As I’ve mentioned before, one of the primary aims of the BTB internship is to demonstrate medical technologies that Rice students have designed specifically for low-resource settings. Since most of the design process takes place in Houston, it’s impossible to account for all of the constraints in low-resource settings.

A short example of just how important this on-the-ground feedback is: The Botswana-UPenn partnership has been doing a lot of work with telemedicine, the use of mobile telecommunications to provide medical care when an in-person consultation isn’t possible. It’s a really exciting field, especially here in Botswana, where there are very few physicians to care for a very spread-out population. One program provided community health care workers with tablets so that they could take and send pictures of patients to physicians, who could then remotely provide a diagnosis. In theory, the program seemed great, but it turned out that male community healthcare workers were much less likely to participate because the tablets would not fit int their pockets.

I have brought several BTB technologies to demonstrate with the hope of collecting this kind of constructive feedback. The first is the SAPHE Pad, which my senior design team has been working on throughout the year. The pad addresses the problem of postpartum hemorrhage, a condition that occurs in 14 million women each year and causes 140,000 deaths annually. One reason for this excessive toll is that the condition is very difficult diagnose; it’s hard to know whether a woman’s blood loss falls within the normal range or has reached dangerous levels. The SAPHE Pad solves this problem by guiding visual estimation of blood loss. The pad, which is placed under the woman during childbirth, is divided into squares that each absorb exactly 50 mL of blood. As the woman loses blood, these squares fill up one by one. The birth attendant then simply counts the number of squares that have become saturated in order to know how much blood the mother has lost. If the volume exceeds half a liter, then they know that she is hemorrhaging, and they can act to provide her the treatment that she needs.

 

I’ve also brought two other really exciting projects: the Invertabottle, a morphine dosing system, and the Dremofuge, a centrifuge based on a dremel. The Invertabottle assists with palliative care delivery by preventing morphine overdosing, a real concern for caregivers who are not literate or who lack the fine motor skills (due to arthritis, for example) necessary for using a syringe accurately. It’s also helpful for dosing in the dark (either at night or in places where there is no electricity) since morphine needs to be administered every four hours. The system consists of a bottle that is filled with morphine, a syringe that connects directly to the bottle, and dosing clips that limit the syringe’s capacity to the correct dose. The Dremofuge functions like a standard centrifuge that is used to separate blood, urine or feces in order to perform lab tests. The advantage of the Dremofuge over a standard benchtop centrifuge is that it is battery operated and relatively inexpensive–key characteristics for medical technologies in low-resource settings.

I began discussing these projects with my mentor, Dr. Ramogola-Masire, this week. Since her work focuses on cervical cancer, she wasn’t able to give specific suggestions regarding the devices. She did, however, express concern over the sterility of the SAPHE Pad. Our research back in Houston suggested that the pads did not need to be sterile, but that they should be manufactured in a clean environment. Because we hand-made all of our pads in the OEDK, our prototypes did not meet this standard. While this feedback was discouraging because it limits our ability to use the pads while I’m here, at least we know that this issue can be easily addressed once the pads are manufactured professionally.