A Week of Gratitude, Growth, and Guanabanas – Week 5

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.

One of the OBGYNs performing an EMB with the model!

 

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.

One of the UNAPs we visited in Barahona.
The interior of the UNAP.

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.

Group picture with UCATEBA!!

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.

Dra. Martinez showing the nursing students how to perform the biopsy!

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.

A training model for the cervical visual exam I found at UCATEBA.

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.

Image shown by laproscopic camera in lower abdomen.
Here they are doing stitches via laproscopy. So amazing!

 

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.

Laproscopic assisted vaginal hysterectomy.
Here, they are removing a myoma from the uterus.

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!!

Amazing people all around.


Innovation and Inspiration in Barahona and Beyond: A Trip to the Southwestern Coast of The Dominican Republic

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.

Plastic wrap can be used as a more sanitary alternative to tape
Tape used to keep broken incubator panels together

 

Gooseneck lamps used to warm preemie babies in the crib

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.

Counter in the NICU where IV solutions are prepared

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.

Bike wheels used to make wheelchairs in Jaime Mota Hospital

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!

This photo was taken at Jaime Mota Hospital with the kangaroo mother care doctors and nurses and UCATEBA nursing students.
Photo taken with the director of Centro de Diagnóstico y Atención Primaria in Neyba
Delicious platter of fruit from Barahona…The papaya was so incredible!
View of the coast of Barahona. There was an alarming abundance of Sargassum (the brown is Sargassum!)

Ignited Passion – Week 4

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.

Me and Dr. Nadal!

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.

Scrubs on!!

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.

Here I am prepping the OB kit for delivery.

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.

Soana Island

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!

A new friend 😀

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!)

A Week Observing Maternal and Infant Care in Los Mina Hospital

This week, I had the privilege of observing maternal and neonatal care at Los Mina Hospital. We began this week in the kangaroo care unit, where I met Dr. Adalia De La Cruz and Dr. Guillermina Nadal. Kangaroo care involves placing premature babies skin-to-skin against the mother’s chest, promoting body warmth, reducing reflux and regurgitation, and promoting breastfeeding. These benefits stem from both a biological and emotional connection between the mother and child. Dr. Nadal explained that the increased breastfeeding seen with kangaroo care stems from the psychological impact of the mother’s physical contact with her baby. She acknowledged there may not be a specific scientific explanation for all of its benefits, instead describing it as “a gift from God.”

I also visited the breastfeeding support room, where nurses help mothers navigate feeding challenges without relying on technology. I learned about methods like using a suction syringe for inverted nipples and applying expressed breast milk to aid healing. They emphasized their reliance on manual methods, which they felt has worked well.

Still, this approach differs from what I’ve heard from Dr. Floren, President of the Dominican Foundation for Mothers and Infants, who expressed concern that many preterm infants may appear to feed adequately but still remain undernourished. In the U.S., babies typically aren’t put to the breast until they reach 1,700 grams and are monitored closely for weight gain. Here, the ability to suck is the main indicator for initiating breastfeeding. Dr. Floren emphasized that beyond survival, we need to ensure optimal nutrition to support neurological development. She believes in a more gradual, carefully tracked approach to feeding—introducing by mouth only when babies are ready, and verifying weight trends closely.

This contrast led me to reflect on many questions: Could babies be going home undernourished without the clinic realizing it? Is there a gap between maternal bonding and confidence and objective nutritional outcomes? And if so, how can we bridge this gap and maintain the strengths of the kangaroo care model while supporting optimal nutrition.

On Wednesday morning, we observed an ophthalmologist screening infants for Retinopathy of Prematurity (ROP). Using an indirect ophthalmoscope and handheld lens in a darkened room, she carefully examined the babies’ retinas for abnormal vessel growth. Mature eyes should have retinal vessels that start at the center of the retina and grow outward towards the edges (periphery). However, with preemie babies, they have an immature retina in which the vessels haven’t finished growing to the periphery. If the baby is exposed to too much oxygen while in the incubator, their vessel development

Me trying on the indirect ophthalmoscope

will be abnormal and can grow out of control. As the body tries to repair the abnormal vessels, scarring and contraction can occur, pulling on the retina and leading to retinal detachment, which can cause permanent blindness if untreated.

Laparoscopy Training Model

Afterward, we toured the labor and delivery unit with Dr. Valdez, a third-year OB/GYN resident. She showed us where mothers labor, deliver, and recover, as well as the area for post-abortion care and uterine biopsies. We also saw simulation models used for training residents in procedures such as laparoscopic surgery, which involves inserting a laparoscope, which is like a lighted camera, through the belly button and using surgical tools through a secondary incision. I’m hoping to observe these procedures, in addition to childbirth, in the coming weeks.

These experiences are also helping inform my work towards the infant breastfeeding monitor. Observing babies latch and watching the coordination of sucking, swallowing, and breathing in real time has been invaluable. It’s helped me better understand the nuances of breastfeeding and the challenges mothers and infants face.

Over these last several days, I’ve also noticed a striking difference from the US, which is the reliance on manual documentation. Everything from patient records to lab results is recorded with pen and paper in a book. While there’s interest in digitizing systems in the future, the current model reflects a workflow that has persisted for decades. Yet despite the lack of digital tools, the care provided was thorough and compassionate.

We ended Friday with a meeting between DOFMI and UNAPEC to discuss our collaboration. Our focus was on kangaroo care and the current use of heat lamps as substitutes for incubator lights, which are often unavailable in many hospitals across the Dominican Republic. While these lamps offer a source of warmth for premature babies, they carry potential safety concerns. We explored how integrating temperature, humidity, and oxygen saturation sensors could help monitor the babies’ environment more effectively and regulate the warmth being delivered. These sensors could guide proper lamp positioning to prevent overheating or underheating. We discussed how these same sensors could also be applied during kangaroo care to monitor the baby’s body temperature. These conversations have left me excited for what lies ahead.

Overall, this week deepened my appreciation for the resourcefulness and dedication of providers working with limited tools. It has reinforced how important it is to understand care in diverse settings and staying open to different approaches. While tools and protocols may vary, the goal remains the same: to care for each patient with dignity, safety, and compassion.

Here are some photos from last week’s tour of Los Mina Hospital, a cacao making workshop we attended over the weekend, and lunch with UNAPEC on Friday!

Inspiration All Around! – Week 2

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.

Just like in the image, they’ve been visited many hospitals to check how modern machines are working in these settings, as sometimes these machines are not used to the climate (humidity in this case). This hospital is doing these procedures perfectly! The only issue is when bacteria is detected, this information needs to be sent out rapidly to doctors so treatment can occur.

 

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.

Gynecology residents performing a biopsy on the model with a pipelle!

 

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).

Tres Ojos

 

Playa Guibia

 

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 😉

 



The Santo Domingo Debut!

Hello everybody, and welcome back to my blog!

This first week has been absolutely amazing!

Every morning we wake up to a view of the ocean, and our walk to campus is surrounded by vibrant trees. The UNAPEC campus is beautiful! I especially love how there are so many trees on campus, and the sunlight filters through them, making everything feel alive and colorful.

UNAPEC entrance

This week, we’ve been primarily based at UNAPEC, where we met the faculty and students. We’ve been paired with two amazing electrical engineering students, Darien and Ezeul, who are helping us implement electrical features into our medical training devices. They are absolutely brilliant, and we are learning so much from them! 

The team getting lunch at a local restaurant (tostones were so good)

For my project, we’re developing a sensor that alerts trainees if they’re about to penetrate the uterus — a serious complication that can happen during real procedures. Our clinical mentors told us that uterine perforation can sometimes lead to intestinal injury, so this is something we want to simulate and prevent during training.

We’re using something called the eddy current effect to detect proximity between the metal curette (the tool used for the biopsy) and a sensor. Essentially, when a conductor (like our metal tool) moves through a changing magnetic field, it induces circular electric currents (“eddy currents”) which, in turn, make the conductor slightly magnetic. We’re harnessing this effect so that when the curette gets too close to the sensor, it triggers a blinking light or a beeping sound that will notify trainees that they’ve gone too far in our model. 

Currently, we’re building the prototype with an Arduino, breadboard, and a wire coil that senses the tool’s movement. When it gets close enough, the light blinks. I’ve always wanted to get more comfortable with circuits and electrical engineering, so this has been an incredible opportunity to learn from Darien and Ezeul.

As well, to give everyone a feel for the procedure, I had the team try taking a “biopsy” from an orange using the curette. Clinicians told us that an orange’s pulp texture is surprisingly similar to that of the human endometrium, and they weren’t kidding. When my Rice team first tried it, we were shocked by how much it did feel like flesh (a bit unsettling, might I say). It’s hard to describe the texture until you feel it yourself, which made it very fun to see their reactions and descriptions. 

Now that the team understands the texture I’m aiming to recreate, I’m really looking forward to getting clinical feedback here and improving the realism of our silicone uterus model. We have silicon and access to a 3D printer, so I hope to make a new mold in the coming weeks! 

The first half of the week was packed with prototyping and Arduino work, but we also got a tour of UNAPEC’s engineering labs, and they had so many facilities! We’ve been spending a lot of time in their library and grabbing lunch at the cafeteria (which has delicious food at mind-blowingly affordable prices). Also, very important: there are campus cats! One of them, a yellow tabby, is named Cheese. Love, love, love. 

 

We also met Dr. George L. Suazo, who’s a doctor affiliated with DOFMI, and we got to show him our prototypes. He’ll be guiding us on hospital visits and bringing us to biomedical engineering conferences! Dylan and I are so excited. Our first hospital visit is on Tuesday, where we’ll meet Dr. Floren and begin gathering clinical feedback. I’m especially thrilled to see OB/GYNs test our prototype and hear their thoughts on its realism.

I also learned from George that cervical and uterine cancers are on the rise in the Dominican Republic, in part due to limited training for screening procedures. Early pregnancies in teenage girls are more common here, increasing their risk for these cancers. I’m looking forward to learn how they train for screening procedures and to tailor our model to better meet their needs.

After hours, we’ve been venturing into the city. We had dinner at Capuccino, which is famous for its desserts (yes, they lived up to the hype), and then tried El Lenazo, where I finally got to try mofongo (something I’ve been waiting to try), and it was absolutely delicious! The ambiance was beautiful, too.

El Lenazo

As someone who is half Puerto Rican, I’ve always felt somewhat disconnected from that part of my identity. Being here in the Dominican Republic, which shares so much culturally with Puerto Rico, has been surprisingly grounding. Hearing and speaking Spanish, picking up familiar slang from my dad’s side, and being surrounded by salsa and merengue bring back so many memories. Growing up, my dad always had music playing in the house, and now I find myself smiling every time I hear a song I recognize in a restaurant or on the street.

This week was mostly focused on prototyping, but this weekend we’re planning to explore more of the city. Our goal: visit the Colonial Zone and hopefully make it to a beach (as we must, obviously).

Also: birding update! So far, I’ve only seen the common pigeon… but I’m officially on the lookout for the elusive green today. Wish me luck T^T. 

I’m so excited for the weeks ahead — from hospital visits to new prototypes to exploring more of this beautiful country. Thank you for reading, and stay tuned for the next update! 🌞


~ Valerie







 









Just a Sneak Peek

Hello everyone!  

 

To whoever is reading this—welcome to my blog! 

This is just the beginning, and so much is in store for y’all, but first let’s start with some introductions—Hello! My name is Valerie Valentin, and I’m a rising sophomore from Lovett College majoring in Bioengineering with a minor in Global Health Technologies. My love for medicine started at a young age, and over time, it grew into a passion for innovative medical technology. This curiosity is what led me to take the introductory Global Health course at Rice, as I wanted to explore how medicine and technology intersect in a global context and the impact they have.

After exploring global health disparities and the process of needs assessment in underserved settings, I enrolled in Global Health Technologies 360, and, hands down, it was one of the best decisions I’ve made. Through that course, I had the most amazing opportunity to create an additional attachment for the LUCIA, Rice360’s Low-cost Universal Cervical Instructional Apparatus. This training model is used to teach healthcare trainees how to screen for cervical cancer, one of the most prevalent yet preventable cancers, especially in low- and middle-income countries (LMICs).

Together with my amazing team (huge shoutout to Lauren Walcott, Saumya Chauhan, Grace Haddad, and Jewel Moore-Young) and under the guidance of Dr. Jenny Karns-Plante and clinical mentors Dr. Mila Salcedo and Dr. Parisa Fallah, we formed Team Uterus Universal. Our goal? To tackle the rising burden of uterine cancer by designing a functional uterus and cervix attachment for LUCIA that would train users to perform endometrial biopsies, which is the current standard for uterine cancer screening.

Over one semester, I honed my CAD design skills, learned how to collaborate and communicate effectively in a team, and applied a global health lens to the engineering design process. The experience was truly meaningful, especially because of my deep-rooted passion for gynecology. It reminded me why I love the intersection of engineering and medicine so much, as well as for innovation. 

Now, I’m incredibly excited to take this passion abroad as a Rice360 Summer Intern in Santo Domingo, Dominican Republic!

This summer, I’ll be working with Dylan Yoon alongside UNAPEC and the Dominican Foundation for Mothers & Infants (DOFMI). One of our main projects will involve designing a sensor for the Kangaroo Mother Care system, which is a method used with premature infants where skin-to-skin contact between the baby and mother helps regulate the baby’s temperature, breathing, and overall health. Our role is to help develop a sensor that monitors vital signs and physiological responses during skin-to-skin contact, so clinicians can better understand and evaluate its benefits.

We’ll also be conducting needs assessments in local hospitals under the mentorship of Dr. George Suazo, identifying challenges mothers and newborns face during hospital stays. I’m really looking forward to contributing to solutions that can improve care experiences for both moms and babies!

I’m also very excited to have the chance to present my partner’s and my previous projects, receive direct feedback, and observe physicians interacting with our LUCIA uterus model! I’m especially thrilled to see how our prototype performs in a real-world context and to support Dylan as he evaluates his own project—a device that quantifies breastfeeding metrics by measuring pressure data.

My goal for this internship is to truly make the most of every opportunity that comes my way—whether it’s learning new skills in electronics, gaining crucial context for solutions designed for LMICs, helping others through needs finding, or observing how physicians stay calm and collected during critical and high-stress moments.

Beyond my interest in more technical aspects, I’m also very passionate about exploring different cultures and trying all sorts of new cuisines (I’m especially excited for the tostones!). I also want to fully immerse myself in Dominican culture—from practicing my Spanish to trying new foods and visiting local landmarks and cultural sites (suggestions always welcome!). I’m also an avid birder, so get ready for some wonderful bird photos in the upcoming blogs!

I know I’ll be stepping out of my comfort zone on this trip, as I’ve never been in a foreign country where I didn’t know anyone, but I’m genuinely excited to learn, grow, and embrace everything this summer has in store.

Here’s to designing for impact, learning from others, and making health more equitable one prototype at a time!

Thanks for following along! See you in the next blog 😀

– Valerie 💙

An Introduction to Myself – Dylan

Hi, welcome to my blog! My name is Dylan Yoon and I’m a rising sophomore majoring in Environmental Engineering. Over the past year, I’ve become passionate about global health technologies, which stems from my interest in studying water quality and treatment throughout high school. To me, both fields embody similar engineering principles of prioritizing the development of affordable and accessible technologies for low-resource communities. 

This interest had brought me to pursue a project in ENGI120 during my Freshman Fall semester where I worked on building a low-cost infant breastfeeding monitoring device. Breastfeeding is essential to infant health and survival; within the first six months of infant life, this form of nutritive feeding is the baby’s primary source of nourishment and ensures the proper intellectual development. Thus, it is imperative to ensure that babies are feeding properly.

We created a low-cost device that provides relevant and objective pressure data to quantify infant breastfeeding ability, while also providing an analytical interface that is highly accessible to parents. It’s designed to be worn comfortably around a mothers arm and can gather pressure data during breastfeeding, thereby helping to preserve the natural connection between the mother and her baby.

During this internship, one of my primary goals is to get feedback from physicians/clinicians in the hospital setting and incorporate their insights into improving the device. I mainly want to streamline the ease-of-use with our device, reduce construction time, and ensure data accuracy. I’m excited to collaborate with the electrical engineering program at UNAPEC and refine the device further.

I’m also looking forward to learning more about Valerie’s project and collaborating on our projects together. In addition, I look forward to the needs-finding process, both for my personal project and for future Rice360 projects. I’m excited to learn about the hospital system here and the healthcare system. I’m eager to explore the local hospital system, learn more about the healthcare landscape, and immerse myself in the rich culture here through food, language, and discovering the city.

Thanks for following along!

 

Clinical Insights and Needs Finding — Zoe

Welcome back! While our first month in the Dominican Republic focused on exploring the various projects and programs offered by DOFMI, July was largely shaped by clinical insights and needs assessments—introducing us to new aspects of the healthcare infrastructure in the Dominican Republic.

We began week six shadowing Dr. Jaisson Colon Bautista in the delivery room department at Los Minas Hospital. During each C-section delivery we observed, we witnessed the collaborative and supportive environment fostered by the doctors and nurses, ensuring a smooth delivery process for the mother. Dr. Colon, the Chief Resident of Gynecology, worked closely with other residents, guiding them through the delivery and offering words of encouragement. While this environment might be intimidating to many, the welcoming nature of the nurses, residents, and doctors created a reassuring experience for the mothers and everyone involved. As the mothers delivered their babies, nurses and residents stood by in case of emergency and used the opportunity to learn from one another. At the end of our shift, we learned how to perform the same stitches the surgeons did in the delivery room, focusing on correctly holding the forceps and suturing material to create the “knots.” It felt like learning how to play an instrument—training my fingers to master the unfamiliar forceps and navigate them efficiently. I ended up using more suturing material than necessary to complete a proper stitch, but I’ll get better next time!

Ansh demonstrating the suturing technique Dr. Colon taught us.

Later in the week, we visited Hospital Pediátrico Dr. Robert Reid Cabral—the largest pediatric hospital in Santo Domingo. While most of our time so far was spent in maternal hospitals, it was exciting to explore a facility dedicated to younger patients, with over 16 departments spread across multiple buildings. During conversations with Dr.Eusebio, we received valuable feedback on the design of both the controller and massage cuff for the ScarStretch device. 

This included suggestions to switch the material of the massage cuff to something more comfortable for the end user, while still maintaining a waterproof surface for easy sanitation between uses. They also recommended ways to decrease the size of both the controller and the massage cuff to better fit pediatric patients, as the current design is more suited for adults. This mirrored our earlier discussion with the UNAPEC team, where we explored options for reducing the size of the motor—currently the largest component in the controller—by considering more compact and powerful alternatives like a brushless motor. In addition to their feedback about switching to a battery-powered design for easy portability, they raised important questions about how to increase adherence to treatment (incentivizing multiple massages throughout the day) and how to improve the device’s flexibility and adaptability for scars located elsewhere on the body. They also expressed their appreciation for the silicone material and massage motion of the device. These are all invaluable insights that future teams can use to enhance the ScarStretch device!

When we weren’t in the hospital, we conducted statistical analysis on PUMANI data that DOFMI had collected over the past year and worked on our Los Minas observational report. This included compiling our needs assessment with complementary literature review to better understand the healthcare landscape in the Dominican Republic. One observation we made from the first week was the prevalent use of paper records over electronic health records. In fact, many first-year residents spend the initial months learning how to properly file paperwork. As someone accustomed to doctors using laptops in patient rooms to update my status and history, it was fascinating to see everything manually written in manila folders or held in blue clipboards as they were passed between rooms. 

On July 20th, we had the privilege of joining Dr. Colon for a 24-hour shift. For the first time, we accompanied Dr. Colon and the residents on their morning rounds, witnessing their kindness and patience as they addressed concerns and ensured each mother felt genuinely cared for. This sense of compassion and guidance was felt among all doctors and nurses, from the initial waiting room to delivery and postpartum care. We observed how Dr. Colon and the other healthcare staff supported each other with lighthearted jokes and encouragement, despite the long hours. During quieter moments, we had the chance to learn more about Dr. Colon’s medical journey and his commitment to his work. This is his final year as a resident at Los Minas Hospital, but he hopes to return during his fellowship. As an aspiring physician, hearing his story was both inspiring and reassuring of the path I will soon follow. Despite his deep commitment to patient care, he always made time for family, friends, and his passion for music. Staying overnight and being on call provided us with a deeper understanding of the dedication and expertise required in this specialty, as well as the flow of care mothers in the Dominican Republic receive. I’m immensely grateful to Dr. Colon for allowing us to shadow him, and for introducing us to the delicious Pica Pollo, a beloved Dominican dish!

Best,

Zoe

Goodbye photos with Teresa and George from DOFMI!

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

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