“I want to remind you all that these students are exactly the same as you. The only difference is the privilege you guys have grown up with. If they were here with you guys, you wouldn’t notice anything different.”
This is how we began our journey through Dr. Reichert’s Intercontinental Design class, with a humbling reminder that we are all the same. This wasn’t just going to be another design class that ended with a prototype and “good-bye” handshakes at a final presentation. This was going to be a class where we learned and experienced much more. Through interactions with accomplished students from an entirely different continent and a week-long visit where we immersed ourselves in modern Ugandan culture, the course became much more than anyone would have expected.
Early in the year, we joined the neonatal jaundice team, Grey Matter Technologies, at Makerere that had been working on a phototherapy blanket as a treatment method. The two most interactive members of the Makerere were Owen and Pius. Neonatal jaundice can often have very serious impacts upon young children, even leading to deafness and intellectual impairment. Jawad was actually born with neonatal jaundice, and as a result we had an immediate interest in this project. In most wards, existing phototherapy units are almost always out of order. The problem is further exacerbated in rural areas, where there may only be one phototherapy unit for the entire ward. As can be seen below, jaundice can lead to very unhappy babies.
A very unhappy (and yellow) baby Jawad
At the beginning of the course, we focused on the various cultural differences between the Ugandan and American experience. Based on our discussions, we expected to meet people with a very different cultural background to ourselves and our other Duke classmates. Through our in-class discussions led by Dr. Karrie Stewart, differences were hyped and overarching statements regarding demeanor and how people think were made. Our analysis and discussion of Clarke’s Guide to Ugandan Customs and Culture left us with awkward statements that Kenneth and Henry (our Ugandan classmates) didn’t always agree with. In subsequent weeks, we discussed sensitivity to culture, and were left feeling that developing a formal relationship with our Ugandan counterparts was likely the best route. Clarke made various mention of how “Ugandans don’t like any kind of confrontation or saying ‘no’, since they feel this is rude”, so our group attempted to maintain a sense of professionalism within all of our correspondence via WhatsApp and e-mail. We would re-edit our messages before sending them, attempting to ensure that our conversations would not be taken in a negative view. Most importantly, we wanted to try and foster the sense that this would be a collaborative project, rather than the Duke team merely serving an advising role within the project.
Our first call with the team was to discuss the status of the project to date and to begin planning for improvements before the Uganda trip. The nature of the call was polite, but clearly showed that both teams were overly cautious whenever mentioning potential ideas as to avoid any confrontation. As time progressed and we began to dig deeper into potential solutions to improving the device (such as identifying potential light sources, examining power supply options, performing testing, as well as considering alternative designs of the neonatal jaundice photothermal device), we also began to discuss topics outside of our project, such as the way parents may punish their children when they misbehave. We noticed the similarities among the expectations that Ugandan, Middle Eastern, and Indian parents may have, where children are meant to respect their elders and be obedient to their parents’ wishes.
Perhaps we hadn’t realized it then, separated by a veil of expected cultural differences, but Owen and Pius were in fact able, driven, and accomplished students, just like us. With time, and by finally meeting them in Uganda, we would understand how true Dr. Reichert’s initial statement was. It would push us to work closer as a team and drive us to solve the pressing issue at hand.
After several weeks of class updates and presentations, we finally arrived in Uganda. When we arrived on March 12th, we ended up running into Pius on our way to the grocery store. It was great to finally meet one another face-to-face, and while the conversation was brief, we were still looking forward to getting a chance to form a proper connection between our teams. The next day, as we spent time hearing from various groups giving presentations, we had the chance to do some initial design work. While the Duke team had e-mailed initial design sketches, and calls on WhatsApp allowed us to clarify certain design choices, it was a completely different experience to show design ideas in person and use the equipment we had brought to work on developing a rough 3D representation of the final design.
We began to realize that there were essentially no differences between ourselves and the Ugandan students. While we spent time working on the presentations, we also were curious to learn what got each of us into the biomedical field. Pius, after hearing about Jawad’s old work doing ovarian cancer detection using nanotechnology, mentioned how interesting he found nanotechnology as a field. We spoke at length about the difficulties that developing countries such as Uganda or Lebanon face in gaining access and expertise in cutting edge fields such as nanotechnology, due to limited resources and a lack of experts in these fields returning to their home countries after studying abroad. A similar sentiment was shared that we all wanted to use the skills and expertise we gained through studies in the biomedical field to bring either technology or improved legislation back to our countries.
It became clear that nearly all differences could be attributed to resource constraints, even the cultural tendencies that we had discussed in class. For example, the more relaxed time scale and lack of immediacy is most likely due to slower flow of information and lack of immediate connectedness. In many senses, it was calming to see students our age not be glued to their phones, poring over social media, and constantly messaging their friends. It was important to consider that without a consistent internet connection, it wasn’t always feasible to be connected to e-mail like in the United States, but it was something we understood due to our own relatives living abroad. Further, these students were driven, caring, and interesting individuals, all the adjectives that are used to describe Duke students.
As a group, the four of us worked together to test various LEDs and assess whether the light intensity was clinically relevant. One of the most exciting moments of our testing was when we performed irradiance tests on our high-power LEDs. One of our major concerns had been finding a light source that could provide the necessary power for therapeutic treatment, so we decided to test a 100W LED in the Engineering College. A main issue in trying to test this was finding a power source capable of powering the LED, which recommended 34-36V and 3A in its specification sheet. The intensity emitted by the LED was alarming, nearly 3x the necessary light intensity for clinical application. Throughout our discussions with Owen and Pius, the 100W LED was a consistent source of fun. A light that powerful would undoubtedly be too powerful for clinical use and would become so hot, it would likely pose a serious issue to any patient. Jokes about the sheer magnitude of 3A and the brightness of the 100W bulb were repeatedly cracked. When we returned with a video of our test, we passed it around the presentation hall for all the students, Duke and Makerere alike, to see. It was the most enjoyable testing experience during our week there.
High-Power LED Testing
Apart from working on the project, the group also bonded over various topics outside of the scope of the project. When we arrived, we had been talking to the teams about an idea to go out together before we left Makerere. Pius and Owen were immediately looking forward to the idea, as was the Duke team. On our last night, we decided to go out for a night of dancing, swapping stories, and getting to spend time with one another without focusing on our design projects. We took over the dance floor, with the Duke and MUK students having dance-offs and teaching one another the most popular dance moves of their respective countries. Owen and Jawad realized that trap music had become very popular in both Uganda and Lebanon, and promised to swap some of their favorite trap songs and share some of the more typical Arabic and Ugandan music normally heard at weddings or large family events.
A Night Out in Kampala
One of the main topics that also came up during our trip was related to soccer, particularly with so many Premier League and Spanish League matches taking place. We spent plenty of time discussing our favorite players, reasons why certain teams didn’t have a chance to make it to finals, and could all agree that Arsenal had to do something different if they ever want to win a title race. One night, a few weeks after our trip to Kampala, Jawad received an excited message from Owen during the final moments of a Real Madrid soccer match. Despite the fact that we both had plenty of work to prepare for upcoming exams, we were incapable of discussing anything other than an incredible match between Real Madrid and Barcelona.
Snippet of our Soccer Discussions
Ultimately, we realized that while there may be superficial differences between our teams on the surface, we all had similar goals. We wanted to work on projects that could make an impact on the lives of others, and realized the important role that we could play in our home countries by bringing our knowledge and expertise back home at a time when fields like nanotechnology or biomedical engineering are beginning to grow. Dr. Reichert was absolutely right, once we arrived in Kampala, it was hard to notice anything different between us. We liked the same music, made the same jokes about how Arsenal would never win the Premier League, and the only real difference was how much better our MUK teammates were on the dancefloor than we were. In the end, it wasn’t our difference that defined us, but our similarities. Although Ian Clarke’s statements indicated otherwise, one thing shone clear: we were students with astonishingly similar backgrounds and interests for having grown up halfway across the world.