Ashley Taylor (MS/MPH'16)

Pediatric Medical Device Institute (Malawi) Practicum

Clinicians in low and middle income countries face many challenges, including high patient-to-staff ratios, limited resources, and inconsistent access to electricity. Traditionally, low and middle income countries have acquired medical devices through donations from charitable organizations. However, community leaders in southern Malawi voiced concerns that much of the donated equipment was not properly suited for the environment. Devices that cannot be repaired locally are placed in “medical device graveyards”, creating electronic waste sites that pose a significant threat to human health if not properly managed.

Working with the Pediatric Medical Device Institute, my practicum work focused on taking an “upstream” approach to medical devices in low resource settings. Specifically, the main goal of my practicum was to improve health outcomes through an enlightened understanding of challenges associated with medical devices in low resource settings. Recognizing the criticality of community-based solutions, my role was to work with community leadership in southern Malawi to conduct a community-based participatory study on medical devices at three clinical settings, including one government hospital, one rural hospital, and one private hospital. We were fortunate to have an incredible team contribute to this work, including clinical and technical staff at each hospital location as well as representatives from the Malawian Health Equity network and university officials. Deliverables for the project included study results as well as the development of educational materials and programs aimed towards improving preventative maintenance of medical equipment in low resource settings.

My passions are deeply embedded in global health, which I was fortunate to first pursue by working with engineering teams in Malawi. However, after several years working in Malawi on engineering efforts, I was eager to understand how to contribute to global health efforts using an “upstream approach” to problem solving, which is the essence of public health. This practicum opportunity was an incredible opportunity to understand how to work at the community level to foster real change through “upstream thinking”.

It is phenomenally inspiring to witness people from diverse experiences, disciplines, and expertise work together for a common purpose. There is a saying that my mentors in Malawi shared with me during my practicum about the remarkable power of collaboration: “When spider webs unite, they can take down a lion”. Unquestionably, the most rewarding part of my practicum experience was uniting with community leaders and working towards a common goal to improve health outcomes. Getting “upstream” of the challenges with medical devices in low resource settings is certainly a “lion” of a task, but after working with such brilliant and passionate mentors and colleagues, I am inspired that the task is attainable. Long-term, our team hopes that by working together, we may move away from the traditional model of dependency on medical device donations and move towards sustainable development, fabrication, and maintenance of devices in low resource settings such as southern Malawi.

The practicum experience provided an unparalleled learning opportunity to build skills in the community-based participatory research framework. Through my practicum mentors, I was introduced to the importance of identifying strengths and assets of communities instead of focusing only on deficits and needs. This mindset is an incredibly powerful tool,  I believe, for public health work, and I am incredibly grateful that this was instilled in me during my practicum.

My practicum experience emphasized the incredible strength of communities and the necessity of working at the community level to foster real, positive change. I think the public health “heart” is about pursuing positive change by embracing and working to edify the strengths and assets of communities to improve health outcomes. After witnessing such positive community-based work during my practicum, I will strive to keep community and people-first solutions as my anchor and guiding vane in public health work.

Embrace every part of the practicum experience, especially the incredible resources around you (mentors, faculty, peers). The practicum experience is so much more than a project- it’s a real opportunity to make connections, grow in skills as a public health professional, and most importantly, contribute to inspiring positive change.

Ashley Taylor
Ashley Taylor working with Humphries Gwedemule and Dr. Kevin Kochersberger on medical equipment in the Pediatric Ward at Domasi Rural Hospital in Malawi.