TMC PULSE

t m c » p u l s e | o c t o b e r 2 0 1 8 16 She spent 15 years immersed in opti- cal imaging research geared toward early detection of cervical, oral and esophageal cancers before leaving for Rice University in 2005. In Houston, Richards-Kortum found herself looking for creative ways to engage her bioengineering students in projects that would have a more immediate impact on the world. She was invited by Mark Kline, M.D., now physician-in-chief of Texas Children's Hospital, to the opening of the Baylor International Pediatric AIDS Initiative clinic in Malawi to explore potential oppor- tunities for her undergraduate students to address some of the challenges African clinics faced in delivering care. The experience changed her life. "That was really a transforma- tional trip because I saw two things," said Richards-Kortum, who speaks evenly, almost always projecting a sense of calm. "I saw the heart- breaking, normal situation for hospital-based care for newborns, but what I saw right adjacent to that was this huge failure of existing technologies that were being imported that couldn't withstand the heat, the dust, the humidity, the lack of trained technicians, the lack of supply chain for spare parts." Donated technologies can save lives in parts of the world with reliable electricity, spare parts and controlled environments. But in less fortunate areas, as soon as a critical component breaks or the electric- ity sputters, high-tech machines can no longer keep infants warm, measure oxygen or pump air into tiny lungs. The machines are ren- dered useless and set aside, piling up into equipment graveyards. In Africa, Richards-Kortum saw them everywhere. Upon returning from Malawi, Richards-Kortum recruited her colleague, fellow bioengineering professor Z. Maria Oden, Ph.D., to create the Oshman Engineering Design Kitchen (OEDK) at Rice, a place for undergraduate students to create solutions for real-world engineering problems. The two also now serve as co-directors of the Rice 360° Institute for Global Health, a program that works in conjunction with the OEDK to foster new tech- nologies for health challenges in the developing world. "It took us a while, honestly, to figure out what was the best way to engage our team and make a differ- ence," Richards-Kortum said. "We did a lot of things that didn't work and learned what could work. And really, what we learned was to focus on a place in the health care system and focus on a place geographically. We applied those lessons to this focus on newborns and a focus on sub-Saharan Africa." The key was to create machines tailor-made to low-resource settings: they needed to be affordable, capa- ble of withstanding harsh environ- ments and repairable with limited tools and resources. A mother herself, Richards- Kortum knew that childbirth could be traumatic under the best of circumstances, but she couldn't live with the odds for newborns in sub-Saharan Africa. In Malawi alone, where about 1,800 babies are born every day, 40 will be stillborn and another 38 will die daily before reaching their first month, accord- ing to recent data collected by the United Nations Children's Fund, known as UNICEF. Surely, Richards-Kortum thought, we can fix that. More space Originally, Richards-Kortum and her husband weren't interested in having children of their own. But then one day in graduate school, she changed her mind. "She probably remembers it differently, but I just remember one day she woke up and said, 'I think we should have children,'" Kortum recalled. "We're sort of careful, considerate thinkers and planners. And so, we had big discussions about it and we decided, yeah, maybe this would be a good thing to do." "It was a process of convincing him at every stage," Richards-Kortum said, laughing. "The first baby my husband ever held was ours." The couple now has six children, ages 8 to 26: three boys and three girls, two of whom they adopted from orphanages in Ethiopia. The idea of adding two more to their family first gripped Richards- Kortum after a trip to Africa. "I came home and I was like, 'You know, we really have more space, in every sense of the word,'" she said. As part of the adoption process, their biological children joined them on trips to Ethiopia to meet their future sisters. "It was good that our kids were able to go over and see firsthand what was going on and why there was such a big need," Kortum said. "It just breaks your heart when you go into the orphanages. You want to help all of them. It's heartbreaking because you realize, you can help in small ways, but helping in big ways is harder." But tackling big problems is what Richards-Kortum does best. "Everybody in the family under- stands what Rebecca's doing and why it's important," Kortum said. "Everybody also understands that when Mom has to go to Africa, it's for a good reason. And certainly, I think, a lot of that was brought home when we adopted our two youngest children. That sort of solidified in my biological children's minds that this wasn't just a job—this was a lifelong commitment to bettering the world. I think it's made them more empathetic to the fact that you've got to use your talents for the greater good." For Richards-Kortum, though, it's more than that. She is a formidable force, and she never steps down from a challenge. Her husband recounted a time during the adop- tion process when social workers visited their Houston home to inter- view their biological children. "In one of those interviews, they asked my children, 'What's the one word that would describe your mother?'" Kortum recalled. "And they said, 'Competitive.'" Richards-Kortum in her lab at the BioScience Research Collaborative. I saw the heartbreaking, normal situation for hospital-based care for newborns, but what I saw right adjacent to that was this huge failure of existing technologies that were being imported that couldn't withstand the heat, the dust, the humidity, the lack of trained technicians, the lack of supply chain for spare parts. — REBECCA RICHARDS-KORTUM, PH.D. Bioengineering professor at Rice University

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