Tuesday, 24 January 2017

Engineering a future for global health


Linnet, one of our Grants Officers, travelled to Uganda to attend the first National Biomedical Conference. Here follows an account of her time there. 


‘Without Heath Technology Management mortality rates go up.’

Priscilla Kemigisha, Biomedical tutor at ECUREI, asserted the fundamental importance of biomedical engineering at the inaugural National Biomedical Conference held in Kampala, Uganda in January 2017.

I represented THET at the two-day conference, which brought together a truly multi-disciplinary audience, from university lecturers to biomedical engineers, doctors to private companies, and members of local government and donors from Uganda, the UK, US and Kenya. The programme was rich and covered a number of topics including, medical equipment donation, innovation and intellectual property rights as well as the roles different attendees could play.

Priscilla's statement  points out a reality that is all too often overlooked within hospitals and by Ministries of Health and is still fighting for recognition from international organisations. Biomedical engineering remains a little known global health crisis. It is only this year that biomedical engineers have been recognised as forming a separate occupation by the ILO. There also remains no Sustainable Development Goal that centres on medical equipment or biomedical engineering.

For THET, the knowledge that donation of medical equipment is not always a help has become increasingly clear, as a recent survey we conducted showed. Throughout the conference, stories of badly donated equipment abounded, including equipment arriving with only French or Chinese manuals that no one could read, or a CT scanner that spent fifteen years outside in a compound as it was too large to move into the hospital.

While it can be easy to think of biomedical engineering just in terms of the machines you see in a hospital or the broken ones sitting outside in a junk pile or cluttering up a store cupboard, for an unconscious patient in the ICU or a labouring mother the difference between life and death often depends on whether a machine is working or broken.

Beyond patients, it is also evident that healthcare workers in low and middle income countries are dealing with crises every day whilst faced with tight or non-existent budgets, pressures from donors and their governments and targets to be met. In this environment preventative maintenance and careful assessment of potential donations can seem like low priority activities for hospital administrations who struggle with stock-outs, power cuts and water shortages.

Whilst this all paints a rather murky picture of the lack of importance accorded to biomedical engineering, the focus of the conference was on how to move forward, to create a national environment receptive to engineers and the equipment we take for granted in the UK. Discussions centred on what innovations could be implemented and how students from the universities were conducting outreach in high schools and working together with the private sector to turn final year projects into reality.

Solutions do not have to come from outside, while we, including those from donor countries, can all work together, Uganda is making strides and taking responsibility for its own ecosystem. From innovations such as a low field MRI being designed by a lecturer at Mbarara University of Science and Technology, to Fort Portal Regional Referral Hospital ensuring that each piece of equipment in the hospital has a service card, and demand that the direction taken should be dictated by those in Uganda is mounting.

For me, the key message of the event was collaboration, from donors to government and clinicians to technicians. With training, budgeting and responsible funding Uganda, and other nations, can move towards the sweeping reform required to improve the state of biomedical equipment and the training for technicians that is most keenly needed.

At THET, the importance of biomedical engineering is one championed by our biomedical consultant Anna Worm, and the team continue create guidance and tools for the donation of medical equipment and the positive impact that training engineers can have on an entire health centre. Since 2011, our work in Zambia has focused on creating the first pre-service training course for Biomedical Engineering Technologists, a country-led initiative which aims at changing the huge percentages, 35 and 50%, of medical equipment that is currently out of service.

Linnet Griffith-Jones
Grants Officer
THET