The Value of Learning from Practice: Discussing Medical Equipment with Professionals in Ghana and Kenya

Before I started as a doctoral student in mechanical engineering, I did not expect that I would get the opportunity to travel to Ghana and Kenya in my first year to learn from health care professionals and engineers about the use of and requirements for medical equipment. I rather expected to have my head deep in books and papers, read about the findings of other scientists, and think about theoretical approaches for my research on the Product Development of Medical Devices for Low-Resource Settings. After this practical experience, I am convinced that these early insights will be highly valuable for my research to focus on the essentials from the very beginning.

Concerning my research topic, I consider myself lucky to not only work theoretically on the Product Development of Medical Devices for Low-Resource Settings but also be part of a team at ETH Zurich that actively develops a medical device: a low-cost ventilator for all. Aimed as an emergency and transport ventilator, the breathe ventilator provides patients in rather rural areas with access to critical care. The ventilator focuses on a simple and user-friendly design for an affordable price specifically adapting to low-resource settings. During the development phase, we asked ourselves how we could ensure that we are designing a device that is not again only suitable for high-resource settings. We felt that it is crucial to talk to the potential users of the device and discuss our ideas with them as early as possible in the product development process.  

That is why earlier this year, Leonie Korn and Thomas Lumpe from the breathe team already spent three weeks at a rural hospital in South Africa. You can read more about their experience here. While that trip mainly focused on the feedback of doctors and nurses specifically on the ventilator and the aspect of training for it, the trip to Ghana and Kenya was planned to have a broader character. We wanted to learn more about the processes and responsibilities at hospitals of different levels, talk to their engineers about service and maintenance, and learn more about the local markets for medical devices. The aim was not only to get input for the further development of our ventilator but also to gain more general knowledge about the challenges for medical devices in these two countries.

Together with my colleague Thomas Lumpe, we packed our updated ventilator prototype and made our way to first Ghana and then Kenya. In total, we were able to visit more than eight different health facilities including public, private and mission hospitals. Some of them were larger hospitals located in the capital cities, Accra and Nairobi, while others were rather rurally located sub-county hospitals. At each hospital, we presented our latest prototype of the breathe ventilator, discussed its functionalities and the general operating conditions for medical equipment with doctors and nurses, and received a tour through their facilities.

My highlight at each of the hospitals was meeting with engineers and technicians. Even though the service and maintenance of medical devices play a great role in the functionality of the devices, the perspective of engineers in low-resource settings does not always receive the attention it should get. Most of these engineers were very motivated to maintain and repair devices but were, for example, blocked by missing screwdrivers or Allen-keys or the lack of spare parts. These challenges were seen at each new hospital we visited. The discussions with the engineers helped me a lot to understand the challenging conditions better and put the findings from the literature into context.

In my opinion, it was the best decision to get these practical insights already within my first year. Now I find it easier to relate theoretical findings to practical context and better understand the local challenges. It was incredibly valuable to visit these many hospitals and be able to learn directly from local engineers and medical personnel. This experience was only possible thanks to the great efforts of our local partners who organized all visits and the willingness, kindness, and openness of everyone to share their experiences and opinions with us.

Thanks especially to Gatwiri Murithi from CPHD (Kenya) and Alex Quaisie from Verifie health (Ghana). But also, thanks to everyone else who made this whole trip possible, especially ETH4D, SASBI Program by Uni Basel and Venturelab, Wilfred Elegba, Nathan Amanquah, Center for public Health & Development (CPHD), Bernard Olayo, Bernhards Ogutu, Dick Oranja from Hatch Technologies, and many others. I am very grateful for the opportunity I received and hope that this was only the start of future collaborations.

About the Author