Alvin Thomas '14

Alvin Thomas is a Chemistry Engingeering major from Skokie, IL. He used his Johnson Opportunity Grant to work at Engineering World Health in Rwanda.

We began with the simplest tests. Was the device plugged in? Did it turn on? If not, did the wall outlet deliver 220 Volts? If so, were the fuses intact? We methodically worked through a mental flowchart of every potential fault. The neonatal ward needed this infant incubator back as soon as possible to avoid doubling up their newly-born patients (a common practice since the supply of working incubators never seems to meet the demand).

The nurse that gave us the incubator complained that the power failure alarm would sound every time the incubator was switched on. Since we couldn't work with the high pitch alarm blaring, I opened up the incubator and disconnected the watchdog circuit. My partner Mason, a biomedical engineering student from Texas A&M, began tracing the circuit connectivity of the "live" wire. He didn't get very far. The on/off switch had a rusted pin that disrupted the circuit. We could not find a replacement switch in the chaotically arranged workshop, so we decided to have the ground wire bypass the switch. Then we moved the live wires connections to the newly liberated pair of the working pins. Some quick soldering, a thorough check of functionality, and the incubator was ready to return to the neonatal ward where a young premature infant waited for its warmth and safety.

Engineering World Health (EWH) gave me the opportunity to get my hands dirty (literally, more often than not). At W&L, our engineering program focuses on the theoretical analysis of engineering problems. In Rwanda, those theories were put to the test on machines that were not designed for frequent power outages, scarce access to clean water, or for the limited (often non-existent) access to disposables or spare parts that afflict many hospitals in developing nations. The job demanded high levels of creativity and determination. There were no cabinets full of spare capacitors, diodes, or resistors. If we failed to scrounge a component off another machine, then we had to make the three hour drive to Kigali and find it in the back markets. Every repair, whether simple or complex, meant better outcomes for the patients, and that was enough motivation to push through the barriers.

The EWH Summer Institute currently operates in three countries (Rwanda, Tanzania, and Nicaragua). The program creates a partnership between American-trained engineers and local technicians, engineers, and health care professionals. In Rwanda, we spent the first month of the program at the Integrated Polytechnic Regional Centre (IPRC) in the Kicukiro district of Kigali. At the IPRC, we had four weeks of intense language classes (French and Kinyarwanda) as well as lectures and labs on fixing medical equipment in developing countries. We applied our newly forged skills at the Centre Hospitalier Universitaire Kigali (CHUK) with local biomedical technicians.

As we slowly learned the tricks of the trade, we immersed ourselves in Rwandan culture. We lived with host families, went shopping in the local markets, and learned how to get around using public transportation. We crashed a birthday party for one of Rwanda's most popular pop artists, walked along a canopy bridge in the Nyungwe National Park, and snapped some shots of giraffes and hippos at the Akagera National Park. We also visited local and national memorials dedicated to the series of Rwandan genocides and heard stories of the most recent genocide during a visit to the Reconciliation Village where genocide perpetrators, victim's families, and former refugees live in peace and community. The people of that community earnestly work together and the vibrancy of their strength and the reality of their reconciliation fueled my desire to work diligently for a better future in Rwanda.

During the second month of the program, the student participants were divided into small groups and assigned to a hospital. My partner, Mason, and I were assigned to the Rubavu District Hospital. We spent the month in Rubavu working closely with the hospital's maintenance department. We completed digital inventories of all the equipment owned by the hospital and its ten surrounding community health clinics. We made design recommendations for an improved biomedical and mechanical workshop. Most importantly, we fixed as many medical devices as we could while generating ideas for a potential new device to meet the needs of Rwandan hospitals.

There was little regularity in our work - other than our daily arrival at 8AM. At first, the hospital had very low expectations of us since we were the first pair of EWH engineers to work at that hospital. Honestly, we barely knew our own potential. Trust builds slowly, and we found it hard to convince the hospital staff of our capabilities. That changed slowly as word of our successful repairs made their way around the hospital. It began with an anesthesia machine that broke down during the pre-operative set-up. We spent all day - skipping lunch - to get the machine working; its repair was as much of a surprise for us as it was for the surgical staff.

Beyond repairing medical devices, we sought to understand why the devices broke down in the first place. As confidence grew in our abilities, a greater variety of equipment found its way to the workshop; however, the variety of root problems did not increase accordingly. EWH began its mission after seeing the absurdly high rates of disrepair among donated medical equipment. Its original focus was to fix medical equipment, but then it transitioned into building local training programs - like the biomedical technician program at IPRC. Tied closely to this new mission is the promotion of medical device manufacturing in developing nations. As we made our repairs, Mason and I began to brainstorm. Ever repair we made gave us insight in how not to design a device for the developing world. We also collected qualitative data on hospital needs through interviews with doctors and nurses. In the end, we were able to generate the design concept for a device that can be used to calibrate various pieces of lab equipment.

I went to Rwanda to get hands-on experience as an engineer. Not surprisingly, I left with so much more. I realize now that I have a deep passion for international work, especially in the public health sphere. My summer in Rwanda was a time for important cultural and technical learning as well as self-reflection. I am deeply grateful to all the members of the W&L community that made my summer in EWH possible, and I am especially grateful for the funding I received from the Johnson Opportunity Grant, the Evans Endowment, and the Avis P. Waring Scholarship.