Engineers Are Unsung Heroes Of Global Health

While you consider international well being, who involves your thoughts? I guess you considered medical doctors, nurses, public well being specialists, illness detectives and educational researchers. You most likely didn’t consider engineers. That’s as a result of they typically keep out of the limelight, however silently preserve issues powered and working within the background – from water and sanitation methods in the neighborhood, to ventilators and biomedical gadgets in hospitals.

International well being engineering might not be attractive, however it saves lives. Take the Covid-19 pandemic for example. Throughout this disaster, engineers have made big contributions by delivering oxygen, oxygen concentrators, pulse oximeters, ventilators, speedy assessments, high-filtration masks, air purifiers, vaccine chilly chains, logistics, provide chain administration, cellular apps, information dashboards, amongst others. In some locations, engineers have constructed Covid-19 area hospitals inside days. However we hardly ever see them on nationwide tv.

Engineers are unsung heroes of world well being, and I interviewed 27 engineers, from varied corners of the world. I needed to higher perceive the work they do, determine what motivates them to tackle international well being challenges in resource-limited settings, and uncover among the limitations they face in doing international well being work.

All engineers are usually not the identical

The very first thing that struck me is the unbelievable range of engineering backgrounds. The engineers I interviewed had educated in chemical engineering, electrical engineering, electronics engineering, bioengineering, biomedical engineering, civil engineering, environmental engineering, pc science, structural engineering, communications engineering, supplies science, and industrial engineering. Apparently, each department of engineering has one thing to supply the sphere of world well being and improvement.

What motivates engineers to give attention to international well being?

Most engineers don’t work in international well being. They earn more money within the company, massive tech, and industrial sectors. So, it’s the distinctive engineer who decides to dedicate their lives to international well being. I requested such engineers about their motivation and inspiration.

Most spoke about the necessity to work on one thing that may be impactful and significant. International well being, it seems, gave them objective in life. Some had been impressed by their early experiences in resource-limited settings. Some see social justice as their aim and use engineering to combat for it. Others are attempting to assist their native communities with their engineering skillset.

“Well being is a proper,” mentioned Mimi Alkattan, an environmental engineer, and a Fulbright Scholar Researcher, and former Peace Corps volunteer. “It will be important for me to work on impactful and international issues and to face in solidarity with communities that have well being inequities,” she defined. Proper now, she is measuring antimicrobial resistance pathogens and antibiotics in floor waters in India.

“I dabbled in a number of tech startups, even spent a while on Wall Road, however actually linked with the problem of bettering international well being,” mentioned Jonathan Jackson, founding father of Dimagi. “The concept of constructing tech that was immediately tied to influence for underserved communities instantly clicked for me,” he added. Dimagi builds high-impact digital options that amplify frontline staff and packages.

Elizabeth Tilley is an Affiliate Professor of International Well being Engineering at ETH Zurich. Whereas she was doing her her bachelor’s in environmental engineering, she has the chance to work with an NGO in rural Mexico. A nurse practitioner there confirmed her an enormous jar of preserved parasitic worms that she defined had come out of a younger lady. “Realising that individuals, kids, may die from not having a bathroom appears very cliché now, however on the time it was thoughts blowing,” mentioned Tilley. “I don’t have a non secular background, however I positively felt that I had a karmic obligation to make use of my very costly, tax-funded schooling to provide again to individuals who didn’t win the beginning lottery,” she added.

Edgar Landivar, {an electrical} engineer in Ecuador, was impressed to work in international well being due to the pandemic. “My nation was hit severely due to the dearth of well being system. Inadequate ventilators and the impossibly of speeding manufacturing made me suppose we’ve an issue within the trade,” he mentioned. Through the pandemic, Openventi, the challenge he was concerned in, delivered 200 low-cost ventilators in Ecuador and Peru.

Some had been impressed by people. Eric Buckley is the Director of Oxygen Engineering at Build Health International (BHI). “My motivation for stepping away from my profession within the company engineering world and becoming a member of BHI got here from studying in regards to the unbelievable work our founder Jim Ansara was capable of accomplish together with his work with Companions in Well being after the 2010 earthquake in Haiti,” he mentioned.

Jonas Twizeyimana, a biomedical engineer, is a Simulation and Biomedical Technician on the College of International Well being Fairness (UGHE) in Rwanda. “Having learn in regards to the unbelievable work of the Late Dr. Paul Farmer, Partners in Health, and UGHE, I used to be impressed. I felt like I had discovered my objective in selling well being on a world scale,” he defined.

Some had been pushed by the necessity to assist their communities. Anpotowin Jensen is a Oglala Lakota and was born and raised on the Pine Ridge Indian Reservation. “The Lakota Individuals on our Reservation face rural healthcare points, meals deserts, restricted entry to water and electrical energy and our well being disparities are among the worst and unattended within the nation,” she mentioned. After doing her civil environmental engineering coaching at Stanford college, she is now working for the Worldwide Indian Treaty Council, a nonprofit, Indigenous group, and serving to sort out water high quality considerations.

Manu Prakash, a professor of bioengineering at Stanford College, did his undergraduate engineering coaching in India. After graduate coaching at MIT, he had the chance to go to Sevagram and Gadchiroli in rural India. “This expertise formed my pondering round working with communities,” he mentioned. “Rising up with well being desparities and seeing the dimensions of the issues we face, I made an express determination to construct low-tech options that may really scale,” he added.

Some discovered their ardour throughout fieldwork in resource-limited international locations. John Paul Mugo is a civil engineer, at the moment primarily based in Nigeria because the WASH Sector Co-Lead with Norwegian Refugee Council. “My first encounter with a cholera outbreak in South Sudan in 2013, gave me first-hand expertise, of how lack of entry to wash water, sanitation and data in hygiene impacts individuals,” he defined.

Nithya Ramanathan did her graduate area work in rural Bangladesh, utilizing sensors to detect arsenic within the groundwater. Her crew determined to transcend measuring arsenic. They labored with engineers to truly construct a deep effectively for the neighborhood. “That have motivated me to construct tech and knowledge methods that preserve lifesaving options in off-grid locations linked and supported for the lengthy haul,” she mentioned. Ramanathan is CEO and Co-Founding father of Nexleaf Analytics, a non-profit know-how firm.

For Rebecca Richards-Kortum, a Professor of Bioengineering at Rice College, a go to to a hospital in Malawi in 2005 modified the whole lot. “I noticed many items of important gear that had failed as a result of they weren’t designed to satisfy the wants of a low-resource surroundings. On the identical time, there have been many infants and youngsters who wanted therapy with that very same gear. I got here again to Rice and advised my group, we’re altering how we take into consideration know-how design,” she mentioned. She is now a part of NEST360, a crew of engineers and clinicians from 16 totally different organizations (12 in Africa), working collectively to enhance new child survival in African hospitals by growing and delivering a bundle of reasonably priced, efficient applied sciences and companies for newborns.

How do engineers add worth in international well being?

By interviewing engineers, I’ve learnt that there’s just about no space of drugs, healthcare, and public well being that doesn’t require engineering. International well being, particularly, requires frugal innovation to design and make issues work in powerful, under-resourced situations. Every little thing is finished on a good funds, and sometimes underneath nice time strain.

“Engineers have at all times contributed immediately or not directly to well being,” mentioned Bernard Amadei, Professor of Civil Engineering, College of Colorado, Boulder, and Founding President of Engineers Without Borders – USA. “Progress in life expectancy over the previous 100 years will be attributed to many disciplines, together with engineering. The query now’s the right way to contribute to the betterment of 3-4 billion individuals whose job is to remain alive on the finish of the day,” he requested.

“Engineers preserve individuals from getting sick within the first place,” mentioned Mimi Alkattan. “Engineers work on the surroundings round us, be it the constructed surroundings (buildings), infrastructure (water, wastewater, transportation, electrical energy), or pure surroundings (water, air, soil). By designing methods to maintain these areas clear and secure, engineers are immediately concerned in public well being,” she defined.

“Being an engineer means being a problem-solver and an innovator,” mentioned Tojan Rahhal, President & CEO of Engineering World Well being (EWH), a non-profit. “International well being encompases among the biggest challenges we face; underserved communities all over the world lack primary requirements and purposeful gear to deal with sufferers in want,” she defined. EWH is a world group that gives college college students and younger professionals in STEM fields with life-changing instructional experiences repairing medical gear in low-income international locations, create locally-sustainable coaching packages for biomedical engineering technicians all over the world, and interact the subsequent era of engineers to enhance international well being.

Anoop Jain, an environmental engineer, additionally emphasised the problem-solving skill that’s inherent in engineering. “Engineers are educated to unravel complicated issues, and international well being is a collection of complicated issues,” he mentioned. Jain is Founding-director, Sanitation and Health Rights in India, and a postdoctoral fellow at Harvard Medical Faculty. His group goals to finish open defecation and supply clear water to communities in India.

For Chandrasekhar Nair, an engineering in India, reasonably priced diagnostics was a means so as to add worth. He developed Truenat, a point-of-care molecular diagnostic platform for detection of infectious ailments in useful resource restricted settings. This platform was not too long ago endorsed by the WHO for speedy detection of tuberculosis, a illness that kills 1.5 million individuals yearly. This platform was broadly utilized in India for Covid-19 as effectively. “Engineering goes to play a definitive and essential position in drugs,” he predicts.

For Prashant Warier, one other Indian engineer, leveraging synthetic intelligence for healthcare was a path to influence. He helped begin an organization referred to as Qure.ai, a healthcare AI agency that makes use of AI in radiological imaging to assist physicians diagnose ailments shortly and precisely. “Radiologist data is briefly provide, costly, and erratically distributed. Because of this, not all sufferers obtain an applicable and well timed prognosis. That is the hole that Qure.ai is filling,” he defined. Their X-ray AI know-how can mechanically interpret X-rays for TB inside seconds, and was additionally endorsed by WHO.

For Linsey Marr, a Professor of Civil and Environmental Engineering at Virginia Tech, addressing air air pollution, a world drawback, was the best way so as to add worth. “Clear air and clear water are among the many most elementary requirements for good well being. Engineers are those who know the right way to ship clear air and clear water to the worldwide inhabitants,” she mentioned. Her analysis group focuses on understanding the mechanisms by which influenza virus and different pathogens are transferred from one host to a different and what components have an effect on the effectivity of transmission.

Jean Luc Mpamije, is the Biomedical engineering lead at Companions in Well being, Liberia. “Our work relies in bettering healthcare know-how methods, capability constructing of native biomedical technicians in rural and hard-to-reach areas to make sure that important gear and instruments will be maintained and upkept,” he defined. It’s well-known that upkeep of biomedical gear is a significant situation in low-income international locations, and it’s by no means straightforward to search out engineers to repair x-ray machines, ventilators, or child incubators. “All sufferers in every single place deserve entry to high-quality care, and engineers are a core element of high-quality service supply,” Jean Luc mentioned.

For Manu Prakash, ‘price aware engineers’ grounded with an understanding of context of a well being care supply system have a key position to design options that may be delivered at scale. His lab works on a broad vary of world well being issues equivalent to diagnostics, illness surveillance and schooling, specializing in ailments equivalent to malaria, TB, sexually transmitted illness, and Covid-19. He has additionally popularized the ‘citizen science approach’ – together with a cellphone-based strategy for citizen pushed mapping of mosquito species.

The Covid-19 pandemic uncovered the important scarcity of oxygen in lots of international locations. It’s not straightforward to overlook the pictures of individuals gasping for oxygen in the course of the Delta wave final 12 months. Eric Buckley of BHI is main a crew of over 20 workers members of their effort to extend entry to life saving medical oxygen in communities which have been hit hardest by the COVID-19 pandemic, with a give attention to Sub-Saharan Africa, The Caribbean and South America.

Ogehenetga Iortim, a communications engineer, is the CEO and founding father of Gricd, a Nigerian chilly chain know-how firm. “Our work goals to enhance entry to life saving vaccines which might be temperature delicate,” he mentioned. They construct actual time temperature trackers and funky packing containers that protect and guarantee the standard of temperature delicate drugs.

Amy Pickering is an Assistant Professor in Environmental Engineering at UC Berkeley. “Our lab research enteric pathogen environmental transmission pathways in excessive illness burden settings and collaborates with neighborhood companions to develop efficient, equitable, and scalable applied sciences and interventions to interrupt them,” she defined.

Francine Umutesi is Medical Know-how Division Supervisor, Rwanda Biomedical Centre, which ensures availability of healthcare infrastructure and gear. “My contribution was and is to make sure availability of infrastructure and gear when and the place wanted to arrange new Covid-19 isolations or therapy centres throughout the nation,” she mentioned.

Imran Cheema is an assistant professor {of electrical} engineering on the Lahore College of Administration Sciences in Pakistan. His Bio-Agri-Photonics lab is engaged on optical sensors for detecting ailments equivalent to TB.

Georgia Tech Affiliate Professor Shannon Yee, a mechanical engineer, has developed a brand new, reasonably priced rest room — the Era 2 Reinvented Bathroom (G2RT) — as an answer to the world’s sanitation drawback.

What limitations do engineers face in doing international well being work?

The engineers I interviewed determine a number of limitations for his or her international well being work. A few of them had been because of lack of recognition. Engineers are seen as ‘fixers’ doing routine upkeep, and never as innovators or important members of the healthcare crew. Some spoke about challenges in securing funding for growing or scaling revolutionary options. Some identified the necessity for engineers to have broader coaching (past simply engineering), in addition to stronger collaborations with clinicians and public well being consultants, to reach international well being.

Most recognized weak infrastructure (e.g. lack of instruments, electrical energy, water, roads, dependable web) and harsh situations (e.g. warmth, mud and humidity) as a continual situation all of them confronted. “You already know what to do and the right way to do it however you lack the suitable instruments,” mentioned Jonas Twizeyimana.

“Most medical groups comprise of medical doctors, nurses, anesthetists, however hardly ever can we hear a couple of biomedical engineer who contributed to saving a life,” mentioned Umutesi. “But, we’ve seen a few of them doing extraordinary issues particularly in disaster occasions. She actually believes higher recognition, higher pay, and empowerment of engineers will go a great distance in constructing capability in low-income international locations.

June Madete is Senior Lecturer, Division of Electrical and Digital Engineering, Kenyatta College. She did her engineering coaching within the UK earlier than returning to Kenya. “After I got here again to Kenya, biomedical engineering was all about upkeep. There was no capability for innovation or drawback fixing. That is once I launched into the sphere of capability constructing in R&D which was missing within the area,” she mentioned.

Afua Gyaama Kissi Ampomah is a program officer on the Aquaya Institute overseeing actions in Ghana for the Hilton Africa Water High quality Testing Program. She spoke about lack of sources as an enormous barrier. “Some engineering options require big quantity of capital to deploy which most growing international locations don’t have,” she mentioned.

Edgar Landivar raised considerations about regulatory processes for medical gadgets. “Laws are set for effectively stablished massive firms. Firms from growing international locations don’t have even an opportunity in opposition to massive international corporations when they should get approval for his or her new gadgets. So, there’s an entry barrier for innovation coming from growing international locations making an attempt to promote globally,” he defined.

Rebecca Richards-Kortum spoke about crossing “the valley of loss of life” between a promising prototype and an precise product. “Sadly, there’s a massive distinction between want for a brand new product and a market of shoppers who can pay for that product,” she mentioned. “If engineers are going to make a distinction in international well being, we’ve to determine the right way to not simply the right way to make promising prototypes however the right way to make merchandise that truly attain and assist the sufferers who want higher medical gadgets,” she argued.

Low price, scalable options require large efforts and focus over lengthy time period. Manu Prakash says such work is “both not supported or not on the scale we’d like, when in comparison with excessive margin merchandise which might be very effectively supported by the enterprise capital funding neighborhood,” he mentioned.

Imad H. Elhajj is a Professor of Electrical and Pc Engineering, American College of Beirut. He’s engaged of their Humanitarian Engineering Initiative. In response to him, funding channels for international well being are totally different than typical ones in engineering area, and it’s not straightforward to rent engineers to work on international well being initiatives. “International well being is just not at the moment a profession path that’s seen to engineering college students, though it must be,” he mentioned.

“Good engineering is messy and boring and repetitive – getting trash off the streets, getting shit out of pits, and getting a little bit of chlorine into water,” mentioned Elizabeth Tilley. She mentioned such work is just not more likely to get funded, whereas everyone seems to be eager to fund high-tech, glitzy stuff. “The most effective “interventions” I funded, however needed to cover from the funder, was to purchase new tires for the rubbish truck in Blantyre. If I had proposed a robotic drone to gather trash and forestall illness from spreading from the waste piling up on the streets, I most likely would have gotten the cash,” she mentioned.

Linsey Marr has comparable ideas. “I believe there’s a lack of expertise of the worth that engineers can contribute towards international well being as a result of most engineers don’t have medical-related coaching and since there’s an affiliation of engineers with whiz-bang know-how, slightly than with points that don’t seem overtly to be technologically difficult,” she mentioned.

Will Moyo is the Innovation Design Studio Supervisor, Malawi College of Science and Know-how & Rice 360 Institute for International Well being Applied sciences. “There are nonetheless too few girls in engineering,” she mentioned. “Not solely are younger girls underrepresented in engineering, in addition they face vital challenges in navigating the workspace. There are additionally only a few pathways for informally educated engineers to prototype and take a look at their innovations,” she added.

“We have to do higher at together with ladies and men of colour, particularly those who have lived experiences of the problems that our work addresses,” mentioned Mimi Alkattan.

Daniel Acosta is an industrial engineer from Colombia, at the moment a PhD scholar on the Division of Environmental & International Well being, School of Public Well being and Well being Professions, College of Florida, the place he’s engaged on veterinary vaccine provide and worth chains. He highlighted that engineers typically lack coaching in social sciences. “If engineers are blind to points equivalent to gender and intersectionality, our work may inadvertently find yourself exacerbating inequalities in entry to well being,” he mentioned. Certainly, there are examples of AI options that worsen gender and racial biases.

Anoop Jain had comparable considerations. “International well being is a collection of complicated issues. However not all of them have technical options. Engineers must get higher at understanding the social, political, and financial determinants of those complicated issues, and design options that account for these determinants,” he defined. He gave India’s sanitation disaster for example. It’s not a technical drawback, however an issue rooted in cultural and social determinants, he argued.

“We want T-shaped engineers which have depth of experience in an engineering area (e.g. mechanical or organic engineering) but additionally have broader expertise in different disciplines equivalent to epidemiology, international well being, product design, economics, city planning, complicated methods, ethics, human-centered design, and neighborhood engagement,” mentioned Amy Pickering.

Inspiring the subsequent era of engineers

It’s clear that engineers have a lot to supply and add large worth in all areas of world well being and medical care. And there are 1,000,000 issues to unravel, from pandemics to international warming. Absolutely, international well being is a dream alternative for engineering college students who wish to see influence of their lifetimes?

However most college students in STEM have little thought about how they’ll become involved in fixing big issues like pandemics or local weather change. Even when they needed to, engineers aren’t inspired to pursue international well being, mentioned Tojan Rahhal. “Frankly, it isn’t normally the very best paying job,” she mentioned. Corporates and industries headhunt good engineers and never many see a profession path in international well being.

“If cash is your primary motivator, the worldwide well being area is probably going not a match,” mentioned Jonathan Jackson. “You want to be intrinsically motivated by social influence, extra so than monetary acquire,” he defined.

Right this moment, many younger individuals are enthusiastic about social influence and are searching for significant profession pathways. Engineers like Manu Prakash are inspiring scores of younger STEM college students by way of initiatives like Foldscope, and Frugal Science programs. Younger individuals are naturally drawn to hackathons and crowd-sourced, open science platforms, eager to assist the place they’ll. Prakash argues that it’s important that engineers centered on international well being are uncovered to area context early and actually perceive the problem at hand. This requires collaborations between international North and South companions, he says.

And devoted teams equivalent to Build Health International, Humanitarian Engineering Initiative, Engineering World Health, Engineers Without Borders, Partners in Health, Doctors Without Borders, Dimagi, Nexleaf Analytics, Rice 360, and Prakash Lab are inspiring younger engineers to roll up their sleeves and get engaged in fixing real-life issues that influence hundreds of thousands of individuals in distant and under-served areas.

It is going to be very impactful if mainstream engineering colleges created particular concentrations in international well being engineering to develop the pipeline of younger individuals coming into international well being. Packages in high-income international locations ought to equitably accomplice with engineering colleges, medical and public well being colleges in low and middle-income international locations or under-served areas, for college students to be taught from individuals fixing actual issues on the bottom. However, Mimi Alkattan aruges that this must be accomplished rigorously. “Engineers want to look at and handle how their work could be intersecting with saviorism, colonialism, and racism,” she emphasised.

As I wrote in my earlier publish, younger individuals are sad with how the world is tackling massive crises. International well being engineering presents them a terrific alternative, fairly actually, to not solely restore the damaged world they’re inheriting, however design a greater future for humankind.

Observe: I’ve no monetary investments or conflicts with any firm, particular person or entity featured on this piece. I’ve no trade affiliations or disclosures.