VIETNAM GLOBAL HEALTH -- VISITING ST. PAUL HOSPITAL

After we visited the injection molder, we then visited St. Paul Hospital, a provincial hospital located in the heart of Hanoi.  Though we are targeting district hospitals – which are typically smaller and have fewer resources in terms of staff, funding, and capabilities – our interview with doctors from St. Paul was fruitful.  We received two validating responses to the user experience around Otter’s interface, which we have been working throughout this past semester.  (Upon asking Dr. Duong Nguyen to set the temperature to 33 degC, she pressed the buttons and then shot us a glance that said, “Is that it?”)

Elizabeth Johansen (ADE Advisor), Nurse Bach (St. Paul Hospital), and

Dr. Hanh Nguyen (St. Paul Hospital) try the Otter prototype interface.

We also began formulating a clearer picture of medical need around Otter used in conjunction with Firefly phototherapy, our primary use-case. To better uncover this information, we created a new prop nary an hour prior to the interview: the patient flipbook.  The patient flipbook allows us to quickly ask healthcare workers about which equipment they would use with a variety of patients with jaundice by highlighting four characteristics: gestational age, weight, core temperature, and jaundice severity.  There is a range per characteristic (ex: mild jaundice to severely jaundice), again – allowing us to quickly cover a broad range of patients and their hypothetical journeys.

Flipbook to explore the best warming & phototherapy devices for different newborns.

Dr. Hanh Nguyen (St. Paul Hospital), Liani Lye (ADE), and Hoa Dang Thanh

(MTTS translator) use the patient flipbook at St Paul General Hospital.

Though these are two positive takeaways from our interview, we must retain team- and project-awareness as we progress through the trip.  We must remember to always validate with our target market in mind; demand at a single provincial does not equate to blanket demand at district hospitals.  And, we should continuously balance streamlining our interview process against eliminating interviewing bias and answering many project questions thoroughly.  Forward and onwards!

VIETNAM GLOBAL HEALTH - VISIT TO AN INJECTION MOLDER

We started our first day in Hanoi with a trip to a local mold maker & an injection molding contractor. The goal was to investigate their facilities and estimate the likely cost of manufacturing our plastic user interface housing for the Otter newborn warmer. The photo below shows the team attaching the white, plastic user interface to our warming bassinet.

How many engineers does it take to drill a hole? Answer: Chloe Nguyen (MTTS), Hoa Dang Thanh (MTTS), Maire Keene (ADE) and Liani Lye (ADE).

There are many options for how to make a plastic part. As the quantities increase, injection molding can become a cost-effective way to make many identical parts with complex geometries. Design that Matters’ manufacturing collaborator, MTTS, suggested a vendor nearby in Hanoi might be able to make our part for an affordable cost.

At the mold-making shop, we spoke with Lai Duc Khoa who reviewed our CAD model and the 3D-printed part we made. We learned about the importance of working with manufacturing vendors close to MTTS in Hanoi to better ensure quality and keep costs like importation fees low leading to lower part costs.

Chloe Nguyen (MTTS Engineering Fellow) translates our questions for Mr. Khoa, a potential plastic injection mold-making vendor.

Duc (MTTS) and Maire Keene (ADE) standing near the CNC machines that make injection molding tools.

The mold maker uses CNC (computer numeric control) machines to create the mold; negative impressions of the inside and outside of a plastic part. The mold for our part would likely be made from steel. This vendor would then give the mold to a subcontractor. To create a plastic part, the subcontractor would fit the mold inside a press that holds the two pieces together while hot, liquid plastic is injected into the cavity formed by the two pieces. We visited one of the sub-contractors who was using one of the molds to create a Mickey Mouse toy.

The negative and positive sides of an injection mold for a mickey mouse toy!

Extra pieces of plastic such as the gate are trimmed from the toy by hand.

It looks like these vendors could be a good option for molding our part. The price estimates are a little higher than we planned, but would only add a few dollars to the price tag of our medical device.

Many thanks to Nguyen Duc Viet, MTTS Mechanical Engineer and Chloe Nguyen, MTTS Engineering Fellow, for setting up this visit, providing insight on how to select a vendor, and for bridging the language gap.

Author: Maire Keene

Food Processing - Central market in Kumasi

Day 3:

Today is a national holiday, the united African holiday, so the shop at ITTU is closed. In the morning we did some documentation and drawings work, and then walked from our hotel to the Engineering Guest House at KNUST, where Ben gave a talk about ADE and IDIN founding to a group of IDIN members. 

After the talk, we headed to the Kumasi central market to buy some fabric to make some custom clothing from a trusted Ghanaian seamstress! Ghanaian women have a great sense of fashion and the majority wear custom clothing from colorful fabric. Each day on the commute from our hotel to ITTU we see a fashion show just by looking outside on the street.

The central market sold everything you can find at a big grocery store and a shopping mall, but in the open air with small "ground stands". People flowed constantly through the narrow alleys like traffic. Women holding bowls of things on their heads, and saying Ago, Ago to you if you don't move. 

Sellers selling vegetables and soap/detergent, next to each other

There were at least 4 alleys of fabric sellers, and the variety of fabric are all so colorful and beautiful to make a choice very difficult.

Fabric shop with a woven type of fabric that is expensive 

Fabric alley full of color 

We decided to buy some batik fabric, a special soft fabric that is patterned by wax and also some block printed ones. 

Tomorrow will be another full day of work at ITTU, then we are excited to visit community villages during the weekend! 

Thanks for reading :) 

Food Processing - Welcome to the shop!

Day 1

Today is our first day working at ITTU! After a good breakfast of whole wheat toast, egg pancakes with scallion, tea and Milo chocolate energy drink, we met our program manager here in Ghana, a female engineer who studied agriculture engineering at KNUST. She hugged each of us and welcomed us with her stunning smile. It took us about 30 mins to drive from our hotel to ITTU (short for Intermediate Technology Transfer Unit), located in the Suame Magazine area, where metal workers and car mechanics are concentrated in a village. ITTU is a KNUST machine shop that produces and assembles our machines. On arriving, we met all of our partners who help us fabricate the machines there. Their open friendliness and happiness to see us made all of us smile. It felt like they have already known us because we work on the same project, even though most of us have never met before, and we started meaningful conversations right away.

The entrance to ITTU in Suame Magazine

Then, we started work by making a list of technical and business tasks as well as planning a community visit.

Then, after lunch we assigned tasks to each of us and started on some of them. The business team discussed updating pricing of the machines and the customer relationship management system. The technical team started unpacking all of the tools we brought from the US, as well as press fitting some bearing adapters into bearings using the local press, and asking a senior ITTU fabricator to broach more inserts.The plan for tomorrow is to build a reference machine for a new grater design. With all of the new fixtures, we can speed up this process substantially.

            The fixtures, parts and tools we brought to Ghana with us all unpacked

Day 2

Today we made lots of progress on both the business and tech side. The business students discussed a plan to incorporate in Ghana and a potential funding partnership to support the machine owners. They also finished updating the Customer Relationship Management (CRM). The tech team trained the fabricators at ITTU to use the templates and newly designed features. They also debugged the broaching method for bearing adapters and tried a new method. We also explored the basement space downstairs that we want to move into. 

In the afternoon, we were distracted from work by a variety of local food, brought by women who carried them on their heads. First we had mangos grown at our shop manager’s house and ball fruit (fried dough in the shape of a ball), then we drank juice from an entire green coconut and also ate the fruity inside. One of our partner fabricator also offered us his daily snack, a local specialty: tiger nuts that taste like coconut but looks like peanuts.

One of our partner fabricators, holding a bag of sweet peanuts that he offered to us to try