MEDICAL device manufacturers in the UK are being warned that opportunities for sales overseas could be scuppered unless innovative technologies are adapted for less-developed nations.
For many companies, the chance of making sales in developing and third world countries is helping to keep them afloat while investment in healthcare in the UK is affected by the Government’s spending cuts. However, experts are warning this international lifeline could fail unless design improvements are made to adapt products to suit these new markets.
The comments come after the World Health Organization (WHO) revealed that as many as 75% of all medical devices sold in the developing world do not function because they are built specifically for Western markets. Parts that are expensive and hard to replace, a need for a constant supply of electricity, a lack of trained operators, and the unsuitability of equipment for rough terrain are all preventing firms from breaking into markets overseas, the experts claim.
Simple, inexpensive technologies engineered for use in the developing world have the potential to save thousands of lives. It’s now up to the engineering and development communities to get these technologies out of the workshop and into the world’s poorest countries
A WHO report states: “A medical device needs to be appropriate for the context or setting in which it is intended. Context in this sense refers to linking the correct medical device with its corresponding health need to maximise its effectiveness. “However, almost all devices present in developing countries have been designed for use in industrialised countries. Up to three quarters of these devices do not function in their new settings and remain unused.
Health clinics in the world’s poorest countries have no choice but to turn to these Western medical technologies simply because there are so few devices that have been designed specifically for them
“One of the main barriers to optimal use is the mismatch between the design of the device and the context in which it is used. An additional problem is lack of proper device management both at government level and within healthcare facilities. Lack of standardisation can also seriously hamper the usability and integration of devices.”
These comments are supported by other industry experts, who claim there are massive opportunities overseas for those companies with the right products. Dr Patrick Finlay, medical division chairman at the Institution of Mechanical Engineers (IME), said: “For years many hospitals around the world have been forced to rely on inappropriate hand-me-downs from richer countries. But what use is an ambulance to a village with no paved roads; or a dialysis machine to a clinic with no mains electricity?
“Health clinics in the world’s poorest countries have no choice but to turn to these Western medical technologies simply because there are so few devices that have been designed specifically for them. Simple, inexpensive technologies engineered for use in the developing world have the potential to save thousands of lives. It’s now up to the engineering and development communities to get these technologies out of the workshop and into the world’s poorest countries.”
One of the main barriers to optimal use is the mismatch between the design of the device and the context in which it is used
And speaking at the recent IME Annual Conference, Professor Chris Lavy, an orthopaedic surgeon who spent years working in Africa, added: “One of the newest hospitals in sub-Saharan Africa was built with infrared sensors to turn the taps on in the operating theatres. Wonderful idea, but is it really appropriate in a country where there are no other infra red controlled taps and no engineer to fix them? Within a year, most of them had failed.”
At the conference, innovative technologies were showcased which provide examples of how properly-adapted technologies can have a huge impact on emerging overseas markets. Just Milk – a nipple shield for HIV-positive mothers; this technology can deliver antiretroviral drugs to infants for prophylaxis against infection or release an edible microbicide into breast milk that directly reduces HIV infectivity in the milk. Devised by an international team of students and researchers, including experts from Cambridge University, the solution is aimed at the estimated 200,000 babies who acquire HIV every year through contaminated breast milk
eRanger – The eRanger Ambulance is a sidecar stretcher for a motorbike, developed to provide transport to and from local health centres in areas where the terrain can be rough and unsuitable for four-wheeled cars. Able to safely and comfortably carry one patient and an outreach medical worker, plus emergency supplies for onsite treatment, it can greatly reduce the time taken to get essential and urgent medical assistance to remote communities.
Designed by British engineer, Mike Norman, the vehicles can be produced for a fraction of the cost of traditional ambulances, are easy to maintain, and can handle almost any terrain. They were first trialled in Zimbabwe and are now available in 18 developing countries
Heartrate monitoring via mobile phone – This involves using the microphone on a mobile phone as a stethoscope to analyse and record heart sounds so that a patient’s condition can be analysed remotely by a doctor hundreds of miles away.
Based on an idea by a South African professor and a post-doc researcher from the Oxford Department of Engineering Science, the device specifically targets tubercolosis pericarditis, which affects around 10% of all TB patients and has an unusually high mortality rate (40%). This is largely due to the fact that the onset of symtoms is insidious and sufferers in developing countries cannot get to a clinic before it is too late. Being able to pick up the early warning signs by monitoring the heart could therefore help to save lives.
Hearware – Hearware is a hearing aid for the developing world that uses bone conduction to send vibrations to the working cochlea, bypassing the need for the ear drum. The aid, designed by Andrew Carr at Glasgow University, is solar powered, with an internal battery that charges from four hours of abundant sunlight and will last for three days. The design is easily adaptable, meaning it can blend in better with local cultures and thus reduce negative social stigma
Donkey ambulances in Afghanistan – The brainchild of engineer, Olivia Comberti, and students at Strathclyde University, this comprises a padded seat which is securely attached to a donkey, allowing patients to be supported in a comfortable position during transportation. The device was invented after it was revealed that Afghanistan has the highest maternal death rate in the world, partly due to delays in pregnant women seeking medical attention, and the often mountainous terrain
The SKUTA – Designed by retired consultant orthopaedic surgeon, John Church, this is a seated scooter designed primarily for disabled people who have limited use of a lower limb, for example due to polio or trauma, and for single lower limb amputees. Featuring heavy-duty wheels, brakes and a footrest, the SKUTA bridges the gap between crutches and a wheelchair, offering a practical, low cost, simple, easy-to-maintain and realistic solution to those with limited mobility.
Almost all devices present in developing countries have been designed for use in industrialised countries. Up to three quarters of these devices do not function in their new settings and remain unused
