ABOUT THE SPEAKER
Tania Douglas - Biomedical engineering professor
Tania Douglas imagines how biomedical engineering can help address some of Africa's health challenges.

Why you should listen

Tania Douglas's research interests include medical imaging and image analysis, the development of contextually appropriate technology to improve health and health innovation management, particularly the mechanisms of medical device innovation in South Africa.

Douglas is engaged in capacity building for biomedical engineering and needs-based health technology innovation at universities across the African continent; two such projects are "Developing Innovative Interdisciplinary Biomedical Engineering Programs in Africa," in collaboration with Northwestern University and the Universities of Lagos and Ibadan, and "African Biomedical Engineering Mobility," in collaboration with Kenyatta University, Cairo University, Addis Ababa University, the Mbarara University of Science and Technology, the University of Lagos, and the University of Pisa. 

Douglas is the founding Editor-in-Chief of Global Health Innovation, an electronic open-access journal focusing on social and technological innovation for improved health, which launches in 2018. The journal aims to serve as a platform for disseminating research on health innovation in developing settings. 

Douglas has been a Humboldt Research Fellow at the Max Planck Institute for Neurological Research in Cologne and at the Free University of Berlin, an Honorary Senior Research Fellow at University College London, a Visiting Professor at Kenyatta University, and a Visiting Scholar at Northwestern University. She is a fellow of the South African Academy of Engineering, a member of the Academy of Science of South Africa, and a Fellow of the International Academy for Medical and Biological Engineering.

 

 

More profile about the speaker
Tania Douglas | Speaker | TED.com
TEDGlobal 2017

Tania Douglas: To design better tech, understand context

Filmed:
1,160,410 views

What good is a sophisticated piece of medical equipment to people in Africa if it can't handle the climate there? Biomedical engineer Tania Douglas shares stories of how we're often blinded to real needs in our pursuit of technology -- and how a deeper understanding of the context where it's used can lead us to better solutions.
- Biomedical engineering professor
Tania Douglas imagines how biomedical engineering can help address some of Africa's health challenges. Full bio

Double-click the English transcript below to play the video.

00:12
This is an equipment graveyard.
0
818
2222
00:15
It's a typical final resting place
1
3064
2228
00:17
for medical equipment
from hospitals in Africa.
2
5316
2786
00:20
Now, why is this?
3
8720
1415
00:22
Most of the medical devices
used in Africa are imported,
4
10641
4187
00:26
and quite often, they're not suitable
for local conditions.
5
14852
3644
00:31
They may require trained staff
6
19095
3250
00:34
that aren't available to operate
and maintain and repair them;
7
22369
3655
00:38
they may not be able to withstand
high temperatures and humidity;
8
26739
3769
00:42
and they usually require a constant
and reliable supply of electricity.
9
30532
4462
00:48
An example of a medical device
10
36104
2099
00:50
that may have ended up
in an equipment graveyard at some point
11
38227
4202
00:55
is an ultrasound monitor
to track the heart rate of unborn babies.
12
43039
4570
01:00
This is the standard of care
in rich countries.
13
48447
3431
01:03
In low-resource settings,
the standard of care is often
14
51902
3746
01:07
a midwife listening
to the baby's heart rate
15
55672
3209
01:10
through a horn.
16
58905
1154
01:12
Now, this approach has been around
for more than a century.
17
60689
3971
01:16
It's very much dependent on the skill
and the experience of the midwife.
18
64684
4485
01:22
Two young inventors from Uganda
19
70528
2805
01:25
visited an antenatal clinic
at a local hospital a few years ago,
20
73357
4532
01:29
when they were students
in information technology.
21
77913
2832
01:33
They noticed that quite often,
22
81425
2668
01:36
the midwife was not able
to hear any heart rate
23
84117
3084
01:39
when trying to listen to it
through this horn.
24
87225
2688
01:42
So they invented their own
fetal heart rate monitor.
25
90665
4537
01:48
They adapted the horn
and connected it to a smartphone.
26
96156
4599
01:52
An app on the smartphone
records the heart rate, analyzes it
27
100779
4493
01:57
and provides the midwife
with a range of information
28
105296
2904
02:00
on the status of the baby.
29
108224
1755
02:03
These inventors --
30
111529
1312
02:04
(Applause)
31
112865
1222
02:06
are called Aaron Tushabe
and Joshua Okello.
32
114111
3103
02:10
Another inventor, Tendekayi Katsiga,
33
118591
3363
02:14
was working for an NGO in Botswana
that manufactured hearing aids.
34
122739
5588
02:20
Now, he noticed that
these hearing aids needed batteries
35
128738
5097
02:25
that needed replacement,
36
133859
1197
02:27
very often at a cost
that was not affordable
37
135080
2634
02:29
for most of the users that he knew.
38
137738
2102
02:32
In response, and being an engineer,
Tendekayi invented
39
140151
5089
02:37
a solar-powered battery charger
with rechargeable batteries,
40
145264
3610
02:40
that could be used in these hearing aids.
41
148898
2319
02:43
He cofounded a company called Deaftronics,
42
151625
3902
02:47
which now manufactures the Solar Ear,
43
155551
2660
02:50
which is a hearing aid powered
by his invention.
44
158727
3249
02:55
My colleague, Sudesh Sivarasu,
invented a smart glove
45
163829
5237
03:01
for people who have suffered from leprosy.
46
169090
2166
03:03
Even though their disease
may have been cured,
47
171799
3005
03:06
the resulting nerve damage
will have left many of them
48
174828
3156
03:10
without a sense of touch in their hands.
49
178008
2538
03:12
This puts them at risk of injury.
50
180570
2058
03:16
The glove has sensors
to detect temperature and pressure
51
184017
4025
03:20
and warn the user.
52
188066
1381
03:22
It effectively serves
as an artificial sense of touch
53
190581
3509
03:26
and prevents injury.
54
194114
1466
03:28
Sudesh invented this glove
after observing former leprosy patients
55
196032
4689
03:32
as they carried out
their day-to-day activities,
56
200745
2946
03:35
and he learned about the risks
and the hazards in their environment.
57
203715
3589
03:41
Now, the inventors that I've mentioned
58
209774
2180
03:43
integrated engineering with healthcare.
59
211978
2679
03:47
This is what biomedical engineers do.
60
215260
2235
03:50
At the University of Cape Town,
61
218558
1905
03:52
we run a course called
Health Innovation and Design.
62
220487
3157
03:55
It's taken by many of our graduate
students in biomedical engineering.
63
223668
3947
04:00
The aim of the course
is to introduce these students
64
228106
3597
04:03
to the philosophy of the design world.
65
231727
2555
04:06
The students are encouraged
to engage with communities
66
234306
3021
04:09
as they search for solutions
to health-related problems.
67
237351
3243
04:13
One of the communities that we work with
is a group of elderly people
68
241055
3269
04:16
in Cape Town.
69
244348
1224
04:17
A recent class project had the task
of addressing hearing loss
70
245596
4140
04:21
in these elderly people.
71
249760
1450
04:23
The students, many of them
being engineers,
72
251886
2772
04:26
set out believing that they
would design a better hearing aid.
73
254682
4851
04:31
They spent time with the elderly,
74
259557
1608
04:33
chatted to their healthcare providers
and their caregivers.
75
261189
3248
04:37
They soon realized that, actually,
adequate hearing aids already existed,
76
265039
5114
04:42
but many of the elderly who needed them
and had access to them
77
270177
3996
04:46
didn't have them.
78
274197
1413
04:47
And many of those who had hearing aids
79
275954
2112
04:50
wouldn't wear them.
80
278090
1233
04:52
The students realized
81
280321
1990
04:54
that many of these elderly people
were in denial of their hearing loss.
82
282335
3937
04:58
There's a stigma attached
to wearing a hearing aid.
83
286296
2500
05:01
They also discovered that the environment
in which these elderly people lived
84
289757
4758
05:06
did not accommodate their hearing loss.
85
294539
2023
05:08
For example, their homes
and their community center
86
296586
3781
05:12
were filled with echoes
that interfered with their hearing.
87
300391
3068
05:15
So instead of developing and designing
a new and better hearing aid,
88
303999
5108
05:21
the students did an audit
of the environment,
89
309131
2683
05:23
with a view to improving the acoustics.
90
311838
2399
05:27
They also devised a campaign
to raise awareness of hearing loss
91
315196
3834
05:31
and to counter the stigma
attached to wearing a hearing aid.
92
319054
3576
05:35
Now, this often happens
when one pays attention to the user --
93
323603
3384
05:39
in this case, the elderly --
94
327011
1650
05:40
and their needs and their context.
95
328685
1965
05:43
One often has to move away
from the focus of technology
96
331219
2846
05:46
and reformulate the problem.
97
334089
1838
05:48
This approach to understanding a problem
through listening and engaging
98
336861
3977
05:52
is not new,
99
340862
1228
05:54
but it often isn't followed by engineers,
100
342601
2612
05:57
who are intent on developing technology.
101
345237
3110
06:01
One of our students has a background
in software engineering.
102
349704
3448
06:05
He had often created products for clients
103
353176
2677
06:07
that the client ultimately did not like.
104
355877
2389
06:10
When a client would reject a product,
105
358902
2177
06:13
it was common at his company
106
361103
1885
06:15
to proclaim that the client
just didn't know what they wanted.
107
363012
3708
06:19
Having completed the course,
the student fed back to us
108
367384
3562
06:22
that he now realized
that it was he who hadn't understood
109
370970
3198
06:26
what the client wanted.
110
374192
1421
06:28
Another student gave us feedback
111
376254
2573
06:30
that she had learned
to design with empathy,
112
378851
2468
06:33
as opposed to designing for functionality,
113
381343
2990
06:36
which is what her engineering
education had taught her.
114
384357
2731
06:39
So what all of this illustrates is that
we're often blinded to real needs
115
387830
4132
06:43
in our pursuit of technology.
116
391986
1593
06:45
But we need technology.
117
393936
1581
06:47
We need hearing aids.
We need fetal heart rate monitors.
118
395541
2969
06:51
So how do we create more medical device
success stories from Africa?
119
399385
4783
06:56
How do we create more inventors,
120
404967
1978
06:58
rather than relying on
a few exceptional individuals
121
406969
3247
07:02
who are able to perceive real needs
122
410240
2108
07:04
and respond in ways that work?
123
412372
1842
07:06
Well, we focus on needs
and people and context.
124
414718
3460
07:10
"But this is obvious," you might say,
125
418497
1832
07:12
"Of course context is important."
126
420353
2278
07:15
But Africa is a diverse continent,
127
423486
2408
07:17
with vast disparities in health and wealth
and income and education.
128
425918
4871
07:22
If we assume that our engineers
and inventors already know enough
129
430813
5027
07:27
about the different African contexts
130
435864
2586
07:30
to be able to solve the problems
of our different communities
131
438474
3841
07:34
and our most marginalized communities,
132
442339
1939
07:36
then we might get it wrong.
133
444302
1448
07:38
But then, if we on the African continent
134
446907
2595
07:41
don't necessarily know enough about it,
135
449526
3272
07:44
then perhaps anybody with the right level
of skill and commitment could fly in,
136
452822
4130
07:48
spend some time listening and engaging
137
456976
2469
07:51
and fly out knowing enough
to invent for Africa.
138
459469
3257
07:55
But understanding context is not about
a superficial interaction.
139
463953
4315
08:00
It's about deep engagement
140
468292
1960
08:02
and an immersion in the realities
and the complexities of our context.
141
470276
4638
08:07
And we in Africa are already immersed.
142
475877
3142
08:11
We already have a strong and rich
base of knowledge
143
479522
3673
08:15
from which to start finding solutions
to our own problems.
144
483219
3678
08:19
So let's not rely too much on others
145
487873
3016
08:23
when we live on a continent
that is filled with untapped talent.
146
491548
4094
08:28
Thank you.
147
496124
1186
08:29
(Applause)
148
497334
2971

▲Back to top

ABOUT THE SPEAKER
Tania Douglas - Biomedical engineering professor
Tania Douglas imagines how biomedical engineering can help address some of Africa's health challenges.

Why you should listen

Tania Douglas's research interests include medical imaging and image analysis, the development of contextually appropriate technology to improve health and health innovation management, particularly the mechanisms of medical device innovation in South Africa.

Douglas is engaged in capacity building for biomedical engineering and needs-based health technology innovation at universities across the African continent; two such projects are "Developing Innovative Interdisciplinary Biomedical Engineering Programs in Africa," in collaboration with Northwestern University and the Universities of Lagos and Ibadan, and "African Biomedical Engineering Mobility," in collaboration with Kenyatta University, Cairo University, Addis Ababa University, the Mbarara University of Science and Technology, the University of Lagos, and the University of Pisa. 

Douglas is the founding Editor-in-Chief of Global Health Innovation, an electronic open-access journal focusing on social and technological innovation for improved health, which launches in 2018. The journal aims to serve as a platform for disseminating research on health innovation in developing settings. 

Douglas has been a Humboldt Research Fellow at the Max Planck Institute for Neurological Research in Cologne and at the Free University of Berlin, an Honorary Senior Research Fellow at University College London, a Visiting Professor at Kenyatta University, and a Visiting Scholar at Northwestern University. She is a fellow of the South African Academy of Engineering, a member of the Academy of Science of South Africa, and a Fellow of the International Academy for Medical and Biological Engineering.

 

 

More profile about the speaker
Tania Douglas | Speaker | TED.com