Cow tongues, orange peels and car wash sponges. Right now, those are considered “best in class” vulva simulation models for medical trainees, says Granville Biomedical co-founder Christine Goudie.
“Isn’t that wild?” she asks.
Goudie’s hoping her swiftly-growing company will help change the class entirely while addressing what she says are major gaps in women’s health research and training, both here in North America and in developing countries abroad.
Granville makes lifelike, 3D-printed anatomical models that can be used by medical students for training or by doctors hoping to give patients a better understanding of their treatment. Some of their models have tears mimicking injuries common in childbirth, giving trainees an opportunity to practice suturing.
Others have fused labia with the clitoris removed, simulating infibulation, a severe type of female genital mutilation (FGM) practiced in parts of northeastern Africa. FGM affects an estimated 300 million girls in parts of Africa, the Middle East and Asia each year. Canadian doctors don’t typically have experience with FGM, but the need for awareness and training is growing as more immigrants from those regions arrive, she says.
“We’re trying to de-stigmatize women’s health care, de-stigmatize women’s anatomy and make it a topic that gets the respect it deserves, and the attention it deserves,” Goudie says.
After interviewing hundreds of clinicians and trainees, Goudie saw “a huge void in women’s health simulation training, and even just women’s health research in general.” Like the car wash sponges.
Though 16.4 per cent of Canadian women giving birth experience tears severe enough to need stitches or damage the anal sphincter, Goudie found that med school students got very little hands-on practice repairing that damage. If they did, well, it was likely with those sponges.
“The consequences of performing that procedure incorrectly is hugely detrimental to a woman. If the trainee doesn’t have the proper training, a woman can face a lifetime of sexual dysfunction, fecal incontinence [or] prolapse,” Goudie says.
On Monday, the New York Times reported that in some U.S. states, as part of their training, medical students were authorized to give unconscious women pelvic exams without their knowledge or consent — an “appalling” situation that shows gaps in modelling and research can cause psychological trauma as well as physical trauma, she says.
Those trainees could be using biomedical models, like the ones made by Granville.
A Team Broken Earth mission to Bangladesh
An industrial designer by training, Goudie was working at MUN Med 3D, a biomedical simulation lab at Memorial University’s medical school in St. John’s when Andrew Furey, founder and CEO of Team Broken Earth, invited her to join a mission to Dhaka, the capital city of Bangladesh, in September 2018.
She lugged her 3D printer with her onto the plane.
In Dhaka, she printed models of vaginas and uteri to be used in workshops for local health care providers about high-risk pregnancies and deliveries. As the workshop participants carefully sutured tears in plastic uteri simulating ruptures that could lead to fatal postpartum hemorrhaging, Crystal Northcott, a registered nurse who had also joined the mission, took notice. She pulled Goudie aside to chat and by February 2019, the two had founded Granville Biomedical. Northcott put up the company’s first private investment.
Goudie was getting ready to start a PhD in biomedical design at the University of Calgary when they got word they’d received another injection of funds, this time from the federal government. She put her academic plans on hold and now divides her time between Calgary and St. John’s, where Northcott is based along with the company’s third full-time employee, Heather Roberts. They’ve since hired six other consultants and experts ranging from biomedical engineers to surgical simulation specialists, and were accepted into the Genesis Centre’s accelerator program in December.
“The PhD, I still want to do at some point, but right now the company takes up 200 per cent of my time,” Goudie says. “Maybe when I’m 50? I think that’s a good milestone.”
Granville’s first order arrived in May, just three months after the company was founded. “We kind of figured some sales might trickle in — one, two, ten — but our very first quote request was for 50 and then it was for 100,” Goudie says. They’re working on an app to go with the models that would guide trainees through suture exercises, she says.
But they’re also staying true to their roots, using the models to help improve women’s health care across the globe.
In November, five vagina models they donated to a healthcare organization called Freedom Tree were used in a series of workshops about sexual health and anatomy aimed at young girls in Sierra Leone. The maternal death rate in that country is particularly high, mostly due to complications arising when women who have undergone FGM try to give birth.
“This is a huge jump from having very little education in that area, [it’s] very taboo to talk about, to suddenly handing young girls models that are culturally appropriate in terms of skin colour and anatomy,” Goudie says.