Project title: Retina Scanner for KiberaTable of Contents (click on “Project title” below and click the refresh icon to update the contents list.)?Project title: Retina Scanner for Kibera 11) Understanding the Context of your Problem (Mon) 12) The Design Question (Tues) 33) Use Engineering judgement to quantify your problem – ball park estimates (Tues) 34) Design Concepts (Tues / Wed) 45 or 6 different designs (1 for each team member) each with accompanying annotation(s). 45) Design Criteria, Option evaluation and Selection (Decision matrix) (Wed) 56) Developed Design (Thu) 67) Writing and references (Thu) 98) Daily Team Review 9?DayName of Team Leader (please enter)Monday: First DayBhavesh PrajapatTuesday: Data DayMaria Bordei Wednesday: Alumni Day(if 6 in your team then use one for general TL and a second as boardroom TL and they will focus on preparing for the Boardroom).Lukas VanhaesebroeckThursday: Report DayAudrey TwesigyeFriday: Presentation DayTin Yi 1) Understanding the Context of your Problem (Mon)Who are the stakeholdersWhat constraints does the context impose what are the env, economic, social/community considerations and assumptions?The stakeholders in principal are the Kenyan government (both local and national), the local community and local healthcare providers.In terms of the local government, there are constraints spanning multiple areas:On a political level, the health and well-being of the people of Kibera is an issue of concern to elected members of the Kenyan National Assembly. They will be primarily concerned with how the system will impact communities across the nation. The Kenya Revenue Authority arm of the Kenyan government will also concerned with the import tax associated with the devices – which will almost certainly be imported to the country for use by healthcare providers.In terms of the environment, the government will be concerned with the electricity provision for the system – which will have to come from somewhere, especially in communities where electricity may be scarce or non-existent. The raw materials needed to construct the product may become an area of scrutiny for the government if portions of the device are to be manufactured there. In overall terms, the government should also be vested in the carbon footprint of the device’s usage and in keeping the carbon footprint to a minimum.The health and well-being of the people of Kibera is the only social consideration that we thought the government might have.In terms of technological considerations, the government in Kenya will want to work with the equipment manufacturers and internet providers and in doing so will ensure that they receive contributions (i.e. tax) for paid work done by external companies and organisations. This is also an economic considerations.Legal considerations for the government to have would be the safe storage of patient’s personal medical information. This information needs to be kept in secure from hackers and also access the information and pictures on file needs to be regulated.The final economic consideration we thought the government may have would be the affordability of the device (both for the residents of Kibera and for the government if they wished to subsidise its usage)The community of Kibera has decidedly less considerations for the product – since they are the intended targets for the system.For them, the system must not harm the local environment and so mustn’t produce and waste or be unable to be produced/run with clean energy and materials sources. The service must also appeal to them and the benefits of the system must also be conveyed such that the population utilises the service and doesn’t see it as a waste of money. Accessibility is another social concern for the community in Kibera. In addition to this, the personal information of members of the public must be kept secure – which would constitute a legal constraint. Additionally, the system must be affordable and easy to use for residents who may not have much practical knowledge of modern technologies.For healthcare providers, there are other considerations in mind:First, they must weigh the benefit of expenditure on the product versus the existing system – is it worth the extra money invested?The transportation of the device while in their use is also an added cost the the healthcare provider – which also impacts the environment. This must be taken in to consideration against the likely benefits of the system. There should also be no harmful effects of using the product, such as radiation, as this would be counterproductive to the provider’s goals and could cost them more if certain negative effects were exhibited by targets of the system. The system must also be appealing to residents.In terms of technological considerations, the scanner should be portable, and safe and easy to use – and there should also be no harmful radiation emitted from the device.A legal considerations that we considered was that there may be patents or copyright associated with the product. Any development would require permission from relevant parties and royalties may have to be paid.There are multiple economic considerations. For example the device must be affordable for the people of Kibera. In addition to this, healthcare professionals in Kibera would have to weigh up the cost of implementing a new system such as this one against existing systems in place. Finally, health care staff or volunteers using the device would need to be paid appropriately where appropriate (volunteers wouldn’t be paid but nurses need to be paid fairly). 2) The Design Question (Tues)What exactly will your design achieve? Who is it for? Develop a SMART (Specific, Measurable, Achievable, Realistic/Relevant, Timebound) design questionTo design a portable and affordable device, for the lowest level of health-care professionals of Kibera within hospitals, to be able to diagnose diseases at an early stage due to the changes in the structure of the retina?S = Kibera communityM = getting people treatment by detecting the illness fasterA = cost covered by organisationsR = people need to have their illnesses found fasterT = detecting the illness fast (within x amount of time)3) Use Engineering judgement to quantify your problem – ball park estimates (Tues) Quantify the problem. Identify what data is needed and what is available. Where no data,use your engineering judgement to seek approximations / assumptions with justification. Economic status:In Kibera, the average wage is 3,977 Kenyan Shillings (KShs) per person per month (39 USD) and there are approximately 2.5 million slum dwellers, all settled in around 200 settlements in Nairobi representing 60% of the Nairobi populationhttp://www.kibera.org.uk/facts-info/# Diseases affecting Kibera:’Typhoid, Cholera, Dysentery, Malaria, Guinea worm, Scabies, Trachoma, Bilharzias’page 10’The demand for health care services is due to HIV/AIDS, malaria, tuberculosis,malnutrition, respiratory infections, cardiovascular diseases, perinatal diseases andaccidents’page 7:https://www.theseus.fi/bitstream/handle/10024/1317/Sanitation+and+Hygiene+Kibera.pdf?sequence=1 document is 50 pages longInfrastructure in Kibera: With information retrieved from Google’s Consumer Barometer, we have discovered that smartphone uptake in Kenya is now at 44% in 2016. http://www.moseskemibaro.com/2016/10/01/kenyas-latest-2016-mobile-internet-statistics/ Predictions of electricity access in Kibera are around 20% according to kibera.org.uk (http://www.kibera.org.uk/facts-info/#)Access to piped water in Kibera covers only 38.4% of the urban population and 13.4% of rural residents’https://www.theguardian.com/global-development/2010/sep/28/kenya-slums-poor-sanitation-disease-exploitationParticulars of mobile retina scannersAccording to Wikipedia, there are numerous disadvantages to the usage of mobile retina scanners:Scanning procedure perceived by some as invasiveSubject scanned must be extremely close to the lensEquipment cost can be highCould lead to eye problems, especially when using cheap equipmenthttps://en.wikipedia.org/wiki/Retinal_scan ‘The scan itself poses no threat to the eye or to your overall health, though users of retinal scans complain of discomfort from the technology as they must lean in and keep their eye close to the machine for 30 seconds in order for a scan to be accurate.’http://smallbusiness.chron.com/dangers-retinal-scanners-70631.html 4) Design Concepts (Tues / Wed)5 or 6 different designs (1 for each team member) each with accompanying annotation(s).External Camera extension: A small device that can be attached to a smartphone camera that is able to give off pulses of low energy infrared light and detect reflections off retinal blood vessels. A database and algorithm on the smartphone will be able to convert the data and make a diagnosis.Compact, can be used inside the densely populated Kibera area. Can be attached to a communal phone which can be kept centrally by a religious or community leader. Can be used more commonly than other devices as can be attached to a smartphone, which 44 percent of residents have. More likely to be damaged as it will be transported around the area and not always used by healthcare professionals. Hospital device: A larger, permanent device which will be able to reliably and sustainably scan multiple peoples eyes throughout the day. Must be easily be used by the lowest skilled healthcare professionals. Make sure it will be able to be sterilized between use to minimize the (online as well as on its own hard drive) risk of the diseases being contracted by other, healthier users. Will have a large database which can upload each scan to improve the reliability and overall success rate of diagnosing the diseases (machine learning).VR-type headset: A more semi-portable device which will be able to be transported to the outskirts of Kibera and set up and used by a healthcare professional. This would be beneficial to elderly residents or residence with mobility issues. This could be used by NGO charities and doctors which can be transported out. This device is effective for door to door treatments and diagnosis, especially in rural areas where access to healthcare is limited. Keyhole Laser: A small portable pen-like device that gives off infrared light that is pointed into a dilated pupil and is able to detect reflections off the blood vessels of the retina and transfers data to a computer/server that will be able to make a diagnosis.5) Design Criteria, Option evaluation and Selection (Decision matrix) (Wed)Develop and weight design criteriaOption evaluation and selection using decision matrix with sensitivity analysis.Justify with reasons for selecting and rejecting.We weighted affordability over portability as we saw that the residents do not earn a lot of money (39 USD per person per month) so this was a major limiting factor. We realised the project would not work if the residents were not able to afford the health care.We chose We chose safety above all other options because our main stakeholder is the community of Kibera and our goal is for them to be comfortable with this device and not feel scared to use this device but rather willing to get their health checked with this chosen non-invasive approach.Ease of implementation had the least weight according to us, because we are looking at the community as first priority as they are in need of such technology to improve their health. Costs of implementation can be covered possible by the Government of Kenya or by charitable organisations.Energy consumption was also given a very low weight because we are looking towards tackling that by using solar powered energy sources instead of Hydroelectric power which is far more ex 6) Developed Design (Thu) Show how the design fulfills the needs of the users/stakeholders with engineering calculations to justify and quantify the solution. With the help of funders the devices may be produced, as the price of the hospital device would be approximately £10,000 . The population of Kibera is around 2.5 million so there appears the problem of how the consultations are being scheduled to cover as much ground as possible. There are many possibilities. For example we imagine the device will be placed in a hospital. A priority would be the patients that have yet to be diagnosed, afterwards a check-up on the other patients to be secure that they don’t have other illnesses that weren’t considered before, or for example if there is a degree of uncertainty in the scan produced by the mobile device. All of this is for the process to be organised and not get out of control. Next with the use of the external camera extension, trained volunteers will go in Kibera to offer consultations.Show how the design addresses the Global Dimensions: environmental, economic and social/community considerations and assumptions.Environment: Extra energy usage as a result of using mobile devices to make scans and the hospital devicesEconomic:Cost of implementing mobile retina scanners in the community and hospital devices in hospitalsCould be unaffordable for the community Social/community:Some people may see the mobile retina scanners as invasiveTo address environmental concerns, we have decided to power the mobile devices via solar panel. This would mitigate some of the power usage. Although the hospital device would use the power grid in Kenya for power – which is almost 40% hydroelectric amongst others including fossil fuels. (https://en.wikipedia.org/wiki/Energy_in_Kenya#Sources_of_electricity)The mobile retina scanners have the potential to be prohibitively expensive. The government is unlikely to subsidise such a system and as such, we would be looking for funding from NGOs or charity organisationsIn addition to this, there is a concern that the device could be unaffordable – however the devices will be contracted out to hospitals (in the the case of the hospital device), and for the mobile scanner, the device will cost much less than the hospital device and will be made from readily available components. For example, the mobile itself has no real requirement other than having a high-quality camera – and does not necessarily need to be expensive. This also addresses concerns about the implementation cost of the system too.The mobile retina scanners could be seen as invasive. In reality, there is very little that can go wrong during a mobile retinal scan. Very few patients report a little discomfort due to the camera being placed near their eye however this is extremely improbable and any discomfort will be marginal. Often during the scans, eye drops are used to cause the pupils to dilate – and allow more of the infrared light to enter the eye. This is the cause of most discomfort, as sometimes people temporarily report blurry vision and become unnecessarily worried about how the scan may affect their vision. However, there is no real long-term risk to vision. To mitigates this, it will be necessary to educate the community on the various diseases that the eye scanner can diagnose and also offer information out to help the people of Kibera understand how the retina scanner works and the minimal risks involvedDetail the Implementation plan and considerations of longevity of the solution:(installation, operation, future maintenance by users and any associated risks). Implementation plan: Hospital device: The device will have to be bought and transported to the the hospital from the developed world where it would be produced. This will be a one time permanent installation in the specific hospital, therefore there will not be any further costs unless the device will need to be serviced for maintenance. The running of the device will be done by a health care professional and a doctor to confirm the diagnoses, although the device will have a database which will first propose the diagnosis. Due to the complexity of the lenses, the maintenance will have to be done by a qualified technician, this can add costs in terms of call out costs and replacement parts needed. The risks with the device will be use of the lenses incorrectly. This could damage the patient’s eyes. The main risk for longevity of the device will be miss-use of the device as this can damage the patient as well as the device. Camera lens: The device will be able to be transported to the community by NGOs due to the small and compact size. The use of the device will need specific training to make sure the device is used correctly and safely. The risks are increased as the device will not always be in the hands of a health-care professional but a trained member of the community. The device will be kept and used by a community leader when required. The regular maintenance of the lens is solely dependant on numerous factors such as quality of the lens as well as how often the lens is used however will require a skilled professional due to the size of the lens and the complexity of the lens.This will result in the device having to be shipped off and fixed elsewhere.The main risk for longevity of the device will be miss-use of the device as this can the give the patient a wrong diagnostics as well as the device. A risk of this design is that the photo of the retina is badly orientated, it might provide a wrong diagnosis which might further harm the patient. Show your proposals for user/stakeholder consultation (throughout the design development process).Stakeholders proposals: Advertising the existing campaign might show a problem as they are still an undeveloped country, there might still be poor nationwide media coverage of existing news. This forces the spreading of news through verbal transmission such as through local newspapers, campaigns, notice boards as well as just through the word of the day. With these methods of communication, the community can be involved as we would need local volunteers to convey the message due to the existence of a language barrier. We could engage with the community to get volunteers by stating our cause as it is non-profit and will greatly affect the community in a positive manner. We will engage the residents with the design process as we will have to know which devices the lenses will attach to and we will need to know how much knowledge they have about how the devices work. We would do this by setting up stands in the community as well as consulting the community leaders to help us advice us on how the designs can be adapted for Kibera. The barriers we will likely to encounter will be the limit of understanding of the device of the community. Language barriers could be an issue if we do not have translators in place. As both devices use electricity, there might be a barrier in terms of who will pay for the electricity or if the electricity is present in the area as only 20% of Kibera has electricity. This could be tackled by using solar powered means due to the all-year sunny weather in Kenya. The methods we would use to involve the community, would be interacting with community and religious leaders which would then be able to bring the community together. These regular meetings would be able to help the occupants of Kibera understand the concept of how this devices would work in the simplest way possible, so that they are more accepting of this technology and appreciate that it will better their lives in one way or another.7) Writing and references (Thu)Sources of Electricity in Kenya: (https://en.wikipedia.org/wiki/Energy_in_Kenya#Sources_of_electricity)Approximate price of the hospital device based on: https://www.hce-uk.com/Optovue-iCAM-Retinal-Camera .https://halshs.archives-ouvertes.fr/halshs-00751833/document Accessibility to the Kenya health care system: http://www.theseus.fi/bitstream/handle/10024/70364/Mwangi_Caroline.pdf;jsessionid=41DB3E02ADEE2AB9C044A77098D638FB?sequence=18) Daily Team ReviewConsider the following:Implementation of any changes recommended from the previous day(s)?What your day’s objectives were, how well you achieved them and reasons why you may not have achieved them in full?How effective the team leader was and any difficulties?How well the team worked as team?Monday:What went well?Worked well as a team, bonded during the introduction challenged which made the team successful and efficient in the early stages of the challenge. Team leader was very effective at combining our individual skills and applying them together for the benefit of the team.Any difficulties?We realised the limitations of our knowledge of the lenses whilst researching the devices.Anything different that you want to do tomorrow?Improve our team bonding with the challenge in the morning. Tuesday:What went well?Team leader was very clear on what the aim was and how we were going to go about brainstorming our ideas. The leader offered constructive, balanced and specific feedback to all our initial designs which allowed them to be developed in the near future. Any difficulties?Yes, developing sketches for the designs as there is a limit to the size which the lenses can have to be able to scan the retina and not just the iris. Anything different that you want to do tomorrow?Look into the community and health care issues around each design. Wednesday:What went well?We advanced our ideas further and with team deliberation we were able to narrow down to two main designs. We made sure we used a decision dominance matrix to see which designs were feasible. Any difficulties?Due to the limit of knowledge of lenses, we were were not sure how big the devices had to be, eg on the phone lens.Anything different that you want to do tomorrow?Dig deeper into how these devices work and how we shall make them suitable for use in Kibera.Thursday:What went well?We were able to advance further into exploring the two main designs. We worked as a team with balanced and objective feedback to be able to respond to the Global Dimensions. We each proposed the implementations of each designs and worked out the main feedback on each device. Any difficulties?In terms of designing the specific designs with engineering measurements and calculations, we were limited with our knowledge on the size of the lenses required. Therefore we roughly calculated the size depending on previous retina scanners. Anything different that you want to do tomorrow?We will finalise the designs for the two areas.