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Tar Heel: Duke engineer turns mind to global health problems

Bob Malkin is the Tar Heel of the week.
Bob Malkin is the Tar Heel of the week. Photo courtesy of D.L. Anderson

On the first day of Bob Malkin’s first service trip abroad, he encountered a broken heart-lung machine in a Nicaraguan hospital – a problem that could postpone a day or more of needed surgeries.

An engineer with a background in medical devices, Malkin fixed the problem, a faulty surge protector, in minutes.

“That was a real turning point for me, because a surge protector is not really that special a piece of equipment,” says Malkin, a professor of biomedical engineering at Duke University. “Any engineer with minimal training could have done what I did, and that five minutes made a difference in people’s lives.

Malkin has since started a series of programs that leverage engineering know-how for the benefit of health care in developing nations – first by fixing medical devices, and later by inventing new ones to solve specific problems.

He oversees hundreds of students investigating dozens of potential inventions. One of their most notable successes was the Pratt Pouch, which looks like a condiment package but has been lauded by the World Health Organization as an effective way to distribute the drugs that prevent HIV from passing from mother to child.

Recently, he founded a program that has high school students work on health care issues in developing countries, with an eye toward creating a new generation of service-minded engineers.

This year, Malkin was named one of five “engineering heroes” by the Institute of Electrical and Electronics Engineers.

David Walmer, a fertility specialist at Duke who does extensive work in Haiti, says Malkin’s program gave his idea of a new instrument to detect cervical cancer a needed boost at a time when there was little interest in devising new medical products for developing nations.

“He was clearly ahead of the curve, and he has made a huge impact,” says Walmer. “What’s unique about Bob is that he attached this idea of innovation to the educational system so that young students learn how to work with people in all kinds of fields to solve problems.”

From tinkerer to teacher

Malkin grew up in Ohio, where he always gravitated toward math, science and youthful tinkering.

He recalls reading his brother’s college-level electrical engineering textbook from cover to cover when he was 13, and using that knowledge to build a synthesizer and a clock, among other projects.

His path toward engineering was fairly clear, but it was not his sole focus.

He was also drawn to teaching, and tutored other students at his private high school and again at the University of Michigan, where he earned his bachelor’s in electrical engineering.

He took classes in several languages, including German and French, and enjoyed exploring other cultures.

Out of college, he started working in the biomedical industry, developing improvements to devices such as pacemakers and defibrillators.

It was a productive and well-paying job, but Malkin chafed at the trivialities of office life. A few years in, he decided he wasn’t happy and quit, burning his time card and throwing a party to mark the end of his traditional work life.

Looking for a chance to travel and explore new possibilities, he wound up teaching English in Thailand for a program that sought to keep young girls from being sold into prostitution.

Malkin had no experience teaching English, but was moved by the circumstances.

“If they could learn enough English, they could go out in the marketplace and sell souvenirs, and they were more valuable there than they were in the sex trade,” he says. “In many villages, they would stop selling their children altogether because of this project.”

He returned to the United States to earn his doctoral degree at Duke, and started working as a professor and researcher, first in New York City at City College and Columbia University, and later at the University of Memphis and the University of Tennessee.

Involving students

Malkin had meant to return to Thailand once he earned his degree, but after marriage and children, those plans seemed to slip away.

He did volunteer work, such as helping in a homeless shelter, but he couldn’t help but feel his expertise wasn’t being put to use. Eventually, he partnered with a doctor who did heart surgeries in the developing world, and accompanied him on a trip where he and another engineering colleague immediately were put to use fixing equipment.

Malkin continued to make such trips, and he soon involved his students at the University of Tennessee. He started a club where engineering students would rehab old medical equipment for use in Third World hospitals, as well as fix equipment on summer exchange trips.

Inevitably, the students started to create devices to solve problems. One of the first could test defibrillator machines so that faulty ones would be removed from use before they malfunctioned. Another was a battery-powered light to prevent jaundice in newborns.

Malkin says he felt the university didn’t support their efforts. So he created a separate nonprofit, Engineering World Health, and then, in 2004, left his tenured position for a job at Duke University. He says at Duke he has been encouraged to focus his efforts on the developing world.

Now, his students collect ideas for needed devices on their exchange trips and analyze them systematically to find the projects that are most feasible and likely to make an impact, starting with up to 500 ideas a year.

So far, he’s overseen the creation of 50 prototypes, and eight have reached clinical trials; two projects are in fairly widespread use. In 2012, the Pratt Pouch was named one of the top 10 health innovations for low-wealth settings by the World Health Organization.

He says part of his success stems from the large number of students with whom he works. They work in teams of five, and the most successful project could go through dozens of teams. But he says it’s the contact with the communities that is most important.

“These ideas come from people in the clinical setting in these hospitals for months at a time, and we’ve been doing this for years,” he says. “That on-the-ground experience is really central to making a difference.”

Malkin continues to expand his efforts. He created a program that gives cash awards for student-generated business plans that address health problems in the developing world.

In 2011, he founded Global Public Service Academies to involve high school students in his health projects, luring them into engineering and health professions by showing them the potential to help others.

The students help run health fairs where they check blood pressure and do other basic tests. In one of the most effective programs, teenage girls talk to younger girls about puberty – a topic that is rarely discussed in some cultures, leading to fear and health risks.

“They are doing things that really make a unique impact, and they’re learning that they don’t have to wait till some point down the road in their careers to help,” he says.

Malkin says the impact this work has made on students who participate in it is another key benefit. In surveys, he says, half of the students who participate in the program say the experience changed their lives.

“That’s an educator’s dream,” he says.

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Robert A. Malkin

Born: March 1962, Cleveland, Ohio

Residence: Raleigh

Career: Biomedical engineering professor, Duke University; founder, Engineering World Health, Global Public Service Academies

Awards: Engineering Hero 2015, Institute of Electrical and Electronics Engineers;

Education: B.S., engineering, University of Michigan; Ph.D., electrical engineering, Duke University

Family: Wife, Alexi; children Rebekah and Jacob

Fun fact: Malkin’s wife is an opera singer.

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