Blog Post

October 7, 2013 Michael Hong

User-Obsessed in Rural Nepal


Garrett Spiegel transports his luggage and engineering equipment through the rough terrain of Kathmandu.

Garrett and I just launched field trials for Comet, our new phototherapy device, in India and Nepal. We at D-Rev say we’re “user-obsessed” and the point of this field trial is to gather critical usability feedback from our users—nurses and doctors in rural clinics that can’t afford traditional phototherapy devices, don’t have room for them, and may have never used phototherapy of any kind aside from sunlight. The device itself was designed for these rural conditions and it showed. Clinicians that were trained on Comet were able to set up and use the device within seconds. Our trip was tightly packed with countless hours of flying to and within Nepal and over 30 hours of jeep and cab rides, trying to reach some of the most remote parts of the country, in an attempt to understand our user.

After an all-too-brief trip to visit the amazing Nyaya Health clinic in the mountains of Accham, we met with Surya Bhatta, a native Nepali and the passionate country director at One Heart World-Wide, who would guide us to clinics on the last half of our trip. I got sick two weeks before we left for Nepal and had gotten progressively sicker during my time there, which was definitely taking its toll on my energy level. With only a few days left in the trip, I had the opportunity to rest for the remainder of my time in Nepal, or visit the last few health posts, which would involve “some hiking,” according to Surya. I decided to go on the trip against the will of my mother’s voice in my head and learned more about our user than I ever would have on any traditional field visit.

Hiking Comet Nepal

Michael and Garrett hiked the beautiful mountains of Baglung to get from clinic to clinic—the same paths used by school children and pregnant mothers.

This was my chance to walk a mile in someone else’s shoes—very sick with the nearest health clinic hours away. Except, instead of shoes, many Nepalis wear plastic sandals, and instead of a mile, pregnant women walk 1 to 2 hours to get to the nearest health post, where they might then get referred to other clinics or district hospitals, depending on the severity of their issues. We hiked about 20 miles in 3 days, up and down steep hillsides over rocky and muddy terrain, in pouring rain and intense heat and humidity, with a one thousand foot drop into a beautiful foggy abyss at any given time along the path. We slept at the villagers’ houses, cooked and ate with them, and curiously badgered everyone with questions about every topic imaginable.


A community health worker meets one of Nepal’s newest residents

This trip was about so much more than just our device. While we gained some great insights and feedback on the design and functionality of our device, the trip was more about understanding what our users go through every day and how to design for them as more than just jaundiced infants, mothers, or nurses. We met female community health volunteers who spent all day with the people of the community, only to come home and harvest a giant basket-load of greens for the livestock, cook dinner, and care for their home and kids. One man welcomed us into his home and gave up his bed for Garrett, Surya, and myself to share, while he slept outside. The children walked the same rocky and muddy paths as us to get to and from school 6 days a week. Our users are so much more than just phototherapy device users and my 3 day trek in flip flops while sick doesn’t nearly capture the complexity and strength of the people we encountered. I’ll never truly understand what it’s like to live on less than $4 a day, but this was not a bad start.

Check out our facebook album for more photos!

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