When it comes to strength in numbers, Engineering World Health does not immediately strike one as a force to be reckoned with. Yet, what this student organization lacks in size, it makes up for in motivation, ingenuity, and passion for its cause. The diverse group consists of engineering students from different disciplines and backgrounds, but they share a common purpose: improving global health by implementing simple medical technologies in developing nations.
For these students, the student organization Engineering World Health (EWH) provides opportunities to work on identified health needs, as well as a support system for implementing their own design projects on a global level. “We basically consist of self-starters who are interested in working on a variety of different global health-related projects,” explains Dr. Amit Nimunkar, the organization’s current faculty advisor. “Each student is working on their own project, but together, our goal is to uphold the Wisconsin Idea – the principle that UW-Madison, or the Wisconsin system, should work to improve people’s lives beyond the classroom.”
The UW-Madison chapter of EWH is fairly young – it has been conducting weekly meetings in the Engineering Centers Building only since 2006, when the organization was founded by a group of biomedical engineering students. These students included Nimunkar, who was then working on his PhD. Although membership typically hangs around only 10-15 students, the ideas and discussions that develop in the meeting room are immense. “We expose students to global health issues, but we encourage them to think of local solutions, solutions which are relevant to the environment in which those issues occur,” says Nimunkar, which, he explains, helps to concentrate the group’s efforts, rather than confronting head-on the colossal wall of problems that are categorized as “global health issues.” With this perspective in mind, members of EWH focus on health issues specific to individual communities and begin to develop designs for devices and systems that will address those needs.
One of the communities fortunate enough to be receiving aid from EWH is the city of Olanchito, Honduras. In January of 2013, the city’s lack of a water fluoridation system was brought to the attention of sophomores Graham Michaels and Emily Carroll. Despite having almost no prior knowledge on the subject, the two dove into the project without hesitation. “The ratio of dentists to citizens in Honduras is ridiculously low,” says Carroll. “Especially in rural areas, there is almost no dental care available at all.” Installing a water fluoridation system would go a long way toward improving dental health for the 60,000 plus citizens of Olanchito. Although this community is the current focus of the project, the engineering students have their sights set even higher. “It is obviously still in its early stages, but I think our long-term goal is to make it a satellite project that could eventually be mimicked by communities all across Honduras,” says Michaels. “The idea is that it will be a self-sustaining system funded by the municipal government once it is implemented.”
Most of the work that Carroll and Michaels have completed so far has consisted of research and outreach to onsite contacts, but now the two are itching to travel to their project location in order to evaluate the situation in Olanchito and transition into the design phase. “If we were doing the project here, we would know what the next steps would be. But we need to go to Olanchito to determine what their next steps would be in a different culture,” says Carroll. “We are hoping to travel there this coming January.” Both students are very excited about their project. “It is a cool way to help people out that is also meaningful on a large scale,” says Michaels.
Indeed, EWH members do not seem to have a small-scale mindset. Another design team made up of biomedical engineering students Caleb Durante, Drew Birrenkott, and Brad Wendorff is hard at work developing a design for a medical device which, if all goes as planned, could help to save the lives of thousands. The roots of their project, the Infant Cardio Respiratory (CaRe) Monitor, can be traced back to 2011, when Durante and Birrenkott chose to create a device to address an EWH prompt for their BME design program.
“The prompt was to build a respiratory/apnea monitor for use in the developing world because of the high incidence of sudden infant death syndrome and apnea (abrupt cessation of breathing) related deaths,” recalls Durante. “This was a response to one of the United Nations’ Millennium Development Goals to reduce the under-five child mortality rate by two thirds between 1990 and 2015.” In 2011, the world’s under-five mortality rate was 87 deaths per 1000 births, and the neonatal mortality rate was 32 deaths per 1000 births. In many developing nations, these numbers were over twice as high. Of these deaths, 22 percent were attributed to asphyxia (severe deficiency of oxygen in the body) and 26 percent to preterm birth complications such as underdevelopment of the heart and lungs. “We believe that this 48 percent would be easily preventable with the CaRe Monitor,” says Durante.
Judging by appearance alone, it is hard to believe that the Infant CaRe Monitor could achieve such a lofty goal. Though it consists of nothing more than an elastic band with rubber electrodes and the small rectangular monitoring device itself, the simple exterior of the CaRe Monitor belies its inner complexity. When in use, the band wraps around the infant’s chest and passes a high-frequency electric signal through the torso, which returns to the monitor overlaid with the wave functions of the body’s breathing cycle and heart rhythm. “What we have programmed it to do is to compare that to the previous twenty to thirty seconds of data, and if it changes, we know we have an issue,” explains Birrenkott. “If the infant’s breathing flatlines for more than 18.5 seconds, an alarm goes off, and if the heartbeat does the same thing, the same alarm goes off. Then the caretaker knows to check up on the child.”
The team’s ultimate goal is to have their device mass-produced for use in developing nations. This summer, Nimunkar took the prototype overseas to discuss the design with potential client GR Medi Corp, a medical technology manufacturer in India. “The client made some suggestions towards making it more manufacturable but is interested in actually receiving the designs for this project and producing them,” says Durante. He and his design team will spend this semester making these adjustments and refining their design. “After those iterations, it is going to be hardcore testing for technical validation. There are a lot of electrical safety guidelines that we have to abide by, and the whole idea of live subject testing is still up in the air,” comments Wendorff. If the client accepts their final design, the three students are hopeful that their success in India could propel their product even further afield to markets in many other countries.
The effects of EWH’s work are resonating around the world, but its members are making a difference closer to home as well. In the fall of 2012, EWH began collaborating with the Wisconsin Medical Project (WMP), a nonprofit organization here in Madison. “It’s a big warehouse maintained by retired doctors who acquire medical equipment from donating hospitals and send it off to many places, for example Cuba,” says EWH vice president Joshua Zent. Members go to the warehouse once or twice a week to try their hand at fixing any of the donated equipment that is broken or out-of-date. Everyone involved gains something from the experience, explains Zent. “Not only are we there trying to help, but we are also learning. You do not get to go play around with medical equipment just anywhere.”
This sort of work has been a major part of EWH’s operations for many years now and has also been the basis for some of the group’s past travel experiences. In 2011, Zent and three other students accompanied Nimunkar to Belize to perform equipment repairs in area clinics. Prior to that, in 2009 Nimunkar travelled to Mongolia to do similar work. Both found shocking conditions: clinics that did not have the expertise do something as simple as a few stitches and hospitals that would spontaneously lose power in the middle of an open heart surgery. For EWH, awareness of such low health standards is at once disheartening and motivating as their small group strives to make a difference against such a formidable foe.
“You have done something, and you can see the effects, but then you suddenly realize that there is so much left to be done,” says Nimunkar. “We have endless energy because there is an endless source of problems, and that’s the motivation for our organization; that’s the motivation for us as engineers to do what we were trained for.”