#ipefacesofengineersabroad

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Looking Back

Prior to the trip, I had been slightly uncertain how the experience would turn out given my lack of experience abroad. However, I can say without doubt that the opportunity taught me valuable cultural and professional aspects of engineering application. Throughout the trip, along with my team, I got the opportunity to display year’s worth of work on a prototype in hopes to solve an important medical problem in Dominican Republic’s resource deprived areas. As part of M-HEAL, a global health design organization that utilizes socially engaged design to solve medical problems, we did our best to strengthen relationships with our community partners in order to tailor our project to better address patient hypothermia in the operating room.

During my time in Dominican Republic, my most important lesson was that to maintain progress in any engineering or any academically-based project, it is not enough to simply come up with a solution and ship it off. By interacting on 1-on-1 basis with community partners in Hospital Octavia Gautier de Vidal and the Dr. Virgolio Garcia hospitals, I learned that connection and understanding must be built on a cultural level. To devise the best solution to the medical problems these regions face, an understanding on every aspect of a place’s need and how the intended recipients will react is extremely important. This insight is tough to gain through the classroom or anywhere on campus, which is why I am grateful for this amazing opportunity of a lifetime.

Lastly, I would really like to thank the International Programs in Engineering Office, M-HEAL, entrena(our guides), and the University of Michigan for giving my group the resources and the opportunity for the overseas experience. Additionally, many thanks to our collaborators in Hospital Octavia Gautier de Vidal and the Dr. Virgolio Garcia hospital for giving us their time and continuing to work with us on solving important medical health problems.

Signing Off,

 Ayush Arora

Biomedical Engineering

M-HEAL PeriOperative 

Dominican Republic

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Journey Back Home

Well, my M-HEAL trip to Dominican Republic is at an end. The journey from Cabrera back to Santo Domingo International Airport is about 2 hours by car, in which we will travel from the north to the south side of the island. The flight was at 2:30 PM, so I had to make sure to leave early to reach the airport in time. Having been surrounded by Spanish for many days, I discovered I could make simple conversation with the taxi driver (despite persistent hand motions to get the point across), but nevertheless much better than when I arrived. The drive went smoothly, and most of it was spent reminiscing about the trip and wishing it could have lasted longer.  

In this experience abroad, I connected with 2 communities, explored natural wonders, toured famous sites, and applied engineering skills in a socially engaged design landscape. Never have I done so much in a single excursion. Along with a group from all majors and backgrounds, the experience was definitely worth it. Until next time!

Ayush Arora, Biomedical Engineering

M-HEAL PeriOperative, Dominican Republic

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Unexpected Events

We went back to the Dr. Virgolio Garcia hospital intending to get a complete interview with an anesthesiologist. Unfortunately, the medical professionals were buried in work and we were left waiting in scrubs for a couple hours. At the end of the day, we understood that the hospital was really occupied and did not want to hinder any important procedures, so we thanked the head nurse who was accommodating us and spent the day discussing and noting everything we had learned from the experience.  

Overall, in both Jarabacoa and Cabrera, we had gotten the information we needed about our prototype. Most importantly, the problem we are attempting to fix, which is loss of control of internal body temperature, is still an important issue in low resource clinics. In both clinics, we observed in detail the environment the device could be potentially used in, cleaning procedures, storage conditions, and staff recommendations on the design and control. Of course, we were unable to interview much of the medical staff in Cabrera, but you can’t expect everything to go your way when traveling abroad. Having something go unexpected only adds to the vitality of the trip. To be honest, we got much more information than initially expected and were more than satisfied with the results. We were grateful to the hospital staff for allowing us to come in, and we hope to be back soon with a completed product. Until next time! 

Ayush Arora, Biomedical Engineering

M-HEAL PeriOperative, Dominican Republic

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Healthcare Inequality

For the last segment of the trip, we spent our time in the Dr. Virgolio Garcia hospital. The medical staff was quite occupied on the first day, so we did not get to interview any of the medical professionals. However, we did get to explore the medical center and observe the environment our device could potentially be used. Since we would be watching operations directly, we had to wear scrubs. Here we are!

We watched a couple procedures with careful emphasis on the layout of the medical setting, noting where the best placement would be for our prototype’s monitor and sensors, as well as the cleaning and pre & post operation procedures. In short, we analyzed in detail anything that would impact the functioning and use of our automatic patient temperature controller.

Throughout the day, I noticed blatant resource deficiencies in the hospital. One of the operating rooms contained a hole in the wall leading outside, making much of the environment desterilized. In fact, our translator, who was familiar with the area, said that in some cases, patients were asked to gather medical supplies for their own procedures if the hospital was low on resources.  Moreover, air temperature control was not properly regulated owing to frequent power outages.

One of the nurses we spoke to provided a brief overview of the healthcare system in Dominican Republic. Simply put, it is a 3-level system, where even the poorest, who are guaranteed free health care, often end up paying for their own supplies. Many public hospitals do not have doctors that tend to a specific specialty, so if a patient has a problem that cannot be solved in the local hospital, often he or she will have to travel many miles to visit a hospital that can take care of the specific issue. Moreover, the government barely devotes any of its GDP to health care.

After witnessing these problems, my respect for the medical staff really increased, for even despite the hardships, the staff was very enthusiastic and kind to both our team and the patients. Despite the odds, the positive attitude the medical staff emitted and the clear drive to help patients is just inspiring. At the end of the day, I really think we all felt humbled by the selflessness the medical professionals displayed, and we truly hope our device can make some sort of difference down the road. We had known to a degree about the medical supplies problem the hospital was facing, so we had brought some donations.  

Living in the United States, I have always had access to a safe, clean, and well-supplied medical environment. Of course, I have always known that healthcare inequalities exist. But until seeing the state of the clinics we visited in Dominican Republic, I never really experienced anything of this scope. Hearing the nurses explain their difficulties and directly witnessing the inequalities really brings about another perspective. I am grateful for the environment I have grown up in and hope that places like this get the resources they deserve.

Ayush Arora, Biomedical Engineering

M-HEAL PeriOperative, Dominican Republic

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Excursion to a Local School & Journey to Cabrera

Throughout the week in Jarabacoa, we continued our visits to the hospital. After hospital hours, we went into a local public school and taught English lessons to elementary students. The experience was really awesome, and the students were extremely enthusiastic. Also, teaching at a local school made us more connected to the community, which is what we are aiming for. I have written an article published on the Michigan Daily that details the experience, so feel free to take a look. Here’s the link (Go to Page 5). https://issuu.com/michigandaily/docs/2018-07-19

We then had one last meal at our host’s home, who we really appreciate for giving us such a comfortable stay and really tasty food throughout the trip.

We then left for Cabrera, which is on the north coast of Dominican Republic. On the way to our residence for the remainder of the trip, we were greeted quite literally by this:

Since this was our “excursion day,” we finally decided to go to the beach and eat some Dominican style seafood. We were treated with very tasty fried fish in some type of Dominican-style seasoning. I have never eaten something of this caliber, but it was really something to savor.

We spent the rest of the day on the beach-side and had a boat guide take us around the coast. Although I have not had many coastal trips, I must admit that I have never seen a more pristine, untouched, and clean coastline.

As I have continued to learn on this trip, Dominican Republic is home to many natural wonders, and I am grateful for having witnessed many sites during my stay. This excursion was the last of the entire trip, so the next couple days would be spent in another public hospital getting further feedback on our device. Until next time!

Ayush Arora, Biomedical Engineering

M-HEAL PeriOperative, Dominican Republic

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In Retrospect

—It’s hard to believe that the program has ended. I’m already missing the convenience of 饿了么 (eleme) delivering food from any restaurant within a 5km radius, and how cheap living in Shanghai is.

At PVG, it’s strange that I don’t need to take off my shoes and walk into a back-scatter X-ray machine, and it’s simply just walking through a metal detector before getting scanned with a portable metal detector.

Terminal 1 at PVG (Source)

Similarly, I was surprised when I had to actually check both of my bags because my airline, China Eastern, limits carry-ons at 10kg maximum. Regardless, I was ready to come home.

I actually flew to Toronto, before transferring to Detroit, since oftentimes air fare is actually cheaper to fly into another airport besides Detroit, such as Chicago, Vancouver, or even Los Angeles, at the cost of a longer trip home. In total, I spent approximately 16 hours flying from Shanghai to Toronto, before finally stopping in Detroit.

The first thing that I did when getting back here is disable the VPN—an annoying inconvenience to access tumblr and Google services in China. After that, I enjoyed my first American meal in a long time, a hamburger and fries. I think being away from all the junk food in the US made me miss the lack of it, and while there are fast food restaurants in Shanghai, like McDonald’s and KFC, nothing quite came close to the greasiness of the average American cheeseburger. I can’t wait for the new semester to start.

Signing off,

Brian Lou CSE UM-SJTU Joint Institute Shanghai, China.

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Final Days

Wow, what a way to end it all. We had a program dinner at a local western eatery, and enjoyed the rest of the night there. On my way back, I’m reminded by how idyllic SJTU is at night, when all the traffic has essentially stopped, and all that remains are the streetlights. I’ve grown accustomed to the view during the day, with distant car horns echoing across campus, but at night, the bustle is replaced by a quiet serenity.

I’m definitely going to miss this campus and biking to class, a rather stark contrast to my life at U-M.

Underpass on Nanyang Rd.

The roads around campus are completely bare.

It’s quite the departure from the typical Shanghai-at-night feeling, simply because the campus itself is mostly fenced-off most of the time, save for the the main gates, meaning that little traffic gets in or out. For the most part, this applies to most of Shanghai as well, as traffic disappears from 9-10pm onwards.

Until next time,

Brian Lou

CSE

UM-SJTU Joint Institute

Shanghai, China

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Wrapping up & Typhoon Weather

Weather in Shanghai reminds me of Michigan a little bit. There are days where in the morning it will be sunny enough to give you sunburns at 7am, followed promptly by downpours a few hours later. It’s a kind of temperamental weather cycle that’s not unlike what I’ve experienced in Michigan, with sudden squalls and thunderstorms punctuating bright summer days.

In fact, it’s hard to believe these pictures were taken a few days apart in Xujiahui, just by the sheer difference in weather.

Walking along the street at night, during a rainstorm.

A busy intersection in Xujiahui.

As I’m preparing for the program to end, I’m reminded more and more of the similarities and differences between my home in Michigan, and “home” in Shanghai.

With final exams approaching, outings are becoming a lot rarer.

Until next time,

Brian Lou

CSE

UM-SJTU Joint Institute

Shanghai, China