The first sign that something might be awry at the Childrens
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.
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
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 Childrens 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 Ms 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 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 Childrens 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 programs donated, refurbished equipment
during her stay at the hospital.
Thanks to our efforts, every station in the intensive
care unit of the Childrens Hospital now has a monitoring
station, says Malkin.
The program doesnt just benefit patients either. Those
who go through the summer institute receive a unique, hands-on
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 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.
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 cant
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 cant 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 Childrens
Heart Foundation, invited Malkin to accompany him on a trip
to Managua. It was here that Malkin witnessed the deplorable
conditions in the Childrens Hospital. He teamed with
Dr. Mohammad Kiani of the University of Tennessee Health Science
Centers 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
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
The goal of every teacher is to offer a class that
is so insightful and exciting that it can change a students
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.