Healthcare on the cheap - innovations from Appropriate Healthcare Technologies event
It takes years for a manufacturer to demonstrate that a new medical device is effective and safe. But, if a less-than-perfect, cheaper innovation can save lives in the developing world, it should be made available, said speakers at the Appropriate Healthcare Technologies event in London, UK. Ledetta Asfa-Wossen reviews four design innovations.
In rural areas of sub-Saharan Africa, a ruptured ecoptic pregnancy is treated surgically and an auto-transfusion procedure is performed in which clinicians remove blood from the abdomen during open surgery by scooping it out with a ladle or cup. The blood is then poured through a nurse’s hand to remove the largest clots, then through layers of gauze. The blood is then mixed with anticoagulant from a citrate bag, and the mixture is poured into the citrate bag and transfused. The process is unhygienic and takes 30 minutes.
In answer to this, product engineer and co-founder of technology producer DIIME, Gilian Henker, has created a quick and portable device called Hemafuse to prevent maternal deaths caused by auto-transfusions. The main body of the mechanical device is made of a clear plastic that is reusable and can withstand sterilisation in autoclaves. In anticipation of misuse or overuse, the device contains disposable micro-mesh to remove clots and impurities larger than 170μ from blood collected during surgery. Only one clinician is required to operate the device instead of three to four with the current method, and whole blood products can be transfused without handling or the use of a vacuum aspirator. It can function without a power source and has reusable parts that allow it to be cleaned.
Market: Ghana, Nigeria, Gambia and Kenya. A prototype has been completed.
Premature infant death is a huge problem in the developing world, largely due to inadequate care for infants’ underdeveloped physiology, including maintaining temperature control, but incubators are expensive.
Product engineer Karla Sanchez of Xiros, based in Leeds, UK, has developed a low-cost incubator made from nylon instead of polyester, which is more durable and water-resistant as an insulation material. The tunnel dome tent has a base radius of 40cm, a length of 60cm and a roof height of 45cm at the highest point. The tent uses compressible fibreglass poles that can be folded to its base for mobility and ease of assembly. The tunnel-dome geometry means the incubator can maintain temperature longer than a conventional rectangular design. Heating is provided via two embedded systems – a primary system using a nickelchrome heating wire radiation device and 12V battery fan located at the duct, and a passive heating mechanism that uses a heated gel pouch for when electricity is hard to obtain. A 10mm removable, and highly absorbent foam sheet acts as a passive humidifier.
Market: India and Pakistan.
Cost: US$1,583 – the price of an incubator in Bangalore, India. US$106,385 – the average price of an incubator in Cleveland, USA.
Engineers at the University of Michigan, USA, have developed an affordable modular centrifuge design that uses either electricity or a hand crank to separate blood. Complete blood separation occurs when the handle is rotated by hand at 45 revolutions per minute for four minutes. It can be used on any flat surface.
Cost: A standard electric centrifuge costs US$140, compared to US$50 for this manual device.
A cost-effective waterless toilet system that uses a patent-protected mechanical sealing unit, Loowatt, contains human waste efficiently within a biodegradable film. The technology features an odour-inhibiting system and is designed to link in with anaerobic digestion systems to provide biogas for cooking, electricity and other applications. The sealing unit can be built into toilets of any material, shape, size and specification, using off-the-shelf parts or local materials.
Market: A pilot system is currently running in Antananarivo, Madagascar.