Author: ar152

Update: Shadowing and a Visit to the Burn Unit! – Ansh

Posted on by ar152

Hey everyone!

Welcome back to my blog! It’s been a while since my last post, so I’m excited to catch you all up on our latest activities. Time is flying by here, and we’ve been incredibly busy with some rewarding projects and visits. Let’s dive into what we’ve been up to!

During the second week of July (15th-19th), we had the opportunity to visit Maternidad Altagracia, one of the only hospitals in the Dominican Republic with a dedicated burn unit. This was definitely a unique experience compared to our usual visits to Las Minas Maternal Hospital, which primarily serves mothers in labor and neonates. Maternidad Altagracia, on the other hand, focuses on pediatric patients aged 5 to 15.

We started our visit by presenting ScarStretch, our Rice360 project designed to massage burn scars for pediatric burn patients, to two pediatric plastic surgeons. It was fascinating to see their reactions and gather their feedback on our innovation. We also noted down some valuable insight, including the need to decrease the bulkiness of our device and change the padding used for wrapping around the patient, since the current material could irritate the skin of a pediatric burn patient.

Anathea, Zoe, and I at the Maternidad Altagracia!

One of the physicians proposed a softer, more breathable material, something we definitely plan on taking a closer look at moving forward as we continue to develop ScarStretch. In regards to decreasing the bulkiness, we brainstormed possibly changing the current DC motor in the device to either a lighter, brushless motor or completely replacing the source of movement with a hydraulic mechanism. Due to our lack of an engineering and design studio here, a hydraulic mechanism was a bit too difficult to explore, so we identified the brushless motor as a more feasible improvement we could take a closer look at in the coming weeks.

A change of scenery and patient demographic also gave us fresh insights into some of the diverse healthcare needs within the Dominican Republic that we haven’t had exposure to. Most of our clinical visits have been at Las Minas Maternal Hospital, primarily serving mothers in labor and neonates. Maternidad Altagracia, the location of our latest visit, focuses on pediatric patients often between ages of 5 and 15. This new environment was not only different but also highly educational. While in the operating rooms, we observed the specific challenges and requirements that Dominican healthcare institutions face when treating children with burn injuries. It was enlightening to see how different age groups require distinct medical approaches and the adaptability of healthcare professionals in meeting these varied needs, which often occur in less intervention-focused ways when compared to infants.

The Entrance of Maternidad Altagracia!

Later on in the week, we visited Las Minas Maternal Hospital (again!) and had the incredible opportunity to shadow Dr. Jaisson Colon Bautista, an obstetrician gynecology surgeon. Our day was filled with observing various procedures that provided us with a deeper understanding of clinical maternal practices in this setting. We started the day by observing two c-sections. Watching these surgeries was both intense and enlightening, and what struck me about this

Dr. Colon Bautista teaching us how to suture!

observational experience was its detailed and delicate nature. Furthermore, it was clear how crucial each action was in ensuring the safety and well-being of both the mother and the child. As we watched, Dr. Bautista explained each step to us, and I found this to help me better recognize and understand the workings of such an intense procedure. Our day at the hospital finally concluded with observing a regular birth, which was an incredibly moving experience. The ability to witness the miracle of life and the joy it brings to families was profoundly rewarding, and made me grateful for this opportunity Dr. Bautista had granted us.

As we begin to wrap up our time here, I can’t help but reflect on the invaluable experiences and insights we’ve gained. This journey has not only broadened my own definition of global health innovation and healthcare delivery in different settings but has also enhanced my understanding of the resilience and dedication exhibited by healthcare professionals in under-resourced settings. Every single visit and interaction has shown me the importance of adaptability in overcoming challenges and improving a patient’s life. Moving forward, I’m excited to continue applying what I’ve learned to our ongoing projects and look forward to sharing more updates with you all soon!

Until next time, 

Ansh

Resilience, Buggies, and Cassava!

Posted on by ar152

“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!

Ideal infant warming bed, with server control temperature monitor

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.

Example of a retractable attachment for the incubator walls

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

Two Weeks Into Santo Domingo, Thoughts, and Reflection– Ansh

Posted on by ar152

Hey everyone,

Welcome back to my blog! Today marks exactly two incredible weeks of our stay in Santo Domingo, which is already a quarter of our total time here. The time is flying by, and I have so much to share with you all!

This week kicked off with a visit to a storage unit where we got an exclusive look at the array of devices and equipment that DOFMI focuses on. From Bubble CPAP devices and phototherapy lamps for jaundice to lullaby books designed to stimulate neonates, each one seemed uniquely impactful. I was especially excited to see their reusable neonatal bag-valve masks, a fascinating device for low-resource settings that I’ve had the opportunity to work with in the past.

Storage Unit Visit!

As our mentor, Dr. George Suazo, presented each device, he discussed the issues DOFMI aims to address for each one. This provided us with a solid introduction to the work we’ll be doing with DOFMI and offered a fascinating insight into the multifaceted nature of global health solutions. It’s not just about engineering a device—addressing needs finding, design specifications for the setting, and incorporating feedback from stakeholders are crucial for a project to truly meet its intended goals.

The next day was marked by our second visit to the San Lorenzo Los Minas Maternal Hospital. This time, accompanied by Dr. Angelica Floren, we were able to take a closer look at the Pumani bCPAP machines currently in use in the NICU and PICU of the hospital. Afterwards, we also were guided through the stages of a hospital visit a pregnant mother would go through, from the waiting room all the way to the postpartum recovery room.

What stood out to me the most was the level of focus exhibited by every doctor, nurse, and birth attendant in each of these rooms. Despite the bustling hallways of the hospital, there was a remarkable, unspoken sense of coordinated efficiency. Many of the expectant mothers at Los Minas are Haitian and speak Creole, not Spanish. Yet despite this language barrier, the quality of care, meticulous attention to detail, and compassion remained consistently high and universally felt. The ability of the staff to maintain such standards in a challenging environment was truly inspiring.

Pumani at San Pedro Hospital!

The next day, we visited San Pedro Hospital, the first hospital in the Dominican Republic to utilize the Pumani bCPAP device. Upon inspecting the three Pumanis present, we found technical issues with two of them. We spoke with the birth attendants there as well, and it was inspiring to hear about the successful cases in whichthe Pumanis had made a significant difference.

Next, we traveled with Dr. Floren to various locations for possible maternal waiting rooms, low-cost places for high-risk mothers to wait and be transferred to a nearby hospital before delivery or complications.

Dr. Floren and our partners at DOFMI had already been working with a local church to find a location for the Dominican Republic’s first ever maternal waiting room, and it felt truly empowering to listen to them speak about these issues firsthand.

Beds at maternal waiting room location!

We wrapped up the day visiting a creole-speaking Dominican Batey, a location for undocumented second-and third-generation Haitians with no ties to their “homeland” Haiti. Our solution for maternal waiting rooms would be tailored to mothers in these Bateyes, largely due to their extensive distance from Dominican hospitals and clinics. The hospitality we experienced with residents of the Batey was incredible to say the least, and left me reflecting on why I find the field of global health so captivating.

I now realize that a powerful driving force of global health innovation is hope. Hope was reflected in the smiles of every person we met at the Batey, it fueled the unwavering focus of the healthcare professionals we encountered, and it is the primary source of motivation for our partners at DOFMI. At first glance, global health challenges sometimes appear overwhelmed with logistical hurdles such as language barriers and inadequate infrastructure.

However, it is hope that transforms these obstacles into opportunities for innovation and change. During our visits, we witnessed firsthand how the spirit of hope permeates every aspect of healthcare delivery. As we continue our work here, it’s clear to me that our mission goes beyond just providing technical solutions. We are here to support and amplify the hope that exists within these communities. By understanding their needs and working alongside them, we can co-create solutions that are not only effective but also sustainable.

The resilience and optimism I’ve encountered thus far reminds me that even in the face of challenges, hope can pave the way for meaningful and lasting change. In the coming weeks, I hope to contribute to this change in even the slightest of ways.

Thank you for reading, and until next time,

Ansh

Introduction and Preparations – Ansh

Posted on by ar152

                          Hey y’all, it’s nice to meet you!

Me (left) and Vivek!

My name is Ansh, and I’m a rising junior at Baker College majoring in Neuroscience and minoring in Global Health Technologies. I was first introduced to the field of Global Health through the introductory GLHT201 course. A semester’s worth of lessons, talks from guest speakers, and team projects later, I decided to try hands-on engineering and design myself through the Introduction to Appropriate Global Health Design course. Alongside a team of four students, I worked to improve the complicated, unfamiliar nature of the Laerdal reusable neonatal bag-valve masks, a device commonly used in low-resource settings for newborn resuscitation. Our design process had to take into account the various constraints that extended beyond financial limitations–many of the birth attendants in these settings using this device had a limited education background and were less familiar with medical devices. To address this, we collectively designed an alternative device significantly reduced assembly and disassembly times, critical for urgent moments where such devices needed to be ready at a moment’s notice.

This experience placed me at the intersection of medicine and health technologies where I became fascinated by the idea of innovatively addressing health disparities across low-resource settings within realistic constraints. This summer, I’m thrilled to be part of Rice360’s internship team in Santo Domingo, Dominican Republic, where I (alongside two teammates: Zoe Wang and Anathea Carrigan) will be working with the Dominican Foundation for Mothers and Infants (DOFMI) to assess some critical health challenges.

Since starting this internship, I feel like I’ve dove headfirst into a whirlwind of excitement and learning. Background research into the Rice360 projects we’re bringing to the Dominican Republic, literature reviews into the basis of the assigned DOFMI projects we’ll be working on, and meetings with our DOFMI partners have all headlined our preparation efforts.

Our first project involves a gastroschisis device made from urine and IV bags, an innovative, low-cost alternative to silo bags used to prevent neonatal deaths from gastroschisis. We’ll mainly be conducting bench and Full Scale model testing to evaluate the device’s performance in a controlled environment. For our second project, we’ll be working on ScarStretch, a tool aimed at improving the effectiveness of scar massage therapy in low-resource settings. Alongside Dr. Angelica Floren from DOFMI, we also plan on working on a series of projects exploring alternatives to maternal care facilities for Dominican mothers in rural settings, evaluating fetal heart rate monitors in maternal hospitals, and conducting a longitudinal scale survey of the current use of Pumani bCPAP machines in clinical settings across the country. Our goal is to reduce neonatal mortality while maintaining the highest standard of care for mothers, something I hope we can achieve as we take on these projects.

As I work alongside partners in this new, unfamiliar environment, I aim to maintain an open mindset working collaboratively across cultures, disciplines, and borders to develop sustainable solutions that improve health equity. I also hope to improve on my Spanish-speaking skills, especially amidst the rapid conversation-based clinical settings I plan on stepping into.

I’m consistently fascinated by the challenges healthcare professionals face to maintain the same level of high-quality care each day, with every single patient. One of the reasons I’m so passionate about global health is that it provides a sense of understanding to connect with people on a far deeper level, and this holds true regardless of setting. It’s about more than just treating diseases; it’s about understanding the social, economic, and cultural factors that influence health and working together to create environments where everyone has the opportunity to thrive. This internship is already proving to be an incredible journey of learning and growth, and I’m eager to see how much more I will gain from this experience.

As I embark on this journey, I am filled with a sense of purpose and excitement. I’m eager to learn from the challenges and successes that lie ahead, and I’m committed to making a meaningful impact through our work with DOFMI.

Thank you all for tuning in to my first blog post, and I hope you’ll stay around!