“A falta de pan, casabe.”
This saying, which loosely translates to “If there is no bread, cassava,” carries a deeper significance in Spanish-speaking culture. It embodies a recurring resilience and resourcefulness I’ve witnessed in clinical settings here—making do with whatever is available to keep going, no matter the challenges.
Hey everyone!
Welcome back to my blog! I know it’s been a while since my last post, and I have so much to share with you all. It’s hard to believe we’ve already spent a full month here—the time is flying by, and the race to the finish line has begun! I wanted to include that introductory quote for a reason: it’s been one of the ways this experience has been transformative for my outlook on medical innovation. But more on that later!
This past week, Zoe, Anathea, and I visited Hospital Maternidad la Altagracia. We were joined by Dr. Emin Rivera, an engineering professor from the University of Action for Education and Culture (UNAPEC), who introduced us to models of neonatal incubators that we hope to emulate in our project: a neonatal warming bed with a temperature sensor. Dra. Kathy Rodriguez, a neonatologist at the hospital, also gave us a tour of the NICU, where we witnessed firsthand the challenges faced by clinics in the Dominican Republic due to malfunctioning equipment. In some cases, incubator beds with broken heating lamps were being substituted with gooseneck lamps. These technical difficulties often forced the adoption of urgent alternatives, balancing the risk of harm to the infant (gooseneck lamps have the tendency to drop lightbulbs onto infants, resulting in burns or scarring) with the critical need to address immediate issues.
It was eye-opening to see how the lack of infrastructure for repairing devices introduces a new level of risk. When proper equipment fails and there’s no immediate way to fix it, healthcare providers must improvise with whatever resources are available, sometimes at the expense of safety. In a way, this experience reinforced my understanding of the importance of our work here. We aren’t just focused on creating innovative solutions– rather, we’re focused on making them reliable and safe as well.
Dr. Rodriguez also shared some crucial features we should incorporate into our incubator design: retractable sides for unobstructed care of the newborn, a temperature monitor to ensure optimal body temperature, and an adjustable, proper lamp for providing consistent heat.
Dr. Rivera joined us on this visit because we are partnering with engineering students from UNAPEC to create this device. These students will be responsible for designing the microcontroller systems for temperature and humidity control, ensuring our incubator meets the necessary specifications for effective neonatal care. We even had the opportunity to sit in on one of their microcontroller lectures, where we observed their proposed PVB microcontroller maps for the temperature sensor aspect of the neonatal incubator.
It was invigorating to see a fresh, engineering-driven perspective on a project we’ve become so familiar with over the past few weeks. And it was certainly interesting, too! In the coming weeks, I’m excited to dive into the engineering aspects of this project with Anathea, Zoe, and our new UNAPEC colleagues.
On Wednesday, we started our morning early with a visit to Las Minas Maternal Hospital, where we joined Dr. Ravelo Soto and his residents on their morning rounds in the Pediatric Surgical unit. During our visit, we presented our NoMoSilo prototype and learned about the ABS Silo bag currently in use at Las Minas Hospital. Unlike the commonly found IV or urine bags used in many hospitals, this alternative employs a cheap polyethylene bag that is significantly more flexible. Additionally, the bag design featured another key difference: instead of using oxygen tubing to enter the abdominal cavity, the ABS bag utilized a feeding tube sutured into a circular ring. Overall, our visit provided us with valuable insights and highlighted new innovative approaches we could take for NoMoSilo.
Reflecting on this week, I now see the true essence of “a falta de pan, casabe.” The resourcefulness and resilience I’ve witnessed have fundamentally transformed my view of medical innovation. It’s not just about having the latest technology at your disposal; it’s about adaptability, creativity, and the relentless pursuit of solutions that work within the given constraints. This experience has shown me that true innovation often emerges from necessity and the drive to overcome seemingly insurmountable obstacles.
This realization has deepened my appreciation for the ingenuity required in global health design. As we continue our work, I’m inspired by the dedication of the healthcare professionals here and the impact we can make together. The spirit of resilience and resourcefulness will continue to guide and motivate us as we push forward in our mission.
Anathea, Zoe, and I wrapped up our week with a visit to Hoyo Claro and Punta Cana, where we went swimming, buggy riding, and then more swimming! The driving was exhilarating, and despite some claims, I only crashed twice due to significant brake malfunctions. Perhaps Anathea was confusing my mishaps with the six or seven times Zoe crashed the buggy… those were definitely the most memorable moments for me. Jokes aside, our trip was a much-needed break from the busy week, and I vow to take better photos for the remainder of the trip!
Thank you for reading, and until next time,
Ansh