March 2012 - Institute of Physics and Engineering in Medicine

SCOPE | MEETING REPORTS
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multidisciplinary networks of students and academics
are galvanised to enter the EWH design competition,
where they compete for financial backing to implement
their business plans.
EWH OVERSEAS: THE ‘SUMMER INSTITUTE’
The EWH Summer Institute programme is a significant
contributor to EWH’s status as one of the world’s largest
suppliers of working medical equipment to the
developing world. Each year on the Summer Institute,
between 50 and 60 student volunteers travel to either
Tanzania or Central America where they spend 2 months
‘on the ground’ assisting in the management,
maintenance and repair of damaged/disused medical
equipment. In 2009 I participated in the Summer Institute
as a volunteer at Salvador Paredes Hospital in Trujillo,
Honduras; this experience exposed me to the issues
discussed earlier in this article, and gave me a platform to
contribute to the remarkable collective efforts of all the
students. When I asked EWH CEO Melissa Beard about
the impact the Summer Institute has had on the work of
the organisation, she replied: ‘The volunteers’
contribution is huge – and difficult to do justice to: I
could quantify it and say that in 10 years they’ve repaired
over 7 million dollars worth of equipment, but the impact
goes far beyond that’. Melissa then went on to describe
the type of impact engineering support can have on
resource-poor settings: ‘The trickle-down into the
community, that even one piece of repaired equipment
can parlay into can be amazing. It’s often life and death;
in Tanzania we’ve had students working in a hospital
that didn’t have any working incubators. Around
Kilimanjaro it gets very cold and all the babies had were
swaddling cloths – no body warmers or infant warmers.
Newborns were dying from hypothermia and the
students were horrified. They ended up modifying an old
space heater, fixing it to the wall and improvising a
thermostat. That little bit of ingenuity – as old fashioned
as it was – is saving babies’ lives.’
EWH OVERSEAS: THE BIOMEDICAL EQUIPMENT
TECHNICIAN (BMET) PROGRAMME
Of EWH’s programmes, the BMET scheme (of which
International Aid is the originator) perhaps shows the
most potential for sustainable development of healthcare.
According to Melissa: ‘The most pervasive needs really
aren’t the pieces of equipment themselves – they are the
training, the spare parts, the manuals and the engineering
logic required to make a lot of those repairs.’ The purpose
of the BMET programme is to meet these needs during
the course of six intensive 2-month training sessions, held
in-country (to avoid brain-drain issues) and spread over 3
years** (figure 3). The courses enrol secondary school
leavers and take them through to BMET certification,
where they themselves can train others and share
experiences through growing professional societies of
engineers and technicians; it’s about as close as one could
get to ‘teaching a man to fish’ in this context.
A unique strength of the BMET programme is that the
course curricula have been carefully researched over
years and balanced to suit the needs of each country’s
hospitals, based on research through the Summer
Institute and evaluations of similar programmes. A 2010
paper from Duke University analysed 3,000 repair records
from 60 hospitals in 11 countries and identified a set of
120 ‘technical skills’ that could be used to bring the
majority of donated equipment back into service. 5 These
skills included ‘tricks’ like replacing a fuse with an
improvised alternative and repairing a blood pressure
cuff with a bicycle repair kit. With these skills embedded
FIGURE 3.
BMET
programme
students in
Ghana inspecting
an incubator.
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14 | MARCH 2012 | SCOPE