daladala bill y’all – Method Man
If you come to enough talks on international development with me you’ll notice I almost always ask some variation of “how is this program funded?”. I ask because sometimes it elicits candid discussions of cost effectiveness and donor motivations. After embarking on a project in Tanzania myself, it’s time for me to answer that question.
In this blog I lay out the costs of the Engineering World Health Summer Institute, a program which trains student engineers to repair hospital equipment before deploying them to developing country hospitals for one month periods. I lay out the organisations that funded my attendance through grants, with the amounts received and then discuss the cost effectiveness of the program and how I justify having attended with that in mind. I also intend this to be a resource for others looking to fund development projects and professional development in global health, and an appendix contains extracts from the funding applications I submitted.
The Engineering World Health Summer Institute is mad expensive. All told it cost over £6000 ($10,000), which I funded entirely through grants. This section details those costs and what the money buys.
|EWH-SI program fee||£4800 ($7200)||See text|
|Medical examination||£95||Required by EWH|
|Vaccinations||£200||Hep A, Hep B, Typhoid |
|Antimalarials||£50||100 doses, doxycycline|
|Maintenance||£300||Mainly food and transport during second month|
 I was already vaccinated for Measles, Mumps, Rubella, Polio, Tetanus, Dyptheria and Yellow Fever. I opted not to be vaccinated against Rabies.
By far the biggest expense is the fee paid to Engineering World Health for participation in the Summer Institute. I do not know if this figure is subsidised by donor contributions (see later for financial aid) or if it contributes to other EWH programs. It is hard to untangle the figure as I do not have a cost breakdown, but I’ve done my best to show what I believe it pays for, though I’ve doubtless forgotten something.
|Month 1||Month 2|
|Tuition: ~30 hours of technical lectures from developing world medical equipment expert; ~30 hours of technical labs including lab supplies, lab book, textbook and support from two staff; ~60 hours of Swahili language training in groups of 10 including textbooks and other learning materials; 4 supervised hospital visits||Hospital placement: Organisation of placement; Tanzania volunteer work permit|
|Staff: 2 On The Ground Coordinators at all times for 25 students; Technical lecturer; Implied cost of maintenance, 4 return flights and stipends/fees|
|Security: Evacuation cover; Insurance; Emergency phone|
|Living: Accommodation; food for first month; transport to and from airport.|
|Equipment: Mobile phone with starter credit; tool kit; medical kit|
|Engineering World Health Overheads: Predeparture support; application process; fundraising|
The fee is fixed and all of the other costs are hard to avoid or reduce. Some money could have been saved on maintenance and by buying antimalarials online. Cost of flights can vary significantly. It is also worth noting that the programme fee is paid in US Dollars via Paypal, and so the exchange rate and transfer fees were very significant.
Most of the this year’s 25 participants in the Tanzania program did not fundraise individually: 10 students this year attended through Duke University’s Engage program which fully funded their place; 6 Danish students and some others fundraised through University EWH branches. Many students received various levels of financial aid from EWH itself. Perhaps 5 privately funded the program (ie through their own/family’s funds).
I raised £6065 to fund my place from four sources.
|Organisation||Award||Amount requested||Amount received|
|Engineering World Health||Summer Institute Financial Aid||£3000 ($4500)||£1000 ($1500)|
|Royal Academy of Engineering||Engineering Leadership Advanced Award||–||£2700|
|Institute of Mechanical Engineering||Overseas/Developing World Engineering Projects Award||£2000||£1865|
|Bristol University Alumni Foundation||Project Award||£865||£500|
This table highlights lesson one of fundraising with grants: always apply for more than you need. No funding body will ever give you more than you ask for, and most will give you less. If you want to make your target, you have to apply for more.
Engineering World Health advertise that they provide financial support for the program. I am grateful for what I did receive, but I was expecting more. My parents had recently moved and were not working, and my own tax return was measly. With the cost of the program so high I don’t know how poor you have to be to receive one of their full grants. With that said, the fact that I did fundraise enough eventually probably justifies their decision in my case. More on this later.
Funding my place would have been much harder without the RAEng Leadership Award I won in 2014. This award is £5000 over three years to spend on professional development. It’s basically the holy grail: a large pot of near unrestricted funding and I do not know how I would have managed without this.
The grants from the IMechE and Alumni foundation are much more repeatable. The application process for the IMechE is particularly arduous (three references and several essays) but the grants are generous. It’s also important to note that it requires you to have financial support from your university, which made the comparatively small Alumni grant very important.
The Engineering World Health Summer Institute is extremely cost intensive. If the equipment repairs accomplished were judged by the standards of an international development project to improve health outcomes, it would no doubt have to be called a colossal waste of resources. Wouldn’t it be more effective to spend the money on other projects, or even just give it directly? I’ve wrestled with this myself and there are no clear answers, but there are some key points to consider:
Firstly, the Institute is not just a placement. Of the two months in country, only 24 days are spent working at the hospitals. The rest of the time participants spend in education: technical, linguistic and cultural. It is an explicit aim of the programme to give young engineers experience of working in developing countries, with the aim of encouraging them to be socially responsible global citizens. The students who attend are selected through a very competitive process and are very talented (/hubris), if even a handful can tip their careers or their companies towards development, what impact then?
Secondly, repairing medical equipment is only one of several functions. Arguably more valuable is the data that the students generate through inventories, catalogs of repairs and needs assessments. This data is used in field leading academic research, featured prominently in journals like The Lancet. We only know 40% of medical equipment in developing countries is out of service because of the Summer Institute and this statistic alone has kickstarted a global rethink in how equipment is donated.
Finally, it’s important to consider that this is not a big pile of transferable cash being spent. The majority of the funding for the Institute comes from educational institutions concerned mainly with the students. An equivalent program without the student element could not be funded from the same sources. The IMechE Award draws from a big pool for professional development, not international development. Had I not secured that grant it might not have been spent anywhere near Tanzania, but on flights to conferences or work experience in arguably less socially productive ventures.
It’s no doubt important to ask these questions, and I hope this blog helps fuel that discussion. My biggest anxiety is that the cost is prohibitive, preventing the most talented attending in favour of a privileged subset. Overall though I conclude that the EWH Summer Institute can be a worthwhile project if it is funded through grants aimed at student development. Most importantly though is what the students do next and the impact we have in the future.
So watch this space.
Institute of Mechanical Engineering – Overseas/Developing World Engineering Projects Award
Members of the IMechE can apply for up to £2000 funding for a variety of purposes, including projects related to international development. The application process is very involved, requiring a detailed application form and three(!) supporting references. My references were from a university academic, my boss from my year in industry and someone from Engineering World Health. Several other engineering institutes have similar awards, notably the ICE.
Below are the two long form answers from my application form:
Give a brief statement of the programme (maximum 250 words)
This award will allow me to participate in the Engineering World Health Summer Institute based in northern Tanzania. This is a nine week programme supported by Engineering World Health, Duke University and local partners. The programme works to tackle the challenge of poor engineering infrastructure in developing country hospitals, where medical equipment is often poorly maintained due to a skills shortage of trained biomedical engineers.
The first month entails extensive theoretical and practical tuition developed by Duke University. This includes laboratory sessions on repair and maintenance of hospital equipment, theoretical study of fault detection and prevention in electrical and mechanical systems, and training on education of local biomedical technicians. There is also tuition in the Swahili language delivered by a local organisation.
In the second month I will be working as an engineer in a hospital in Tanzania, supported by Engineering World Health. My role will include repair and maintenance of medical equipment and working with hospital staff to put in place improved procedures. I will also undertake a review of the medical equipment needs of the hospital and undertake monitoring and evaluation of the systems in place. Summer Institute participants annually return approximately $1m worth of hospital equipment to service, greatly increasing the quality of care delivered by the hospitals partnered with the programme.
The programme fee includes tuition (technical and lingual), accommodation, most meals and required insurance including evacuation cover.
In order to permit the Educational Awards Committee to assess the merit of your application for financial support please set out below the benefits which will accrue from a successful application. It is expected that you should identify benefits to both yourself and the wider mechanical engineering community. Add, if you wish, any further information, which will support this application.
I am passionate about the role engineering can play in improving the lives of people in developing countries and this award will allow me to use my engineering expertise to save lives in northern Tanzania. By repairing medical equipment and improving the maintenance systems that stop it breaking in the first place, I will have a direct positive impact on health provision for local communities. An illustrative example of the impact I could have would be working with a local technician to repair an ultrasound machine and putting in place a maintenance routine, leading to reduced mother and baby mortality rates at the hospital.
This award will further my experience of engineering for international development, which I have built up as president of the Engineers Without Borders (EWB) society at Bristol University, managing a team of 19 committee members, six technical projects and a budget of £16,000. I am also a trustee for the national EWB-UK organisation. The first-hand experience of engineering in development this award will enable will be an essential asset as I progress in the sector, allowing me to further my impact going forwards.
I have chosen the Summer Institute for the close links with my technical experience, having worked for one year as a mechanical engineer at DCA Design International designing medical devices. This experience solidifies my technical competence for the programme of work, while the electronics and troubleshooting experience I will gain will likewise by valuable for my continuing professional development here in the UK.
I am a strong advocate of the mechanical engineering profession, having run outreach workshops with over 2000 school children through EWB-UK. I gained national recognition for myself and the profession in January, winning the national Student Volunteer of the Year award from the National Union of Students. I will be maintaining a blog during the programme and afterwards delivering presentations on my experience to audiences at university, at work, and to the public. I hope to be a real asset to the IMechE in promoting the mechanical engineering profession and its role in creating a better world.
My leadership potential was recognised by the Royal Academy of Engineering in 2014 when I was awarded a prestigious Engineering Advanced Leadership Award, worth £5000 over three years.
Bristol University Alumni Foundation
They’ll tell you they don’t fund individuals, but they definitely will if you can build a case. Though the sum was small, this was a really important one: the much larger IMechE grant requires you have support financially from your university.
Helpfully, the foundation was gifted £30,000 several years ago by a nice man called Geoffrey Lemon, who specified the money had to be spent on Engineering for good causes. Thanks Mr Lemon.
Application deadlines are strict and the process takes a while, so make sure you plan ahead. Below are two long form answers from my application. They really exist to benefit Bristol Univeristy, hence the focus on that element.
Please provide a short description of your project and how you intend to use the grant to benefit your club/society/department/student experience/the University or the wider Bristol Community.
This grant will allow me to participate in the Engineering World Health Summer Institute, based in northern Tanzania for nine weeks. I will be working to tackle the challenge of poor engineering infrastructure at a hospital, where medical equipment is often poorly maintained due to a shortage of trained biomedical engineers. Building on my academic progress as a mechanical engineer, and experience designing medical devices during a year in industry, I will undergo an initial training period (four weeks) before beginning a placement at a hospital.
My role during the placement will include repair and maintenance of equipment and working with hospital staff to improve procedures. I will also undertake a review of the medical equipment needs of the hospital and undertake monitoring and evaluation of the systems in place. An example impact I could have would be working with a local technician to return an ultrasound machine to service with a maintenance routine, leading to reduced mother and baby mortality at the hospital.
Following the project I will share my experience with Bristol. I will deliver lunchtime talks through Engineers Without Borders and I am in discussions to organise a workshop session to pass on to students some of the practical engineering skills I will gain. If possible I will deliver an academic lecture as part of the Engineering for International Development module, as several Bristol students with similar placements have done. I will also engage with the public through outreach events and the Bristol International Development Conference and reach beyond engineering to deliver talks with medical societies. As I enter my final year this grant will enable me to continue my contribution to Bristol and the university, for which I have previously been awarded national Student Volunteer of the Year 2015 from the NUS.
Please describe; (i) who the beneficiaries of a grant would be and (ii) the number of beneficiaries.
The primary beneficiaries are the predominantly poor Tanzanian users of the hospital where I will work. They will benefit from improved care and could number 50-100 depending on the specific outcomes. Hospital staff (~30) will also benefit through improved systems and reliability, and technicians (~2) will benefit from the new skills I will bring. These benefits should continue after the nine week project concludes. Post-project, engineering students at Bristol (~60) will benefit from lunchtime talks and workshops. Other students and Bristol residents will benefit through outreach events and talks (~60). Personally I will also benefit from first-hand experience of engineering in development, and technically from the skills gained, which will allow me to increase my impact going forwards.