The Equipment Graveyard

“Almost all the hospitals have a graveyard,” says Dr Harry Aigeeleng, an anaesthetist in Papua New Gunea, when he sat down with us at the WCA last month.

Lifebox Trustee Angela Enright and Dr Aigeeleng are old friends - they like to catch up and pose for photos

This isn’t quite as morbid as it sounds, but it’s certainly depressing.  Harry is talking about equipment graveyards – warehouses, cupboards, row after row of medical devices that are theoretically useful but practically useless in the context of the environment they’ve been sent to.

“There’s no maintenance, so things break down,” Harry explains, of the many devices that could be fully functional if it weren’t for the impossibility of replacing basic spare parts, or calling out a service engineer to a rural hospital on a regular – or even emergency – basis.

All this potential...

Even worse than those items made redundant in action are those that never had a chance to serve.

“There are those devices that are donates – but some part is missing, or they didn’t come with an instruction booklet – or the booklet is in a foreign language…” he shakes his head.

...that might as well be empty space.

Look at the pictures, and it’s shocking to see what these graveyards equate to in wasted value and opportunity – and what a disconnect in communication they memorialize.

This is  Jimmy, a nurse anaesthetist in Uganda. 

He was photographed by Dr Louise Finch, a member of our UK faculty running the Lifebox training programme in Mbarara, Uganda last summer.  From September, Louise spent three months traveling the country to follow up on the 80 donated oximeters (an adventure that deserves many and more blog posts of its own, so stay tuned!) and met up with him at his hospital.

He’s standing proudly next to an anaesthesia machine, which he keeps in pristine condition despite the ubiquitous red Ugandan dust.  It makes a very useful table for his Lifebox oximeter, but not much more.  All of the dials are in Italian.

We conceived the Lifebox pulse oximeter for a long life three feet above ground (about the height of an operating table).  It doesn’t need servicing or recalibrating; it is compatible with generic probes, so it’s much more likely that you can find a replacement for it; and it runs on rechargeable batteries so that you can continue to use it if the power cuts out during an operation.

There are a lot of organizations that aim to keep equipment mortality low.  One part of Global Partners in Anesthesia and Surgery (GPAS)’s work focuses on improving service and education infrastructure.  Engineering World Health sends biomedical engineers to low-resource countries to teach and train locally.  Powerfree Education Technology (PET) aims to develop fit-for-purpose medical technologies to improve maternal healthcare.  And our own WFSA offers guidelines and assistance to hospitals, so that they can question manufacturers directly about the suitability of equipment.

“If people have monitors, they work them till they are dead,” says Harry.  They don’t need expensive and misplaced wallflowers – they need equipment that will work to last, as long and as hard as they do.

Long live fit-for-purpose medical equipment!

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The Days Are Just Packed!

We’ve been typing circles round our to do lists at Lifebox since we got back from the WCA  last month.  We left Buenos Aires with heads, hearts, (stomachs) full of plans and opportunities for closing the global pulse oximetry gap, implementing the WHO Surgical Safety Checklist and getting ‘Make It Zero‘ underway (now in Spanish!)

We’ll have lots of updates and conversation snippets for you in the coming weeks, but in brief…

 The sun was shining!

We found our booth…

…and made ourselves at home!

We rode the subte like porteños 

(and took photos of the beautiful old carriages like giddy tourists).

Three of our trustees delivered the very prestigious Harold Griffith Lecture in front of several thousand delegates…

and officially launched the Make It Zero campaign!

 We ate too many of these:

And wished we could dance like this:

We introduced the Lifebox pulse oximeter to its ancestors:

And sent some on their way to new homes:

We talked to anaesthesia providers from hospitals with hundreds of pulse oximeters, and anaesthesia providers from hospitals where they monitor with a finger held against the patient’s pulse.

We left resolving, more fiercely than before, to work towards raising the safety and quality of surgical care worldwide, to close the global pulse oximetry gap, to…