A class that visits Africa during spring break? For most of us, this was all we knew prior to enrolling in Dr. Reichert’s Intercontinental Engineering Design class. It was enough to know that we would be experiencing another part of the world, that we would be flexing our engineering education towards something meaningful, but there was so much more that we gained from the course unimaginable to us before we got started.
Our task was to tackle a problem with monitoring patients in the neonatal ward in Mulago Hospital in Kampala, Uganda. For 40 babies facing respiratory conditions after birth, less than 8 pulse oximeters were available to diagnose blood oxygenation levels. The team we were assigned to was working on a way to design cheap pulse oximetry probes equipped with Bluetooth. This way you could send multiple blood oxygen readings to a single monitoring device. Achieving such a monitoring system would significantly cut costs and make it possible to simultaneously keep track of all babies that require monitoring in real time.
We were immediately motivated by this project, and reached out to the student team at Makerere (MUK). The first interaction was a WhatsApp call to make introductions and answer initial questions. Before the call, we were nervous about making contact. The discussions we held in class prior to the first call on cultural sensitivity, the validity of KONY 2012, and aspects of the HIV epidemic instilled in us a heightened conscientiousness with which to tread forward with. Thus, the questions before this first call were heavily prepared and even rehearsed. WhatsApp was how we found a time to schedule the phone call. However, there was a slight mishap in initial communication. It was taken as an opportunity to make a first joke.
Snippet from first Whatsapp conversation
Just the simple humorous e-banter that took place before our phone call was enough to break the ice. We really believe it was the down-to-earth approach in our communication that really made us take on this project as friends. From here, we split up work naturally, offered resources from each of our academic environments, and generally interacted as a team. Although we learned lots about the sensitive issues of Ugandan culture, we also learned about the Ugandan sense of humor from Kenneth, our Ugandan classmate at Duke, and now from our project team members. Humor is the best medicine, and for the intercontinental design of a healthcare device, this was especially the case.
We reached Kampala on the afternoon of March 12 to present and meet our team for the first time. All the Skype, WhatsApp, and email communication finally had faces and personalities. What we were doing felt so real.
Classroom where presentations were held
In the midst of the presentations, a burning question came from one of our MUK team members:
The majority of our discussion outside the project centered on politics. Adam, one of our group members, is considering going into politics, so it wasn’t surprising when he broke the silence with his ironic “So…Trump.” Generally, everybody we talked to was surprised, worried, and confused about the results of the US election, and that concern was largely due to the similarities seen between President Museveni and President Trump.
The most readily apparent commonality was the geographic distribution of electoral support, with rural areas supporting the sitting presidents and urban areas opposing them. Perhaps more meaningful, though, was the general perception of their disdain for the democratic process, Museveni in action and Trump in words. As evidence of this anti-democratic action, Adam and others were quick to point to voting day delays in the opening of polling stations in Kampala, where opposition to Museveni is highly concentrated, and to the incumbent party controlling the departments responsible for counting votes.
Nobody, however, mentioned the arrests of Museveni’s political opponents, most notably Dr. Kizza Besigye, or the human rights abuses that pervaded the election, two points the United Nations pointed to in expressing concern over the election. Perhaps such occurrences have become too normal to spend energy on, or alternatively perhaps everybody was expected to already be outraged about those topics, leaving no need to mention them.
In addition, based on our media intake, we were expecting opposition to Museveni to translate to support for Besigye, but we found the opposite. The MUK students with whom we talked politics considered Besigye to be roughly equivalent to Museveni, just a different face. This evaluation centered on the two having worked together since before they became involved in politics and coming from the same tribe. All the students still made clear that they much preferred Besigye to Museveni, but only because he’s a different face. As Adam put it: “It’s like walking across the street, and you know the other side is better, but the first step is into a thicket of thorns. And Besigye is that first step.”
We also learned to give thumbs-ups at your own risk as the thumbs-up had become a lasting sign of Museveni’s campaign. “We just meant good job!” we promised.
Travelling to Uganda and being able to work directly with the Makerere students enabled us to make more progress in a week than we had all semester. On the first day that we worked together, we combined our circuit, which consisted of an Arduino Uno and a Bluetooth module, with their pulse oximetry probe circuit. Then, we decided to combine two pulse oximetry probes to our circuit to lessen the cost of our design.
Our circuit (right) connected to their probe (left)
This turned out to be much more difficult than we had imagined as the software for both pulse oximetry probes had to be run simultaneously on one Arduino without the oxygen saturation calculations for one probe affecting the other probe’s values. We took a night to sleep on it, and by the next morning over some African tea, chapatti, and fruit, we successfully combined the probes on our circuit.
Thus, the work we accomplished at Duke was finally one with the work of the MUK students. The next step would be to use Bluetooth to send and receive values from this circuit and another circuit built in the exact same way. This will enable us to have a system of 4 probes with 2 probes per circuit which can then be expanded simply by increasing the number of circuits and connecting them via Bluetooth.
We did not want to only focus on the technical aspects of our project. Another crucial part of our journey was visiting the neonatal ward at Mulago Hospital. This allowed us to get a better sense of the context of our design project. The room had approximately 100 babies, with many of them being premature. Not having seen premature babies before, we were all shocked at how small they were and how many of them were in the ward. We observed that there were no pulse oximeters for any of the babies, with only the head doctor carrying two or three in case a baby is in need. We got a sense that the healthcare workers at this hospital must greatly adjust their care-giving model according to resources that are available to them. Thus, the doctors and nurses were very excited to learn about our design project and were eager to answer any questions we had. We learned about the structure of the new ward where the babies will be shifted to, the type of monitoring system that we will need, and how our system can fit in with their protocol and setup.
All the group members, Duke and MUK, came out of the meeting with a greater understanding of the impact of this project. This was not just a design project anymore. It was something that could change the lives of people we met. The group decided then that this project would not just be a school project. We would keep in touch through the summer and recruit first year students to take over after we graduated and see the work through to the finish.
Duke and MUK hanging out after 3 days of work and presentations
The grand finale was a party that was held for the Makerere students and us. We enjoyed playing cards, board games, and learning more about life in Uganda. Words such as “I’ll miss you guys” and “keep in touch” were even heard throughout the night.
The festivities concluded with a dance party to a mix of American and African music. Like our projects, we shared our various styles and eventually found a rhythm to groove to together.