Hey everybody!! 

Thank you so much for checking back in with the blog. 

I can hardly believe how quickly these two months have passed. It feels like just yesterday I was getting off the plane, absolutely petrified yet excited at the same time. Looking back, every single moment, experience, and connection I’ve formed here in the Dominican Republic is truly something that I will carry with me for so so long. This internship has been so much more than a professional opportunity as it has been a journey of learning, growth, and self-understanding. 

Over these weeks, I’ve learned so much, not only about medicine, engineering, and needs-finding, but also about navigating a different culture, practicing my Spanish, and embracing personal growth.

Right off the bat, I can tell you what one of my favorite parts was: the culture. Being half–Puerto Rican, I’ve always wanted to feel more connected to that side, and being here was and is the closest I could get, and I absolutely loved it. I felt an immediate connection to the food, the warmth, and especially the music. Listening to salsa almost every day brought me so much joy, especially when I saw people dancing in the streets, unafraid to celebrate life in public. It reminded me of my dad and his love for music, his ability to create joy at home, and his stories from the past. This connection made me even more proud of my Latin heritage.

I want to first express my deep gratitude to UNAPEC. The faculty and students welcomed us so warmly, and it has been an honor to collaborate with them. One of the main projects we worked on alongside the electrical engineering students, Darien and Ezeul, was developing a temperature monitor and regulator for premature babies in the NICU. Many of these babies could not experience prolonged kangaroo mother care due to their condition, meaning the incubators had to reliably maintain a safe temperature to prevent hypothermia.

Our goal was to design a thermal mattress with an integrated monitor and regulator. In the end, we learned that Rice360 had already developed a similar solution that had passed FDA approval. Instead of reinventing the wheel, we connected the manufacturer with Dr. Floren, the president of DOFMI. And honestly? That was such an important lesson for me

In global health technology, one of the biggest challenges is redundancy; projects often repeat the same work because of limited awareness of existing solutions. Sometimes, the real innovation lies not in creating something new, but in bridging the gap between what exists and the communities that need it most. By bringing the device here, usability tests could be conducted to see if it truly meets the needs in this context, especially considering local factors like climate and humidity. This also really showed me how many big problems in medical technology management come from straight education. Many of these medical professionals are unaware of how to fix or identify a simple problem that has a simple fix, and they assume it’s broken and leave it that way. There is truly a need for programs that allow them to get the time to flesh out new devices to allow for a better flow of maintenance. 

We also collaborated with UNAPEC students on research related to LEEP, a common procedure in the DR for screening and treating pre-cancerous cervical lesions. We explored designing a training model for the procedure and considered ways to make a smaller, more portable electrosurgical generator. I’m especially grateful for the dedication of the students who worked with us while balancing their own senior projects and eight classes. Their hard work and generosity of time inspired me deeply.

From them, I also learned something simple yet profound: a small shared interest can open the door to meaningful connections. The joy of seeing someone’s face light up because you mentioned something they love, it’s a feeling I’ll treasure.

I also want to thank DOFMI for taking us to hospitals across the country for needs-finding and for organizing OBGYN meet-ups to test our project from Rice.

Dr. Floren is truly a force of nature. She could be living comfortably in the U.S. with her family, but instead, she’s here, pouring her energy into improving healthcare for premature babies. Watching her in action made me realize what it really means to put patients first. She has strengthened my passion for medicine in ways I can hardly express in words.

Through all of this, I’ve realized how much joy I find in helping people, whether it’s something in the hospital or as small as a kind gesture in a café. That joy is something I want to carry into my future career. As an engineer or a doctor, I want to design and implement solutions that truly make healthcare better for people everywhere.

Our trips to Barahona and Santiago were also incredibly eye-opening. Seeing the differences between private clinics and the poorer regions firsthand brought a new level of understanding that no report or statistic could ever match. Witnessing the environments where the needs are most urgent reinforced the importance of human-centered design in healthcare technology.

I am deeply thankful to the OBGYNs at Hospital Materno Infantil San Lorenzo de Los Mina, who allowed me to shadow them in the OR. This was definitely one of the most impactful parts of this internship. I watched countless gynecology and obstetrics surgeries and learned so much from their explanations, and not only about the procedures themselves, but also about the healthcare challenges they face daily. Their commitment to their patients and to improving the country’s healthcare system was beyond inspiring. And their love for their profession and for the patients they are caring for is so tangible and beautiful. I will truly miss these amazing people. 

 

I’m leaving the DR with more than just memories. I’m leaving with new skills, new friendships, new perspectives, and a stronger sense of purpose as a future engineer or maybe one day, a doctor or other professional. I’ve learned that innovation is as much about connection as it is about invention. I’ve also learned how empathy is as vital to engineering or medicine as technical skills. That joy, whether from a patient smile, a shared meal, or music playing in the background, is something worth protecting and cherishing :).

Thank you for following along on this journey with me.

Till next time, DR!! 

– Valerie

 

And yes… I also brought home some Dominican food. Some lessons you can taste.

Thank you for coming along until our very last week of the internship! These 8 weeks have flown by, and It’s been an incredibly rich and rewarding experience.

From Saturday through Wednesday, I dedicated my time to working on a report for the reusable feeding syringe. I spent these days diving deep into research into understanding the background context and problem, as well as developing a methodology to test various reusable syringe models and cleaning protocols. This paper outlined the context and a methodology for studying and developing the syringe project.

Thursday and Friday, however, were quite different, as I shifted from research to hands-on shadowing at Circuimed in Santiago.

Thursday began early with an 8:30 AM Caribe bus ride from 27 de Febrero in Santo Domingo to Los Jardines in Santiago. Upon arriving, we took an Uber to Circuimed, where we spent the day immersed in medical equipment repair and maintenance. We worked with Bleidy George, who was fixing an electrocardiograph (ECG).

An ECG records the electrical activity of the heart by using electrodes placed on a patient’s skin. These electrodes capture electrical signals produced by the heart and send them to the machine, which amplifies and displays them as waveforms on a screen or prints them on paper. These waveforms are crucial for healthcare professionals to assess heart rhythms and monitor overall cardiac health.
The ECG we worked on had stopped functioning due to humidity getting inside the device and causing a short circuit. The source of the issue was the blown fuse, two small glass cylinders responsible for carrying electrical current, which we confirmed with a voltmeter. Testing across the fuse showed no current flow, indicating it needed to be replaced.

After restoring the ECG, Bleidy shifted his attention to a System 5000 Electrosurgical System, a device commonly used in operating rooms to cut tissue and stop bleeding during surgeries. This machine operates in two modes: cut and coagulation. The cut mode uses continuous, high-frequency current at higher voltage levels to vaporize cells quickly and make precise incisions. The coagulation mode employs pulsed current at lower voltage to slowly heat tissue, causing blood to clot and sealing blood vessels. We got to experiment with these modes by testing different voltages on a bar of soap, which was a great way to observe how the device functions practically.

The main issue with this electrosurgical device was that it often turned off unexpectedly during use, forcing doctors to pause procedures while waiting for it to restart. This instability clearly impacts workflow and patient care.

Later, we visited a private hospital clinic where Bleidy was installing pulse oximeters at patient bedsides. I noticed that each pulse oximeter was only compatible with monitors of the same brand, a business strategy that restricts cross-brand equipment use. While understandable from a commercial perspective, this practice unfortunately makes equipment access more complicated and costly for healthcare providers.

Friday’s day at Circuimed started with meeting Vladimir, who introduced us again to Anthony, who specializes in fixing ventilators. Anthony was working on a ventilator with a malfunctioning internal compressor. This component is responsible for filtering ambient air to produce medical air, which typically contains about 20% oxygen. For patients requiring higher oxygen levels, the ventilator mixes this medical air with pure oxygen using a blender, ensuring the delivered mixture meets the specific clinical needs.

Many hospitals in the Dominican Republic lack centralized medical air supplies through wall outlets, so ventilators must rely on these internal compressors. However, these compressors represent older technology and are mechanical in nature. More modern ventilators use turbines, which are smaller, quieter, more durable, and regulate airflow in real-time.

Anthony explained that when an internal compressor breaks, repairing it is often not cost-effective because the price of a new compressor is comparable to that of an entire ventilator. Instead, Circuimed salvages functional components from these incubators to keep other machines running.
Watching Anthony troubleshoot the ventilator was a great learning experience, offering insights extending into my personal project. For instance, to calibrate pressure sensors, he modified a syringe to have two tubing outputs, one connected to a pressure measuring device and the other to the sensor. By pulling back the syringe plunger, the pressure readings on both devices should match, allowing precise calibration. I saw the applications of this kind of procedure for calibrating the pressure sensor that would be used for my breastfeeding monitoring device.

Anthony also shared an important story about visiting a hospital that owned Comen incubators but continued using gooseneck lamps to keep newborns warm. The staff were unaware that the incubators had thermal mattresses capable of safely warming infants. This highlighted a critical need for educating hospital staff on the proper use of equipment to improve neonatal care and reduce risks associated with outdated practices.

Hello everybody, and welcome back to the blog!!!

As our internship comes to an end, I have been trying to take in every moment here: the people, the culture, and everything we have been learning. This week, Dr. Lee visited the country, and we traveled with her to San Pedro de Macorís to visit the bateyes. These are small communities where many residents work in the sugarcane fields.

During previous visits, I had only seen these towns from a car window, but this time we were able to walk through one. It was the first time I really saw what life is like there. Many of the homes did not have flooring, the roofs were improvised, and there was no air conditioning.

Still, the sense of community stood out to me. Even though it is a small area, everyone greeted each other in a friendly way. The church was full of energy, with people singing and dancing in Haitian Creole. It was my first time hearing the language. At the same time, learning about their situation was difficult. Because of the immigration issues in the Dominican Republic, many Haitians are afraid to go to hospitals. Some fear being deported, while others worry about unfair treatment. As a result, people sometimes die from conditions that could have been prevented. Maternal mortality is especially high in these communities because women with high-risk pregnancies often avoid care out of fear that they and their babies could be deported.

We were guided through the area by Mrs. Malena, a local woman who leads programs to help other women learn new skills and also provides emotional support. She explained the need for a mobile clinic because the towns are far from each other, and the regional hospitals are even farther. She shared that when she was a child, it took her two hours to walk to school, even though it was still within the batey region. As we traveled between communities, we saw families walking long distances in the heat with groceries. Cars were rare, and motorcycles were the main form of transportation.

She also showed us places where bodies had been found. That moment really stayed with me and reminded me how serious the situation is.

The next day, we went to Santiago de los Caballeros, the second largest city in the country. We visited Circuimed and met again with people we had previously spoken with at Altagracia. Circuimed distributes and refurbishes medical equipment. They showed us their mock operating rooms and several incubators that needed repair. During our conversation with the owner, we learned that most problems with incubators come from the heating source or temperature sensors. Many of these parts are replaceable, but medical staff are not always aware. Sometimes they reuse disposable sensors or do not realize replacements are available. Because of this, many incubators go unused when a simple fix could solve the issue.

We also visited hospitals in the area, including one [name to be added], where all the incubators were functioning. They were even using ceramic wrap instead of tape to seal older incubators. Tape leaves residue that increases the risk of contamination, so this was a much better solution.

After Dr. Lee left, we met with David Kimmey, a Rice360 fellow who worked on the Celsi Warmer and Monitor. He explained that the device was originally designed for hospitals in Africa, but we noticed a lot of overlap between that context and what we have seen in the Dominican Republic. We also spoke with Jackie Foss, a tech translator from Rice360, who told us that the Celsi Warmer was recently approved by the FDA. We connected her with Dra. Floren to explore whether the device could be used in local NICUs to address issues with temperature regulation.

I also worked on prototypes for a training model for the LEEP procedure. From our hospital visits, we found that LEEP is frequently used to treat cervical intraepithelial neoplasia (CIN), a condition that can lead to cervical cancer. Some hospitals perform the procedure up to five times a day. A common problem is access to small and affordable electrosurgical generators. Our goal is to create a training model that doctors can use for hands-on practice while keeping costs low.

In addition, I have been writing down need statements based on what we have observed. I plan to share these with UNAPEC, since they are working on launching a biomedical engineering major. These statements could help guide their future projects and classes in a direction that addresses medical topics, which I think would be wonderful for the country.

This experience has been very informative. I am so thankful to have had the chance to learn from the people here and to better understand some of the issues they face.

– Valerie

Some bonus pics!!

This past week, we continued our work in understanding the context of challenges with incubators in the NICU in the Dominican Republic. On my own, I’ve continued my development of the syringe model and researched into possible needs/use cases for NeoFeed.

On Wednesday, we toured the NICU at Los Mina Hospital, meeting Dr. Ruth Encarnación, head of the neonatal unit. She gave us a walkthrough and explained the current setup. Their incubators varied in age, some were new (around 6 months to a year old), while others had been in use for much longer. Compared to other public hospitals we’ve visited, Los Mina seemed to have relatively better equipment. 

We also learned that the procedure for monitoring the baby’s temperature involves placing the sensor at the liver. However, when the incubator temperature sensor stops working, they switch to manually taking the baby’s temperature by placing a thermometer in their armpit. 

She also introduced another warming tool they use for NICU infants, and this is called the Mistral-Air Patient Warming System. It’s essentially an air-pumping device that connects to a blanket and blows warm, HEPA-filtered air. Originally, it was designed to prevent hypothermia during surgery under anesthesia. They’ve adapted it for use in the NICU, but it’s clear that it’s not an ideal fit: it costs about $1300 and is only used in more severe cases. Most babies are still kept warm with basic gooseneck lamps, so there remains a gap in accessible/cost-effective methods for monitored and adjustable thermal care. 

After this, we spoke with a biomedical engineer who maintains equipment at Los Mina weekly. He walked us through how he repairs incubators and showed us the temperature sensors. These sensors are lightweight and fragile, with thin wires that plug into ports on the incubator. He said the most frequent failures occur because staff either don’t understand how to properly connect the sensors or damage them during use. Poor installation and handling practices, such as plugging sensors in incorrectly, lead to malfunctions.

We asked about incidents of sensors burning babies, as I learned that was an issue at Hospital Juan Pablo Pina, and he said it’s possible, usually due to a short or electrical surge. This can happen when the wire isn’t properly insulated. He showed us how you could unscrew the connector and apply heat shrink tubing to protect it. 

Overall, hearing these simple fixes to these problems that we’ve seen again and again has made it clear that a lot of these issues may come down to maintenance and proper training. 

He told us that the temperature sensor is the part of the incubator that breaks most often, which makes sense given how delicate and detachable it is. He also explained to us how incubator temperature regulation takes into account three variables: the baby’s current temperature, the target temperature, and the heater temperature. An alarm sounds when the baby’s temperature falls outside the desired range. Ambient room temperature is also measured, though its specific role was unclear.

These insights clarified key design priorities for our project: durability, low cost, and simplicity. One potential improvement would be designing sensors as non-removable components to reduce breakage. However, beyond these design changes, I’ve realized that technical solutions alone won’t solve these issues. There is a need for a stronger educational effort to be made to ensure proper equipment use and maintenance.

In the delivery area, we saw a newborn wrapped in surgical drapes, taped down, and placed under two gooseneck lamps inside a thermal crib. The engineer quickly fixed the crib’s heater on the spot, which really highlighted how important it is for nurses to know how to perform these simple fixes and avoid the use of gooseneck lamps as much as possible.

The main takeaway from the visit was that training and education are as essential as equipment itself. Many of the recurring issues stem from human error, not hardware failure. Innovation can support improvements, but without user understanding and technical training, equipment will continue to fail.

Later that afternoon, we called with Dr. Floren. We updated her on our findings and discussed next steps, including upcoming hospital visits and potential site visits to bateyes. She also spoke about DOFMI’s collaboration with Fundación Grupo Puntacana, which is focused on improving healthcare infrastructure and health education in the Punta Cana region. Despite its reputation as a luxury tourism hub, the people living and working in Punta Cana, particularly Haitian migrant workers in construction and sugarcane fields, face limited access to public healthcare.

The Dominican Republic, despite its economic development, has the second-highest maternal mortality rate in the Caribbean, just after Haiti. Dr. Floren also emphasized the ongoing issue of congenital syphilis, a preventable but still common infection passed from mothers to newborns, due in part to gaps in screening and treatment.

The rest of the week was focused on research and prototyping. After 3D-printing my first syringe prototype, I created two additional versions to refine the design. I made the syringe tip longer and began experimenting with mechanisms to create a tighter seal for liquid suction. I also spent time researching NICU practices in the U.S. for evaluating infant readiness to transition from NG tubing to breastfeeding, which could inform a use case for NeoFeed. I looked into milk flow sensing technology as well—integrating this with pressure data could give nurses and doctors insight into breastfeeding coordination and milk ingestion, two of the most definitive markers of effective breastfeeding.

I also began looking into low-cost methods for thermal control to support the temperature monitoring device we’re developing in collaboration with UNAPEC and DOFMI. During this process, I came across the Celsi Warmer and have since reached out to its developers. We’re hoping to learn from their approach and, if possible, explore opportunities to introduce it in the Dominican Republic.

Finally, we visited a few cafes around the city, exploring different study spots and enjoying a change of scenery from the apartment.

I find it difficult to put into words how wonderful our experience has been so far. Words alone don’t capture the passion, love, and sheer determination of the people we’ve met along the way. As my co-intern mentioned in his blog, we had the blessing of visiting Barahona, which was an opportunity that deeply expanded my understanding of the country and its people.

Traveling outside the city offered a different lens. The homes we passed were smaller, many without floors, and some constructed with metal sheets for roofs. I observed them through the car window as we moved from hospital to hospital, but even that brief glimpse gave me a lot to reflect on. These weren’t just buildings — they were the homes of the very patients we were seeing in nearby hospitals like Jaime Mota. Families. Children.

I don’t have a perfectly polished takeaway from what I saw, but what struck me most was this: when living conditions are difficult, access to quality healthcare becomes even more vital. It’s not about pity, it’s about justice. It’s about making sure that every mother in Kangaroo Mother Care, every baby born too soon, every family, regardless of where they live, receives the care they deserve.

And yet, amidst what some might see as hardship, I witnessed joy. There was music in the air. People dancing in the streets. A vibrant sense of community. There is a compassion here that I’ve rarely seen elsewhere, a compassion that I have also seen in healthcare providers when it comes to quality patient care.

One of the people who’s left the deepest impact on me is Dra. Floren. Despite having a family back in the U.S., she is here, fully present and committed to her patients. From expanding Kangaroo Mother Care to supporting maternal units and even creating birthing centers in Haiti, her work stems from a place of pure love. She reminded me what true passion in medicine looks like: patient-first, always.

Often, when we talk about global health, the narrative centers around tragedy or lack. But there is so much hope here. That’s why visiting KMC clinics meant so much to me. I got to hold a beautiful baby girl who was once a preemie, and now she’s healthy, smiling, and thriving. Her mother was kind and full of gratitude. It reminded me that behind every clinical term like “neonatal care” is a real family and a story of survival.

 

At Jaime Mota Hospital, I had the honor of presenting my project to a group of OBGYNs and gynecologic oncologists. These professionals are shaping the future of medicine here, and their feedback was invaluable. Dr. Mendez Lopez suggested making the cervical ectropion on our training model more pronounced, as it’s often mistaken for pathology by trainees. He also recommended pairing the model with real clinical images and step-by-step guidance, which is an idea I’ll be taking back with me. I’ve had multiple doctors offer images they have taken of cervical appearances, and I am more than excited for this collaboration.

We also met Dr. Delfido Feliz, a specialist in endocrinology, fertility, and gynecology, who posed a pivotal question: “What is the ultimate goal of your project?” I told him it’s about democratizing training. Hands-on gynecological education should be accessible not just to medical students and residents, but also to nurses and primary care providers, especially in areas with high cancer burden and high risk. He shared how facilities known as UNAPs ( small, local centers of primary care) serve as the first line of care across the region. Yet, many PCPs and nurses from these centers still lack the training to confidently perform procedures like pap smears.

We visited one of these UNAPs and spoke with a general medicine physician who explained how care can sometimes get lost in the system. Patients are referred back and forth, often missing follow-ups or never receiving their lab results. These aren’t just logistical issues, but structural barriers that can delay lifesaving diagnoses.

I also got to share the model with nursing students from UCATEBA and saw how even limited tools, when paired with knowledgeable mentors, can open new doors. One physician demonstrated how to use a pipelle for endometrial biopsies, and it was amazing to see the model possibly being capable of teaching.

Interestingly, this experience has shifted my view. It’s not that this country lacks proper screening procedures or quality care. Many of those services are already present, whether it be a public or private hospital. What’s often missing is awareness. Currently, I am trying to help start an awareness/educational program with DOFMI in the DR, as female health is something that cannot go unnoticed, especially in a country where the average start of sexual activity is 10-16 years old.

Hospital visits also highlighted key differences in maternal care. Unlike in the U.S., where labor, delivery, and recovery happen in one versatile room (LDR), here the stages are separated — prenatal, postpartum, labor rooms, and the OR. While this system works, it comes with risks, particularly when a woman has to be rushed while crowning, potentially increasing the chance of complications such as postpartum hemorrhaging or vaginal tears. Versatile birthing beds and integrated spaces could make a big difference, yet implementing them is a whole other story.

At Hospital Juan Pablo Pina, we met a baby from the KMC program who had to be readmitted for intestinal parasites. Doctors suspected that poor hygiene at home was the cause. It was a sobering moment. How do you care for patients when the root of the problem is not medical, but structural? Dra. Floren once told me about a time when many babies were brought in with black lines on their gums, which turned out to be a sign of lead poisoning. The issue became so widespread that international organizations had to step in to help. Stories like these are a powerful reminder that good health isn’t only about medicine. It also depends on clean water, fresh air, safe housing, and public awareness. Every part matters.

 

Thursday brought an entirely different kind of experience that I will truly never forget. I observed several hysterectomies, one of which was performed by a team of incredible physicians, including Dr. Jimenez, Dra. Paulino, Dr. Libert, and Dr. Suriel. Watching a laparoscopic assisted vaginal hysterectomy (LAVH) unfold in real time was surreal. One person manned the camera, two others worked with precision instruments, and another used a manipulator to position the uterus — all while the anesthesiologist monitored vitals and nurses kept instruments sterile. That was truly the embodiment of teamwork. The whole procedure, lasting nearly four hours, was a lesson in coordination, endurance, and focus.

This week has touched me deeply. Dra. Floren’s unwavering commitment, the clinicians’ thoughtful feedback, the welcoming communities will all stay with me. It’s also made me feel hopeful about the potential impact of our models and inspired to keep improving them.

Some random fun things: we started cafe hopping, which is something I wish we’d done sooner! It has been a refreshing change of environment for working. As well, I’ve been in search for a guanabana, and one of the doctors from Jaime Mota, Dra. Martinez, gave me one from her neighbors backyard. So good!!!

Thanks for reading!!

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This week has been incredibly informative and exciting. From Sunday through Wednesday, we visited multiple hospitals in the southwest region of the Dominican Republic with Dr. Floren, the president of the Dominican Foundation of Mothers and Infants (DOFMI). We observed firsthand the challenges and adaptations present in neonatal care. 

At Jaime Mota Hospital in Barahona, we spent quite a bit of time in the NICU, where we observed many of the incubators were visibly outdated, some over a decade old. We saw nurses compensate for broken incubators by taping cracked panels together. Unfortunately, tape traps bacteria and is difficult to clean. Dr. Floren recommended plastic wrap as a safer, low-cost alternative. Many incubators lacked working heating systems and temperature sensors, resulting in nurses relying on placing thermometers in the baby’s armpit to monitor temperature. This method does not allow for continuous monitoring and may delay detection of issues like hypothermia. In addition, thermal support is often provided by gooseneck lamps, which do not distribute heat evenly and pose risks if they fall or overheat.

We also noticed that IV solutions are mixed directly at counters in the NICU rather than in a pharmacy using sterile procedures. This is particularly concerning given the humid and salty coastal environment, which contributes to the rusting of equipment and contamination risks. Dr. Floren emphasized the need for laminar flow hoods and in-hospital pharmacies that can safely prepare IV fluids, something considered standard in higher-resource settings.

One room in the NICU was used as an “equipment cemetery,” filled with broken or unused devices, many of which had been donated from American manufacturers. While these donations are well-intentioned, they often create problems when the devices require specialized parts or training to operate and maintain. For example, one machine had been donated from the US but could only be used with tubing sold by the original company, which isn’t accessible locally. Witnessing this made it very clear to me the importance for solutions to be designed with sustainability and local supply chains in mind.

Despite the challenges, I was deeply moved by the ingenuity of local staff. Wheelchairs made with bicycle wheels, thermal care using gooseneck lamps, and a strong emphasis on kangaroo care demonstrated their commitment to doing the best with what they have.

There was also a surreal moment when entering the NICU: I saw the Pumani bubble CPAP, developed by Rice undergrads, being used here. To think that student innovation could become a standard part of care around the world and save lives was incredibly inspiring. 

At Centro de Diagnóstico y Atención Primaria in Neyba, the facilities were more modern, with better air circulation and infrastructure. Still, we observed similar issues: taped oxygen hoods that don’t allow for accurate oxygen concentration monitoring, IV mixing in open areas, and limited temperature warming/regulation for newborns. Despite these limitations, kangaroo care is well-practiced, and there is clear motivation among staff to improve outcomes with the tools available.

We also visited Hospital Regional Juan Pablo Pina in San Cristobal, where several cases highlighted the clinical complexity of newborn care. One baby born to a diabetic mother was significantly larger than average and required monitoring for hypoglycemia. Others were being treated for jaundice with phototherapy, which is common in preemies due to underdeveloped livers. We also saw a baby with Down syndrome and multiple congenital anomalies such as cleft lip and atrioventricular canal defect, which made feeding especially difficult.

Throughout all six hospitals we’ve visited over the last month of being in the Dominican Republic, a consistent pattern has emerged: outdated incubators, broken heating systems and sensors, unreliable monitors, and makeshift thermal care using gooseneck lamps. These issues are systemic and widespread. It’s clear that if improvements are made in one hospital, they could be replicated across the country’s public healthcare system.

At the kangaroo care clinic at Jaime Mota Hospital, I spoke with Dr. Martinez, a pediatrician running the clinic. She explained to me that since preemies often aren’t strong enough to breastfeed, as the act of sucking requires a significant amount of energy. As a result, they’re fed using syringes. This contrasts with practices in the U.S., where preemies are often fed through a syringe and feeding tube directly into the stomach to conserve energy and ensure adequate nutrition.

Another key difference is the duration of hospital care. In the US, preemies stay in the NICU until they are ready to breastfeed. But here, hospitals discharge preemies earlier due to capacity constraints. This means that mothers continue feeding their babies at home using syringes. The issue is however that mothers are reusing disposable syringes, even though they aren’t intended to be reused. Their designs have ridges and internal scaffolding that are difficult to clean and can harbor bacteria, leading to gastrointestinal infections in the babies. 

Dr. Martinez proposed I create a solution to this problem by developing a reusable syringe that could be sterilized by boiling, addressing the limitations of existing disposable and hard-to-clean models. She believes this simple innovation could save lives, not only in the Dominican Republic but also in other low-resource settings where syringe feeding is common and the risk of infection is high. I’m excited about the potential of this project and the impact it could have. 

Later in the week on Friday, we joined Dr. Floren as she met with the Dominican Republic’s Minister of Health to discuss ongoing public health initiatives, including plans to open health centers that will expand access to maternal and newborn screening. One key concern is maternal anemia, present in over 60% of women at delivery. This increases the risk of postpartum hemorrhage, especially since anemia reduces the body’s ability to form strong clots.  DOFMI seeks to raise awareness, ensuring that mothers are identified early for anemia. They want to educate women around the country so that they can be identified for anemia earlier than later, so that by the time they deliver none of these issues will be present.

We also toured Acromax, a local pharmaceutical company working on a more affordable version of Hydroxyurea, a medication used to manage sickle cell disease. With about 10% of the population carrying the sickle cell gene, early diagnosis and affordable treatment could have a significant national impact. DOFMI is working with Acromax and the government to develop newborn screening programs that are expected to roll out in November of this year. This is incredibly important and the potential for impact is immense.

This week offered a closer look at how infrastructure limitations and supply chain barriers affect care delivery. It has also allowed me to learn from the people themselves. I greatly admire Dr. Floren’s ability to treat everyone with humanity, compassion, and respect, characteristics that make her so effective in her work. Leaders like her are exactly the kind who can drive an initiative like DOFMI forward. She builds trust and creates the kind of connection that inspires real change, as evidenced by the impact she’s already made across the country. 

In addition, the doctors and nurses we met demonstrated remarkable adaptability and a strong willingness to embrace new tools and drive change. Their resourcefulness was impressive, particularly evident in the kangaroo care practices we observed at every hospital. Despite limited resources, these healthcare workers do an incredible job saving infant lives, and the deep trust between them and the mothers clearly reflects this.

 

These are some photos we took over the trip!

Hello again!

It’s kind of wild to realize we’ve already been in the Dominican Republic for a month now. Time really does fly when you’re fully immersed in meaningful work and constantly learning in a new place.

This week was one of my favorites so far! It was packed with experiences that challenged me, moved me, and reaffirmed my interest in gynecology and maternal-child health.

Early in the week, we had an in-depth discussion about the Kangaroo Mother Care (KMC) project we’re contributing to. George Suazo visited to present the scope of the work: developing a low-cost alternative to the gooseneck lamps currently used in NICUs to warm premature babies, and designing sensors that could be placed on infants in kangaroo care to monitor vital signs. These sensors would help generate clinical data to support the efficacy of skin-to-skin care.

We had already visited the Kangaroo Clinic at Los Mina the previous week, where we observed about 10 consultations under the guidance of Dr. Guillermina Nadal. Seeing KMC in action really helped us understand the value of the method. Most of the babies were stable and benefited greatly from the warmth and regulation skin-to-skin contact provides. Since I’m NREMT certified, Dr. Nadal even let me take vitals, including bpm and lung auscultations, which was incredibly rewarding. Some babies were underweight, some had genetic or neurological conditions like Edward’s syndrome, and each had their own unique challenges. I was very astonished by how small some of these babies were, as she told me they were all the same age, but their development was an issue.

The visit to the NICU also brought up some critical insights. Many incubators lacked proper heating regulation and instead relied on gooseneck lamps, which sometimes led to burns due to fragile neonatal skin. On top of that, humidity regulation was missing, and only the most critical babies were hooked up to vital-sign monitors. These conditions really shaped how I interpreted George’s presentation and highlighted the urgent need for both thermal regulation and accessible vitals monitoring, especially for premature babies in both stable and critical conditions.

A major takeaway from this week was realizing that we could possibly be designing for two very different neonatal audiences:

1. Stable premature babies—these infants benefit most from kangaroo care and shouldn’t be placed on warming beds unless necessary.

2. Critical premature babies—these require intervention in NICUs, whether for jaundice treatment, ventilation, or monitoring. They can’t stay in skin-to-skin contact for long stretches and thus need a reliable thermal crib setup, ideally with vital monitoring sensors as well.

However, since we don’t have much time left, we want to figure out which is more of a priority.

On Thursday, we discussed our project plan with Dr. Emin Rivera. While we came up with a few great ideas, we also agreed that we needed to talk to more clinicians and nurses to really sharpen our needs statement. The upcoming trip to Barahona with Dr. Floren will help us do just that, and we are excited to practice some need-finding skills and ask all the right questions to pediatricians (the most difficult part!).

The highlight of the week for me was shadowing OBGYNs in the obstetric ward at Los Minas on Tuesday and Saturday.

I had the honor of working with Dr. Rosa, a second-year resident, who explained each prenatal patient’s condition during rounds. I met patients in early labor, those requiring C-sections, and others with high-risk conditions like preeclampsia.

Preeclampsia is a complication of pregnancy involving high blood pressure and signs of organ damage. One patient I observed had a catheter inserted, which helped monitor her urine; a darker color could indicate HELLP syndrome, a dangerous progression of preeclampsia. Due to systemic inequities, many patients at Los Minas arrive without having received any prenatal care, making these complications more common and severe. For these cases, babies are delivered pre-term in order to save more lives.

I witnessed three births: one vaginal and two C-sections. Watching the medical team manage each step of the delivery, from using Doppler ultrasounds to track fetal heart rates to performing an amniotomy with a syringe instead of a specialized amnihook (due to resource limitations), was incredibly eye-opening. I even learned how the placenta is removed and how physicians carefully stitch vaginal tears after childbirth. Dr. Solano Turbi, the chief resident, took the time to walk me through the C-section procedures, including each layer of incision and the cauterizing tools used. Truly unforgettable.

Something that I noticed at this ward was the fact that they walked patients who were about to give birth to the OR. These patients almost tripped and fell multiple times. I asked one of the residents about this, and he told me how he disliked how they do it here. He believes that walking these patients over results in the frequency of vaginal tears here. I’ve been trying to brainstorm an alternative to walking patients over to the OR; however, the hallways are pretty narrow and bringing over the whole bed would be inconvenient. This is definitely a problem I want to explore in different hospitals.

Other than that, I couldn’t believe they had 50 births scheduled that day; it was a hectic but amazing environment to learn in. I fully plan to return to this hospital to continue learning and maybe even get feedback on our prototype.

As the week wrapped up, we focused on refining our approach to the KMC project. We now clearly understand that:

• Babies stable enough for kangaroo care should stay with the mother and do not need a thermal crib.

• Babies who require NICU interventions must have a reliable thermal environment and do need vitals sensors to guide care.

• Both groups would benefit from affordable, non-invasive sensors to monitor vital signs.

We’re heading to Barahona soon, where Dr. Floren will also be distributing Dream Warmers—a portable, non-electric warming solution developed by Boston Children’s Hospital. I’m really excited to see how these are received and to learn more from the pediatricians and nurses working in those facilities.

Now moving on to some quick excursion updates!  Went to Soana Island last Sunday! SO surreal! Fun fact: Pirates of the Caribbean: The Curse of the Black Pearl was filmed there. I also tried quenepas for the first time—they brought back memories of similar fruits I’ve had in Thailand. Definitely a nostalgic (and delicious) moment!

Thanks for tuning in again this week!

Writing these entries reminds me how lucky I am to be here. I came in loving gynecology, and each week I get to experience it firsthand, I leave more sure that I’ve found something I’m truly passionate about.

Until next time,

-Valerie

(P.S. here are some long-awaited photos of the first time I tested my model at Los Minas!)

This week has been nothing short of incredible. From walking through centuries of history in the colonial zone to examining NICUs, I felt like I was straddling two worlds—one foot in the past, one charging toward the future of medicine.

We started off by visiting Nuestra Señora de la Altagracia University Maternity Hospital, the largest maternity hospital in Santo Domingo. Accompanied by Dr. Angelica Floren, a pediatrician and president of DOFMI, and her colleague from the University of Zaragoza (a microbiologist specializing in infectious disease), we attended a presentation on neonatal sepsis and hospital-acquired infections. He emphasized not just early detection but also the critical importance of cleanliness in clinical settings, something that, honestly, feels like such a basic concept but is too often overlooked in resource-constrained environments.

Later, we were introduced to three biomedical engineers from Comen, a company that develops neonatal incubators and other medical equipment. I was fascinated watching them at work: observing, photographing, and analyzing every inch of the NICU setup. They weren’t just there to pitch products. One of the engineers told us, “I’m not a salesman, I’m here to help hospitals improve their care.” That stuck with me. It was inspiring to witness someone so committed to making technology work for people, not just selling it to them. That’s the kind of biomedical practice I want to be part of.

 

On Friday, we visited Los Mina Maternity Hospital, the second largest in the city, known for taking in overflow cases from other facilities. Dr. Floren and her colleague introduced us to the hospital director, Dr. Armando Cemejo Cepada, an OBGYN. The facilities were clean and clearly improving, especially compared to years ago from what Dr. Floren mentioned. We toured their obstetrics unit, NICU, and microbiology lab, where I got to see the BacT/ALERT system in action, a machine donated by CHOP (Children’s Hospital of Philadelphia) that detects bacterial growth in blood cultures. It’s been a while since I’ve seen biotech like this in a clinical setting, and it was very interesting to learn about these machines once again.

 

But the absolute highlight of the week? Presenting my cervical and endometrial biopsy training models to a group of gynecology residents. It felt surreal to share a project we’ve poured so much time and heart into. When we brought out the models, the residents lit up. They immediately started matching cervical abnormalities to the correct sliders, and several tried taking biopsies themselves. Seeing their reactions was so rewarding, as they told me it felt very accurate. I also gained very insightful information during this time. They told me that they performed cervical biopsies around 4 to 5 times a week; however, they mainly perform LEEP, loop electrosurgical excision procedures. This was a procedure that I very much want to add to the LUCIA, and I am excited to get started on that. I’ve done some research on the procedure, and I was curious if there was a need for an alternative to electrosurgical generators. These generators are used to heat up the instrument that is used to cauterize the cervix tissue during the biopsy, and I did not know if med schools could afford to buy extra just for training. I got mixed answers from the residents, but I plan to dive deeper into this need. They also told me that they performed endometrial biopsies more often than cervical biopsies. This matched up with some prior research I had done, where there has been a sudden trend in risk for uterine cancer in Dominican women. This truly showed the need for such a training model.

They also shared how, during their own medical training, they used old models or even fruits to practice procedures. There was no proper training model they were actually using in medical schools, despite how common cervical and endometrial screenings have recently become. I gave them surveys to gather feedback, and they even invited us back to shadow them in surgery and delivery rooms and to continue refining the model together. We are very excited to begin working with these residents, and I am truly honored by their offer!

One conversation really stayed with me: a resident told me how early teen pregnancies and rising obesity rates are leading to more cases of endometrial cancer here in the Dominican Republic. Many teen mothers suffer from severe hypertension, and premature births are common. Seeing such tiny babies in the NICUs was heartbreaking—but also deeply motivating. These hospitals are doing everything they can to save these little lives, and with the help of advanced equipment and passionate clinicians, we are making progress. Even small changes, like replacing tape with clean plastic wrap to reduce contamination, can make a difference.

Outside of the hospitals, we made sure to explore a bit of the country too last weekend. We visited the Colonial Zone, the oldest European settlement in the Americas, and walked the cobblestone streets lined with history. At the Christopher Columbus Lighthouse, I stood in awe of its sheer size (it was HUGE). We also relaxed at Boca Chica, where we met a very sweet local boy who proudly offered to teach us how to swim (definitely a memory I’ll always carry with me).

 

 

On the technical side of things, I’ve been developing the endometrial biopsy training model further. We’re now prototyping with an infrared sensor with an LED to detect proximity to the uterine wall—goodbye Eddy current, hello precision! It runs on an Arduino board, and I’ve been diving into the code to get it just right. It’s been fun flexing my engineering muscles again. I’m also redesigning the LEEP component of the cervical model in CAD, aiming to improve on what LUCIA didn’t quite perfect. My current focus is creating a better cervix holder that can withstand repeated procedures and give more realistic feedback.

This week reaffirmed everything I’ve ever felt about wanting to be an OBGYN. Being here, learning from these doctors, engineers, and residents—it’s a dream come true. I feel inspired, humbled, and ready to keep pushing our projects forward to provide quality care to everyone, no matter where they are from.

Thanks for following along. Until next week!

– Valerie <3

p.s. I’m waiting on a bunch of awesome photos that were taken by their photographer, so brace yourselves 😉