Hasta Luego Costa Rica

And just like that, our short time in Costa Rica is over. Ten weeks ago, I had many reservations regarding my trip. I had never been away from home for such a long period of time (and in a different country for that matter). My high school Spanish was rusty, I had graduated a couple weeks before, and I had just met 7 complete strangers with whom I was going to spend the rest of my summer. However, even amid all those reservations, I can definitively say that my experience in Costa Rica was one of the most fulfilling experiences, both professionally and personally.

Recap

Our cohort accomplished so much in a short amount of time. It was really encouraging to see how well the personalities on our team meshed together. There is always the concern of clashing personalities and tensions arising in a group setting, especially being that our cohort would constantly be around each other, there was the chance that we could wear each other out. I can confirm that we all still like each other even after 10 weeks. In fact, it was very nice seeing familiar faces here in Houston during orientation. Although we may have different ambitions and outlooks on life, when it came to working on projects, we all wanted to ensure that our work helped others. That is a great sign for year to come! Just to reflect upon the work we did in Costa Rica, here is a brief recap of our summer:

  1. Needs Finding with TEC Students
  2. Observations at Hospital Mexico
  3. Medical Device Innovation Course
  4. Needs Finding at Hospital Liberia
  5. Working on DialOasis in Guanacaste
  6. Medical Device Implementation Course
  7. Internship at Boston Scientific (Coyol)

I have learned more in this 10-week span than I could have imagined. I will try to encapsulate my experiences as effectively as I can to paint the picture of my summer in Costa Rica.

Needs Finding with TEC Students

Our first glimpse of the medical device market in Costa Rica started here. We spent time learning about the concept of needs finding (or insight-informed innovation). We were assigned to groups in which we could work on various projects (that the TEC students will implement throughout the upcoming year). My group worked with a high school student who suffered from cerebral palsy. With his family living in the more rural setting of San Marcos, there were unique challenges that they had to endure. Two other students and I were able to see these conditions firsthand, and it really opened our eyes to the amount of improvement that could be made. Here are some key takeaways:

  • Be thorough with observations, even the little things can make a big difference
  • Examine who the stakeholders are, and understand all perspectives to a problem
  • Be earnest in talking to stakeholders, they will give more input if they feel you are invested in the problem
  • Having diversity within a group can be utilized as a strength
  • There are often external issues that exacerbate the problem (prioritize what are primary and secondary issues)

Our Project with a Cerebral Palsy Student

Rural School in San Marcos

Observations at Hospital México

Now that we had received instructions on how to tackle issues and problems with specific projects, it was time to implement the mindset of “insight-informed innovation” at a local hospital. Hospital México is the largest hospital in Costa Rica, and it was a prime spot to observe opportunities for innovation and improvement.  Our cohort was able to observe different medical procedures (bone marrow aspiration, cardiac catheterization) and ask the medical professionals performing them their thoughts on the procedures and how they could possibly be improved.  Here are some takeaways from our experience at the hospital:

  • Observe as much as you can (people’s mannerisms, instances of heavy foot traffic, building conditions, general logistics of hospital, etc.)
  • Don’t assume that the issues of a hospital are due to lack of equipment or resources
  • The hospital does not utilize an EMS, patients carry their medical records around
  • You may need to schedule an appointment 6 months in advance, and if you miss it, you may have to wait up to a year to get another one

Medical Device Innovation Course

Our next step revolved around the front-end innovation in medical devices. The Rice students were tasked with finding potential projects for which to make low-fidelity prototypes. The function of a low-fidelity prototype is not to necessarily imitate the function or form of a potential device, but rather get an illustration across of what your idea is. We were given common arts and crafts materials and although our device looked silly, it helped effectively communicate our idea of a device to help children with cerebral palsy move to and from a wheelchair. Here are some more takeaways from this course:

  • Even the craziest of ideas can be viable solutions. In brainstorming, let your group members individually write down a plethora of ideas.
  • Developing key criteria by which to judge your designs is key in picking the most effective solution
  • Understanding the costs associated with implementing a design is essential for an Engineer to understand.

Our Lift-Assist Rendering

 

 

Our Low-Fidelity Prototype (yes, that is a stick-man)

 

Needs Finding at Hospital Liberia

After our initial time in San Jose, we went up to the more rural province of Guanacaste and visited a hospital in the Liberia area. This was a much smaller hospital than the one in San Jose, and the issues that they had to deal with were of a different subset. Issues such as kidney failure and HPV are more common in that region than others, and so understanding how we could best improve the healthcare for this hospital could have a long-lasting impact on the community. Here are some key takeaways from our trip there:

  • There is a high-likelihood you will have HPV at some point in your life
  • Peritoneal dialysis is the most common form of treatment in Guanacaste (compared to hemodialysis, which is more expensive)
  • Leftover paraffin from biopsy samples are used to make candles
  • Doctors enjoy using WhatsApp to send pictures of malignant tumor histology

Breast Cancer Histology

DialOasis

As mentioned before, the need for dialysis in Guanacaste is significant. Those who have the resources to conduct peritoneal dialysis at home save a visit to the hospital every day (they can spend most of the day in the hospital due to their condition). Some of the poorer families lack the sterile environment in their homes to be able to conduct in-home dialysis. This is the demographic that we wanted to focus on with the DialOasis. Creating a sterile, portable system that could be implemented within patients’ homes would save countless hours of time and restore some quality of life. Without a sterile environment, infections with peritoneal dialysis is likely. Patients must go through a stringent hand-washing and sterilization process to ensure that this does not occur.

With the previous year’s GMI cohort already having done the design work on the “cuartito”, it was our job to optimize the design to make it as durable, portable and modular as we could. With the collaboration between Rice and Invenio, we were successfully able to source materials, assemble the room, and test the device in a hospital setting. Here are some key takeaways from this experience:

  • When working in collaborations, make sure to clearly define roles and dynamics between the collaborators (especially if in a foreign country)
  • Understanding the resources available in a region is key to identifying sustainability long-term
  • Initial testing of product is all about the creation of a “façade”. This is to gauge the consumer’s interest in the product
  • Designing for manufacturing and ergonomic efficiency are key in further developing this project into the clinical trial phase

Medical Device Implementation

In school growing up, my concepts of engineering revolved around breakthrough research and intricate designs and machinations, however, rarely are you taught about the reality of implementing a product from conception to market availability. There are numerous hurdles you must overcome and consider before you can go forward with innovation. We took this course to better understand those aspects and how we can better prepare for it. To emphasize our project-based learning approach, we were placed in groups to put currently available medical devices through these criteria. Here are some key takeaways from this course:

  • Understanding the need for PDPs (product development processes) and analyzing the current trends in the medical technology industry
  • The importance of developing a concrete IP strategy
  • Learning about the roles of quality (risk mitigation, validation and verification, IQ/OQ/PQs, ISO 13845 adherence, QSR, QMS, QA, QC, etc.)
  • Learning about the roles of manufacturing (LBM, Design for Manufacturing, Design-to-value)
  • Learning about the regulatory processes involved (FDA approval, 510(k) vs. PMA, Predicate devices, etc.)
  • Learning about sales strategy (product vs. service, knowing your customer, product distribution, value-proposition, ICD/HCPCS codes)

Internship at Boston Scientific

In the last six weeks of our Costa Rica trip, Boston Scientific provided us the opportunity to intern at their company. We were divided up into different divisions (R&D, Quality and Manufacturing) to broaden our understanding of what an Engineer does. Being that this was my first time working in an industry setting, it was a great exposure and glimpse of what the industry looks like. However, since we were in Costa Rica for this internship, there were some unique experiences to be had during the course of our time there. There is a certain dynamic you expect with typical internships. You expect it to be a lot of learning and listening to much more experienced Engineers, however, in my experience, my coworkers genuinely viewed me as someone who could provide a unique insight and perspective to their processes. I grew up in a completely different environment than my coworkers did, and with that, I could be a fresh set of eyes in examining problems. The internship was an eye-opening experience for me in more ways than one, and here are some of the aspects which I learned from my time at Boston Scientific:

  • Having time management and communication skills is crucial in finishing projects in an effective manner
  • Immerse yourself in company culture and learn as much as you can from your fellow co-workers
  • Be prepared to read company policies and procedures – it is a necessary evil
  • Be patient with others. You will have days where there is not much to do and you will have days where you have a lot to do
  • Be ready to do work that others may not want to do, it shows that you are willing to put in effort and time for the good of the company
  • Understand that you are establishing a personal brand. Conduct yourself with the future in mind
  • Networking is important, especially for entry-level Engineers such as myself

My Name Spelled in Spanglish

Readying Myself for the Next Chapter

These past few months have really taught me so much. The relationships I made in Costa Rica are ones that will be missed. Costa Rica is a country full of beauty, kind people, and immense potential for medical innovation. With a flurry of MedTech companies already established there, Costa Rica will nonetheless be a hub of innovation and that is truly exciting. I cannot think of a better place and better people to have had shared this unique experience with. It’s now time to look forward towards the new projects that I will have for the upcoming year, but of course I cannot forget just how awesome this Summer has been. Hasta luego Costa Rica, pura vida!

I Wish Houston had these Views

Until Next Time

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