Erica Frenkel – TRANSCRIPT
I’m going to talk to that guy, I need one of those bottles for my apartment in Park Slope. Thanks for having me. I’m going to talk to you today about the design of medical technology for low-resource settings. Some of the countries that Arun just highlighted that were dark in that map. I study health systems in these countries. And one of the major gaps in care, almost across the board, is access to safe surgery.
Now one of the major bottlenecks that we’ve found that’s sort of preventing both the access in the first place, and the safety of those surgeries that do happen, is anesthesia. And actually, it’s the model that we expect to work for delivering anesthesia in these environments. Here, we have a scene that you would find in any operating room across the US, or any other developed country.
In the background there is a very sophisticated anesthesia machine. And this machine is able to enable surgery and save lives because it was designed with this environment in mind. In order to operate, this machine needs a number of things that this hospital has to offer. It needs an extremely well-trained anesthesiologist with years of training with complex machines to help her monitor the flows of the gas and keep her patients safe and anesthetized throughout the surgery. It’s a delicate machine running on computer algorithms, and it needs special care, TLC, to keep it up and running, and it’s going to break pretty easily.
And when it does, it needs a team of biomedical engineers who understand its complexities, can fix it, can source the parts and keep it saving lives. It’s a pretty expensive machine. It needs a hospital whose budget can allow it to support one machine costing upwards of 50 or $100,000. And perhaps most obviously, but also most importantly — and the path to concepts that we’ve heard about kind of illustrates this — it needs infrastructure that can supply an uninterrupted source of electricity, of compressed oxygen, and other medical supplies that are so critical to the functioning of this machine.
In other words, this machine requires a lot of stuff that this hospital cannot offer. This is the electrical supply for a hospital in rural Malawi. In this hospital, there is one person qualified to deliver anesthesia, and she’s qualified because she has 12, maybe 18 months of training in anesthesia. In the hospital and in the entire region there’s not a single biomedical engineer.