Our time in Tanzania was nearing its end. By now, we had done an adequate amount of hospital visits and had identified problem areas that we could innovate within. It was time for us to do our final internship capstone project! Julia narrowed the projects down to two: a mechanism to prevent the backflow of fluid in suction pumps, and a modification to the Clean Machine to serve Amana Hospital’s needs. As Joel, Sadick and I had already worked on repairing and troubleshooting the suction pump from Amana, and we were assigned to the suction pump project.

After our experience repairing the suction pump, we had multiple ideas to address this problem. These ideas were varied- they ranged from a training and troubleshooting app to a completely revamped design of the pump. Our assigned project statement helped us narrow down these ideas and focus on the problem at hand. We knew that we had to focus on a mechanism to prevent, delay or limit the damage caused to the aspirators by fluid backflow. We narrowed down our ideas to those that explicitly addressed the problem.

During our visits to Amana and Muhimbili Hospitals, we had a chance to focus our observations and interviews on the suction pump problem. In addition to interviewing nurses and surgeons about the common problems faced with the suction pump, we got an opportunity to see broken suction pumps in the Muhimbili Hospital Graveyard, as well as speak to technicians who had to repair these suction pumps. From this, we learned about the problem with the current solution. The built-in valve mechanism was often removed by the users. The bacterial single-use hydrophobic filters were not always effective, expensive and had to be replaced often. Our solution had to serve the purpose of the valve as well as ensure that it was not removed by the users.

Although we had just about eight days till the end of the internship, our team decided to go through the entire engineering design process, doing focused research, forming design criteria and making screening and scoring matrices. Our design criteria focused on what we thought was the most important to Amana Hospital- requiring minimal clinician input, effectiveness, accuracy, durability, and low cost. After screening and scoring our ideas, we decided to prototype our top two ideas, to be able to further decide what was best suited to Amana Hospital’s needs. Our top two ideas were a multiple canister system- adding more canisters to the suction pump to delay the backflow of fluid, and a sensor system that would detect when the valve shut off the suction and alert the user that the canister needed to be emptied.

Using lunchboxes, modeling clay and pipes, we began by prototyping the multiple canister system. Although the prototype worked, we agreed that it was not a permanent solution to the problem. We could add multiple canisters to prevent the backflow, but it would take up precious space in a surgical theater. It was also a temporary solution- how many canisters could we keep adding before the backflow ruined the pump?

We decided to move on to our valve-sensor mechanism. It was a combination of a 3D printed valve which served as a reusable backflow prevention mechanism, coupled with a sensor system that would alert the user when the canister filled up. We hoped that the sensor system would let the user know exactly why the pump stopped working once the canister was filled, and hence prevent the removal of the valve. To prototype this idea, we needed a functioning suction pump to test our valve and our sensor mechanism. We had returned our repaired suction pump to Amana Hospital and did not think that they had one to spare for us to prototype on. Hence, in the spirit of ‘making do’, we fashioned our own suction pump out of a leak-proof lunch box, 3-D printed parts, pipe, and a hand-pump. We estimated the dimensions of the cage that would house the valve and 3-D printed it. Now, with a makeshift suction pump ready, we decided to work on our prototype.

We began by researching the shapes of existing valves. After some research and testing, we had a simple valve that fit in our cage, floated, and shut the suction off once the canister was full. Our next step was to prototype the sensor system. Here, we ran into some problems. We first attempted to use an IR sensor and emitter pair to detect the valve closing. Although this system worked in the beginning, we ran into some trouble making the system accurate. It would give us plenty of false positives and false negatives. We tried to fix this problem by using different materials and colors for the valves, as well as creating temporary ‘hoods’ to remove interferences to the system. But after multiple attempts were unsuccessful, we realized time was running out and we had to try a different system.

Our second attempt was a magnetic sensor system. This system was a little bulkier as it required the use of an Arduino board, as well as a bigger sensor and a magnet on the valve. Although we got the electronics to work, we ran out of time and couldn’t manage to design a valve that could float while handling the weight of the magnet. With just a couple of hours left until our presentations, we decided to create a functional prototype that would communicate the idea. For our final presentations to the DIT Faculty and Dr. Mafele from Amana Hospital, we presented our valve in our in-house suction pump and presented the sensor mechanism separately with an external magnet. These were enough to demonstrate our idea, and we also explained that the entire system could be customized to any make and brand of suction pump.

Our prototypes were well received by both the faculty and Dr. Mafele at Amana Hospital. Along with the positive comments, we also received multiple suggestions and additions that could make our system more effective and easier to operate. This experience reiterated to me how important it is to have constant clinician interaction and input while prototyping a device that will be used in a medical, surgical setting. Dr. Mafele and the professors at DIT brought up points that we hadn’t heard of during our interviews and that we hadn’t thought of during our brainstorm sessions.

Our project was far from a complete prototype, but we had done the work of developing the problem, homing in on a solution, eliminating options that would not work, and making the first attempt at a prototype. I felt myself get restless and frustrated when our ideas and their executions failed, and I was disappointed that we couldn’t make a complete, neat prototype. Julia, Matthew, and my team helped me put things in perspective and appreciate that working on any project is a slow, iterative process, and no amount of progress is too little progress. I’m sure that this project will continue to be worked on by engineers in DIT, and I plan to bring this project back to Rice so we can work on it here as well! In the meantime, I am happy to have learned so much more about CAD, 3D printing, Arduino, suction pumps, valves, sensors and patience in the process.

“Everyone, make sure you are here on time tomorrow, we are visiting Amana Hospital and have an appointment at 10 am”

When Julia announced we were going to visit Amana Hospital, our excitement was palpable. I immediately went from sleepily designing and CADing an interlocking puzzle-like organizational system for the low-fidelity prototyping table to typing up questions for feedback and needs-finding interviews. It had been a long week of engineering design workshops and small projects around the studio, and I thought we were well primed to sink our teeth into something more substantial and challenging. I could not wait to gain first-hand experience at finding problems and developing solutions.

During our visit to Amana Hospital, we had the chance to tour and observe their surgical theatres. Dr. Marie, who had kindly agreed to be our tour guide, took us into an OB/GYN surgical theatre that was not in use anymore. According to Dr. Marie, almost every medical device around the theatre did not work. The pulse oximeters, suction pumps, and blood pressure monitors were all malfunctioning. Even the surgical beds were unstable and missing some features. They shook so much that performing CPR on them was dangerous. As they had no vertical movement, the surgeon had to operate standing on a stool. Dr. Marie told us about a time that a surgeon fell off the stool and injured himself during surgery.

I was shocked. This was my first time in a surgical theatre, and I kept looking around, trying to take in as much as possible. Wearing an oversized hospital gown, gloves and hairnet, I tried to scribble observations and draw diagrams into my tiny notebook. Our team spread around the surgical theater, looking at different devices, translating signs on the walls, asking questions. We knew Amana was counting on us to fix their devices, and we were focusing on absorbing as much as we could from our surroundings.

We left Amana excited but slightly intimidated, with a vaguely defined task looming ahead. We were buzzing with new ideas and opportunities for the future. I was struck by how many medical devices were donated – fancy, sophisticated, branded equipment, from big, established medical device companies- most in disrepair, lining the sides of the operation theater. It broke my heart to think that these crucial devices sometimes were the difference between life and death in a surgical setting.

From Amana, we brought back a malfunctioning suction pump, caked with an unidentifiable dark maroon substance (we later identified this substance to be blood). We had decided to begin our relationship with Amana by troubleshooting and trying to fix this pump. It sat in the corner of our design studio. The six of us studied it from afar- where to begin? We decided to start by addressing the obvious biohazard. A trip to the supermarket and a pharmacy equipped us with cleaning supplies and medical grade gloves. We wheeled the suction pump into the men’s bathroom and cleaned the outside with all the disinfectant we could find.

Once the outside was clean enough, we decided to tackle the inside. On the trip back from Amana to the design studio, we had noticed some mysterious sloshing noises coming from the inside of the pump. We very hesitantly opened the back panel of the pump, to see the inside covered in much more of the same dark-maroon substance. There was solidified, crystallized blood caking the inside as well. By now, it was the end of the day and we decided to go back home, take a break and come back refreshed and better equipped with more PPE.

The next morning, Julia decided to split us into teams so that we could effectively finish our tasks before the next Amana visit. Joel, Sadick and I were assigned the suction pump. Before opening the pump and beginning to clean the inside, we decided to plug it in, turn it on, and see if it would work. Much to our surprise, the pump began whirring, and the pressure gauge showed -0.9 bar as expected of a well-functioning pump. The only problem that we noticed was that the pump made a lot of noise, but we realized that this could be easily solved by cleaning out the tubing system inside the pump. We then decided to open the pump and clean the insides. Dressed in makeshift garbage-bag gowns, we took out all the tubing, labeled it, and cleaned it well. Once we put the pump back together, it worked like it was brand new. We tested it on some water using a straw and some play-doh to replace a missing pipe. Not only did it suck all the water, it also regulated the pressure well.

 

Once we were done with our maintenance of the pump, our team sat down to reflect on our observations. We deduced that the solidified blood inside the pump was due to the backflow of body fluids into the pump once the canister overflowed. On further examination, we noticed that the protective valve on the canister lid was missing. It now made sense that the suction apparatus had stopped working due to the presence of fluid inside the pump, and as this fluid solidified, the suction capacity of the pump returned to normal. We realized that this problem could be avoided by training users on how to safely use the suction pump. In addition, we decided to develop a technical solution that would prevent backflow as well as alert users once the fluid began to overflow. On our next visit to Amana, we were happy to take back a fully functional suction pump and a list of recommendations, which we presented to a panel of doctors and nurses. Our audience was astonished to see the clean suction pump and were receptive to our recommendations.

Taking apart that suction pump and putting it back together taught me a lot about how medical devices function. After looking into the suction pump, I realized that the technology behind it is quite straightforward and easy to understand. It reminded me why I first fell in love with engineering – I am so fascinated by finding simple, elegant solutions to big problems. After studying the backflow problem, I realized that along with innovating new medical devices, it is important to make existing solutions easy to use and intuitive for settings like Amana Hospital, where they are used heavily, often in a rush.

An important part of our internship and experience here is to gain a thorough understanding of the social and technical context of our innovations. Before I visited Amana, I thought this was limited to hospital visits, observations, and talks with doctors, nurses and health professionals. Now, I have altered that definition. I realize that active participation- opening, troubleshooting and using existing medical devices is incredibly essential while creating new devices. Without literally getting my hands dirty and having the experience of taking apart and reassembling the suction pump, I would have never fully appreciated the elegance of the solution, the challenges to the design in a low resource setting and the importance of incorporating human factors into technical designs. I’m sure that this learning will help me during this internship and beyond, as I learn more about appropriate designs for global health challenges.

It has now been three weeks since we landed in Dar, and two weeks since we started our internship at the Dar-es-Salaam Institute of Technology (DIT). Along with four interns from DIT- Joel, Anicia, Daniel and Sadick, we work in the DIT Design Studio under the guidance of Julia, the Design Studio manager. In the last two weeks, we have converted the design studio from an empty room with benches and stools to a vibrant design studio we can call our own. I really love our seventh-floor design studio- the natural light and the breeze makes working here easy and enjoyable. However, when I am here during the day, it is easy to forget where I am. It is easy to dissociate from the city and my surroundings, and never interact with the outside world except on our walks between the hotel and the institute.

On the first day of our internship, we went over our goals and expectations from this internship. We wanted to use this opportunity to work collaboratively, get hands-on experience in engineering problem solving, and gain an in-depth understanding of challenges and needs. In addition to this, we agreed that it was important to truly immerse ourselves in our surroundings to best understand the challenges and context that we would be working in.

Kariakoo

Although Matthew and I brought along plenty of supplies from the US, we were still missing some crucial tools that we needed to procure for the design space. In addition to these tools, we needed to buy buckets to complete prototyping the CleanMachine, the automatic sterilization machine that was developed in the GLHT 360 class. To purchase these materials, the interns took Matthew and me to the Kariakoo market. I’ve been to roadside markets before, but Kariakoo was bigger and better! Shops selling most everything under the sun lined the streets, and there was a constant din and hustle-bustle of customers, vehicles, and vendors. In some places, the delectable smell of fresh lime being sold on the streets permeated the air. There was such chaos- so many interesting things happening, and novelty items being sold. On my first visit to Kariakoo, I was struck by the many stimuli and was distracted and disoriented the entire time. I had to focus on staying with the group and not losing them in the crowds. Not only was the maze of the market completely foreign to me, but I had also left my phone behind for safety. I didn’t let the interns leave my sight as we navigated our way to the stores.

After that first visit, I have visited Kariakoo four times! I have spent many hours walking around, visiting various shops- a mechanical tool shop to buy a drill, drill bits, and safety equipment, an electronic component store to buy wire and extra components, a stationary store, and a maze-like mini-market selling pots and pans where we found the buckets we needed for CleanMachine. The streets have begun to look more familiar- I can identify the stores, and I am less disoriented.

I anticipate multiple more trips to Kariakoo as we continue to populate the studio. As I visit the market, again and again, I am struck by how comfortable I become in my surroundings. On my first visit, I was frantic and confused- lost in the crowds of customers and the vendors on the sidewalks. Every visit since, I have been able to find order in the chaos- navigating the crowds is more natural, and in a pinch, I am sure I could find my way home alone.

 

Boda Boda

As our internship progresses, we have developed a routine that involves a short lecture from Julia in the morning, and independent work and projects in the afternoon. In Julia’s lectures, she outlines the engineering design methodology. We focus on one step per class, and last week, we focused on research and empathy.

Julia outlined research methodology; the steps followed to gain the most information about the social context of the innovation. We went over recruiting tools, primary research, and secondary research. In the afternoon, Julia had a project for us. She gave us a question: Are boda bodas unsafe? Boda Bodas are motorcycle taxis. We see them around all the time, zooming and weaving through the traffic, carrying a precariously perched pillion rider. Julia asked us to go through the research methodology- doing both the more passive secondary research, as well as actively conducting interviews and observations as part of active primary research. This would entail going out and talking to boda boda drivers, as well as their potential passengers.

We brainstormed questions and split up into two groups- Joel and I would go interview the drivers, while Matthew, Anicia and Sadick would interview the passengers. My lack of Swahili skills meant language would be a barrier during the interviews. Additionally, I did not look or behave like a local- would the boda boda drivers be comfortable talking to and sharing their experiences with an outsider?

We went to the nearest boda boda stop, right outside the university. It was chaotic, as the riders kept calling out to potential customers in the nearest bus station. The afternoon sun was harsh and kept getting in my eyes. Joel and I weaved through the din of the drivers and picked a few to interview. Joel asked the questions and translated their answers while I took notes and made observations. The boda boda drivers had so much to share- we only managed to speak to two drivers in one hour. After our interviews, we met back in the studio to discuss and synthesize our findings. Later in the week, Julia helped us develop concrete insights and “how may we” questions for this design challenge.

 

Squinting in the sun hearing boda boda drivers describe their experiences in Swahili and aggressively making my way through Kariakoo pushed me out of my comfort zone by putting me in a situation that was uniquely Tanzanian. Although I have interviewed people on the street and been to a roadside market before, this time, the language, people and my surroundings were completely new to me. I am reminded of the culture shock and the adjustment cycle I went through when I moved from India to the US a couple of years ago. Although I spoke the language and had a basic understanding of the culture, I took baby steps. In an insulated environment like Rice, going to a new floor of the library or speaking to a new person was an exposure that brought me closer to the comfort level I have there today. In Tanzania, however, where we must plunge into solving problems that are inherently linked with the social and cultural context, I realize I must take leaps to be familiar and comfortable enough to empathize and innovate in my new surroundings.

After spending nearly a month here, my level of comfort has increased exponentially. I realize that my greater familiarity is a result of small things- exploring Aura Mall in search of a Subway that ended up still being under construction, ordering Pizza Hut to our hotel room, and trying out new restaurants every week. Calling an Uber-bajaji and hearing the familiar whirr of the motor as I feel the wind on my face. Smiling at the cashiers in Maisha Supermarket and the lunch ladies at DIT. Eating the same Wali na Maharage every day for lunch. Initially, I was hesitant to step out and explore- if I was on my own, my risk-averse nature would have never allowed me to truly adjust. However, I am thankful to have Matthew as an ally. Although we attract attention because we look nothing like the locals, there is strength in numbers. We combine our knowledge to figure out things we don’t understand and laugh at ourselves when things go wrong. I feel fearless and comfortable- nothing seems impossible now- apart from planning visits to beaches and museums, I think we are now better suited to visit hospitals and clinics and talk to people affected by the problems we will attempt to solve.

As we wait to visit hospitals and conduct more interviews, I am glad we got this time to gain a deeper understanding and familiarity with our surroundings. From the interviews we have conducted so far, we have learned that the problems and circumstances identified in Malawi cannot be extended to Tanzania. We will have to approach our needs finding research with fresh eyes and a knowledge of the conditions and resources specific to Tanzania. When we do go on the field soon, I think our newfound familiarity will help us conduct more organic interviews, observe things that may have otherwise been latent, empathize further, and understand the impact of sustainable health-care innovations in Tanzania.

My favorite part of electronic prototyping is stripping wires. There is something very soothing about stripping wire after wire- first making a slight incision that just goes through the plastic covering and then removing the piece of covering entirely, leaving behind a small exposed bit of copper. At my high school in India, there was always a shortage of wire cutters- and we learned how to use scissors instead, or- rather unhygienically, our teeth. At Rice, we have plenty of wire cutters and strippers- allowing me to settle into the comfortable routine of using handy, precise, modified scissors for all my wire needs.

A couple of weeks ago, I had to cut and strip some wires at the DIT Design Studio to make a basic LED circuit. The design studio was still in its very preliminary stages. Apart from the supplies Matthew and I brought over from the US, we had two utility knives, some pliers and screwdrivers from the assembly of the 3D printers, and Julia’s personal toolkit with a wrench, hammer, and screwdriver. No wire cutter or stripper, no scissors, and I really did not want to use my teeth unless it was a last resort. So, I picked up the utility knife. I used the blade to make the small incision and yanked the plastic covering out with my fingernails. Not the most appropriate tool to use, but it worked, and it was kind of fun!

This reminded me of the time that I had to cut a foam block to prototype something in my GLHT 201 (Introduction to Global Health Technologies) class at Rice. There was no saw or utility knife in sight, and a scissor was not going to cut it, the block was way too thick. I picked up a box of toothpicks and a scissor. Using a toothpick as a nail and the side of the scissor as a hammer, I made small holes along the line I wanted to cut. At one point, the makeshift hammer missed the mark and the toothpick went through the skin of my finger. I immediately discarded this hazardous endeavor and changed gears- I opened the scissor so that it looked like a knife and used it to complete the job, which was made remarkably easier due to the perforations I had made with the toothpick.

These seem like small, almost obvious substitutions, but in the past weeks, as the design studio continues to grow and become more stocked with supplies, I have learned how to use our limited resources for a variety of different purposes. With just a (rather flimsy) utility knife, hand-drill and screwdriver, the interns and I reproduced the CleanMachine, a GLHT 360 device that we hope to get feedback on. I learned that a screwdriver can be used to puncture plastic and foam, and a drill can be used to cut off whole pieces of plastic and wood, and with enough force and the right angle, a utility knife can cut through nearly anything within reason. These methods are not the safest, nor do they give us the best results. However, armed with safety goggles and gloves, I have learned to think laterally, look beyond the obvious use of tools, think on my feet, and adapt to circumstance.

 

I realize that I am so fortunate to have the immense resources of the OEDK at my disposal when I am at Rice. For so many other universities around the world, like DIT, these resources are not something they can take for granted. The other day, Julia and I visited the woodworking workshop in the hope that they would have a saw to help us cut some wood. After looking around for a saw unsuccessfully, we met someone working there and requested him to help us. He could not find a saw either, so he took us to his worktable and used a hammer and chisel to cut the wood. I was surprised that there were no saws readily available for use at a wood-working workshop- at the OEDK, I wouldn’t have to think about their availability. Perhaps we are so used to having the most appropriate, super-specialized tools for every task that we often forget the myriad uses of the most basic tools? I realize that as we continue to innovate medical devices in low-resource settings it is important to think of these various uses while creating devices that are truly self-sustainable.

As the design studio becomes more populated, we have begun to buy tools, and now we can use the “correct” tools for the “correct” purposes. This will save us time and effort during prototyping. However, I can’t help but think that while working within constraints, we learn to empathize, look beyond obvious solutions, and truly make sustainable innovations in low-resource settings. As I spend more time with the DIT Interns, I have observed that they think about things and the uses of tools differently than I do. A lack of resources does little to faze them in achieving their eventual goals. There seems to be a spirit of “jugaad”- an untranslatable Hindi word that refers to the spirit of ‘making do’ with the given resources or using innovative hacks- the use of the ‘duct tape’ to solve almost every problem, ubiquitous in developing nations. When we eventually do needs finding research here, we have been told to look for the duct tape- find the makeshift solutions so that we can help create permanent ones. But I can’t help but wonder- those makeshift solutions are often so creative, innovative and practical. Wouldn’t it be terrible if we did not incorporate a bit of this spirit while designing our technologies?

“It tastes like something, but I can’t put my finger on it..”
“What do you mean? What do you put your finger on?”
Today I tried ugali for the first time, and in the process remembered how important it is to foster good communication.

Here in Tanzania, the national language is Swahili with English also being used in many governmental and educational settings. On becoming independent in 1957, the first president, known often as Mwalimu (“teacher”) Julius Nyerere, established Swahili as the national language, with students being taught in Swahili through primary school and then in English for secondary school. This was an effort to unite speakers of the over 100 regional or tribal languages present in Tanzania. Today, most natives speak both a tribal language and Swahili.

The adoption of an official language, among other factors, has led Tanzania to develop a strong national unity. However, this can make it harder for outsiders to communicate. In countries like Malawi, where no one language is ubiquitous, many people are familiar with English. In Tanzania, however, it is unusual for us to meet someone outside of the university or hotel with conversational English skills. Even at the university, most non-technical conversations default to Swahili. For those in the outside environment that do speak English, they likely do not speak enough to engage in more technical conversations; this becomes significant when identifying needs and interviewing technology stakeholders.

Throughout my life, I have had the luxury of never having difficulty communicating. In my daily life in the United States, it has been a continuous assumption that anyone I communicate with will be able to speak English; additionally, they will often understand the idiomatic language that is used. At Rice, I have been working on projects with those of a similar or complementary technical background – this has led me to communicate with certain assumptions about the knowledge and perceptions of the other person. With this mindset, it is easy to become frustrated if a team member does not understand a discussion.

The language environment here means that it can be difficult to communicate about medical or engineering concepts. While the engineering students are well beyond what I would consider fluent, many phrases or technical words do not translate well or are not used frequently enough to be recognized. Other things are just described differently here – some (like lift) are familiar, but others (like using soldering gun for what I would call a soldering iron and soldering iron for what I would call solder) result in miscommunications that require us to stop and clarify terms. Additionally, the design team comes from multiple disciplines within engineering and Aarohi and I are the only bioengineers. Thus, technical terms are often not shared and must be clarified.

Over the week of work that we have done so far, I have been forced to reevaluate the way in which I communicate. Sometimes I am not clear in my definitions, and other times I do not understand concepts with enough depth to describe them without using specific key words. Over my time here, I must work on my ability to clearly communicate technical concepts to a variety of different audiences. I will work to better identify whether everyone in the conversation is speaking in the same terms and understanding each other fully. Because of this, I believe that I will return to Rice a better engineer and communicator of technical concepts.

 

 

 

It has been a week since we landed in Dar es Salaam, and Matthew and I are rested, settled and ready to begin our internship! After long and hectic journeys, we arrived in Dar last Monday afternoon. We checked in at our home for the next two months, the Sophia House Hotel and Apartment. Our spacious fifth-floor room, located on the terrace of the hotel, has two bedrooms, a shared bathroom, common space, and a kitchen. The staff at the hotel have been incredibly kind and helpful and made us feel welcome. From helping us get our stove fixed so that we could cook homemade meals, to helping us carry our (very heavy) luggage up five flights of stairs, they have made every effort to make us very comfortable.

On the day after we arrived, we met Dr. John Msumba, our boss for the next two months. We also met Joel and Anicia, two of the four interns from Dar es Salaam Institute of Technology, who will be working with us during this internship! Joel, Anicia and Dr. Msumba helped us carry all the design space supplies (5 suitcases, approximately 250 lb!) all the way from our room to DIT. After a short meeting with Dr. Msumba in his office, we got a tour of the room designated to become the design space. Airy and naturally lit, the seventh-floor room has large windows along one wall and is furnished with tall wooden tables and stools. It is a lovely place to work, and if we let the windows open, a cool breeze fills the room. As I mentioned before, one of our tasks for this internship is to convert this room into a design studio for DIT, one analogous to the OEDK at Rice. Not only will this studio be used by us during the internship, it will also serve as an interdisciplinary, creative, engineering design space for the students of DIT. As soon as we saw the room, I could envision the fully functional design studio. Matthew and I planned to spend the first week of our internship setting up the studio: rearranging the furniture, unpacking the supplies we carried from Rice, and conceptualizing what the space should look like.

The beautiful view from the window of the DIT design studio

We soon learnt that Wednesday, Thursday, and Friday were holidays because of Eid-al-Fitr, and our internship would only officially begin on 10^th June. We would have five free days to get acclimatized and get over jetlag. Although this prospect seemed exciting at the time, by Friday I was bored and missing work. Luckily, Dr. Msumba invited us to meet him on Saturday, and we began work on the studio. We rearranged all the desks, came up with a schematic for the use of the space, and began setting up one 3D printer. On Sunday, we met with Julia, the new manager of the DIT design space, and spoke to her about our tasks and plans for the internship.

The redesigned design space with the building of a 3D printer in progress

With enough time to rest and get systems in order, I now feel primed to make the most out of this internship. We have a routine set- we walk to DIT in the morning, eat traditional Tanzanian fare for lunch in the DIT canteen with the interns, and buy groceries for dinner on the way home. I already feel so inspired by the people we have met so far. Anicia is one of five girls in her seventy-person mechanical engineering major, Joel has been untiringly teaching us Swahili, and Dr. Msumba’s incredible vision and passion for the design studio and the future of engineering education at DIT is infectious. I am so excited for what the next two months will bring. We’re learning some Swahili, eating our vegetables, meeting new people and learning new things every day!

Over the past week, my fellow interns and I have been preparing devices and researching supplies to take along for our respective projects. In three weeks, I am headed to Dar es Salaam Institute of Technology (DIT) in Tanzania. Over this time, we have been assigned four tasks: setting up a design kitchen similar to the OEDK at Rice, conducting interviews about three Rice 360˚ devices, identifying medical needs that might be addressed by engineers at Rice and DIT, and finding and completing an intern-identified project. All of these tasks come with unique challenges.

One of the three Rice 360˚ technologies we are taking is OxyMon, a continuous oxygen monitor intended to identify the state of oxygen concentrators and relay this information clearly to clinicians. I was on the team responsible for developing this device during the semester, so I have mostly been working to prepare this device to be taken abroad over the past week. At the advice of several mentors, we have been designing a version that is intended more as a diagnostic tool for technicians than as a continuous monitor; this includes making changes like displaying flow and temperature alongside concentration and adjusting the device so it is more comfortable as a handheld. I am extremely excited to gain feedback on this device from clinicians in a setting where it could be very useful.

The goal of setting up a design kitchen has also been a major focus for myself and the other Tanzania intern, Aarohi. One of the important goals of the global health program at Rice is to give local engineers the prototyping tools they need to take on design projects. One challenge that we anticipate in setting up a space like this is getting the word out that it is available. In order to encourage people to utilize it fully, Aarohi and I have discussed organizing a design challenge or hackathon to increase knowledge of the tools available. More specifics on the tools available in the design space will be provided in future blogs.

Another challenge that we have in Tanzania is identifying clinical environments for observation and interviews regarding the Rice medical technologies. Because we are only the second class of interns being sent to DIT, the connections are not as available as they are in Malawi. I look forward to this challenge as an opportunity to get out into the area and potentially explore different clinical environments.

While I find myself focusing on the challenges we will face, it is important to remember that where there is a challenge, there is also an opportunity. This summer will be full of opportunities not just for the achievement of our goals, but for my personal growth as an engineer. With that in mind, I look forward with excitement and anticipation.

 

The countdown has begun! We will leave for Dar-es-Salaam in 3 weeks. Until then, the other Rice 360 interns and I are working at the OEDK to prepare. We spend all day prototyping technologies we will be carrying with us, gaining a thorough understanding of these technologies, and planning out our projects for our time in Tanzania. Matthew and I have divided the technologies we have been assigned between ourselves. As Matthew is the inventor of the OxyMon, he is focussing on it, while I am responsible for the Clean Machine and the IV Drip Lock. The Clean Machine is a simple device, made out of two buckets and pool floats. It makes the sterilization of surgical equipment an automatic process and prevents inadvertent rusting. The IV Drip Lock is a mechanical lock for the roller clamps of IV Drips. It prevents non-clinicians from gaining access to the roller clamp and changing the dose of the patients. I spent the last week prototyping these technologies and learning enough about them to be able to troubleshoot on the field and get useful feedback.

Matthew and I have also been tasked with setting up the design studio in DIT, analogous to the OEDK we have here at Rice. This is the project I am most excited about! After spending the last 10 days in the OEDK learning new skills and using its wide variety of resources, I have been able to experience just how essential hands-on engineering design is to my understanding of the theoretical knowledge I gain in class. I am so excited to share this with my Tanzanian peers! We have been thinking about creating a website, some training videos, and posters for their design space.

I am sure these next weeks will go by really soon, and preparation is in full swing. We got vaccinated for yellow fever and typhoid yesterday, and we also got our malaria medicine. Our flights have been booked, and we know where we will be staying. Now, I must begin packing my bags. Along with the equipment and prototypes in my suitcase, I will try to fit in as many books as possible and my mother’s spice jars. As I am a vegetarian, my dining options are quite limited, but I am excited to cook for myself.

I am nervous and eager as I anticipate my time in Tanzania. I cannot wait to meet my Tanzanian colleagues and begin work in DIT. But I am also full of uncertainty. As we are the second intern cohort heading to Dar-es-Salaam, we are responsible for cementing the connections made by the first intern cohort and establishing new ones. Although our predecessors have left us a useful guide with loads of advice, there is still so much that I do not know about the environment we will be working in. However, I plan to be armed with a ton of research such that I can adapt to a variety of circumstances. This is a huge responsibility, and I am raring to go. Tanzania, here we come!