There was an anticipatory silence in the room. Dr. Mafele, Dr. Marie, and a small group of nurses and doctors sat in a small, dimly lit office with a faint smell of disinfectant. To further our relationship with Amana Hospital, we were presenting on the progress we had made since our last visit. After a week of working on instrument repairs, brainstorming project ideas and recommendations for the hospital, we were very excited to present to our audience. We had planned this presentation well- we knew who would talk about what and had prepared a deck of slides that Julia printed out and handed to all the clinicians. Julia said a few words introducing us, and then the presentations began.

I have a weird relationship with presentations. I usually get very nervous a few minutes before, but when I’m giving the presentation, I am relaxed and excited. I love explaining the thought process behind my work, justifying my decisions, and getting feedback. As I sat in the room waiting for my turn to present, I felt the familiar butterflies in my stomach. Only this time, the feeling was exacerbated by the knowledge that I would have to present solely in English to an audience that, although fluent in English, was more familiar with Swahili. I realized that while my DIT peers could easily switch to Swahili to explain something further, detect audience cues and understand concerns, discussions and questions, I could not do the same. I was nervous about my accent being understandable and being able to answer their questions satisfactorily.

An important part of this presentation was selling ourselves. Amana Hospital had been quite skeptical of our skills and intentions to begin with, and we were extremely keen on building this relationship with them. They had explicitly asked us to ‘prove ourselves’, and this presentation was our attempt to do just that. Over the last week, we had reflected on our observations from Amana Hospital at length- going through research and brainstorming multiple times. We had well thought out recommendations, but they were not easy recommendations. I was acutely aware of the fact that while our audience were highly educated and very experienced, we were just a group of young engineering students, inexperienced and unaware about the trials of a hospital setting. How could we strongly convey our concerns and recommendations without making assumptions or overstepping the line? In addition to my general nerves, I was afraid of being inadvertently presumptuous. I paid close attention to my tone and word choice while presenting and noticed my fellow interns do so too.

Luckily, the presentations went extremely well. Our audience was receptive and appreciative. I couldn’t help noticing that while our audience listened to Matthew and me with rapt attention, when the DIT interns presented, they had an unmistakable expression of pride on their faces. Once we were done presenting and receiving feedback, the conversation switched to Swahili for a bit. From what I could gauge, the doctors and nurses congratulated the interns- telling them that the work that they were doing was incredibly important. They mentioned that they needed more engineers like them, and if they continued doing this work, they would be solving huge problems and bringing about remarkable change around Tanzania. Dr. Mafele mentioned starting a business with their ideas and making a lot of money. Our audience was noticeably excited about us and our contributions.

After conducting multiple needs finding trips and interviews, one of the biggest takeaways is the need for training of technicians and health professionals, and maintenance of medical devices. Inherently linked to these is the need for sustainable, in-house innovation. A doctor told us that most biomedical technicians are trained in South Africa and most medical equipment is manufactured outside Tanzania. This leads to increased taxes and import fees, making important medical devices more expensive, and prevents accessible, regular maintenance of those devices. This makes me think that cultivating in-house capacity for both training and maintenance can have long-lasting, positive effects on the Tanzanian healthcare system.

Multiple times after our visits to Amana I found myself questioning my purpose as an intern. All the problems we seemed to notice were deep rooted in structural things- government policy, education systems, hospital administration. As a nineteen-year-old bioengineering student studying in the U.S., I questioned my ability to enforce lasting change. I had only been in Tanzania for a few weeks. I barely understood Swahili. How could I possibly make a difference? I felt that the most that I could do was make surface recommendations, understand the problems as best as I could, and go through the design process, attempting to innovate engineering solutions. Although those engineering solutions would make small changes and make people’s lives easier, they couldn’t solve the huge, systemic problems that seemed to permeate everything. The more I thought about it, the more pessimistic I grew.

I quickly realized that I was missing a crucial piece of the puzzle. My fellow DIT interns, who were more comfortable giving our first Amana presentation, were better suited to solve the large problems. As we went through the engineering design process together, I was struck by how perceptive they were, and how easily they understood the problems and the human factors involved. While my job was to understand as much of the context as I could to inform decisions for engineering design, they inherently operated in the larger picture and could easily tell how every issue was interconnected. This came across every time we made design criteria or screened and scored ideas. Matthew and I came in with new perspectives, different ideas, experience with developing observations into problem statements and the engineering design processes. Our contribution, apart from working on a project for an identified problem, was in setting up the design studio, supporting and collaborating with the future engineers and innovators of Tanzania. In our time working at the design studio, we have been lucky to meet inspiring role models, examples of local innovators and change-makers- Paul, a DIT graduate who is the founder of STIC Labs (see Matthew’s post about STIC Labs here), Dr. Elphace, a DIT professor who studied in Russia, Finland and Thailand, and has the craziest, most inspiring stories ever, and Dr. Shah, a newly graduated doctor with a passion for biomedical engineering. My fellow Tanzanian interns continue to inspire and amaze me. My experiences here have reaffirmed my belief in the system and this internship. I now have an unfailing belief in the potential of my friends from DIT, and by extension, the future of Tanzanian healthcare.