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magazine home > archives > spring 2002 > features

U of M biomedical engineering professor Robert Malkin was so appalled by the deplorable conditions at the Children’s Hospital in Managua, Nicaragua, he decided to take action. Now, a summer institute at The U of M is playing a part in upgrading facilities and saving lives in developing countries.

Prescription for Success
by Greg Russell

The first sign that something might be awry at the Children’s Hospital in Managua, Nicaragua, are the sheep grazing in the medical equipment repair area. A better clue, though, would be the fire that unexpectedly erupts above a patient on an operating room table.

 
Malkin with student
 

Malkin and a student work on medical equipment that they will send to one of several Third World countries they target. He says that civil and electrical engineers have programs that help impoverished nations. EWH is a way biomedical engineers can be involved.

“A lot of people would be shocked if they saw some of the things that go on in this and other hospitals in Third World countries,” University of Memphis researcher Robert Malkin says. “Some of the occurrences are totally unbelievable.”

Dr. Malkin was so appalled by such conditions that he created a new institute at The U of M that focuses on correcting problems at hospitals in economically depressed countries.

The program, Engineering World Health (EWH), sends biomedical engineering students to hospitals in under-developed countries to repair and install donated medical equipment. The result has been better care facilities and in some instances, saved lives.

“When we see the people come from the University and from Memphis, we are happy because we know improvements are on the way for our hospital,” says Dr. Enrique Alvarado, director of the Children’s Hospital (Hospital Infantil Manuel de Jesus Rivera) in Managua. “Their work makes our hospital function better and in the process, has helped play a role in saving lives.”

Children whose existence relied heavily on antiquated or non-working medical equipment now have a new life because of support monitors and other equipment installed and repaired by U of M students. Surgeons are better able to operate on patients because of upgraded medical equipment supplied by The U of M’s Summer Institute.

Malkin, who holds a Herbert Herff Chair of Excellence in Biomedical Engineering, says Engineering World Health is divided into two parts. The non-profit side sends volunteer engineers to provide services in Third World countries. It has established a clearinghouse of donated medical equipment and parts and provides the professional expertise to design and rebuild the equipment.

The other part of the program — the EWH Summer Institute — provides training to students from around the country who are interested in making a difference abroad.

Malkin says the program is already showing results. In one instance, he says that a 2-year-old baby named Jessica, a patient at the Children’s Hospital in Managua, might not be alive today if not for Engineering World Health. Suffering from totally anomalous pulmonary venous drainage, a congenital disorder that is fatal if left untreated, Jessica was completely dependent on the program’s donated, refurbished equipment during her stay at the hospital.

“Thanks to our efforts, every station in the intensive care unit of the Children’s Hospital now has a monitoring station,” says Malkin.

The program doesn’t just benefit patients either. Those who go through the summer institute receive a unique, hands-on educational experience.

“The students get extensive clinical experience while receiving nine to 12 hours of college credit for language and technical training,” says Malkin. “The opportunity to spend a month in a foreign country — especially a Third World country — can be a life-changing experience.”

The program entails four to five weeks of training at The U of M, where students learn Spanish and how to repair medical equipment. Participants also take courses in political science to learn about sensitive issues they may encounter in the target country. Students then travel to a target country, where they spend the final four weeks of the summer program installing donated medical equipment, repairing and calibrating existing equipment and training staff how to properly use the machinery.

The institute is open to engineering, physics and chemistry majors from any University. Besides The U of M, Malkin has fielded inquiries from Rhodes College in Memphis, North Carolina State, Washington University and students from Seattle.

Malkin with student
At the EWH Summer Institute, Malkin prepares students for trips to underdeveloped countries where they install and repair medical equipment in hospitals. During the final month of the program, the students visit a Third World country to practice what they have learned.

“This is an opportunity for me to apply my technical engineering background in an environment that benefits underprivileged children,” says U of M student Nicolle Kramer. “It makes me aware of the importance of things that I would otherwise take for granted.” Kramer and fellow U of M graduate student Chris Powell helped install the monitoring stations in the hospital where baby Jessica was a patient.

Malkin says a major problem at many Third World hospitals is not fixing a broken part, but having the ability to pay for a part.

“One government donated an intensive care unit to the hospital in Managua, and another country donated ventilators to be used in the unit,” Malkin says. “But the hospital was lacking one simple piece needed to make the ventilator work, so the facility was totally empty and not being used. The piece that was missing costs only five dollars, but to the Nicaraguans, that is a lot of money. They just can’t afford it.

“Our students arrive with the needed part and it has a huge impact even though it is a relatively small amount of money. Now the facility can be used.

“Another example is light bulbs,” Malkin continues. “There is a certain type of light bulb needed for surgery, but they can’t afford it, so they use regular light bulbs. These bulbs can give off too much heat, sometimes resulting in a fire. The nurses have to quickly cover the patient until the fire is extinguished.

“We try to provide things as simple as light bulbs or as complex as monitoring stations,” Malkin points out. “On campus, we have a lab piled high with old stuff. We fix it, recalibrate it and get it working. It is then shipped down to Nicaragua where it is installed.”

Malkin first became interested in setting up the program when biomedical engineering students approached him “wanting to make a difference” in the world.

“Electrical engineers have organizations that place engineers in Third World countries to help with delivering power and communication services,” he notes. “Civil engineers send people to poor countries to help in building schools and sewage treatment plants. Until our program, there has really never been a way for biomedical engineering students to help with world problems.”

Malkin contacted local heart surgeon William Novick to ask his advice on how his students could find their niche. Dr. Novick, who has provided operations to needy children in dozens of developing countries through the International Children’s Heart Foundation, invited Malkin to accompany him on a trip to Managua. It was here that Malkin witnessed the deplorable conditions in the Children’s Hospital. He teamed with Dr. Mohammad Kiani of the University of Tennessee Health Science Center’s engineering department to create an educational program that would provide humanitarian aid to countries in need. Projects also are being planned in Haiti, Brazil and Peru.

Malkin says that it is easy for U of M alumni or anyone else to become involved. Because of a lack of money in the depressed areas, he says that monetary and equipment donations are important to Engineering World Health. Information on donating can be obtained at the Web site www.ewh.org or by contacting Malkin at 901/678-3733 or through e-mail ramalkin@memphis.edu.

“The goal of every teacher is to offer a class that is so insightful and exciting that it can change a student’s life,” says Malkin, who holds degrees from the University of Michigan and Duke University. “This educational experience has that potential. It can open students up to an understanding of the real world and their place
in that world.

“I am convinced we can make a major impact,” he says. “The best thing about it is that it not only provides a great educational experience, it helps serve people who are in need.”

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