Hello Again! It’s been a while since I last posted, but a lot has happened ~ so let’s begin :)) 

On Monday, June 24th, we accompanied Dr. Emin Rivera on a visit to Hospital Maternidad la Altagracia. During our visit, we met with Dr. Kathy Rodriguez, a neonatologist at the hospital, and toured one of the largest and most well-equipped NICUs we have encountered. However, similar to our previous visits to other hospitals, they also faced an issue with insufficient functional incubator beds capable of providing proper warmth to the babies and equipped with a temperature sensor for healthcare professionals to monitor. As a makeshift solution, many babies use the incubator beds but rely on heat supplied by a gooseneck lamp, which necessitates regular staff intervention to ensure adequate warmth for the babies.

Dr. Kathy Rodriguez emphasized several critical factors in the design of the incubator: height (distance from the warming lights to the bed), types of light bulbs used, temperature supply and regulation, humidity monitoring (if using a closed incubator system), and sides that can flip down completely, allowing easy access to the baby on the warming bed.

Dr. Rodriguez also provided feedback on DOFMI’s current prototype designed by Jhonson and suggested ways it can be modified to better fit their needs. While the mechanical design is still being improved, Dr. Rivera’s students will be working on the electrical systems for temperature and humidity supply/regulation concurrently this semester. We had the opportunity to listen to their preliminary ideas during their Microcontroller class on Wednesday, and it will be exciting to see the final incorporation with the new warming bed design; their systems diagram was a throwback to senior design hahaha. In the future, DOFMI plans to donate these new incubators to clinics around the DR that are facing a shortage of proper warming beds.

During our visits to different public hospitals in the DR, I could not help but wonder if there was a way to 1) categorize the type malfunctioning system(s) in the incubator + how it could be fixed 2) design a device/system that could be incorporated into the existing systems.This approach could potentially provide a way to repurpose the hospital’s incubators, addressing issues with individual components that may not be working. It was incredibly special to be a part of this process—both in hearing Dr. Rodriguez identify needs and in witnessing the innovative solutions healthcare professionals and students brainstormed to solve these problems.

Early on Wednesday, June 26th, we returned to Los Minas Hospital where our day began with morning rounds alongside Dr. Ravelo Soto, Chief Pediatric Surgeon, and his team of residents. During this visit, we had the opportunity to introduce No Mo’ Silo and learn about their current solution for gastroschisis: the ABS Silo bag. Invented by three doctors (Abello, Brito, and Svetliza) in Latin America, this polyethylene bag is partially folded around a circular feeding tube, sutured to the desired radius. Unlike No Mo’ Silo, the ABS Silo bag is designed for single use and does not utilize IV bags or oxygen tubing, with the former not commonly available in the hospital setting. This innovative design has been successfully used at Los Minas for a decade, demonstrating the hospital’s commitment to leveraging locally developed solutions to enhance patient outcomes.

To celebrate the conclusion of our first month, we decided to explore Hoyo Claro, a natural pool, and Punta Cana, following recommendations from our new friends. From the serene waters of Macao Beach to adventurous buggy rides and discovering Dominican coffee and chocolate, we cherished every moment. And just like that, our first four weeks here have come to an end—which is so hard to believe!

As we prepared for tropical storms related to Hurricane Beryl, my first week in July began with a meeting with Fausto, an electrical engineering student from UNAPEC. Since I had presented ScarStretch to him two weeks earlier, I wanted to delve deeper into alternative motor suggestions, code improvements, and features of the device he liked or disliked. We brainstormed ways to reduce the size of the controller and identified potential features that doctors here would find valuable. His feedback was immensely valuable, especially considering my non-electrical background, and I thoroughly enjoyed discussing my ideas with him. Next week, we look forward to visiting Dr. Kevin Eusebio at the burn unit in Robert Reid Children’s Hospital to demonstrate ScarStretch and gather his insights.

During the week, we finalized our internal Pumani Survey to assess the utility and functionality of Rice360’s Pumani bCPAP device at clinical sites across the country. By having a healthcare representative complete this survey at each hospital equipped with a Pumani, we aim to gain insight into its usage and familiarity in the Dominican Republic. After meeting with Dr. Floren, we are excited to begin disseminating the survey and initiating data collection next week.

On Thursday, July 4th, we visited Los Minas Hospital to shadow Dr. Colon, Chief Resident of Gynecology, who provided us with a tour of the NICU and delivery areas. During our visit, a neonatology resident explained that the two Pumanis in the NICU are not currently in use, and many staff members are unfamiliar with their operation. I plan to collaborate with George on converting the existing English pamphlet for the Pumani into a user-friendly guide with illustrations for unfamiliar users. Dr. Colon also introduced us to the stimulation room, where we learned about female anatomy and the techniques for conducting vaginal tests. This space is equipped with various models and equipment that residents can utilize to practice alongside their studies and rotations!

As we approach the final three weeks in the DR, I’m filled with the same excitement and curiosity as when I first arrived. It is not to say my internship has been different than what I expected, but rather unique in the best way possible. During my time here, I have been able to work on and learn about multiple projects, providing the opportunity to understand a wide range of needs and be part of the efforts to address them—something I could not have imagined. This experience has left me more open to change and eager to embrace new challenges in the future. In the coming weeks, I look forward to continuing to research and contribute to the different projects and adapt them to address the needs and settings of DR!! 

Until then,  

~Zoe 

Extra Photos: Over the weekend, we visited the Santo Domingo Zoo which had a free train that took us to the different enclosures.

Sunrises and Selfies are the words I would describe week 3, and you’ll soon see why :)) 

We began the week at Universidad APEC (UNAPEC), where we met Dr. Emin Rivera (Dean of Engineering) and Dr. Emma Kareline (Physics professor). During their presentation, we learned about the unique history of the university, various international collaborations, and the university’s research interests in addressing some of the Dominican Republic’s (DR) most pressing issues. These include water purification, renewable energy systems (some parts of the university are solar-powered), waste management, and sargassum—a type of large, brown seaweed that floats in clumps on ocean surfaces.

With the ideal temperature conditions of the Caribbean, sargassum poses a health risk and is recognized for causing major disruptions to the DR’s significant hotel and tourism sectors. Therefore, finding a way to monitor and clean up sargassum has become a pivotal point of research at the university and for the government. As someone unfamiliar with sargassum, learning about it and the projects undertaken by the university highlighted the importance of focusing on the needs and challenges specific to local settings. It reminded me that the DR, despite some of the similarities I see day-to-day, is still an island with different challenges than those of Texas, my home state.

Later in the day, we met with students from Cemprende: the Center for Entrepreneurship, Business Development, Innovation, and Technology Transfer at APEC University. Their bubbly energy was infectious as they presented what constitutes innovation, avenues to pursue entrepreneurship at UNAPEC, and thought-provoking questions that made us reflect on ourselves.

 

 

We finished the day by touring the different labs with Professor Carlos Hernandez. Each room was dedicated to a different subject, and it was fascinating to see the similarities between these labs and those at Rice. We’re looking forward to taking classes in these spaces in the coming weeks!

 

 

 

 

 

 

The next day, we met virtually with Dr. Floren at UNAPEC to discuss the background and specifications for neonatal warming beds with the professors. Our hospital visits and literature review highlighted the need for inexpensive and safe warming beds that can be readily manufactured and distributed to various hospitals’ delivery rooms. Key considerations discussed included the temperature sensor, type of material used, and the distance and type of lamp used. The current prototype draws inspiration from designs commonly found in high-income countries; however, its high cost is a significant barrier for many hospitals in the DR. While we are still in the initial background and brainstorming phase, it will be exciting to see where this project stands by the end of the summer.

We finished the evening by presenting our Rice360 projects (No Mo’ Silo and ScarStretch) to UNAPEC electrical engineering students. It was refreshing to talk with them and exchange ideas on ways to improve these projects. Since ScarStretch has many electrical components beyond my understanding, they provided helpful suggestions on potential motors, coding ideas, and overall design improvements I could try out this summer. We also learned about their semi-finalist Sargassum project! Despite only meeting them on Tuesday, the students’ warm welcome made it easy for us to connect. One of our new friends, Maryam, even took us to Santo Domingo’s Chinatown on Sunday—a community I would have never imagined to see this far away from home. 

 

 

 

 

 

 

 

From Wednesday to Friday, we journeyed with Teresa (Director of DOFMI and a former nurse) to the southern Dominican Republic, visiting Hospital Municipal De Polo, Hospital Jimani, and Hospital Provincial San Bartolome (Barahona, Neyba). With our home base in Barahona, where we enjoyed beautiful sunrises and sunsets, we started our days at 5:30 am, traveling to a new hospital each day. These early mornings and car rides were worth it when we arrived and participated in the training sessions for proper newborn care and resuscitation measures. As Dr. Colon and Dr. Floren emphasized the importance of the “Golden Minute” last week, these skills are critical for all nurses and doctors to know. Doctors and nurses like Teresa travel to different clinics across the DR to lead these full-day training sessions, drawing in healthcare professionals from surrounding areas to learn these life-saving skills. Using the NeoNatalie model, presentations, videos, and interactive demonstrations that simulated real-life scenarios, the 30+ daily participants gained a comprehensive understanding of how to resuscitate a neonate. Ansh, Anathea, and I were able to help facilitate the pre- and post-assessments and saw the impact of the training firsthand, with scores improving drastically afterward.

Photos from Wednesday at Hospital Municipal De Polo. Nurses and doctors were in the conference room and practiced with the NeoNatalie Models in small groups in the hallway. 

Photos from Thursday for Hospital Jimani at a community center & sunrise photos. Each table had their own NeoNatalie Model where they can follow the Doctor and Nurse leading the training. 

Extra Fun Photos: 

On our drive back from a clinic, we briefly stopped at a park known for their many iguanas. The ground was also filled with many fossils indicating the area was used underwater. The photo on the far right is of a solar charging station students at UNAPEC created.

Good Morning or Buen Día! What began as a chill week working at Casa Barista and Co, it quickly became one filled with many places to visit and observe.

On Tuesday, June 11, we met with George at the DOFMI storage facility, where he showed us the various equipment and resources that DOFMI donates to surrounding hospitals. This provided us with a greater understanding of DOFMI’s mission and work they have done. George highlighted the need for a low-cost, safe, and effective system to warm neonatal incubators and beds, a need we have observed in both the NICU and the delivery rooms at the hospital.

The current prototype utilizes non-medical grade light bulbs, which pose a risk of breaking over the baby. Additionally, the distance between the lights and the bed is too great to provide sufficient heat over time, and there is a lack of a temperature sensor to properly regulate and maintain the baby’s temperature. Later this summer, during our collaboration with Universidad APEC (UNAPEC), we will brainstorm and prototype ways to improve the current design with the hope that companies like Jhonson can produce and distribute the device.

The next day, we revisited San Lorenzo de los Mina Maternal Hospital and met Dr. Floren in person for the first time. She’s just as lively and passionate in person as she is on Zoom. We saw the Kangaroo Care room—the first of its kind in all of the Dominican Republic—where all babies under 2.5 kg are required to come for regular check-ups. This practice has helped reduce infant mortality and shorten mothers’ hospital stays at this facility. DOFMI has been working on expanding this practice to other hospitals!

One question that I was curious about from our last visit to this hospital was: What is the current treatment flow or standard of care a mother experiences when she’s about to go into delivery?

When I asked Dr. Floren, she walked us through the waiting room, where chairs are separated according to a mother’s trimester, and a nearby check-up room. Here, doctors and nurses conduct preliminary assessments of the mother, including blood tests and ultrasounds, all documented on paper. This is a critical step since many mothers come in during their last trimester or close to their due date without many health records on file at the hospital. After the initial assessment, mothers are transported to the second floor for the remainder of their stay.

Dr. Colon (OB/GYN) kindly offered to show us the delivery area of the hospital, where we witnessed both a C-section and a vaginal delivery. In these rooms, we learned about the “golden minute”—the first minute after birth, where resuscitation care and assessing the newborn’s health are crucial. It was here, along with many other sections of the hospital, that I saw the team of nurses and doctors, like Dr. Colon, seamlessly working together to provide a comfortable and safe delivery experience for the mother. Despite the challenges they faced, such as language barriers or equipment shortages like Doppler ultrasounds, they maintained a high level of commitment to their patients, full of care and empathy, which was admirable. 

The following day, we were joined by Dr. Floren, Teresa, George, and Mariana as we visited San Pedro Hospital. This hospital holds significant importance for DOFMI as it was where the Pumani device was first introduced in the Dominican Republic. They currently have three Pumani’s, but two of them will need to go through some technical repair before use again. Through demonstrations and lectures, hospital staff became familiar with how to use the device, and its success in reducing neonatal mortality has led to the Pumani being expanded to many other hospitals in the country.

In the afternoon, we visited potential maternity waiting home spaces that DOFMI wanted to establish. One option was a local church with a vacant two-story building consisting of individual rooms equipped with four or more beds and a bathroom. This community-centered area would provide a place where high-risk mothers could be cared for before being transported to the nearest hospital. Many mothers living in the surrounding Bateys would otherwise have to travel a long distance to reach a hospital. After visiting a Batey Clinic later on, it became clear that having a maternity waiting room would provide more resources and care to mothers during their last few weeks of pregnancy, ensuring a safer delivery.

From researching maternity waiting homes to now seeing DOFMI take proactive steps in creating the first maternity waiting home in the Dominican Republic, I am inspired by their dedication to improving maternal and neonatal health. At each step of their mission, they extend their generosity and warmth to others—listening to their stories and working alongside them to create solutions tailored to their needs, unafraid to try something new. As I continue this internship, I hope to deepen my understanding of the unique challenges faced by these communities, actively contribute to the development and implementation of impactful healthcare solutions, and build lasting relationships with the dedicated individuals involved in this transformative work.

~ Zoe

Hello again! From music videos playing in the car, ocean/mountain views from our apartment, and giant avocados—my first week in the Dominican Republic has brought me many warm welcomes and new experiences. 

In between the sprinkles of rain, our first couple of days centered on our conversations with Dr. Floren and Mr. George Suazo about the challenges many maternity hospitals in the Dominican Republic faced. Our zoom meetings ranged from the lack of fetal heart monitoring devices, clinical studies between mother’s fever and baby infection rates, kangaroo care, sterilization through laminar flow cabinets, breast pump suction, assessment of Pumani bCAP, warming beds for neonates, and current diagnosis and treatment for Jaundice. Our conversations bounced from one topic to the next, and after hours of literature review, Ansh, Anathea, and I finally visited our first hospital, San Lorenzo de los Mina Maternal Hospital, on Thursday, June 6.

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As we toured the three floors, I was struck by both the similarities and differences compared to hospitals in Houston. In the triage area on the first floor, there was a section dedicated to pediatrics consultation. Rather than having doctors move between patient rooms, a doctor and nurse would stay in one of the pediatric rooms in a hallway, and patients would come to them for their appointments.

During our time in the hospital, we also explored a simulation room with models and equipment that residents and fellows use for training. Dr. Jose Mordan explained how this room helps new residents become acquainted with cases they may commonly encounter. In an effort to build a greater knowledge base of recent research findings relevant to the hospital, the physicians also discussed Mina’s Data, a new platform providing easy access to research articles and case studies, which they will be launching next Friday!

On the top floor, we visited the NICU and PICU sections where we saw two Pumani bCPAP machines in use. During the tour, I learned how they currently keep the babies warm (using lamps), the organization of the rooms (preterms, at-risk of infection, etc.), sanitation practices, phototherapy lights to treat jaundice, and ways they strive to decrease infection. Doctors, nurses, mothers, and fathers all worked together for the health of the babies.

In preparation for our next hospital visit, one topic we researched heavily was Maternity Waiting Homes—a common solution in LMICs to provide obstetric services for high-risk mothers (severe anemia, hypertension, infections, etc.) in their last weeks of pregnancy. This low-cost method has decreased maternal mortality and improved neonatal health across many countries, with each waiting home tailored to its local setting. Dr. Floren highlighted how the Dominican Republic has invested in many clinics with proper equipment and nurses; however, there is a lack of a standardized system to 1) properly enroll mothers and 2) establish guidelines for better prenatal care used among these clinics.

Oftentimes, mothers who would benefit from the care of a waiting home face a language barrier (they mainly speak Creole) and do not trust these clinics for safety, privacy, or other reasons. As a result, finding ways to decrease these barriers and misconceptions as well as increase enrollment among girls of reproductive age could improve the usage and outcomes of these clinics.During our second week, Dr. Floren and George will bring us to three homes to observe and talk with some of the healthcare professionals!

Alas, when I was not busy researching on one of the projects, I was switching between 10 different tabs of places to explore Santo Domingo ~ ask my friends and they will tell you I’m a person with bucket lists!! And so our city adventures began! Just 20 minutes away from our apartment is the Zona Colonial, the first permanent establishment of the New World when Christopher Columbus arrived. Nicknamed the “Old City,” it is filled with historic landmarks and churches that we kept bumping into. We took a stroll from Columbus Park to Independence Park, seeing the shops that lined the roads, before making it to Calle Las Damas—the first street in Santo Domingo. We even got a glimpse of Fortaleza Ozama!

When Saturday came around, we explored Los Tres Ojos (Three Eyes) National Park, a limestone cave system with three different lakes or “eyes.” A fourth lake, open to the outside, can be accessed by a wooden boat, which we got to ride. Later, we spent the afternoon in Boca Chica, the nearest beach to Santo Domingo. The water was so clear and beautiful, making it a great swim and the perfect end to my first week in the Dominican Republic!

I’m looking forward to learning more this coming week :)) Thanks for reading!

~ Zoe