Month: June 2018

Workshop Whizzes (Part 1)

Posted on by Grant

One of the main goals for our internship was for Angela and I to pilot a biomedical equipment troubleshooting workshop for DIT students and find ways to integrate the workshop into the biomedical engineering curriculum. Keeping with this goal, we worked with DIT students, graduates, and lecturers to understand the curriculum and education system here.

At DIT, the biomedical engineering program is still relatively new (the first class matriculated 5 years ago), and the nascent department is housed under the electrical engineering department. In all of Tanzania, there are currently only two universities offer programs in biomedical engineering: DIT (where the highest degree offered is a technical diploma) and Arusha Technical College (where students can earn up to a Bachelo’s.)

The biomedical engineering curriculum at DIT lasts 3 years, and students accrue additional certifications at the end of each year (levels 5-7 in the chart below). In between years of study, students have the chance to go on Industrial Practical Training (IPT), a 2-month job shadowing opportunity that embeds students in the engineering departments of hospitals across Tanzania and even internationally.

Students take 12 modules per semester: 6 core courses (typically centered on a particular medical device) and 6 general education requirements (math, physics, finance, and the ilk). Grades are determined by high-stakes midterms (40%) and final exams (60%). All this sounds fairly banal, and you may wonder why I am going into such detail about these education requirements. Had Angela and I stopped after this assessment, we may not have seen a role for ourselves in the coursework here. However, peeling back some layers and asking questions of current and former students revealed some disparities between the curriculum’s design and practice.

For virtually all of their core classes (half of their coursework), our fellow interns had either never met their lecturers or met them only once. Their teachers, they explained, were typically busy professionals and adjuncts who lived and worked far away, so they rarely (if ever) show up to scheduled classes. Students end up attending fewer than half of the lectures on their syllabus, and they are left to study on their own and guess at what material will be covered on their exams. Even when lecturers make an appearance, they teach theoretical concepts without demonstrating on real devices. The students’ core curriculum is supposed to include 2 sessions of practical lab work per week, but almost all the sessions are cancelled or never scheduled.

The list of grievances go on, but students cite 2 major problems again and again with their education: lack of instructors and lack of practical training. This leads them to feel unprepared when they go for IPT or enter the workforce. When asked about DIT graduates, the head of engineering at Aga Khan hospital noted that they lack the required technical skillsets.

The challenges faced by DIT are compounded by the fact that the national government is pushing DIT to establish a Bachelors program for biomedical engineering. As Mr. Moshi, the head of curriculum for the biomedical engineering explained to us, the degree-conferring system in Tanzania is strictly hierarchical, with National Technical Association (NTA) levels assigned to each degree (detailed in the chart below). Instructors in a particular program must have an education level at least 1 above the students they are instructing (i.e. a Masters or above is required to teach Bachelors coursework). The current biomedical engineering staff, already spread thin, does not have lecturers qualified to teach Bachelors courses. Moshi expressed worries that he would have to hire unreliable adjuncts that were unlikely to stick around to teach upper-level coursework.  
Source: Tanzanian National Commission for Universities Qualification Framework

Armed with this enhanced understanding of the educational bacground at DIT, Angela and I set out to pilot the Rice biomedical equipment troubleshooting workshop.

4. Pole pole: Slowly, slowly

Posted on by Angela

As always, our week was quite eventful! Since we had finished all the troubleshooting modules, I was honestly feeling a bit frustrated going into the week. I’m the type of person who likes to plan things out and get things done, especially when responsible for a group of people, so not having any specific next steps was a bit stressful. However, Dr. Leautaud joined us at DIT from Monday through Wednesday, and helped us establish some more goals for the coming weeks. I also learned that I should be more patient, take things slower, and try not to stress about things that I can’t control. For example, we finally got a permission letter sent to go to Muhimbili, and ~yay!~ got internet working in our room.

Dr. Leautaud also brought the great news that Rice 360 has received a grant from the Lemelson Foundation, similar to the one received for Malawi (1,2), to further the Rice-DIT relationship and help establish a biomedical engineering design studio and practical workshop. Our DIT cohort was really interested to learn about the resources we have at the OEDK, and together we created a set of student and instructor surveys to help gather ideas for the new spaces.

Right before Dr. Leautaud’s departure

We also came up with a few more projects to tackle: creating practical electronics modules and installable centrifuge safety switches. For these two projects, we walked the DIT students through the design process: defining design criteria, brainstorming solutions, and selecting the best one. The DIT curriculum only has 1 design project that is assigned during the final year of study, and it consists of pitching a solution to a problem, building it, and giving a functional demonstration. It seemed that they are not taught the processes of needs-finding, definition of design criteria, brainstorming, and validation of design criteria, so these exercises were a bit challenging. However, with lots of patience, we pooled together some good ideas and a shopping list for electronic components to buy in Kariakoo.

Kariakoo is a HUGE market that sells everything. Literally everything. The DIT students accompanying us on the trip took us straight to the electronic components shop, but we easily could have spent hours looking for the right place if they hadn’t guided us there. Seriously, Kariakoo was like a physical Amazon.com, without the search bar. Unfortunately, I didn’t get a photo of the streets because Gilden was paranoid I’d get my phone stolen, and kept it in his pocket for safekeeping.

The tiny storefront for the electronic components shop

On Saturday, Grant and I had a chance to visit Aga Khan, meet the head of the BME department, and tour some of their facilities! We will get a chance to take the group there in the next few weeks as well. Their current ICU is tiny, only 4 or 5 beds, but they are constructing a new building with an entire floor for the new ICU, complete with brand new equipment.

Stacks of brand new syringe pumps

And finally, on Sunday we ended the week with a visit to Coco Beach! Though I only have Galveston Beach to compare it to, I thought it was absolutely beautiful. We even found a spot to do a little cliff diving! All in all, a very relaxing trip that provided some time for me to destress and think about what we’ve accomplished so far. “Pole-pole” (slowly, take it easy): adjusting to a slower pace of life has been different but definitely enjoyable.

Before the jump

3. Eid Muburak!

Posted on by Angela

We have now finished the first two weeks of our internship at DIT! At this point, we have finished going through all the modules of the troubleshooting course that Grant and I brought from Rice. While we did not have access to a syringe pump or oxygen concentrator, we watched the associated videos and also were able to look at several centrifuges. Additionally, we got to check out some of the other devices that have been stored in our work space: an incubator, water bath, shaker table, and EKG machine. I think that all of these practical sessions have been really beneficial to the students, and our next step will be to figure out how best to implement this in the DIT curriculum and ensure its sustainability once the course passes on to other lecturers.

Centrifuge Day

Apart from the troubleshooting course, we also held a soldering workshop, showed the Rice GLHT projects, and discussed the engineering design process. As for soldering, it seemed that most of the DIT students had little to no soldering experience. Grant and I brought the basic tools- soldering irons, soldering wire, and wire cutters- but were challenged to find materials to practice soldering with. I’ve definitely been spoiled by how plentiful the resources at the OEDK were. Initially, I thought that maybe we could solder together a simple LED circuit on a through-hole PCB. However, not only could we not find a PCB, we couldn’t even find an LED in the electrical engineering workshop. But after some digging, we made do with some lightbulbs and a switch and were able to construct a simple circuit together. I really wish that we had the capability to work on some more sophisticated circuits, but at least we were able to have all of the DIT interns get some hands-on experience with soldering.

Soldering Practice

We combined our discussions on the GLHT projects and the engineering design process. We explained the needs for and designs of both the Mathermal and Colostomate, which the DIT interns were pretty interested in. By showing our fellow students these projects, we were able to introduce the design process that we are taught at Rice: needs-finding, brainstorming ideas, establishing design criteria, prototyping, and testing. Hopefully, we will get to show the GLHT projects to medical professionals for more feedback and conduct some needs-finding sessions with our fellow interns soon!

Our work week ended slightly early because Friday was a holiday. It was the end of Ramadan, or Eid, and Madam Kianja invited us and all the interns to her house in Pugu to celebrate! The food was delicious and the hospitality was, as always, amazing. I have never experienced an Eid party, and this one did not disappoint. Grant and I made some beef dumplings to bring to the gathering. Though it seemed like most were wary of the unfamiliar food, Dr. Kianja’s son and daughter were happy to try them!

Very full and very happy at Dr. Kianja’s!

2. Karibu: Welcome

Posted on by Angela

This first week in Dar has really flown by! We arrived in Tanzania on June 1st, last Friday. At the airport, we were greeted by two DIT students, Gilden and Hamida, and the DIT driver, Stuart. They spent the entire drive to our residence at the Raha Tower telling us about Tanzania and asking about Rice. Once we arrived, they helped us settle in and promised to come back in the morning, before finally returning to DIT. But this was just one example of how welcomed we’ve been. From teaching us greetings in Swahili, to helping us figure out ATMs and SIM cards, to checking up on us every day, despite being in the midst of a two-week exam period, our colleagues have gone above and beyond in ensuring that our stay is off to a good start.

We started off our week by meeting the DIT intern group that Grant and I will be working with. Gilden, Hamida, and Godwin are all second-year students, while Nyangige, Twalib, and Kasim have already graduated. They are all very friendly and were eager to get started on our troubleshooting workshop. Though their 3-year diploma allows them to begin working as biomedical technicians, most of them have had little experience with devices beyond classroom lectures. Kasim, in particular, currently works as a technician at Muhimbili National Hospital. Though he still has to get permission to work with us for the duration of the internship, hopefully he’ll be able to show us around the hospital and help us access more equipment next week.

So far, we’ve worked on different modules of the troubleshooting course we brought from Rice: microscopes, suction pumps, and refrigerators. We’ve focused a lot on the troubleshooting process: observing the failure, defining the problem area, identifying possible causes, ranking them in order of probability, and testing and repairing the equipment. We want them to understand how important it is to think about the problem, using the aforementioned process, rather than jumping in and trying to see what the problem is. While the process seems unnecessary for the simple devices we’ve looked at so far, it is definitely an important skill to learn for situations with unfamiliar or complex equipment. Thankfully, we’ve had positive and enthusiastic feedback from our fellow interns so far.

Microscope troubleshooting

Some more notes:

  • We’re often greeted by “m’china”: Both Grant and I are Chinese, and there are quite a few Chinese people in Dar. Lots of Tanzanians know bits of Chinese. Gilden, for example, knows greetings and the numbers from 1-10. The fishermen at the fish market knew all the names of the seafood they were selling in Chinese too. And right across the street from our apartment, there’s a pretty authentic Chinese restaurant that we checked out on Saturday night.
  • DIT is trying to start a bachelor’s program in biomedical engineering. However, teachers of first-year diploma students must have at least finished second-year diploma courses; teachers of freshman level classes must have at least finished the sophomore level. Similarly, senior classes must be taught by someone with a Master’s or PhD, but there aren’t enough current faculty with these degrees. Hopefully they are able to recruit enough faculty to offer the bachelor’s!
  • I turned 22 on Wednesday! Grant made me a delicious cake, and the interns sang happy birthday to me at work. They sang the same song that we’re used to, with the addition of another stanza: “How old are you now, how old are you now, happy birthday dear Angela, happy birthday to you!” Finally, they told me that a birthday custom is to pour water on the head of the birthday person! Fortunately, I escaped this “shower” because we still had work to do on our suction pump.

A very yummy mango cake

Overall, this first week has been a great experience. We hear “karibu” (welcome) and “mambo” (how are you) all the time. I have definitely felt extremely welcome here and am looking forward to the rest of the internship!