GSIF Blog Post #7 Rohan Ekambaram

I believe that overall, the presentation that my group gave to the judges had a lot of strong qualities, but as always there is room for improvement. One of the comments that most of the students and judges had for my group involved the fact that the people who answered questions were the same for every question. They thought that our group should have spread out who answered the questions to show the validity of the groups’s work. This is a valid comment on our group and we will work to improve this but it was also a conscious decision by the group to have these specific people answer the questions. The group members who answered the questions were long time members and had a lot more experience than the newer members both in the lab and in Sierra Leone. We decided it would be better for them to answer the questions because they have a much larger scope of the issues. Personally, I could improve my presentation skills a lot. I did not make as much eye contact with the crowd as I should have. I looked down a little too much and that took away from the message we were presenting. I also stuttered a little bit during my part of the presentation. This could have been solved by a simple flashcard or just putting in more time on practicing the exact words I would be saying. Another problem we had with our presentation was the lack of cultural information about the people of Sierra Leone. This is a much harder issue to tackle because it is such an enormous topic, it would take a lot of time to fully explain. My responses personally were not very strong. I did not answer any questions in the question portion of the presentation. I will personally have to work on this in order to increase my confidence in my knowledge of the information to answer questions. I also could have talked about the quality control portion of the presentation since that is the part of the project I am working on. I think we also could have improved our responses by having more specific numbers memorized. We also could have used the backup slides in our presentation more. There were some questions that would have been explained but we just answered the question instead. Another comment that some of the students had was that I did move around enough and that I stood still. This is just another problem that can be solved with confidence in the information. The problem I saw in our presentation that not many people commented on was the transitions for the slides. We had a clicker but no one really used it, and I think that is a simple problem to fix, but still is a noticeable problem.

The work that we will be performing in Sierra Leone will require IRB approval since we are working with human subjects. Although the work we are doing is noninvasive and has minimal risk for those involved we still need to gain approval for our work since we are trying to create a widely used screening device. Most of our approval has already been laid out since the project my team has been working on has been going on for a long time. The problems that might arise are something that needs to be lookinOne of the tougher things that we will have to deal with when it comes to IRB approval is the identifiable information. One of the harder things will be to track the progress of individuals since the identification process will be much harder without out formal identification. Private information will also pose a problem because there is a lack of privacy in a lot of the health care centers in Sierra Leone. There were stories told by the veterans of the project that some of the health care workers would often talk about a patients symptoms and problems out in open in the middle of the community health centers. Informed consent might also be a problem without a translator since there might be a large language barrier between us and the people who live in the more rural areas where english is spoken much less often.

The logic model of our project is very simple. We develop test strips that are easy to read, accessible to all, and cheap to buy. Afterwards, we have to develop quality control to make sure that each bottle stays viable. Then we have to solve the last mile distribution problem. The final indicator of whether or not our test strip has entered the market and is there to stay is a lowering of maternal death rate. This is a statistic that has to be measured over ten years in order to make sure the study is viable. The short term goal is to raise the number of diagnosis and treatments.

GSIF Post #6 Rohan Ekambaram

I have played music ever since I was young. I started playing the piano when I was 5 and the trombone when I was 12. I believe this creative outlet gave me the ability to think in more creative ways than the average engineer. Intertwining creativity and engineering solutions to problems would be a large part of my design process. I have also found that depriving yourself of resources when trying to solve a problem makes you more creative and can help find ingenious solutions. After you have found that solution, it is usually only a simple task of improving it with the resources. I learned this technique when I taught myself how to play chess. The way to get good with a certain piece is to play someone by only using that piece. Eventually you learn the strategies and begin to think about the smaller picture while never loosing focus on the grand scheme. I know it sounds like a process that does not work because why would anyone work with less resources than are available, but I have seen it do amazing things to some people.

The overarching point of the Ukweli project is to reduce the maternal mortality rate in Sierra Leone by making it easy for people to screen for urinary tract infections. UTI’s are also one of the largest contributors to spontaneous abortions and complications during birth. In the long term, the validation for our product will come from a reduced maternal mortality rate, but such a task is hard to measure in such a short period of time. In the short term, our project will be validated if there is an increase in screenings and referrals to the hospital. Although this does not directly correlate to our goal, it is a good indicator that our test strip is being used and that people are trusting it enough to go to a hospital if the results show positive. In order to validate our technology, we need to develop a system of quality control to show which strips have been affected too much by conditions like humidity, temperature and light. This is the part of the project I am focused on. I have found stickers that change color as these conditions change. I am beginning talks with the supplier in order to begin testing in order to determine if these are viable. Although I have only begun to research this thread, I believe this could be the cheapest option since many pharmaceutical companies in the US use a similar product when they ship vaccines. The usability of the device will be validated when are able to teach the community health workers (CHW’s) how to use the test strip. We designed the strip so that it could be used by people without an enormous amount of medical knowledge. If the CHW’s are able to properly screen and refer people who come to them with symptoms, then we will have succeeded in our goal. Our operational model is something that we have worked on for a while now. The next step in our operational model is to solve the last mile distribution problem. A goal of this project was to make the strips accessible to the more rural areas of Sierra Leone since those areas are much farther away from any hospital or practicing doctor. When we solve this last mile distribution problem we will validate our operational model.

Many people believe that when they volunteer they are educating those around them in the developing nation and I think this is wrong. I think when it come to engaging with communities, partners, and markets in Sierra Leone, they are the ones teaching us. In order to help them solve a problem we have to learn why that problem began and only they can teach us. The underlying cultural significance of something is not an easy thing to pick up. You have to listen to the people of the region and understand their point of view of the world in order to really help them. For example, when working with the communities, you do not want to change their ways just to mirror the US. They have their own culture and that should be respected. By listening to what the community has to say, you can learn a lot about the real problem and then use that to help them. Furthering this thought, I believe that open and honest communication is also extremely important and should be valued just as highly as respect.

GSIF Post #5 Rohan Ekambaram

Nature is an amazing mentor for some of the more complicated problems. Watching the video about biomimicry made me think about the correlations between my project and nature. One thing that immediately stood out is the stark difference in the number of complicated materials we as humans use compared to those used in nature. In the natural world there are only 5 polymers used to make everything, but in the human world we use 350 polymers, and most of it is turned into trash at the top of a landfill. The lesson behind this point is that the answer is not always a complicated one, it is often a simple one. This is not always the case but trying to simplify problems is definitely something that we could try.  Another example of how nature can be used as a model is the shark’s way of  keeping bacteria off its skin. The formation of its skin makes it impossible for bacteria to easily bind and cause infection. Instead of using a chemical solution to what is usually known as a chemical problem, the shark has a physical answer for a chemical problem. This just shows that sometimes you have to change the way that you go about solving a problem in order to solve it the most efficiently. It probably will not work too well in relation to my specific project but it is still a good idea to keep in mind moving forward. Finally, nature could also be used to test for humidity. As seen in the video about biomimicry, there is a bug that is able to retrieve water from fog by use of specially coated bumps on its back. This is an amazing evolutionary ability, but it could possibly have applications to my project. The test strips my group is working on cannot be exposed to a lot of humidity or it will show false results. We are looking for a cheap simple way to make sure that each bottle has a way of telling if it has been exposed to too much humidity. If we were able to design a sticker or a button that could trap water from the air at a specific humidity and change color then we could have quality control on every bottle of UTI test strips.

I think one of the most important of Life’s Principles is “Be Resource Efficient (Material and Energy)”. I think this is one of the most important lessons to humanity as a whole. We as people have become wasteful and inefficient with our material. We output dump trucks and dump trucks of trash everyday and we all act like it is just commonplace. We have become inefficient in using materials in every part of our daily lives and it is driving society to the edge of destruction. Because our inefficient use of materials, in about 30 years, the earth’s atmosphere will be past the point of no return unless we drastically change the way we live on this planet. I think this principle also applies to the project I am working on. We are not aiming to make a profit in our venture, we just want to make the people of Sierra Leone happier and healthier. In doing this, we are not able to mass manufacture these strips on our own and we have to look for outside funding. Being efficient with these funds and the materials we get with them is imperative to the success of this project.

I think integrating cradle to cradle would be a lot tougher in a project that involves a screening device since contamination is something that always has to be accounted for and we would have to find a way to use this kind of technique in Sierra Leone where resources are much more limited but I believe it could be done. I don’t know if we would be able to come full circle like the man in the video did with the yarn to carpet idea, but I think we could find a way to make our test strips better. If we could find a biodegradable material to make the strips from, people could use them after getting the results for fertilizing their gardens or something like that.

My friends have taught me many things over the years. The biggest thing they taught me was to enjoy myself and not just do what my parents tell me to do. I used to play the viola and absolutely hated it until one day I saw the trombone and wanted to pick it up. My parents did not want me to but after talking to my friends I realized that I should enjoy what I do and ever since then I have played the trombone. My friends also taught me about the real injustice given to those in the LGBTQ community, not just the publicized stuff. Many of my friends in high school came out and they would often tell me about the insults they received. The final thing my friends taught me about was unhealthy food.  My mother is a pediatrician and would often not let me and my brother eat unhealthy food so eating unhealthy food at a friends house was a novel concept when it first happened.

GSIF Post #4 Rohan Ekambaram

There are many stakeholders for our project of making UTI test strips for people in Sierra Leone. The most important stakeholder is the women of Sierra Leone and whoever else this strip helps. By increasing awareness and screening for UTI’s people are able to live happier and safer lives. Sierra Leone has one of the highest maternal mortality rates and these test strips aim to help lower that. If we can succeed in our efforts, then the women of Sierra Leone will live much healthier lives. Another stakeholder in our project are the Community Health Workers in Sierra Leone. These people work extremely hard to provide the best care they can with limited resources and training. Most Community Health Workers have not had education past a middle school level, and it is tough to provide good care without proper education. Our goal for them is to make an easy to use and easy to read diagnostic test strip so that they can provide better care for the people of their village. If we can make their job any easier, then we will have made a difference. Another stakeholder in our project is World Hope International. They are a national charity that does amazing work and they have people on the ground in Sierra Leone who work tirelessly in order to help the people around them. They have given their time, resources and money in order to further our cause. They give us a place to work while in Sierra Leone, help us visit different communities during our research, and provide us with a translator so we can further our work with the community. Their motivation to have stake in our venture is the same as ours, to help people lead better lives. Another stakeholder for our venture is Lehigh University. They have created a number of programs that do amazing work to improve the lives of others just like ours. They have invested money and resources by funding a lot of altruistic projects like our own in order to see results around the globe and bring recognition to the university. The final stakeholder in our project is the Ministry of Health in Sierra Leone. The Ministry of Health is the overarching governmental body that regulates the medical practices in Sierra Leone. It has tried in different ways to lower the maternal and infant mortality rate but it has proven to be a difficult task. Sierra Leone is not one of the wealthier countries in the world, and therefore does not have a lot of medical resources to allocate to more rural areas. With our test strips, more people who live farther away from the city can still have a chance of getting a semblance of a medical opinion from their Community Health Workers and other people employed in the medical field in rural areas.

Over the semester I plan to validate my project and increase my credibility. One way I can do this is by developing a leukocyte test that can withstand variations in humidity, temperature and sunlight. A current problem we have with the test strip is that it is sensitive to all three of these factors. In fact, if it is exposed too long to any of these conditions, the test begins to show false negatives. This is a troublesome problem since Sierra Leone has a rise in all of these factors compared to America. It also leads to problems because electricity is not an easy commodity to find as you go farther into the rural areas of Sierra Leone. This makes it tough to regulate the conditions the strips are being kept in and makes it harder to transport them. If we could develop a sturdier strip, then we would be able to distribute the strips much more easily. Another way of validation is to help educate the people of Sierra Leone about the problems with UTI’s. There is a large stigma about having UTI’s, but they are a common thing for everyone. One of the goals of our group is to create a radio program that will teach people about the dangers of UTI’s. If we could educate people about UTI’s and help diminish the stigma even slightly, then our project will have been validated. A way to increase my credibility would be to participate in writing one of the papers our group is trying to produce. There are many smart individuals on my team and if they help, I could educate myself enough in order to actually give ideas and thoughts towards a paper.

GSIF Post #2

Cultural issues are some of the hardest to understand when starting an international venture. The project of creating low cost UTI test strips for people in Sierra Leone has run into a couple of these problems. First of all, there is a large stigma against people with urinary tract infections in country. This makes it tough to educate people about them. It also means that it is hard to market the test strips when people are stigmatized for buying them. Another cultural problem is the reliance on traditional or alternative medicine. Many people will go to these kinds of doctors and not receive the proper treatment. The reliance on these types of alternative health practitioners is driving some people away from the real health clinics. The third cultural problem in Sierra Leone is the privacy that comes in the health clinics set up in the rural areas. In America, there are HIPAA laws that prevent any medical information being shared without your permission, but in Sierra Leone there are not these kinds of laws. This problem further affects the stigmatization of people with UTIs because even if people are brave enough to go to a clinic and get checked out, they do not always have the privacy they want.

I have not experienced most of these problems in America but while staying in India with family I observed some similar cultural issues. In India there is a large stigma against people with UTIs and I have seen people shamed for going to see the doctor for something like this. In some villages there is also a large reliance on alternative methods for curing diseases. I remember seeing just a hut that the town “doctor” worked in and the treatments that he gave out were a little questionable. One of the largest cultural issues in India is the caste system. Although it was outlawed, it is still very prevalent in society today, and it can affect the treatment you are given. If you are at the top then you can receive the best, but at the bottom, no one will treat you.

A cultural factor that could be used to market the UTI test strip is that most people using them do not have a high level education so we made the strip simple to use and read. Most of the people administering the tests are Community Health Workers (CHWs). Most of the time CHWs have not received more than a middle school education, so by making test strips simpler we can market to them more effectively than other strips. There is also a cultural practice in Sierra Leone that when you miss work to attend a class or something similar food or retribution will be provided. We could use this by partnering with a project also here at Lehigh that is working on making a low cost nutritional meal for malnourished children. Since most people who are going to attending these classes will be woman, and since culturally the women cook and feed the children, we could give out food and the nutritional meals to the mothers. By combining the cultural practice of giving food and women cooking we could get more people to come to our classes and learn about UTIs.

In Sierra Leone, the structure of the health care system is much different than here in America. Usually we have medical practices filled with doctors and nurses, but in Sierra Leone there are about 136 doctors for 6 million people. This has caused a rise in what is known has Community Health Officers (CHOs) and Community Health Workers (CHWs). These are less trained people who can screen and refer people but cannot diagnose diseases. It will also be different because nurses have variable training depending on how close they are to the urban areas. The farther out you go, the less training they usually have. This is much different from America where most nurses have the same amount of training in an area. The largest problem the African context presents is the language barrier. Thankfully we will have a translator when we are in country, but there are certain things that just can not be exactly translated.

There is also a large disparity between the resources available in America compared to the resources available in Sierra Leone. In America, electricity is easily accessible almost everywhere, but in Sierra Leone it is much harder to find in the more rural areas. Some people in Sierra Leone make money by charging others to charge their phone. Transportation is also a lot different in Sierra Leone. Less people have cars and there is not as much public transportation. This makes it much harder for people to make it to health clinics and information sessions. The clinics in more rural areas also do not have the same resources that a clinic in America would. Usually they only have the basic necessities.

Post #1

I enrolled in this course because  I have always been interested in the healthcare profession. As a kid I wanted to be a veterinarian, but after getting to college, I realized that this wasn’t my true passion. After moving on from this goal, I still wanted to work on something would help people and improve their lives. A friend of mine pointed me in the direction of the research opportunities at Lehigh and I was blown away by the amazing work that people have been doing and I just knew that I wanted to be apart of this impactful program. I also enrolled in this course because I love learning through a hands on experience. You can only learn so much in a classroom about what you intend to do after college, but getting real experience through research and field work sounded like an amazing opportunity. The final reason I took this course was because I wanted to be given actual responsibility in a project that matters. Over the summer I interned for a pharmaceutical company where all they had me do was input numbers into a database. Although this is an important part of pharmaceutical process, I did not feel like I was making any impact in the grand scheme of things.

I think this course will make me a better bioengineer because, as said above, it will give me real experience for what I plan on doing after college. I think it will also shine a lot of light on the more intricate parts of what happens in the bioengineering field. For the most part, classes about bioengineering at the sophomore level are very general and do not talk about the specifics of what goes into a project like this. I think it will be interesting to see what kind of work the nitty gritty details of this project will entail. It is also one of the few courses at Lehigh that shows students what working in the real world is like. Giving students the independence to succeed or fail on their own in this type of situation is not something that is seen too often. In most cases, the professors or professional researchers give students small tasks like filing papers but in this case we have a higher level of freedom, which is both exciting and a little scary.

The lack of glasses in third world countries like Kenya is a hard problem to fix. There are a few charities that have set out to fix this problem. I found one that is addressing this problem called Eyes on Africa. Eyes on Africa, founded in 2005, is a non-profit organization that provides glasses at no cost to people in Africa with no access to eye-care specialists or products. In order to decrease cost, Eyes on Africa partnered with a sunglasses company DIFF Eyewear. The company runs a promotion that every pair of sunglasses they sell, a free pair is given to Eyes on Africa. This partnership was a smart move by Eyes on Africa, because it allowed for larger production and better distribution facilities. Since there are already many charities like this, I think the focus shouldn’t be on creating a new system from the ground up, but improving the cost effectiveness of what is already in place. If cost could be brought down enough, then more people could be helped, especially because the money saved could be put towards distribution and expansion.

I think this idea can be slightly improved upon in the way that the glasses are manufactured. I think it would be a lot easier to help out people in third world countries if the glasses were made to be easily fixed and repaired. When glasses are given away for free, it is hoped that they last for a while but that is not always the case. Sometimes they break or crack and nothing can be done about it. I think the glasses should be built so that anyone can easily replace each part of the pair of glasses. With the glasses we usually use, if something breaks you have to take your glasses to a repair shop or use a somewhat expensive tool kit to fix it. If every part of the glasses are easily replaceable, then the person who buys them could fix it themselves. It could also help with glasses that are broken during transport. I think reducing the cost of the system in place is the way to solve this problem.