I can’t wait to hit the ground running in Malawi next week!

Thanks for reading my post!
Alex

1. Introduction and Preparations

Hi everyone, my name is Pranav Mandyam, and I’m a rising junior majoring in Biosciences (Cell Biology & Genetics) and minoring in Global Health Technologies. I was first introduced to Rice360 through the introductory Global Health class I took in my sophomore fall. After learning about the various facets of global health and listening to a variety of guest speakers, I excitedly enrolled in my first project-based class, GLHT 360, which helped solidify my passion for developing healthcare technologies in low-resource settings. My passion for medical innovation in various settings and my interest in directly collaborating with local experts and students made it an easy choice to decide on taking part in the Rice360 summer internship. I’m looking forward to getting a more complete understanding of the design process and the opportunity to work as a team with colleagues in Malawi. 

As I finish off my first week in the internship, I learned a lot about the cultural competencies that we must consider when immersed in a new environment. We started off our discussion by reflecting on our values, and then conversed about cultural differences and the ethical considerations of working within a different country. One thing that really stood out to me was communicating our experiences through photography, and the ethics behind it. I love to take photos everywhere I go, so it was really interesting to understand the impact that images can make in telling a truthful story.

Earlier this month, we were given the projects that we were taking to Malawi. The two projects that I was assigned were an IV Drip System and an Infant Oxygen Concentrator. The IV Drip project involves constructing an IV infusion monitor to deliver and monitor IV fluids at an accurate rate that is not achievable through a solely gravity-based drip system. Meanwhile, the Infant Oxygen Concentrator is a needs-finding project that focuses on modifying a previous Oxygen Concentrator to accommodate infants and be portable. This week involved a lot of research about these two projects so that I can hit the ground running in Malawi. 

On June 19th, Alex and I will be boarding our flight to Malawi, a trip that takes almost two whole days. We’ll be stopping over at Atlanta and Johannesburg (an overnight layover!) before landing at the Blantyre airport. Throughout this week, we’ve been preparing for our travel, from arranging our Visas to making (and remaking) packing lists. As the date gets closer, I’ve been getting more and more excited and nervous in anticipation of our time in Malawi. I’m really looking forward to meeting the Malawi team and all the new experiences I’ll encounter!

8. Zikomo Malawi

Now that I have been home for a week, I’m not sure how to feel. Everything is familiar yet different at the same time. I somehow managed to go from living with 10 other people to 11 considering I had extended family in town. However, it was quite easy to keep busy with unpacking and spending time with friends and family. Every once in a while when things slowed down, the little things would remind me of my time in Malawi and the people that became another family. Like making tea and piling on the bus to head to the Poly design studio in the morning or joking around while cooking dinner. It feels like only yesterday we were at the studio working on our prototypes.

On our last day in Malawi, saying goodbye was the hardest part. In the midst to completing our presentations and celebrating our hard work, we realized that it was time to say goodbye to everything we had known for the past few months, goodbye to the Poly design studio, goodbye to market in central Blantyre, and goodbye to our friends. Without them, I don’t think I would have enjoyed my time in Malawi. Sometime in the distant future when I will look back on this time, it won’t be the little things I remember, but the friends we made and relationships we built.

Overall, this experience has been one that I will cherish forever. It taught me so much about engineering, people, new cultures, and healthcare in different countries. I hope the knowledge I have gained does not end here and I can continue similar work in the future. I am proud of my teammates and our engineering accomplishments and I wish them all the best in their future endeavors. I know they are going to do great things and impact people’s lives for the better.

I also want to say a special thank you to donors who supported Rice 360 and made this internship possible without your help I would not have another place to call home.

8. When I Was in Malawi

an excerpt from my journal…

Day 50:

A few weeks ago, I wrote about how hard it was to believe that we were halfway through this internship. Now, looking out the window of one of my four flights back home, I can say it is even more difficult to accept that our time in Malawi has come to an end. 

This morning felt just like any other morning: I woke up, showered, and watched the sunrise while drinking my morning tea. Soon after we finished dragging our luggage up the stairs, Mr. Richard appeared with the bus to drive us back to the Lilongwe airport. While loading the suitcases, we joked about how it was just like the day we first arrived in Malawi, only now he would put the bus in reverse. 

It was then time to say goodbye to Kabula: the kitchen where we cooked all of our meals together, the terrace where we soaked ourselves doing laundry, the place we all began to call home as time went on. Soon after that, it was time to say goodbye to Blantyre, then our friends from Tanzania, and finally Malawi. 

One Week Later:

The past week has been full of quality time with friends and family. Due to the time difference between Michigan and Malawi, it was difficult to keep everyone fully updated throughout the course of the internship. As a result, I often share my stories starting from day one, using my journal entries and photos as guides to what I was seeing, thinking, and feeling. In day-to-day conversation, I’ve noticed myself begin to repeat a phrase: “When I was in Malawi…” I’ve said it while driving down the road and cooking dinner, comparing my experiences here to my time abroad. I’ve even said it while going under for oral surgery, sharing that we had gathered feedback in Malawi on a locking mechanism for the IV that was feeding into my arm.

In my downtime, I’ve also been working on finishing a book I started reading at the beginning of the internship. “Don’t Let’s Go to the Dogs Tonight” is a collection of personal narratives from the African childhood of Alexandra Fuller, some of which take place in Malawi. Reading through them at a time when I am also reflecting on the past few weeks has given me a lot to think about, and one quote, in particular, has stuck with me…

When describing an English guest to their house in Zambia, Fuller writes about how people like this man never last long, and then they return to their homes and say “when I was in Africa” for the rest of their lives. Coming across this similar phrase, I couldn’t help but compare myself to the foreign man. We too had spent a short period of time in another country, seen both its beauty and its challenges, and then returned to the United States to share our experiences. 

Thinking through this comparison, I began to once again flip through pictures of our work, and eventually the differences became clear. I saw our very first hospital visits, our ideas at every stage of the design process, and the final prototypes that came out of it all. Continuing to flip through my camera roll, I soon came across our speeches at the internship’s closing dinner. As I played the videos, I heard Nana talk on living with people of diverse cultures, personalities, and mentalities. Hannah highlighted the similarities between each of our lives, despite living on opposite sides of the world. Foster recounted an interview question that we all received: “Are you able to associate with people of different backgrounds?” Tebogo then gave the answer, saying that the studio would not feel the same once we all returned home. 

Finally, I began to play the speech of Dr. Ng’Anjo, one of the professors who welcomed us to the design studio when we first arrived at the Polytechnic. To the room of interns from three different countries, he said, “Keep the course. Whatever you have learned, don’t just say: Oh, it was an experience. We were in Malawi … Blantyre … a lot of dust.” The room laughed. Smiling at his own joke, he continued: “Amidst the dust, amidst the noise, amidst all that you have experienced… say this is the knowledge that we got, and I’m going to run with this knowledge.” 

Listening to these words once more, I am reminded that while our time in Malawi has come to an end, the experience is not confined to a single summer. The names of my fellow interns do not simply stay on the pages of my journal, they light up the screen of my phone. Despite the distance, ideas continue to flow. I receive updates from my teammates as they gather feedback from district hospitals on our training model and application. As progress is made on the MUST Design Studio, suggestions are shared from what is done at the OEDK and the Poly. 

When I was in Malawi, I found something that I want to continue to be a part of for years to come. As Dr. Ng’Anjo put it: “by working on these types of projects, you serve life itself.” I chose bioengineering because it lies at the intersection of technology and people. I wrote this statement when I applied to Rice. Last year, I used it as motivation whenever I was struggling with a problem set in a physics or math class. This summer, I had my first opportunity to understand what this statement truly meant. 

– Alex 

Team SimpleBallard after final presentations.

I would also like to thank all of the donors and supporters of this internship program for making this possible. Without you, our newfound community of engineers from Malawi, Tanzania, and the US would not exist. 

7. Down to the Wire

Our last couple of days in Malawi were a whirlwind and I honestly can’t believe that it is over. Of course, we had a lot to do and not enough time, but part of the experience is making do with the time and resources available. On Monday, we were finally able to set up the first ever design studio at the Malawi University of Science and Technology (MUST). For majority of the summer, the design studio has been under construction, but we finally had the opportunity to view the space and at least begin the process of organizing and assembling the equipment. Due to time restraints, we only had the Rice and MUST students set up the new studio while everyone else continued to work on their projects. Our focus for the day was to get as much of the 3D printers built as possible, create an organized inventory check out system, label everything, and make sure all the laptops brought had the proper software. Unfortunately, we couldn’t finish everything we set out to accomplish given that we only had a day, but we made a good start and left and extensive list of tasks to improve the studio in the future. One day I hope I get the chance to see it in use knowing it will encourage students to learn through hands on experience.

Tuesday, the final workday before presentations, was a long day to say the least. The only way to we were going to accomplish everything remaining in the project was to make design decisions together and then divide and conquer. Once deciding on the best way to approach completing the last portion of the project, Maureen and I worked on the final presentation, while Cholo and Tebogo started assembling the acrylic pieces. As we were making the presentation, we had to anticipate that our audience did not have prior knowledge of our project or the need we were trying to solve, yet technical engineering experience

Late night at the studio

as they were mainly professors. With that in mind, our main priority was to demonstrate the need to prevent hypothermia specifically during transportation between the wards, how it significantly impacts a neonate’s health, and how the device functions. After a tedious amount of time, we were able to include the information we wanted and now it was just a matter of making it presentable and easy to understand. By this point, majority of the students had left the studio and the rest of us came to terms that it was going to be a late night, so it was all hands on deck. After putting the last touches on the presentation, I began working on the device with the rest of the team. The device was almost done for the most part, we only had a few brackets to put secure the device which seemed simple enough, but took time working with acrylic and the size of our device. We did one last check to make sure everything was working properly (thankfully it did!) and we Eventually we are able to finish the device and it is a huge relief. Now all that remained was our big final presentation the next day.

 

Final presentations!

On Wednesday morning, we were all a bundle of nerves for our presentation. For me personally, this was only my second formal engineering presentation, so I was especially nervous to say the least. As the time came near, we each practiced our presentation multiple times to ourselves and each other and made sure everything transitioned smoothly. Luckily our group was going third, so we had the opportunity to observe a few presentations before presenting. Before the first group presented, all the professors and Rice 360 engineers in the audience introduced themselves which only intimidated me more. The first two groups did an amazing job clearly describing the need for their device as well as how it works and handled questions from the audience with ease. Finally, it was our turn and there was no going back. During the presentation, everything went off without a hitch. We remembered to say all the additional information however the questions were more of a challenge. A few of the professors already had experience working with devices in the same field as ours and were more technical with our questions, but having only developed a first iteration, it gave us a lot to consider for future improvements. At the time it felt like we were under a lot of pressure, but we received nothing but positive. Of course, there were questions about why we chose to design something a particular way or if we had considered doing something differently, but that is how progress is made. Obviously, these professors had way more experience and their criticisms could only improve our design and in the end help people. Walking away from that project, we had a long list of future improvements to make and design aspects to reconsider, but it could only get better from there. That last day in Malawi could not have ended better, with everyone together celebrating our accomplishment and looking to the future with hope.

 

-S

 

 

 

Week 7. Final Thoughts

It’s been four days since I returned home to Prosper, Texas, USA. People keep asking me if it feels weird to be home. I think people expect me to say something along the lines of “Yes, of course! Everything is so different! What a strange feeling!” And it’s true that lots of things are different. I’m readjusting to driving on the right side of the road. My family and I stopped at Buc-ees on the way from the Houston airport to my hometown near Dallas on the day I got back to the states. For those non-Texans who are unfamiliar with Buc-ees, it’s basically this massive gas station general store. It has every gas station snack you could ever imagine, times ten. I was sleep deprived from over 45 hours of travelling at that point, and I almost had a meltdown when my sister walked my half-asleep self into the Buc-ees. It was something to behold. I had forgotten how absolutely massive stores in the US are. The sheer number of options was unsettling. Another area where the differences particularly struck me was this morning when I went to the GP for my yearly doctor’s check-up. After spending weeks growing used to the state of hospitals in Malawi, the cleanliness and abundance of technology and resources in my GP’s office really struck a chord. As the nurse took my blood pressure, I stared at the mobile BP machine and all I could see in my mind’s eye were the dozens of mobile patient monitors sitting broken in PAM facilities that I visited over the last two months. She took my temperature and all I could think about was the lack of temperature monitors in the labor wards at the hospitals we visited and how nurses often resort to using the back of their hand to guess if a patient has a fever. There are so many differences, and it’s important to recognize them and talk about them.

It is important to talk about the differences between our two countries. It is true that I will move forward being eternally more grateful for all that I have in this amazing country I was lucky enough to be beorn in. I will never again use random and obscure electrical components from the OEDK without thinking about how the Poly Design Studio didn’t have access to a pulse sensor for Nimisha’s team to complete part of their prototype. I will never walk into a hospital or doctor’s office without remembering the babies wrapped in chitenge in the neonatal ward of Queens Hospital. But what I think is a more important thing to say after this experience is not so much how different Malawi and the US are, but actually how we are both the same. While some differences are critical to speak about and deserve attention, most differences are illusions. During our last week, we had a really fancy dinner with our boss, all the interns, a handful of professors at Poly, and people who work in the design studio. Our boss asked one intern from each of the four universities to speak to the whole group on behalf of our cohorts: What had our experience been like? What did we expect coming in to the internship, and what did we take away at the end? It ended up being an emotionally charged moment. All four people who spoke talked about how in the beginning they were afraid that it would be difficult to relate to people from other countries, but how working with and becoming friends with all the interns was actually so easy. Everyone spoke of learning from each other and growing close to people they feared they’d never relate to. I am so, so sad to leave these friends behind. In Tebogo’s speech, he looked right at the US interns and told us “The studio is going to feel empty without you.” I almost cried.

Dr. Ng’Anjo spoke towards the end, and he told us that we shouldn’t let this internship just become an experience in our past. We should keep talking to each other, and we should make sure this week is not the end of something small but the beginning of something great: careers that transcend borders and save lives with technology. He told us to keep talking to each other, because we understand each other and the unique challenges that engineering students in the global health field face. Twenty years from now, we should be reaching out to our friends in Malawi and Tanzania to work together to start startups, help each other network and get jobs, to work at as team on the next generation of medical innovation. More than that, though, I know I will hold these friends in my heart forever, a shining testament to the fact that yes, there are differences between the US and Malawi, but at the heart of things, people are all people. For the many, many people in this world who grow up in homogeneous, small communities, it can be hard to internalize the sameness of people from very different places. But, for people making careers out of global health, or heck, even people just watching the news and voting in elections these days, it is so critical to remind ourselves that the same friends and family in our own backyards who we’d all fight for are the same as people all around the earth, and it’s important to fight for them, too.

Zikomo kwambiri, Malawi, and I will see you again.

 

All the interns on our very very last day in the studio, after final presentations

 

Zikomo (Thank You), Everyone

I’d like to thank the generous donors of Rice 360 for making this internship possible. If it weren’t for you, I wouldn’t have planted a small part of my heart on the other side of the world, and I will always be grateful for that.

 

I’d also like to thank all the staff members and professors involved in Rice 360 and the Polytechnic for your support and guidance throughout these weeks and beyond. It is because of your investment in education that us interns are empowered to shape our lives into careers that might change the world. Thank you for believing in us.

 

To the Malawian interns: Racheal, Maureen, Foster, Boniface, Christina, Chisomo, Tebogo, and Rodrick: Thank you for showing me your country. Thank you for becoming my friends. I know many of you are graduating soon, and I wish you the best of luck with your future careers. I know you’ll all do great. 😊

 

To the Tanzanian interns: Nanah, Betty, Cholo, and Joel: Thank you for being so much fun to live with for seven weeks. It was wonderful getting to know you all and exploring the country of Malawi together. I know our many inside jokes and memories will last a lifetime. Keep in touch. <3

 

Finally, to my fellow Rice interns: Nimisha, Alex, Shadé, Sally, Kyla, Liseth: It was such an honor to get to know you all better than I did before. My life is much brighter now that you’re all in it. I can’t wait to keep learning alongside you. See you in two weeks!

7. Progress

The past two weeks can be summarized by two words: rapid prototyping. Everyday, we walk into the studio with ambitious goals of finishing multiple attachments to our model, but somewhere along the line we’ll hit an obstacle. One 3D print’s dimensions are incorrect. A ball and socket fails to replicate the range of motion of a human shoulder.  Our elastic strings don’t properly simulate muscle tension. But once a prototype falls short, its life is not over. We immediately begin shaving away extra material, cutting new holes, and taping on components to test potential directions that our next iteration could take. After a new low-fidelity prototype has been created from the remains of our previous failures, the cycle begins once more. We arrive at obstacles, meet to discuss the shortcomings of a design, and a new design is born. It’s kind of like the Circle of Life (sorry but I’m listening to the soundtrack of the new Lion King movie as I write this).

Of course, the model’s thin rods of plastic don’t necessarily resemble the contours of a baby’s arm or leg. The method of adjusting muscle tension could be simplified. But despite these imperfections, our current model establishes a solid foundation for the project.

By the end of Friday, we had completed all neuromuscular attachments to our training model, and with only one week remaining, our focus shifted to developing the assessment app. In the last half hour of work before the weekend, my team grabbed a huge white sheet of paper from the back of the studio. We then began to create a flowchart, outlining the basic progression of screens within our app. Once we decided on the placement, text, and purpose for a component, I would draw it onto our plan with a vibrant red marker (I found this part super satisfying). Not only did this process help us produce complete idea of what our app would be, but every member of our team left the studio visualizing our app in the same way. In engineering design courses back at Rice, it was always stressed that a crucial step in any project is making sure all of your team is on the same page. This helps avoid any major misunderstandings later on while prototyping.

The red markings outline different screens and the ways in which users will interact with our app (buttons, sliding scales, or scrollable lists). The dashed black lines illustrate a user’s navigation through different screens.

On Saturday, we drove to the Satemwa Tea plantation, the first fair trade registered tea plantation in Malawi. We began the morning with a tasting at the factory, where we each tried a spoonfuls of 18 varieties. I never knew this, but apparently even without flavoring, the different methods of rolling tea leaves have a large impact on the taste. My favorite teas were the white hibiscus, red hibiscus, green verbena, and the green mint. We then went on a walking tour through bright green rolling hills of tea plants, some of which were close to 90 years old. In the evening, we had dinner with some previous 360 interns from Malawi who had worked in Houston last fall. It was neat to compare experiences between the two different internship locations and hear about their time at Rice.

Sunday morning, Shadé and I woke up early to put finishing touches on the Clean Machine. With the craziness of prototyping our own projects, recreating this technology was a responsibility that we had pushed to the side. Taking it home to Kabula and working on it over the weekend was a good call, but looking back, we definitely had to get a little crafty with some components. For example, we completely forgot to bring the pulley’s counterweight from the US, and not being at the Poly, there was no clear replacement or way to attach the counterweight to the belt. Still wanting to test our work, we borrowed rocks from the garden and used some clothespins…

Eventually, we found a rock that provided the perfect amount of force to lift the lid and release the inner bucket without applying too much strain on the pulley brace.

After working on Clean Machine and making a little progress on this blog, we began to prepare food for a cookout we were having with all of the interns. We underestimated the amount of time it would take to chop all of the veggies, cook the hot dogs, and fry all of the chips, samosas, and spring rolls. As a result, dinner was delayed a little, but boy was it worth the wait! I think all of us were surprised at our ability to create such a spread of food.

Returning to work on Monday, our team began to develop our simplified assessment app for the Ballard Score. Looking at our plan, we started with the simple stuff: creating different screens and adding in buttons. Once that was done, we had to think a little more on how we wanted to program more complicated things like our sliding scale. Being that I was the only one who had done something like this before, I initially felt as though I had to serve as a resource for the rest of my team, but this didn’t last long. I remember the moment we tested our work on a phone emulator for the first time. At that point, we had only made the buttons that switch between screens. Still, the feeling of seeing your work come to life is thrilling. Everyone soon began to practice with the program on their own time, and our team began to fly through developing the rest of the app.

Since last Thursday, we have been testing and tweaking our work. You can find our most recent version attached below. If you are viewing this blog on an android smartphone, simply download, open, and install the file to try it out!

Download SimpleBallard App

Early Friday morning, I hopped in a taxi to Queens for a meeting with Prince, a nurse who frequently collaborates with Rice360. He was able to give plenty of useful feedback for the Clean Machine prototype and even had the time to look at our new Ballard Score training model. After talking with him, I arranged to observe in the NICU for a few hours until work started at the Poly. Heading into the ward, I was very concerned about my presence becoming an obstacle for nurses to work around. This was the last thing I wanted, so I began by sitting in the corner towards the back of the room. After a short while, Sarah, a fellow at Rice 360, tapped my shoulder and told me that something was happening on the other side of the room that I might be interested in seeing. A new baby had been admitted into the high-risk section of the ward. From a distance, I saw nurses quickly retrieving equipment from all around the room. The level to which every nurse is able to work with one another is incredible. Their communication is clear, quick, and their collaboration is efficient. Observing led me to better understand the role in which an engineer could contribute in this setting.

 

Prince trying out the heel to ear attachment on the new Ballard Score training model.

When the new baby was admitted, I saw Prince run to the other side of the room and grab a linen blanket. He then held the blanket up to a radiant warmer used to heat the room for at least 30 seconds. As I was reminded by Sarah, the best treatment for a cold baby is a warm blanket, warm socks, and warm hat. After the situation had calmed down, Prince came over to tell me that a useful project would be a warm storage container for linen blankets. This idea would save time in situations where every second counts. Prince’s suggestion got me thinking about ways to simplify processes, and I soon began to observe other opportunities for engineering to have an impact.

Recently, I’ve been thinking more and more about the scope of this program. As an intern, one of my primary responsibilities is needs-finding for projects at Rice. These projects are then worked on, and taken back for feedback. Looking forward into my next few years of education, I may even end up working on a need we identified through this internship. It truly is a cycle, involving every stakeholder at every stage. From nurses in hospitals across Malawi, to the students from four separate universities, to the professors and organizers that make it all possible, everyone is fully invested in a common goal. Step by step, prototype by prototype, progress is made, never losing sight of the bigger picture.

5/6. Let the Prototyping Begin

It is surreal that we only have a less than a week left in Malawi. Somehow the time has gone by and I didn’t notice it, but on the other hand we started prototyping! Our focus for the past couple of weeks (sorry it’s been a while since my last post) after the pitch competition has been on finalizing our solution design, get materials, and physically build our prototype. We started by making a few alterations to our final design transitioning from a water heat source to a light bulb heat source and deciding on the exact dimensions for each compartment. Once we had a plan in place, we transitioned towards dividing the work into three components the electronics, heating compartment, and the neonate’s compartment. For our first task, we collectively decided on how the heating system should operate:

  1. Contain a manual on/off switch
  2. Measure the temperature of the neonate’s heated environment
  3. Turn the light bulbs off when the temperature exceeds the desired temperature
  4. Turn the light bulbs on if the temperature falls below the desired temperature
  5. Alert nurses of the temperature

With these criteria in mind, we used various electronics, such as a thermistor, relay, Arduino, LEDs, resistors, and light bulbs, we spent multiple days trying to fit them all together. Each day we were able to build the circuit using the component and then program the Arduino to control the function of that component until we had a completed circuit. Of course, there were challenges along the way with not knowing the proper way to integrate the components together or the code not working, but eventually with enough trouble shooting we were able to acquire accurate temperature readings, automatically turn on/off the light bulbs, and indicate extreme temperatures. Not only were we able to work together and accomplish this task, but we took the time to teach each other the skills and reasoning behind each component so we understood their purpose (relays are really cool by the way).

       

Once we completed designing the electronics portion of our design, our next goal was to complete the heating compartment which contains the light bulbs, wiring, metal sheet, and insulating material. One challenge we faced in this portion of the   design was obtaining the physical materials themselves. It seemed that the best way to know where to get the proper materials was by word of mouth. Luckily the design studio already had plenty of wood available to use, however, the more specific materials were difficult to find. Working with the materials we had in the design studio, we built a simple rectangular box out of sheets of wood. On the bottom face of the box, we decided to add a plank of wood across to attach the light bulbs parallel to bottom and ensure they fit within the specified dimensions of our design. We also added a metal sheet above the incandescent light bulbs to retain heat and lined the inside of the box with aluminum to retain heat for a longer duration of time through insulation and radiation. As we continued to work, there were many decisions and adjustments that needed to be made such as adding a closed off housing area to separate the electrical components from the heat and laser cutting outlets in the box before assembling so the LEDs are visible and power switch inlet could be added. Despite planning our design for a significant amount of time, I realized that there are always going to be on the spot changes when completing a design. Because of this, my team and I had to discuss each possibility and would only move forward when we all agreed on the best option.

After completing the heating compartments, we then started on the base of the design to make the device mobile. Because we had already assembled the heating compartment with limited available space, figuring out a way build a secure and stable attachment point between the legs of the cart to the heating compartment was a challenge. At first, we attempted to attach for legs as a base and then add the wheels however, when we test it, legs were uneven causing it to be slanted (sawing perfectly level and straight lines with a hand saw is difficult). Unfortunately, this meant we had to either redo the base with the hopes of it being level or try an alternate method of attaching the wheels. Knowing that we were still unable to cut straight, we came up with another design that relied less on how the pieces of wood were cut but still stable enough to handle any obstacles when being pushed and this time we were happy with the physical results.

Despite having completed majority of our design, there are only a couple of days left before final presentations and we still have a lot to do, but I am hopeful that we can get it done in time. As for our time outside of the design studio, we had the opportunity to have dinner with the past Malawian interns who did their internship in the United States last year. It was really nice to compare our experiences having both traveled to different countries to work on global health projects. Something I found interesting was that they actually did their internship while Rice was still in school, so they worked mainly with Rice 360 fellows rather than other undergraduate students. I personally was curious to hear some of the cultural differences they found shocking in the US. Apparently one observation they had is how people treat pets as members of their family especially dogs. I can understand their surprise considering all the dogs I have yet to see in Malawi are either guard dogs or strays. It turned out to be a very nice dinner and I wish we could have spent more time with them or even met while we were at Rice.

On another note, here are some pictures from the adventures we have had over the past couple of weeks that I hope you enjoy as much as I did.

 

Until next time!

-S