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Week 4: Helpful Insights

Posted on by Kaitlyn Heintzelman

During this past week, we had the opportunity to speak to stakeholders of a wide variety of backgrounds including businessmen, nurses, non-profit heads, professors, engineers, and even other undergraduate students. Each day we presented our technologies to the various stakeholders and then were sent to breakout rooms to ask more device-specific questions and gain the stakeholders’ perspectives on our current device. This opportunity proved to be invaluable as it opened our eyes to some potential solutions to key issues we had presented and also made us aware of a few problems that we had not previously considered.

 

Some of the advice we collected through this experience for the walk-through decontamination unit is as follows:

  • Reconsider the problem context and consider all the scenarios in which the device could be used. For example, consider the different positions that people may assume when in the unit, what they might be wearing (hats, masks, etc.), and the different types of people (children, disabled, tall, etc.). Each of these considerations will drastically impact how the device functions, and thus should be contemplated in the design of the device.
  • The need to possibly readjust some aspects of our current design:
    • The shape and structure of our device. Could another shape possibly result in a more positive perception of our device and be more accurate in dispensation? How could the materials of our device be altered to increase movability and decrease cost?
    • The chemical that is aerosolized. Throughout this internship, a major concern of our group has been what chemical to use or how the chemical could be sprayed to limit possible negative effects on the user. To do this we will need to do further research on other disinfection methods and how to adjust the spraying area based on the user to prevent interaction of the chemicals with the mucus membranes.
    • The function of the drainage system. Should the drainage system just seek to collect the runoff for disposal or should it seek to collect runoff in a manner in which it could be reused? We are currently looking into the feasibility of the latter.
    • How the device is activated. In high traffic areas, there is a possible issue of false sensing of a user (false positives) that would waste the disinfectant. To prevent this we plan to look into other activation methods that would instead rely on mechanical elements, pressure plates, etc.

Some of the advice we collected through this experience for the handwashing station is

as follows:

  • Reconsider the end user. How will someone unfamiliar with the device work out how to use it? What would promote them to use it? This would involve some component of education to promote proper hand hygiene procedures.
  • The need to possibly readjust some aspects of our current design:
    • The powering of our device. The power source of the device should be sustainable both in lifetime and in the environmental context in which it is placed. We have started to consider solar panels that would recharge the device’s battery both in outdoor and indoor settings (would work with UV and artificial light sources).
    • The sanitizing agent used. Our stakeholders in Malawi noted that hand sanitizer can be very expensive so often other disinfectant agents are used. Therefore our device should be able to work with liquids of different viscosities.
    • The overall structure of the device. Some of our stakeholders suggested looking into more mechanical backup options such as the use of a foot pedal. Additionally, they provided advice on how to deal with the manufacturing constraints of this setting and how they will come into play when we look to scale up.

In addition to receiving advice on our current prototypes, we also sought guidance on some possible future areas where technologies could be implemented. These areas include PPE that can be quickly disinfected and reused, quick diagnostic tests, patient room disinfection, and incubators in which procedures can be performed (instead of moving the infant to a secondary location and increasing the risk of infection).

 

Moving forward into the last two weeks of our internship, we hope to further research these areas that were brought up by our stakeholders and include what we find in our recommendations to the design studio. Overall, this busy week provided us with some great insights into the developmental process of our technology and into the needs of the end-users.

 

Rather than ending the week with our usual group workshop, some members of my team were able to meet up on Friday for a really fun activity. We played an online game that was reminiscent of charades (see image below). I had a great time and really hope that we will be able to do something like that again as it was a fun way to get to know everyone better and bond more as a team.

This past week has been a whirlwind of new ideas and I can’t wait to see where we go from here.

 

Signing off,

 

Kaitlyn Heintzelman

Week 4: Interviews, Interviews, Interviews….

Posted on by Sana Mohamed

Throughout this week, we dived into conducting stakeholder interviews. In total, we interviewed 14 people from a wide variety of backgrounds—we talked to businessmen & CEOs, nurses, heads of non-profits, undergraduate and graduate students, engineers, professors, and more. Daily, we accumulated pages and pages of notes based on the invaluable expertise and feedback we received. To conduct these interviews, we drew on the lessons that we previously learned and were able to put into practice the concepts of active listening and effective communication. It truly felt like a culmination of many of the principles we learned—from presentations, human-centered design, brainstorming, documentation, and more.

There were some instances where stakeholders would push us to think of more creative ways to address a facet of our design. It really challenged us to go back to our problem space and think of holistic solutions to address our problem context—solutions which may include our current prototype yet also do not discount the potential of other devices or public health measures to address associated challenges. As we rotated among stakeholder of differing backgrounds, it became evidently clear how critical it is to gather feedback from a diverse group of people.  I am very proud to be aligned with an organization that forges these kinds of partnerships and honors the perspectives we all bring.

A snapshot of our notes from the stakeholder interviews–these 5 pages are based on only one day of interviews!

Based on the interviews we conducted, we grouped together some common themes from the stakeholder feedback:

In terms of the walk-through decontamination unit:

  • Look back to the problem context: Many of our stakeholders encouraged use to think broadly about the problem that the decontamination unit was addressing and think of innovative ways to supplement our current design.
  • Consider designing by end-user: Rural areas, high-traffic urban areas, and hospitals all have unique considerations that we will need to account for in the design of our device. Ultimately, we hope to have a device that is most appropriate for the local communities that will use them, so we will do further research on how to best do so in different environment.
  • Adjust some aspects of the design:
    • Structure: Many of our stakeholder urged us to think critically about the shape of our device, the material it is made of, how we will incorporate instructions into the device, and the aesthetic value of the overall structure.
    • Chemical: The toxicity of chemicals is a major concern, especially as we hope to limit exposure to vulnerable areas of the body such as the eyes, nose, and mouth. We hope to do further research on both the different kinds of chemicals and on the potential of other non-aerosolized solutions.
    • Drainage System: Our stakeholders urged us to consider some of the ramifications of collecting disinfectant and how we may have to implement newer additions to the device if we hope to re-use collected disinfectant.
    • Activation: It will be imperative for us to conduct testing and determine the sensitivity of the activation mechanism. We also received feedback to consider a variety of mechanisms, such as mechanical, push-powered activation systems.

In terms of the hands-free sanitation station:

  • Consider how to best adjust the device for end-user education: We will have to consider how to best promote hygiene practices and sanitation education in our device, particularly across different environmental contexts.
  • Adjust some aspects of the design
    • Power Demand: It is critical that any power source should be sustainable and best suited to the environment it is in. Solar panels, for instance, that are used in indoor spaces, should be able to be powered through artificial lights.
    • Sanitizer: We learned from many of our Malawian stakeholders who work in healthcare that sanitizer is expensive and often out of stock. Hence, we should also build a device that can accommodate different solutions that may be used, such as bleach or methylated spirits. After our discussions, we also believe it would be best to add an indicator for when the reservoir is nearly empty.
    • Structure: We will need to critically think about some of the manufacturing constraints of different parts of our device and potentially find more sustainable, locally sourced materials.

In addition to the feedback on our devices, we were able to conduct some needs-finding and identify some areas of opportunity for future innovation. Many of our stakeholder outlined challenges in testing, compliance with public health measures, and manufacturing. We also learned of many technology-related gaps that Rice 360˚ could potentially address, including:

  • Reusable PPE and PPE disinfection technology
  • Quick, high-sensitivity testing (ideally, breath tests)
  • Affordable and reliable infrared thermometers
  • Devices that ensure facilities can respond to treating asymptomatic patients
  • Disinfection of entire rooms where patients have been
  • Incubators where procedures (such as breast feeding, replacing of tubes, etc.) can be done without moving the infant

We will be sure to pass along all of this feedback to the Rice 360˚ community!

After a busy week of stakeholder interviews, I have been able to relax quite a bit over a 4-day weekend and spend some much-needed time with my family. On Friday, some members of my team were able to meet up for a game day–we played a virtual drawing game similar to charades and were able to bond over our indecipherable doodles. Coincidentally, the American and Malawian Independence Days are only 2 days apart. I am curious to see how the celebration of these holidays may compare—I will definitely ask my teammates when we regroup. In the traditional American style, my family held a barbeque and grilled up just about every kind of meat available (as a vegetarian, I watched in terror at a distance). It was great to spend some time with my family and recharge before the final two weeks of the program.

This week presented an incredible opportunity to learn more about various nuances in global health and hear the perspectives of a diverse group of leaders and innovators. We were able to practice many of the skills that we have been building towards in previous workshops. The thoughtful feedback from our various stakeholders will be a major input in the direction of our designs. I am incredible grateful for the stakeholders in giving us their time and feedback, as well as the Rice 360 team for arranging and facilitating this opportunity. I am excited to charge forward in the last two weeks of our internship!

Until next time,

Sana

Week 4: Speaking with Stakeholders

Posted on by Lauren Payne

This past week has been the most productive yet, full of presentations, interviews, and conversations that has greatly progressed both our understanding of the project and our potential suggestions to the design studios for my team’s two prototypes. Our group workshops Monday through Wednesday consisted of interviews with our stakeholders, which are individuals, groups, or organizations that may be impacted by our project. As we previously identified with our stakeholder maps, this includes suppliers and manufacturers, the Malawian public, hospitals, design studies, the Malawi government, distributors, and more. Prior to presenting the stakeholders with our projects, we found it important to conduct further group and solo brainstorming to give the individuals we were interviewing a better idea of our direction with our project. After going through the process, my team and I selected a few designs that we wanted to present for feedback, and I drew them in a clear way to add to our presentations.

Our brainstormed ideas for the intubation box.

For the intubation box we focused on three design concepts. The first involved a slanted front panel to help with the ergonomics of the intubation such that the physician would not have to crouch in such an awkward position to have adequate visualization and they would rather look down into the box through the slanted front panel. The second idea is the pop-up tent which is made of a wire frame and some form of clear vinyl/plastic sheeting. This would allow the box to fold up for storage so that is could easily be stored in the hospitals in Malawi that often have limited storage closet space or excess rooms in the ORs for a large solid box. The final idea was the “gloves box”, similar to an isolation gloves box used in biology labs. This involves a thick solid ring outside the arm holes of the box where the rim of a glove would be slipped over and then the physician would insert their gloved hands into the box. This would further reduce the spread of aerosol droplets through the arm holes of the intubation box.

Our brainstormed ideas for the contactless temperature monitor.

For the contactless temperature monitor we focused on two design shapes and two design features. The first shape is like a flashlight or torch (fun fact – I learned that a flashlight is called a torch in Malawi, while here in the U.S. torch typically refers to either a blow torch or a stick with a flame on one end) where the sensor receives input on the light-end of device while the display is on the opposite end. The other shape resembles a water hose attachment that has grooves to improve the ergonomics of holding the device. We wanted to avoid a gun-shaped device due to hesitation for use in today’s climate, and while our design uses similar design principles to a gun-shaped monitor, we believe the shape is different enough that it would not be misconstrued. One feature we would like to be included in the monitor is a solar cell as an additional power source so preserve the batteries. We also believe that a color indicator to indicate the severity of the temperature would be helpful for users not familiar with clinical measurements. In this design, the color green would indicate no fever, yellow would indicate a temperature that is not severe but should be watched, and red would indicate a severe fever.

With our project scope and brainstormed ideas in mind, we set out on Monday to begin interviewing our stakeholders. Our first conversations were with Edward Matengele from the MUST Innovation Center, Erin Keaney from Nonspec, Inc., Jade Kissi from the University of Michigan, and Agyen Obeng from the University of Ghana. Our main takeaways from our first day of interviews was that, first, we as a team needed to do further research on the initial background of the prototypes we received so that we could better answer a number of the stakeholder’s questions. We received important feedback for the structure of the intubation box, including suggestions for filleted edges to address safety concerns for sharp corners of the box or the idea of using heat to bend acrylic for a more rounded design. For the temperature sensor, we discussed in depth the cost of the devices components and the balance we must mind of the sensor accuracy and the cost as a more accurate sensor will be 1) more expensive and 2) less likely to be found in Malawi and will thus have greater shipping costs. We also determined from our stakeholder Erin that there is a need for a continuous temperature monitor in hospital settings that does not require human input, which is something that we will further look into as a proposal for a future project.

Our interviews on Tuesday were with Msandeni Chiume from Kamuzu Central Hospital in Malawi, Jackson Coole from Rice University, Prince Mtenthaonga from Queen Elizabeth Central Hospital in Malawi, Elizabeth Johansen from Spark Health Design, and Caroline Soyars from the University of Michigan Global Health Design Initiative. After feeling slightly unprepared for Monday’s interviews since my team did not know who we were interviewing or what their backgrounds were, we spent time together on Monday researching Tuesday’s stakeholders and drafting questions specific to them based on their background and area of expertise. Going into the second day of interviews, my team and I felt significantly more confident in our ability to make the best use of our limited time with each stakeholder. Our conversations on this day focused largely on the clinical components of our devices. For the intubation box, this meant the cleaning reagents that would be used and whether they would affect the transparency of the box and the types of materials that can be disinfected with UVC versus other methods. For the contactless temperature monitor, feedback from the stakeholders covered input on our color indicator idea, which was taken favorably, an option for the device to not be handheld so as to reduce risk to the person using the device, and cheaper microcontrollers that could possible be found in Malawi. Finally, a key question asked in this day’s interviews is something that is a constant challenge for many global health devices – how can we make the public receptive to the device? We also discovered that a significant challenge in Malawi right now due to COVID-19 is the lack of screening devices or centers, coupled with a lack of proper PPE.

Our final interviews on Wednesday were with Steve Adudans from the Center for Public Health and Development in Kenya, Robert Hauck from GE Healthcare, Dineo Katane-Mkwezalamba from Dzuka Africa, Brian Kamamia from the African Drone and Data Academy in Malawi, and Rhoda Mtegha from Kamuzu Central Hospital in Malawi. While our other interviews were heavily specific-prototype focused, Wednesday’s conversations largely surrounded the bigger picture of designing devices for low resource settings. For example, a key takeaway was that to breakdown the prototypes into their individual components and to determine where every minute part is coming from. This would allow us to analyze how the device is being manufactured and which components could feasibly be locally sourced rather than imported. Additionally, it was reiterated that our devices should be adaptable, affordable, safe, and multi-purpose (if possible). We also discovered that we need to do more research on the rationale behind the current designs when Robert asked us a simple question about the intubation box – Why is it a box? – and we didn’t have an answer.

Our Thursday group workshop consisted of a debrief of our stakeholder interviews and an overview of what we should expect for the remainder of the internship and the internship showcase. Although we began discussing what we learned from our interviews during the workshop, my team felt it necessary to meet again to continue our conversations on Saturday so that we could have more time to debrief with one another and share the feedback that we found most important and critical. After these discussions, my team and I relaxed with a fun fact game that our wonderful TAs had prepared for us.

This was one of the questions from our fun fact game, and it’s also our first team picture!

During this time of laughter, smiling, and goofing around, I realized how much we’ve learned about each other in our four short weeks of purely online interactions, and I absolutely love the close friendships we’ve developed. Majority of the game involved simple questions like “what superpower would you have” or “what’s your favorite snack”, but the final question in the game has become my favorite because our answers clearly show our personalities and who we are, and when it popped up on the screen, we all immediately knew who answered what. Our time together on Saturday was my favorite so far, and I’m excited about where our friendships and work as a team will go (our next virtual meal together is already penciled into the calendar).

This was my favorite question of the game simply because each of our answers somehow directly reflected each team member’s unique personality.

This has been the most productive and busiest week of the internship thus far (although I think I may say that every week), and I’m so excited about the work my team has done on our two prototype projects. I am also incredibly grateful for the opportunities we had this week to speak to so many individuals that are experts in their fields and to get to hear the unique insight and perspective they each bring. No other internship out there provides opportunities and activities like these, and I can’t wait to see what’s in store for us these final two weeks.

See you next time,

Lauren

Week Four: Interviews and Feedback

Posted on by Andrew Abikhaled

This past week can only be described as a whirlwind. After weeks of breaking down the problem at hand, researching, brainstorming, and more, we were finally ready to talk to stakeholders about our prototypes. While we were excited to present our work and to get feedback that could make our prototype and design ideas much better, we also knew that with feedback comes constructive criticism. For the most part, our stakeholders were incredible. They came from a wide variety of fields: from doctors to drone designers to chief engineers. They helped us to consider aspects of of our project that we had previously overlooked. They took a genuine interest in the work we were doing and were excited about helping us to move forward. It really was a whirlwind due to the constant turnover of different stakeholders. We would try to get as much feedback from each stakeholder as we could in the 20 minutes allotted. We met with 14 different stakeholders in three days and took more than 8 pages of notes on the feedback they gave us. This week was also invaluable. We now know where the weak parts of our projects are and we know what people generally like. We are much more comfortable talking about our prototypes, as we had to do it all week long. Finally, we have a strong sense of direction heading into the last two weeks of the program.

Many of the stakeholders we met with had engineering backgrounds. They gave us all types of useful advice. They suggested different materials, they helped us around some of the possible complications, and they pushed us to considered new models. They had just as many questions for us as we had for them, and this discourse allowed for better understanding and feedback than our list of questions could have ever achieved. They were also usually able to answer any of the specific questions we had for them, which helped us compile a list of our most important points. They often pushed us to get back to the why. Why did we choose to do things this way? Why this shape? Why this material? Why this size? After weeks of working on a project, we had focused on an idea for a prototype that we had come up with, and we brainstormed ways to make that idea better. Instead, we were advised not to constrain ourselves to the idea that we had based much of our project on. If there is a way to better incorporate all of the aspects that we were discussing, it is necessary to free ourselves from thinking within our self-constructed box.

It’s very easy to think of engineering design and to only picture the prototyping process. Images come to mind of engineers with safety goggles in a design studio hunched over an evolving project. It’s very easy to forget about the very people that those engineers are trying to serve. This week helped us to once again keep our project rooted in the people we hope to serve and not the prototype we hope to create. It was the non-engineers who possibly helped us the most. They were the ones who pointed out how our prototypes would affect the end user. Doctors and nurses stressed the importance of proving that our disinfection system had decreased the viral load on the N95s. Without proof, clinicians would be very skeptical of reusing the masks, rendering our project useless. Students at the University of Michigan who had previously worked on face shields emphasized the importance of sourcing materials and manufacturing methods so that they were easily available in Malawi. These stakeholders reminded us of the importance of human-centered design. Without carefully considering the end users, even the “perfect” prototype might be a complete failure. We are determined to not let this happen with our project. We are going to work to consider how the end user will be affected by our designs, and we hope to improve them where they fall short.

After this week of stakeholder interviews, my team got together and we condensed all of the feedback we got into a few main bullet points. We now know where to focus our energy. We know what to do in order to get the most out of our prototypes in the time we have left. We have direction and confidence going into the final portion of the internship, and I absolutely cannot wait to see what we are able to do.

 

-Andrew

Week 4: Remembering the Human Element

Posted on by Bhavya Gopinath

This week felt like the culmination of the past three weeks of work — we had prepared, we had researched, we had brainstormed, and finally, we were going to get advice from our stakeholders.

Prototyping and engineering design is something that I felt knowledgeable about, going into this internship. But one of the things that I love about bioengineering and global health is that these particular fields are an intersection of the advancement of these amazing technologies as well as the humanistic component. The design of the face shield and the UVC system, for instance, might be incredible from the perspective of an engineer, but may be wholly useless and uncomfortable for the user. Stakeholder interviews taught me just that — the importance of keeping the problem and the people in the front of your mind, always. 

Over three days of stakeholder interviews, our team talked with 14 stakeholders and generated eight pages of useful feedback to help guide our project suggestions. Some of the stakeholders were engineers and designers, experienced in medical device design as well as the complexity of local supply chain management. Their expertise helped us more critically analyze the prototypes we have been given. Why is the UVC system orientation the way that it is? How can we determine a better orientation? Why use long UVC bulbs when we can use smaller strips of UVC lights? Why did the design studio make the face shields using the open-celled foam material? Should we start considering using PET film rather than 3D-printed plastic for the shield? Our team had suggested viable, useful innovations, but we hadn’t critically questioned the prototype we were given, and why it was designed the way that it was. While I didn’t expect the criticism that came from some stakeholders, every single person still provided useful information that our team needed. 

Other stakeholders, like clinicians and hospital administration on-site in Malawi, were useful in ensuring that the prototypes we were improving would truly help the people we were trying to help. They gave us critical information on the number of masks that needed to be disinfected per day, as well as the softer materials that they really wanted on the face shields. We learned more about the power and space capacity some of the larger hospitals in Blantyre and Lilongwe have, and we also gained a deeper understanding of the lack of PPE that is available. Right now, in Kamuzu Central Hospital, a nurse told our team that the entire hospital is not provided with N95s — only those that work in intensive care units, or work directly with COVID-19 patients, are provided with the masks. The rest, on the other hand, wear surgical masks. The fact that the mask I wear at home is the same as medical professionals on the frontlines in Malawi is crazy. It saddened me, but it also reinforced the sentiment that the prototypes that the Rice 360 teams are working on will really make a difference. That’s something that is incredibly special. 

After debriefing with my teammates, and sorting through the pages upon pages of feedback we had, I was tired, but more excited for the next two weeks. It’s the final stretch, and with all this information, I know my team is ready to dive back into these projects and further develop our final improvements for the design studio. 

– Bhavya 🙂 

Week 3: Empowering our Users

Posted on by Krystal Cheung

Half the internship has already gone by!! I honestly cannot believe it! I feel like we’ve just gotten started and we’re still riding in on so much momentum.

In this week, we have really built upon the foundation of our problem context. The entire premise is that we want for the decontamination unit and hand sanitizer dispenser to be effective and easy sources by which Malawians can maintain sanitation to fend off COVID-19. We want to provide solutions that can improve the current availability of these resources. In order to do that, we have to also understand how much people understand the efficacy of hand washing and other decontamination methods. It seems like the greatest challenge regarding implementing these units will come down to how approachable they are, how easy they are to use, and ensuring people understand how to use them. So from here, where do we go to achieve all of this?

To find some answers to this question, we’re embarking on around a week and a half of interviews.  We kicked off this phase by approaching health and technology in Malawi, through speaking to Wayne Decker, president of The Flame Tree Initiative, and Dumisani Kaliati, founder of MicroMek.

Speaking with Dr. Decker, we received very insightful perspective on how energy or lack thereof in Malawi is a great barrier. At least 80% of the entire country remains off-grid. For those of us with technologies that will require a power source, this is an extremely important piece for us to address in our designs. Dr. Decker leads a start-up that has been working on how to sustainably develop energy sources and partnerships over the last decade. This means not only creating opportunities to harness energy and create various grids throughout Malawi, but also to ensure that the way that these sources are developed expands out to create a network of occupations and educational options to Malawians in the surrounding area.

 

Malawi Power Africa. Retrieved from USAID.gov

Before this, I was generally aware of how resources create a network and subsequent opportunities available to a community, but I did not fully understand the scope of just how broadly this influences Malawian operations. The resources provide a base to develop infrastructure to support communities. The locations of the broadest networks of existing infrastructure used by industries taking advantage of the natural resources Malawi has to offer. Outside of urban areas and communities nearby these industrial grids, there is a large gap to narrow in order to improve equity for citizens of Malawi.

Mr. Kaliati further expanded on how the lack of grid structure contributes to how he started his company. Micromek aims to decrease the gap in diagnostic care in order to provide Malawians with the ability to have their basic medical needs met. Under normal circumstances it requires 11 days to get testing kits to and from members of remote villages. After this, it could take 4 weeks for the results to be received. This is valuable time when looking at providing medical treatment. Micromek is working to close this gap by working with villages and communities to provide proper testing via drone operations. This cuts the travel time down to a few hours and speeds up the process of transporting kits, results, and treatments. Particularly with COVID-19 looming on the horizon, these provisions will become more necessary to combat the deadly effects of the virus.

COVID-19 cases by region as of Tue. Jun 30 2020. Retrieved from the Ministry of Health Malawi COVID-19 Dashboard.

In these conversations, my team and I realized just which areas we would need to strongly consider working on outside of prototype development itself. Through Dr. Decker’s insight, we would need to understand how much of a grid network we could possibly tap into depending on where our decontamination unit or hand sanitizer dispenser would be implemented. In an ideal situation, these units could be connected directly to grid power, but that likely won’t be feasible in every space. Particularly if we are seeking to expand usability of these devices to rural communities, a self-sustaining power source will be required. Having this perspective, we have started to look at the potential to incorporate solar power to the devices. We want these devices to be effective and if it can’t be operated due to power limitations then we would have missed the point of creating a usable device, and our users would be stuck with a useless electronic device.

Additionally, establishing relationships with the village leaders and members themselves will be critical to implementing these technologies. Through Mr. Kaliati’s advice, we realized how much making a device approachable and trustworthy hinges on establishing the trust of village leaders. In fact, establishing and valuing these connections are important not only for our technology, but any technology developers desiring to create for the citizens of Malawi. Working with village leaders allows creators an avenue to observe what a village’s ultimate needs are. It also establishes trust throughout the village community which enables us as creators to really connect with our users more personally to continue designing to fit their expressed needs.

Of course, during this pandemic, it is difficult to perform these evaluations and make these connections. However, this situation provides us with the time to really step back and evaluate and collect information on how to best approach implementation moving forward. It also allows me to really reflect on how I can apply techniques toward future projects and goals I have in health promotions both locally and abroad. All of these principles apply regardless of who we are working with. Working with a community means investing in building relationships with the members. Without speaking and seeking the members’ perspective on their needs, sustainable empowerment cannot be established.

I look forward to continuing to really connect to stakeholders as we move into next week. From having conversations with two stakeholders, we have already learned so much. I cannot even begin to imagine how much more we’ll learn in another week of interviews.

 

–Krystal

Week 3 – A Glimpse into Engineering Design

Posted on by Austin Hwang

Can you believe it has been three weeks already? We’re halfway through our internship! I have learned so much through our morning workshops, team meetings, and reflection, but I just wish there was more time. More time to think, create, and implement our prototypes in the field. More time to talk to our mentors and friends to learn more about who they are and what inspired them to do the work that they do. More time to reflect on how life (resources, culture, environment, etc.) is different between the U.S. and Malawi. There’s always so much more to learn but so little time. In the coming weeks, I hope to continue taking in all the different ideas from the program and reflecting on how these lessons can impact my perspective.

On Monday, our team reflected on who would impact or be impacted by our product and created a stakeholder map. As we went through each step of the engineering design process from the initial research to the final product, we realized that many stakeholders could contribute to a wide assortment of steps and surprisingly interact with each other based on their different priorities. For example, a hospital may be interested in the clinical functions and ease of use of our device, while a manufacturer may only consider how easy it is to mass-produce or if a specific component would be resource-efficient. With all these different inputs and priorities, it’s hard to prioritize which should take precedence in our design, but I’m slowly working through the reasoning with our teammates to be intentional with our final product. What do we want our device to do? Which should be more of a priority: cost or function? Why? And so forth.

Stakeholder Map

On Tuesday, it was Election Day in Malawi, so our internship took a day off.

On Wednesday, Dr. Wayne Decker talked to us about the Productive Use of Energy like sustainable energy production in rural areas. I wasn’t too familiar with the topic, so it was interesting to hear an expert in the field and feel how passionate he was for his work. I hope to share the same energy for my future career, but for now think about what I do as a living, a hobby, or just for fun.

On Thursday, we had a workshop on Needs Finding, where we learned about different strategies such as observation, interviewing, research, etc. to identify and contextualize an existing need in a scenario. It was an important segway for our coming week when we will interview stakeholders and get their input on our design proposals as well as understand what their prioritized needs are.

On Friday, Dumisani Kaliati talked about his company MicroMek that uses drones to deliver medical supplies to rural communities where access may be limited. It was incredible to hear how he continued to persist through challenges such as initial funding, employee recruitment and training, and finding community partners (village chiefs). Some resistance came because his method (drones) were so unconventional in Malawi, and he was also a very young graduate so there wasn’t much credibility or title established to his name. But even then, he persisted and aligned himself with recognized organizations, applied to grants/business competitions, and ultimately became 2018 YALI Mandela Washington Fellow and Goalkeepers Youth Action Accelerator Advocate. It’s amazing to hear a success story, and I hope to become as resilient as he is.

Signing off,

Austin

Week Three: Diving Deeper

Posted on by Andrew Abikhaled

At the halfway point in the internship, there are varying versions of a similar thought floating in my head: it’s only been three weeks, it’s already been three weeks, there are still three weeks left, but there are only three weeks left. It seems like just yesterday I was writing my first blog about my excitements and reservations as the internship began. Had just met my teammates and we were just beginning to gel. We had only scratched the tip of the iceberg that is the engineering design process (that’s still probably the case), and we looked forward to the journey to come. Three weeks in, we have done so much that it’s hard to believe that it’s only been three short weeks. We have heard from some incredible people during our workshops, and we have had great team meetings in which we really worked through certain aspects of our projects. Going into the final three weeks, I’m confident that I couldn’t have a better team, that I are doing meaningful work, and that I am learning so much from this experience.

On Monday we learned from our TAs Aubry and Hannah about ways to effectively present on and write about a project. They gave us some incredible advice and showed us some of the tools that will allow us to effectively and efficiently display our ideas to stakeholders who may want to get involved in our project. This workshop also helped me to identify ways that we had not considered interacting with stakeholders. We realized as a group that we needed to further refine the groupings that we had assigned to our stakeholders. Each stakeholder is going to be connected to our project in a different way and is therefore going to be especially interested in unique aspects of our project. A clinician may care mainly on a face shield’s comfort of use, while the hospital administration cares about how many times they can be used and how much they cost. The workshop helped us to realize this and we were able to come up with a more clear and defined stakeholder map as seen below.

Tuesday was Election Day in Malawi, so we did not have a workshop. However, we did meet as a team. Not all of our group members were present for last weekend’s team bonding exercise, so we did it again with all four of us plus Hope (our TA). We had a great time playing the game and spent a lot of time laughing. We must have talked about Marvel superheroes for at least half an hour. It was great to get to know my teammates better and to laugh and enjoy the virtual equivalent of hanging out with them.

On Wednesday, Dr. Wayne Decker joined us for an impassioned workshop on Energy Poverty. He inspired me with his drive, vision, and knowledge on a subject that he desperately wanted to improve. While the bulk of his presentation was on Productive Use of Energy, he also taught us quite a bit on sustainability and supplying energy, jobs, industry, etc. to rural areas. His energy and his work were an example to us that working on projects that we are passionate about has the potential to significantly improve the quality of life for many people. Finally, he gave us advice on tips for being happy and successful in the future. This stuck with me, as it showed that he not only cared about our projects, but that he cared about us and our happiness as people. I will be trying to implement his pieces of advice as best I can in the future.

Dr. Bond and Professor Million lead the way in a workshop about Needs Finding on Thursday. I learned that there is more to a need than meets the eye. There are multiple dimensions behind a need, and incorporating all of these dimensions into a solution usually provides the most effective and long lasting results. We went over the techniques of needs finding which center around background research, interviews, and observation. While this internship is heavily focused on the research and interviews portion of needs finding, we are unfortunately not able to conduct observations given the current situation. It is difficult because observation is likely the most “pure” form of needs finding, but we are making do with what we’ve got (and looking forward to possibly conducting observations of our own next summer). On Thursday we also had a team meeting with Dr. Taylor. It was great to talk to her about our progress through the internship and about our team dynamic.

On Friday, we had a workshop by Dumisani Kaliati in which he gave us great insight on what it means to meet the user/customer where they are. He is doing great work with his company to find the specific needs of their target users and to educate them on exactly how his intervention would function to help them. We were also able to ask him about the face shields that his company has been working on which was extremely helpful.

During the weekend, our wonderful TAs put on yet another fantastic team bonding activity. It was a virtual scavenger hunt. We had to first solve a riddle to which the answer was a household item. We then had to sprint to that item in our house, take a picture of it or with it, and send it to the group with the name of the item before the other teams did. Let me tell you, this was a high stress and intense game. For much of the competition, my teammates were the brains and I was the legs as my track training paid off and allowed us to send in our answers quickly. We all had such a great time, again filled with laughs and great memories. I can’t wait to see what the next half of this wonderful internship holds!

Till next time,

 

Andrew Abikhaled

Week 3: Back to the Basics

Posted on by Lauren Payne

Week three is complete and it’s crazy that we are halfway through the internship! Our time in the program has gone by so fast, and I along with my team have begun to learn the importance of looking back on our work and discussions to facilitate greater understanding of what we have covered and get the most we can out of the internship. Whether it be our casual conversations about COVID-19 in the United States versus Malawi, the need for public health education globally, or what the patterns in our stakeholder maps mean, we have really started to dive deeper as a team and come together to learn from one another. Coming into this week, I was excited to further explore technology development in low resource settings and needs finding for global health, a key component of the internship.

This week has been focused on expanding our understanding of our designs and getting back to the engineering basics. On Monday the group workshop conducted by our TAs Hannah and Aubrey covered the principles of presentations to guide us when presenting to stakeholders and other audiences as well as the basics of technical writing and documentation. During my experience in the Rice 360 Global Health Capstone course, I learned how important informative yet succinct documentation is when working in a team and collaborating with outside partners. Successfully written documentation, whether it be a final report or something as simple as an update memo, can greatly help with communication in a group, especially in a virtual setting. While I had some prior experience in technical writing, it was helpful to receive a refresher in the “do’s” and “don’ts” of writing for an technical or engineering audience as we head into stakeholder interviews next week.

The following day, June 30, was Presidential Election Day in Malawi so we did not have group workshop or any team meetings. As this was not a typical election for the country and the process differs from the United States, I thought it’d be worthwhile to share some interesting facts surrounding the election circumstances and outcomes:

  • Elections were initially held last May, however the Constitutional Court annulled the results because of evidence of irregularities and poorly managed elections. This is the first time this happened in Malawi, and only the second time a “re-do” election has happened in Africa!
  • In addition to other concerns about fraudulent actions, it was alleged that the 2019 ballots were tampered with using the correction white-out fluid locally called Tipp-Ex to alter votes.
  • The voting system in Malawi changed from a first-past-the-post system, in which the candidate with the most vote wins, to a two-round system, which involves one round of all the candidates and a second voting round of the top two candidates.
  • The election was a landslide victory for Lazarus Chakwera of the Malawi Congress Party who defeated Peter Mutharika of the Democratic Progressive Party, the previous president that was seeking a second term and had won initially in the 2019 election.

On Wednesday the guest speaker for our group workshop was Wayne Decker from Flame Tree Initiative, an organization that focuses on growing social entrepreneurship in Malawi. His presentation focused on innovation and the productive use of energy in low resource settings. This was my first exposure to the concept of energy poverty and the downstream effects that a lack of energy poses on a country and individual community. We learned that existing electrical grids in Africa are not built for rural development or public health purposes; rather, they reflect resource allocation and prior colonialism that causes significant issues in energy distribution and access. Since only 11% of Malawi is connected to the national electric grid there is a need for the productive use of energy to maximize the benefits of the limited energy available. Decker connected this back to our projects in the internship through discussions within our team about the ways we can have a productive use of energy regarding our device function and manufacturing.

On Thursday we switched our focus to the needs finding side of global health as a significant goal in the internship is to find needs that fit the focus of Rice 360 and could be addressed by future teams. Through a presentation by Million Mafuta from the University of Malawi The Polytechnic, we explored the necessary steps of scoping a potential project through interactive problem solving examples that we then related back to our own prototypes.

Our final activity of the week on Friday focused on local digital health innovation in Malawi presented by Dumisani Kaliati.

To end the week, the TAs held a virtual scavenger event for us where we competed in our design teams to solve riddles and race to take pictures of the riddle answer. The highlight of the game was definitely fellow intern Andrew’s blurry selfies and ridiculous speed (someone I almost always ended up second to him no matter how fast I ran). Despite my team’s quickness with answering riddles and my effort in quickly sending pictures, we ended up tied for 2nd place out of the three teams. Though we hoped we would have a greater comeback, my team and I had a fun time interacting with the other interns and we’ve definitely grown to appreciate the social aspect of our internship. My team also took the time on Saturday to meet as a group to conduct further brainstorming together. Using Google Slides, we each wrote or drew as many ideas we could think of within 10 minutes for both prototypes then went over each of our ideas; we then each started bouncing off each other’s ideas and came up with some new concepts for us to explore. We ended our session with numerous ideas that we wanted to research and develop further ourselves, and we also planned to use the ideas as examples for the stakeholders next week.

The collection of our group brainstorming session ideas. Any of the points that were bolded are ones we want to continue looking into or further draw out.

This past week was busy with interactive workshops and activities covering engineering design and community interaction to prepare us for the next step of the internship, stakeholder interviews, where we’ll be talking with individuals and experts from manufacturing, entrepreneurship, and clinical fields to gain a better understanding of our projects and some initial feedback on the prototypes and our brainstormed solutions. I look forward to everyone we’ll get to speak with and the input they will have to advance our prototypes and projects!

See you next time,

Lauren

 

 

 

Information on the 2020 Malawi election was found at https://en.wikipedia.org/wiki/2020_Malawian_presidential_election and https://www.voanews.com/africa/malawi-opposition-leader-wins-fresh-elections-landslide-victory

Week 3: Half-Way Through and Still Much to Explore!

Posted on by Sana Mohamed

Hello!

This week, we have been diving into the concept of localized needs findings and innovation opportunities in preparation for our stakeholder interviews next week. It’s hard to believe that we are already halfway through the internship. It is so exciting to reflect on some of the personal and professional growth I have had thus far—while I have already learned an incredible amount, I still have so much to explore.

Monday started off with a workshop from our lovely TA’s Aubrey & Hannah on presentations and technical communication. This workshop really emphasized that regardless of how amazing a design or innovation may be, there are still many skills such as communication that are essential to the success of a device. We also had some time in the second half of the workshop to meet as a team and catch up on some of the deliverables we started last week. We continued stakeholder mapping by connecting that various ways in which there are not only differing levels of stakeholder in our devices, but their interconnectedness with each other and the various nuances that exist in each level.

Some of the stakeholder mapping we worked on Monday! A very colorful, connected web of influences that affect our device design considerations in unique ways.

Tuesday was National Election Day in Malawi, so we did not meet as a group. It’s great to hear that my teammates exercised their civic duty. I wish we had a national election holiday here in the U.S!

On Wednesday, we had a guest speaker, Dr. Wayne Decker from the Flame Tree Initiative, an organization that focuses on fostering entrepreneurship among local communities in Malawi to tackle social problems. Dr. Decker was an engaging and witty presenter who imparted a lot of wisdom to us. I found the focus on energy poverty and rural contexts to be extremely informative. Especially as an American, this is an area that I may fail to sufficiently pay critical attention to. Afterwards, we brainstormed some ways that our own devices could incorporate the productive use of energy for mutual success in Malawi. We are now further looking into the existing supply chains, the use of sustainable, locally sourced manufacturing material, solar energy, potentially scaling into rural areas, and creating economic opportunities for local communities. This further reinforces that so much of global health design goes beyond the devices that we iterate. It is truly about forging sustainable relationships with local communities for mutual benefit. Dr. Decker also left us with some life advice that has been continuously on my mind over the past week. As a rising senior, I have a lot of anxiety about post-graduate plans, especially because there are so many potential options and paths to take. Dr. Decker imparted on us that in the future, we should “find a big problem that keeps you up at night” and work to tackle it through listening, forging multi-disciplinary partnerships, and incorporating feedback.

A brainstorm of the potential drainage system we can implement in the walk-through disinfection unit. Dr. Decker’s workshop made me think of the sustainability that the collected run-off disinfectant could have if it was reused.

On Thursday, we had a workshop led by Dr. Megan Bond on identifying opportunities for innovation. Professor Million also provided an informative presentation on some of the concrete, tangible steps we can take to engage in effective project scoping. This was a great build-up of some of the concepts I learned in GLHT 360 with Dr. Bond last year, supplemented with interesting case studies I encourage you to read. While needs-finding has been critical component of internships in the past, given the virtual nature of our internship and our limited observation capacity, we will have to rely on the strength of our stakeholder interviews to really dive into needs finding. While this presents a challenge, I think this also provides an interesting opportunity to try and creatively engage. It also highlights how critical the skills of communication and listening are.

On Friday, we met Dumisani Kaliati, a Malawian innovator who created MicroMek, a company that uses low-cost drones to deliver medical diagnostics to young children and pregnant women. I previously worked on cervical models in LUCIA and I am interested in women and maternal health, so it was great to hear Dumisani presenting on the work that he is doing in digital health innovation, as well as some of the recent COVID-19 relief efforts. I found his advice on some of the common challenges we might run into, such as a lack of trust from early adopters and a heavy dependency on imported raw materials, particularly relevant, as Dumisani is a young entrepreneur who has successfully dealt with many of these challenges. As we move forward, we will have to critically address these challenges by aligning ourselves in partnerships to enhance our credibility, identifying the sustainable development goal our project aligns to, incorporating feedback on our minimal viable product, finding local alternatives to imported materials, and researching policies that may affect our device.

We ended off this week with a scavenger hunt our lovely TA’s created based on some riddles of common household objects. Everyone was “zoom”-ing by frantically scrambling to take pictures of eggs, toothbrushes, showers, pencils and just about anything found in a home. I got some pretty strange looks from my family as the competition really heated up (even though there was no prize), but in the end team PPE had a very well-deserved victory.

This week, we explored how to adapt our devices to become more sustainable and learned strategies to engage in localized needs findings. It was great to learn about how we can further ground our technologies in the local communities and ecosystems they will inhabit. I am excited to apply these concepts to our stakeholder interviews next week and further iterate on our device and needs recommendations.

Signing off,

Sana