Engineering World Health

Senior Design Projects That Matter

2009/10

New for 2009/2010:

Field Testing: This is a project where we have a design for a working prototype, but we need a
team to reproduce the bench tests, potentially fix any problems, and ideally test the device in the
developing world. If the team is not able to travel to the developing world, it may be possible to
generate useful results from bench tests in lab (i.e. testing the device under different conditions,
using the device to take measurements from multiple people, etc.).

Engineering World Health is an extraordinary fusion of engineers, scientists and

physicians who donate their time and talents to positively impact the quality of
healthcare in disadvantaged areas around the world. Our vision is embodied in
the “Cycle of Caring,” which begins with donated medical equipment and parts
and relies on professional expertise to recycle and restore the technology for
reuse. We then deliver and install the refurbished machinery for a community in
need. Our commitment does not end there. Unlike any other organization in the
world, volunteer engineers and students return to that same equipment year
after year to ensure that it remains in good working order.

Our ultimate goal is to train local engineers and technicians to maintain their own
equipment. However, this ultimate goal is constantly frustrated by the lack of
adequate testing equipment. Even where the staff is adequately trained, they
lack testing equipment which Biomedical Engineers in the developed world take
for granted. The objective of these projects is to design testing equipment that
can be provided as kits and built by engineers in the developing world.

Individuals, groups of students, senior design teams, BMES or IEEE chapters or

just a bunch of friends can submit designs. Designs are generally accepted in
December or January, but can be submitted at any time. If your design meets
the design criteria, you will receive up to $150 to build a prototype. If your
prototype works, it may be selected to be produced. If you wish, in the summer
following the production of your design, you, or your team, can travel to the
developing world to distribute the product by participating in the EWH summer
program.
EWH chapters may also be interested in participating in the EWH Design
Competition. Winning chapters will receive cash prizes, and participating design
teams will be invited to present their work at an international conference. Check
out the website (www.ewh.org) or email info@ewh.org for more information.

In order to receive prototype funding from EWH, you must meet several criteria:
A) Your design must be documented, including 1) a description of the theory of
the device (approximately two pages) including the specific specifications
(accuracy and such) that your device will meet, 2) a detailed parts list,
including source, quantity, part number, price (in quantities of 1 and 5)
and anything else that would be required for one to order the parts. Your
design can be kit-able (requiring no custom parts). Some projects require
kit-ability. 3) engineering drawings including construction drawings for
the enclosure, if there is one, top and side views of the completed item
(multiple if required), 4) a requested amount (up to $150) for the
prototype with the detailed budget to support the request, and 5) a cover
letter stating your team members (name, address, telephone and e-mail
for each) and to whom the prototype check should be made and sent.
Additional documentation may be provided, if you deem it necessary.
Your cover letter must state if you are designing a locally produced item
(all parts on the parts list are from a developing world country of origin)
or a kit (some parts must be ordered singly from a US distributor and
shipped to the developing world) or a typical product (all components
purchased and assembled in the US and then shipped to the developing
world). Preference is often given to locally produced items.
B) The cashing of the payment you receive constitutes a license to Engineering
World Health to freely produce the final design non-exclusively, for
donation to hospitals anywhere in the world in kit, documentation or final
form. Engineering World Health is also licensed to publish all technical
specifications on its web site for general use.
C) All submissions must be made electronically in Word format.

When your design is complete, you will also need the following documentation
for the design to enter production:
A) Updated documentation of anything that has changed. Be sure to update the
kit/locally produced status of your design.
B) New diagrams which include: 1) detailed construction instructions. If a kit,
instructions for assembly of the kit of parts in the developing world with
 no special or custom parts. No special tools must be required. Assume a
high school student or person in the developing world could construct
your device from, typically, a sequence of photographs. For local
construction, use mostly pictures of each stage of construction. For
traditional products, assembly diagrams are usually sufficient. 2) testing
instructions so that the builder can confirm that it is working. 3)
operating instructions (must be in pictorial form, not words).
C) Calibration data and testing data to show that your design works.

We prefer that you write us before beginning the design (info@ewh.org). That
way, we can give you any updates or clarifications on the design criteria. If you
decide to send a letter ahead of time, please include your projected date for the
submission of the design and documentation and your mentors name and title.
However, it is not necessary to write ahead of time.

Any design which meets the published specifications and the criteria set out
above receives the $150 to construct the prototype. If the criteria are met on
your first submission, you will typically receive the $150 within four weeks or
less. If you have written ahead of time, you may be able to receive the $150
sooner.

We may select your design if 1) it the final prototype testing data shows that it
meets the specifications, and if 2) its performance exceeds (lower cost, more
features, higher reliability, etc.) any item which we are currently producing in
that category and any other designs submitted that year of the same type. If
you write ahead of time, we can inform you of what other teams have selected
the same item, and what items we are currently producing in the selected
category.

Don’t hesitate to write an e-mail to info@ewh.org if you have any questions.

Your efforts can have a tremendous impact on the developing world.
Projects:

These items have been requested by personnel working with Engineering World
Health in developing world hospitals. These project specifications are intended
to be used as guidelines. You should design your device to deliver the maximum
possible performance while still staying within the cost specification. Some
deviation from the cost specification may be tolerable if the benefits in
performance warrant. Where superior performance specifications are given, they
need not be followed for the design to be acceptable. Be sure to note if the
design is for a kit, local production or traditional production.

We cannot accept designs which are not on this list. However, we can accept
suggestions for items to be added to the list. Feel free to suggest a new design
project. If the project is accepted, it will be added to the list for everyone to
see, and you will be able to submit your design as well. Write an e-mail
describing your idea in one paragraph to info@ewh.org to find out if it is a
project that we can support.

In the following paragraphs, all costs are for parts only (no labor costs) and
include all the costs of production, even costs that you may not encounter in the
prototype, like the box or printed circuit boards. You can assume that the parts
are purchased in the developing world or the US, as appropriate.
FIELD TESTING:

Non-electronic Oxygen Concentration Test

Engineers are often faced with oxygen concentrators of unknown quality. A

team has now designed a device that allows an engineer in the developing world
to quickly determine if the device is producing concentrated oxygen without
using electricity (batteries, etc). It uses a candle, match, water, soap, bubble
gum (or clay) and a calibration table that depends on a found bottle size. It
claims to be accurate to within a few percent. There has been secondary
confirmation that the device operates as designed. There have been some
preliminary field trials. The early field tests are promising. A team is needed
that can take this project and thoroughly field and bench test its operation under
as wide a range of environmental conditions and expected uses as possible.

Pulse Oximeter for Heart Rate

The pulse oximeter is one of the most common medical instruments, and is the
most frequently requested piece of medical equipment in our partner hospitals in
the developing world. Prices have dropped for this product to the point where
nearly every patient in a US hospital will be connected to such a device.
However, in the developing world, pulse oximeters are still difficult to find and
those that are found often require disposable probes that are not available. The
most important function is to display heart rate. A team has developed a simple
pulse ox device capable of reporting that heart rate. There has been no
secondary confirmation that the device works. The design does not have a
housing or instructions. No manufacturing stream has been suggested (kit or
traditional or local). No field tests have been attempted. PIC programming is a
necessary skill to replicate the prior work on this project.

Universal Surgery Light Bulb Replacement

Approximately 80% of the surgery lights that are found unused by Engineering
World Health are sidelined by the lack of lighting. These older machines have
light bulbs that are broken. While the replacement is simple, the bulbs are
expensive, not available in many developing world countries, and in some cases
not available anywhere due to the age of the surgery lamp. A team has
developed an LED, universal replacement bulb system for multi-bulb surgery
lamps. Hospitals with broken bulbs attach this replacement to the bulb stem and
reinsert the stem+LED+circuit into the former housing. Bench testing indicates
that the light output is sufficient. A team needs to thoroughly test the device
under as wide a range of environmental conditions as possible. No field testing
has been conducted, especially for compatibility with as wide a range of multi-
bulb surgery lamps as possible.
Spectrophotometer

Spectrophotometers provide a light source with a given wavelength for clinical

laboratory tests. The expensive ones use gratings and filters to insure the
proper wavelength. They are heavy and cannot be jarred. In third world
countries there is a lack of power or an improper power source. Yet, clinical
laboratory is one of the most requested areas of medical instrumentation for the
developing world. A volunteer has developed a spectrophotometer that uses
three colored LEDs in one convenient package that provides blue, red, and green
wavelengths. They have sharp cutoffs of 470-nm, 574-nm and 636-nm
respectively. These three wavelengths are sufficient for measuring hundreds of
different compounds. The photo detector used is a silicon blue enhanced
photodiode photoconductive type. An analog to digital 8-bit microprocessor
(PIC) uses a lookup table to convert the percent transmission to optical density
which in turn can be converted to concentration. No secondary testing has
been done. Some field testing has been done on the original prototype and it is
promising. We are looking for a team to build the device and provide
procedures for the most commonly requested and possible clinical laboratory
tests, considering that reagents must be obtainable in the developing world.

Pulse Ox Phantom

Pulse oximeters are common pieces of medical equipment. However, testing

them can be difficult, as healthy people always read about 99% Spo2. A
volunteer has developed an electronic phantom that provides a low heart rate
and low Sp02 reading. However, no secondary confirmation has been done. No
field testing has been completed. This is an excellent project for those with
electronics background and access to a pulse ox, either purchased or used (only
about $100 to get one on-line).

Semi-Permanent ECG Pads

Disposable, or single-use, ECG pads (electrodes) have replaced permanent ECG

pads in the US for all cardiac monitoring and diagnosis. However, they are
relatively expensive and difficult to find in the developing world. During the
summer of 2008, one team in Tanzania had to drive to Nairobi, Kenya to
purchase ECG pads!

The majority of patients in the developing world can be measured non-

ambulatory. This greatly simplifies the design of the electrode, as an interface
sponge is not necessary. A previous effort (Samaddar, Mahapatra, Ray, Indian J
Anaesth, 2002 46(6), 437-440) has developed a potential alternative for non-
ambulatory patients in India. This effort was refined by an EWH team to be
usable with materials commonly found in Africa. There has been some field
testing with very promising results. However, the early work suggests that a gel
may be required. Saline evaporates too quickly. Preliminary work with common
substances has been completed. The team needs to test this with the widest
range of people and environmental conditions possible.
LEGACY PROJECTS:

Defibrillator Tester

EWH has a defibrillator tester product. However, it is designed to be used with

monophasic defibrillators. Most hospitals defibrillators, even in the developing
world, are now biphasic defibrillators. We wish to have a defibrillator tester that
meets at least the performance specifications of the current device (providing a
go/no-go test for a non-automatic, transthoracic defibrillator) but will be able to
handle both biphasic and monophasic devices well. We would prefer a device
that exceeds the performance of the current device, by for example, providing
current, voltage or energy readings and indicating waveform shape. The device
should be kitable (therefore requiring only simple soldering skills), but could use
a PIC processor, where EWH would burn the PIC before sending out the kit.
Teams will have access to the current design and the design of a general
purpose PIC platform. It is ideal if the device takes its power from the
defibrillator (by, for example, requiring two shocks to be delivered at one
strength), however, battery powered devices are acceptable.

Temperature Monitor Control Alarm

A common set of problems seen in the developing world is measuring

temperature, alarming when the temperature exceeds some threshold and
turning on or off a device when the temperature reaches a threshold. This is
most pressing when primitive incubators overheat, killing their occupants, or
when primitive baby warmers fail to provide enough heat (perhaps out of fear of
overheating), also killing their occupants. In fact, all of these functions should
be provided by a single device, a temperature control system. A previous team
has produced a design for a temperature control system. However, the design is
not quite complete (it does not include the control of an outside device) and did
not meet the battery specs (it consumed too much power when sleeping). This
is potentially a very high impact project, as the low-cost but versatile
sensor/processing/display platform can be used for a wide variety of designs for
the developing world.
Non-Legacy PROJECTS:

Non-electronic BP Assist Device

While many philanthropic studies focus on “high-profile” killers such as HIV and
malaria, the primary cause of death throughout the developing world still stems
from issues related to the heart. The WHO has begun to seriously consider the
growing number of hypertensive patients throughout the world, and as a result
we are focusing specifically on improving the diagnostic capabilities of hospitals
throughout developing countries.

This project will develop a low cost, easy-to-use device to assist a minimally-
trained person in taking the blood pressure using a sphygnomanometer. The
device should be a mechanical adjunct to the existing device (clamp around the
manometer tubing, for example) that amplifies the AC (or oscillatory) pressure
signal. With the AC signal now visible, the oscillatory BP method is possible with
a standard sphygmomanometer. This eliminates the need to be trained to
identify Korotkoff sounds (the oscillatory use of a sphygmomanometer does not
require a stethoscope). The user should be able to identify at least systolic
pressure without training (only picture instructions). Ideally the user should be
able to identify diastolic pressure with minimal training.

Relevant additional specifications

Only available for traditional production
Cost: <$5 in quantities of 2000 or more

Liquid Medication Delivery System

The number of children infected by HIV continues to grow. There may be as

many as 2.1 million children worldwide infected with HIV. Over the past 15
years, several options have become available for treating children and preventing
the transmission of HIV from mother to child, including zidovudine (AZT),
didanosine (ddl) and nevirapine. A study in Uganda found a single dose of liquid
nevirapine delivered to the infant shortly after birth lowered the rate of HIV
transmission by nearly 50%, and the WHO recommends this method of
preventing mother-to-child transmission where other more expensive and
advanced means are unavailable.

The problem is that a single, small dose of 0.6 ml must be provided to a mother
so that when she gives birth, some number of months later and many miles
away, she can deliver the dose to her newborn. In poor countries, liquid
medications are now given in plastic bags, open syringes or recycled plastic
bottles, all of which lead to medication spoilage and loss. For the poor
pharmacy, extracting the correct dose from the bottle without contaminating the
bottle and presenting it to the mother in a form she can transport home and use
safely and effectively has presented serious challenges.

A team has now developed a simple foil package that can receive a small dose of
a liquid medication and be sealed for transportation and temporary storage.
Now what is needed is a bottle topper capable of resealing the bottle and
measuring the correct dose and delivering it to the packaging. Special care
should be made to test the device with liquid medicine, as it is considerably more
viscous than water.

The bottle topper should fit on the nevirapine bottle. Nevirapine is patented by
Boehringer Ingelheim (BI), and they have one type of bottle that all nevirapine is
distributed in.

Relevant additional specifications

Only available for traditional production
Cost: <$2 in quantities of 2000 or more

Universal ECG Connecting Cable

Because most US hospitals replaced all of their bedside monitors every few years
over the last decade, most developing world hospitals now have bedside
monitoring capabilities. However, few of them are in use. The most common
two problems are the lack of ECG pads (see field test problem above) and the
lack of a cable to connect the machine to the ECG pads. ECG machines lack a
cable because some donors do not know that this is required, or assume that the
manufacturer or provider of the ECG pads can provide a new one, as they do in
the US. This project is to develop a universal cable so that bedside monitoring
machines, including those that are no longer manufactured or were
manufactured by companies that no longer exist, can be used in the developing
world. The universal cable would have non-connector, male terminators (like
posts). These color-coded, male terminators would then be plugged into the
female connector of the donated ECG machine in a prescribed fashion. The
project team must design the cable and identify a scheme whereby the color-
code can be communicated. Ideally the design team would also devise a method
for determining the appropriate code for a previously undocumented ECG
machine in a developing world setting.

Relevant additional specifications

Ideal if manufacturable from locally available materials
Cost: <$50 in quantities of 1
Research Projects

Non-Invasive Blood Pressure Machine Failure Modes

Non-invasive blood pressure machines are now available for about $25 at some
drug stores and on-line shops. The expectation is that they would be used once
or twice per day at home (about 300-600 cycles per year). These devices will
last many years when used according to expectations. However, when these are
donated to the developing world, they are used 24 hours per day, seven days
per week (about 5000-10,000 cycles per day). What is unknown is why they fail.
In this project, we anticipate the team will purchase several devices, modify
them for continuous use, and then document their failure modes.

Medical Waste Incineration

This plea came to our attention: “It seems that our hospital in Congo is forever
plagued with waste, bandages, and other things that need to be incinerated. But
most of it just gets buried in a hole and then we find children and others
climbing down into the hole to get stuff which is usually quite contaminated.”
The problem of medical waste incineration plagues hospital far beyond Africa.
We find this problem in hospitals throughout the world. The project here is to
research all the work that has been done on medical waste incinerators for the
developing world. There are several plans available. Also, there may be some
products that can be adapted. The successful project will also document the
engineering constraints of the problem, including performance and cost
specifications.
Frequently Asked Questions

The device has to be very simple to use, right?

No. Clinical engineers and doctors in the developing world are just as capable as
you and I to learn how to use a device. If you can figure it out, they can too.

The device has to be really quick to use, right?

No. The concept of time is different in the developing world. It is quite an

acceptable design to require a significant amount of man-hours (minutes?) to
operate your device.

The device has to be maintenance free, right?

Pretty much. If any maintenance is required, it must be something that itself

does not require a specialized tool or part. If your design requires maintenance,
you probably should write to us first (info@ewh.org).

What environmental conditions must the device meet?

Your design must not be destroyed even with extended exposure to

temperatures down to -10 degrees centigrade and temperatures up to 40
degrees centigrade. It should be useable in environmental temperatures ranging
from 20 degrees centigrade to 40 degrees centigrade.

My design doesn’t meet all the specifications, but it exceeds some.

Should I send it in?

If your design doesn’t meet all the specifications, you are not guaranteed to
receive the $150. However, you may be able to make an argument that the
added performance in one area is worth the missed specification in another.
Make sure to include a cover letter of one page or less which describes your
argument.

How do I know what is locally available for production?

You must contact a clinical engineer and talk with them about this. There is no
substitute for a conversation with the clinical engineer that will use your design.
I have just one custom part. Surely that won’t affect your
consideration of my design.

Assuming the question is for a project that is designated for local construction,
yes it will! If you have one custom component, and that component cannot be
manufactured in the developing world in single quantities (and those costs are
included in your cost estimates), then your design will be rejected.

What if a part is not locally available?

If you really need a component that you can’t find locally (a capacitor or fuse, or
a special plastic), then you should consider making your design a kit, not local
construction. Many of the projects don’t specify and you can choose.

What if the component requires programming or burning?

Most PICS and FPLA and such devices require burning or programming. Most
clinical engineers in the developing world do not have access to a computer or a
programmer. Therefore, your project requires a special tool that is not available
in the developing world. It is a conventional design and could perhaps be a kit,
but it could not be locally produced.

The project I picked doesn’t specify kit, local or conventional. What do

I do?

You have the choice. We prefer local construction, then kits and finally
conventional construction. If we receive multiple submissions, we’ll choose the
preferred design.