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

Tuesday, 17 January 2017

Digital tools building the future of global health?

Digital tools building the future of global health?

In December, Marta our Senior Partnerships Manager, travelled to Maryland to attend the third annual Global Digital Health Forum, a platform focusing on digital and connected health in low and middle income countries, sharing lessons on what works and what doesn’t in technology for development. Here follows an account of her time there.

The potential of digital tools are proving not only crucial to the provision of health services but also to the wider health system, allowing strong systems to be built before crisis occurs. Digital data, for example, helped bring an end to Ebola in West Africa. The global usage of digital tools has also led to a surge in popularity for supporting the growth of digital health globally, it has become trendy. It is coming to be seen as a key part of a complete health package, which needs to be fully integrated into the health system, with countries such as Tanzania and Nigeria having developed national health data strategies.

Over 400 people beat the cold, in Maryland, to attend the third annual Global Digital Health Forum, a platform focusing on digital and connected health in LMICs, sharing lessons on what works and what doesn’t in technology for development. Over two days in December, it seemed that everyone that mattered in the global digital health field, including newcomers such as myself, came together to discuss the future of digital health. A number of shiny, new solutions to global health challenges were shared. From Facebook to Google new innovations such as the use of drones and balloons to bring Wi-Fi to those in remote and rural areas were debated, while others spoke of using apps to ensure healthier babies and mothers. Most discussions, however, revolved around sustainability and collaboration. How can one ensure that technology solutions live beyond the funding period? Digital tools are after all useless if citizens themselves do not use them.

Most of the tools developed for gathering data are, however, disease specific. The donor community are partly to blame for this as most funding mechanisms tend to favour linear health responses.  Partnerships between government, private and civil society actors offer a solution to health information challenges. Yet, collaboration may suffer in the current country-focused political environment. In these times, it is important to remember the nine principles for digital development, which were written by and for international development donors and their implementing partners. These principles emphasise the importance of human-centred design, context-specific solutions, re-use and improve existing technology and tools and being inclusive and collaborative. If we can get these principles right, we’ve come a long way in ensuring sustainable health information systems and better health responses as a result in the future.

With so many new digital avenues and innovations forming in the global health arena, there is certainly much to think over. For THET, we must now ask how we can use this technology to complement our partnership work and apply digital solutions to the strengthening of global health systems.

Marta Roxberg
Senior Partnerships Manager