Hello! As one of the three interns that are not bio-engineering majors, I’d like to begin my first blog by talking a little bit about what drew me to the Global Health Technologies Minor and this internship with Rice 360. For most of my life, I’ve known that I wanted to become a doctor eventually. Also, pretty early on in high school, I became aware that there are there so many other factors that affect health other than the skills or knowledge of an individual doctor and that this statement was especially true for those living in poverty. So, when I visited Rice as a high school, during the information session, my interest was piqued when the admissions officer briefly mentioned this internship and the opportunity it brought to really look at and address some of the more systemic factors that affect health. However, when she started talking about its focus on technology, I  cast this program aside in my mind as something I personally was not capable of.

This perspective stayed with me during my first weeks at Rice as I thought about what I wanted to study and  to an extent, throughout my first semester even as I was taking the Intro to Global Health Course. I loved the minor and the Rice 360 program, but I was terrified of the word “technologies.” As a girl, I never really was encouraged or given the opportunity as a child to explore engineering or, even, just building things. By the time I had the opportunity to explore engineering through extracurriculars in high school (thanks to Science Olympiad), I had already told myself that engineering was something I wasn’t interested in or capable of.

I realized how flawed this mindset was when taking GLHT 360. My team, also comprised of people who had no background in engineering whatsoever, and I were tasked with designing a training model for the Ballard Score assessment. To give some quick background on what this entails, the Ballard Score is a examination with 12 components that is commonly used in lower resource settings to determine how mature the baby is at birth. Initially, we struggled so much with just trying to figure out how to brainstorm a specific solution or how to prototype. This project was the first time I’d ever used a hammer or a drill on my own, far less gained exposure to 3D printing components or creating digital diagrams with Adobe Illustrator. Even though there was definitely a learning curve, I realized that, like upperclassmen and our professor, Dr. Bond, tried to assure us, these techniques could be learned. And we did end up successfully creating a prototype for one of the 12 components of the Ballard Score, and it was amazing to something go from an idea in our heads to a physical thing.

Although there is a long way to go to create a complete training model for the Ballard Score, I’m so excited to be taking our model to Malawi to get feedback from healthcare providers. Over the last week and a half in the OEDK, in the process of polishing up some aspects of our model and watching the interns prepare other technologies that are being brought to our sites, I’ve continued my path in gaining more familiarity in prototyping techniques for engineering. One day, Hannah showed us how to solder, and, on another day, Matthew gave us a quick crash course in Arduino. I was aware of these techniques before, but, while I am hardly an expert in either of these, I’d never imagined being able to do them at all.

In addition, to clean up the appearance of our Ballard Score training model, I switched out a foam component we used to a 3D printed version. That was the first time I used CAD on my own (one of my teammates did most of the CAD for our project). It took me a day and a half to learn to use TinkerCAD through their modules and create these very uniquely shaped pieces, but I did it! And, with Alex’s help, I learned how to operate the 3D printers in the OEDK.

I’m looking forward to whatever I may have the chance to learn over the next week in the OEDK, and, while, I may not be directly involved in an engineering project while in Malawi, hopefully another team builds on and develops other aspects of the Ballard Score training model, and I’m excited to collaborate with them/support them in any way I can. Half a year ago, who knew I would be this invested in an engineering project?

-Sally

Hello everyone! Welcome to my Rice 360 Blog!

This is my first blog post, so let me introduce myself. My name is Kyla Barnwell and I am a rising junior at Jones college majoring in Cognitive Sciences and minoring in Global Health Technology (GLHT). I was fortunate enough to have the opportunity to travel to Blantyre, Malawi with Rice 360 this summer and we leave in a little over 3 weeks!!! It’s finally happening! The closer our departure date arrives (June 3rd), the more excited and nervous I am to start this amazing experience. Between getting all of our technologies and materials ready for departure and making sure all the other affairs (flights, vaccines, passports) are in order, I have been really busy getting ready to leave.

These past two weeks, our team of Malawi interns have been working in the Oshman Engineering Design Kitchen (OEDK) on Rice’s campus building and prototyping the necessary materials in order to make some of the technologies we will be taking over to the Polytechnic Institute and the Queen Elizabeth Central Hospital. We are taking a slew of technologies including: a mechanism to lock IV drip rates, an automatic bleach sterilization machine, a neonatal temperature monitor for Kangaroo Mother Care, a training model for determining the Ballard Score Gestational Age, a cervical thermocoagulation training model, low-cost ostomy bags, a low-cost oxygen monitoring system, and reusable phototherapy masks.

One of the technologies we are taking is one that my own team has personally designed which I am very proud of. During one of our classes last semester, our team developed a model cervix that can be used train providers in a new cervical cancer treatment technique called thermocoagulation, which is essentially burning any cervical tissue lesions found on the cervix that might develop into cervical cancer. Our team worked extremely hard developing this model and we are amazed to see it actually going over to places like Malawi, Brazil, and Mozambique to get more design feedback and eventually, be used to train providers in this potentially life saving technique. At the OEDK, we worked on 3D printing the molds used make the model cervices and once our ordered materials arrive, we will get to work developing some prototypes very quickly in the next few days. The Brazil team is looking to take around 5 model cervices while we will be mainly making around 20 model cervices prototypes when we are in Malawi. I have also had the chance to learn more about 3D printing software, laser cutting, and other cool OEDK technologies that I have really not had previous exposure to. Since I am not in an engineering major, it has been very cool to watch and learn how to use some of these advanced prototyping tools and software. It was also really cool to learn how to develop a lot of the other innovative technologies we are bringing. I had been exposed to them through peer presentations in our GLHT course, but actually hands-on learning and seeing how each part is made and how it works has been so much more informative. All of the other interns have been really helpful in every project and I have really loved bonding with everyone at dinners and team meeting luncheons.

While in Malawi, Liseth (another Malawi intern) and I will be working together at the Queen Elizabeth Central Hospital. Our project mentor, Dr. Claudia Aceyman, has tasked us with some very important assignments concerning valuable human factors work and data collection. While in the hospital, Liseth and I are going to be documenting the use environment pretty extensively. This means we will be taking notes on hospital dynamics and interactions, how the environment changes from the perspectives of a doctor versus a nurse versus a patient or family member, and of course, looking into how users interact with our designed technologies and assessing how we can improve in order to best fit the needs of the user. Liseth and I have been reading a ton of articles, journals, and books on human factors research in order to decide how we can best compile and organize all of our findings. We are also looking to develop a survey/interview format that can be used to gauge usability for the Incubaby Neonatal Incubator technology (but also can be applied to other technologies as well). We are brainstorming appropriate questions to ask users while they interact with the technology. We will need to take note specifically of human behavior, abilities, limitations, cognitive resources, and other characteristics to the design of systems, tasks, and equipment/technologies that we are bringing.

Between prototyping, packing, ensuring I have the right anti-malaria pills and vaccines, and the upcoming 15 hour flight from JFK to Johannesburg,  it seems as though I already have a lot in store for me in these upcoming weeks. I definitely have a lot more in store for me once I arrive in Malawi. This trip will be the farthest from home I have ever traveled in my life, so I am a little nervous. I really hope things go very smoothly but there’s always small hiccups to be prepared for when traveling. I am glad I get to see my family back home in Atlanta, Georgia for a little while before I head off abroad. I’ve really missed a good home-cooked meal. Stay tuned for more updates!

Hello, everyone! Pardon the delay in posting – I wrote this and many of the following posts many weeks ago, but had to save them until I could get some computer problems fixed. And now here we are!

22 June, 2018

These have been my very first few days in Malawi. It doesn’t take long to see life is very different here. It has already been eye-opening for me, despite having experienced many corners of the world already.
A quick introduction, since I am an atypical undergraduate, and probably an unusual global health intern as well. I’m a thirty-two year old philosophy and kinesiology major and a part owner of a small maritime company in the Port of Houston. I used to be a nuclear submariner (mechanical engineer and chemist), and am working towards a career in surgery. How did I find myself in Malawi? Well, since 2014 I have been blessed to work in the Richards-Kortum lab, and I was part of the original team that invented Bilispec. I brought a lot of diverse engineering and design experiences to our research, and now I’m here to help make our device a more sustainable reality for our partners here in Blantyre. So, my three goals:

1. Manufacture our single-use Bilispec cards locally
2. Train our friends at the Polytechnic Institute how to manufacture them
3. Equip and train our friends at the Queen Elizabeth Central Hospital to validate those strips for use in the hospital

Of course my fellow interns and I are all eager engineers at heart, so we’ll be supporting one another with each other’s projects as well. I am so very grateful to Rice 360 and its sponsors for allowing me to continue contributing to the Bilispec project and also to the other initiatives which my peers have undertaken at both the Polytechnic and the QECH. This is my first time in Malawi—in Africa, even—as well as my first global-health-step outside of the laboratory. It will also be my first introduction to medicine in a low-resource world, and to top it all off, my very first blog post in my life. That’s a lot of firsts! Thank you!

After a warm welcome by my new Rice family, I am all settled here at Kabula Lodge.
The weekend is about to begin, so I will have to wait until Monday to introduce myself at the Polytechnic and Queens, but I am excited to see what everyone has been up to, and to get started on my own projects! For the next few days, however, it seems we are leaving Blantyre for a two-day trip to the Majete Wildlife Preserve. What an introduction to Malawi.

A week of learning! We first met our fellow interns that study here at the Polytechnic on Monday, this moment of introduction was exciting and came after a long time of anticipation. There were so many students and every single one is so fun to be around, from working together to just goofing off outside. The rest of the day was spent with icebreakers and presentations of our medical technologies and looking at the projects that they have been working on all year. Later that week we were assigned our projects for the remainder of the internship.

Some of the projects that were given to us were: Oxygen concentrator filter reinvention/optimization, sieve bed (for oxygen concentrator) renewal, suction machine monitor, a continuous temperature monitor for mothers undergoing labor. My team is made up by Alfred, Gloria, and I; the project we were assigned was the oxygen concentrator filter optimization. This project was given to the interns last year and we are continuing it as well as adding to the project. The filter that was worked on last year was only for the external filter but they did not have time to continue work another filter, the internal filter. So we will be spending our time optimizing and finalizing the external filter as well as creating a universally fitting internal filter. This project is important because most oxygen concentrators used in the hospitals are used around the clock almost never turned off until they break down, the reason most of these devices fail is due to the entry of dust through the filters. The filters used regularly poorly filter the dust from the outside air. So by fixing this problem then more oxygen concentrators can be used for longer periods of time. I’ve already got ideas churning in my mind for designs of this device, I hope I have a well-advanced project by the end of this summer!

After being assigned projects and meeting the interns we were given a brief and speedy introduction to microcontrollers. Microcontrollers is a fancy term for a small electronic chip that can be programmed to control things like lights and sensors as well as process and display data. A common microcontroller is the Arduino, an open source microcontroller board, the Bilispec is actually run on Arduino. We learned how to program in Arduino and how to read and process data on the Arduino! Another program we learned to used and practice is called Autodesk Inventor. We use this program to create 3D models that can be printed on 3D printers. This program is really helpful for creating prototypes four our medical devices. The majority of the week was all learning and I know it will be supremely useful for the duration of the internship!

Then this weekend to wind down from all the work as well as a welcoming to Kristoffer the last intern, we went on 3 different safaris at the Majete community campsite including elephants, impalas, a porcupine, some hippos, crocodiles, baboons and many bird species, it was a fun end to the week!

This week is our first week of official, getting down and dirty work, the anticipation has been building up. The work will be expectedly difficult but extremely worthwhile.

As of today, we are completing our first (half) week here in Blantyre, Malawi. We landed on Wednesday and our travel felt endless, each of us having been in 3 different continents in the span of 3 days. During this travel I was in Europe for the first time and now it is my first time in Africa. Aside from losing a bag on our last flight and recovering it the next day, the flying was enjoyable. Travel aside, the city of Blantyre has been nothing but good to our group. The people are extremely kind anywhere you go, the food is cheap and fantastic (lunches are no more than $2!), the weather is comfortable during the day, and the views of the mountains are enjoyable at any time of day. We purchased cell phones to use locally and bought groceries to cook dinner, it was fun and complicated all at once since phones here are used on a credit basis where scratch cards are used to obtain data and minutes.

Thursday was all about introductions and locations. We visited the Rice 360 office and the NICU at Queen Elizabeth’s and we visited the “MOEDK,” which is the design studio at the Polytechnic University of Malawi. At Queen’s they have the largest NICU in the country, but they still only have about 20 beds total and the area of this ward was about the size of two small classrooms. It was humbling to see such dedicated and caring nurses watching over the infants in this unit as well as the standard of care here in Malawi. At the NICU they do not have typical incubators, they use a wooden box called a “Hot Cot” with heating bulbs underneath but this tool can sometimes overheat and harm the infant since there is no temperature control. The NICU also had no way of continuously monitoring the infants aside from the nurses making constant rounds of the ward. Being in this ward really showed the real and dire need of better tools to care for neonates, and thinking that this is in the largest NICU of Malawi. During the night shift only 3 nurses are on duty for as many infants that the NICU can hold, and at night 75% of infant deaths occur, mostly due to lack of monitoring of infants. At the Polytechnic we met Andrew and Francis, they run the design studio and we will be working with them extensively this summer.

Then, on Friday we worked all day at the Polytechnic preparing our technologies for presentations on Monday, we will be presenting to Rice 360 staff and joining them will be Dean Reginald DesRoches, our Dean of Engineering at Rice. I’m excited to show the staff the work we have been doing and the devices that have been developed by Rice students in engineering design teams. While working on these devices, one of them, Optoco, broke on us about an hour and a half before our day ended, which was very frustrating but we were able to construct a proof of concept design which will suffice for now. I’m excited to meet the other interns that study at the Poly that we will be working with in the coming weeks, I can’t wait to see the work they will be doing and what I will be able to learn from them.

The weekend was a bit more relaxed, we went to visit a tea plantation and were a part of some tea tasting, I bought myself a small bag of loose leaf tea cultivated in that plantation to bring back home. We also washed our clothes by hand for the first time, easier than I thought but quite time consuming. Drying our clothes is the hardest part because the majority of the day is cold and the sun goes down at 5 pm and it is dark by 6pm so the clothes must be out the entire day for it to dry.

For the following week we have planned to visit district hospitals on Tuesday and Thursday to perform some needs finding and to learn about the standards of care in smaller hospitals in Malawi.

One of our drivers, Edson, took us to a local restaurant where we had some of the best food I have had ever. At Njamba we had Nsima, a typical staple food here similar to grits made of Maize, some Okra, and Chambo, a typical fish that lives in Lake Malawi.

Tiwonana nthawi yina, see you later!

–franklin–