D-Rev On the Ground: Medical Care for Newborns in East Africa
My colleague Dorothy Zhuomei and I have been in East Africa on a short-term assignment to better understand neonatal healthcare and delivery. We’ve learned a great deal and have had the good fortune of witnessing a transforming Africa.
Naivasha District Hospital, a public hospital in Naivasha, Kenya
Let me start by describing for you the situation as we see it. There exists a wide range of healthcare facilities in East Africa. The public systems are the most commonly used, given their affordability to patients, yet oftentimes are the least resourced financially. This in turn affects the quality of medical devices—like phototherapy lights—used. In contrast, there also exist strong private hospital networks. Care at these facilities is affordable only to the region’s affluent residents.
The high cost of service means private hospitals have the spending power to obtain the latest and greatest medical technologies, like LED phototherapy lights. Somewhere in the middle of the two extremes lie faith-based and NGO hospitals. These hospitals are run as non-profit centers and can therefore plow back the small fees they charge patients into improving the quality of service.
Jamaa Mission Hospital, a faith-based hospital in Nairobi
More than once, I caught myself mid-interview with a healthcare worker thinking, “OK—so when I get back to the U.S., I’ll pack up a box of blue bulbs and ship it here so they can at least start using blue instead of white light to treat jaundice.” After pulling myself back from wandering thoughts, my rational mind reminded me that continuing the trend of unsustainable solutions is not the answer.
Once I stopped and listened to the inspiring, hard-working, tireless doctors and nurses in front me, I could hear clearly that these people are in fact not helpless. They are resourceful and determined and also want run-down, unfixable, and donated equipment to become a thing of the past.
The stories of our new friends Christine and Margaret are just two examples that Dorothy and I witnessed of passionate people defying old norms and using innovative approaches to improve neonatal care.
The author (left) with Sister Christine (right), who single-handedly built her hospital’s Newborn Unit
Sister Christine single-handedly built her hospital’s Newborn Unit. After months of persistent requests, the hospital gave her a small space to establish the unit. After being told multiple times that there were no funds to purchase equipment, she started pulling old, used equipment from corners of the hospital, then took the initiative to seek out donors who could help outfit her ward.
She uses anti-microbial curtains for walls, insists all who enter her unit wear hairnets, masks, and robes (unfortunately not common practice as we’ve seen) and improvises wherever necessary (see the photo showing the “octopus” she made to split oxygen lines). Through her diligence in operations and data management, she has effectively driven infant mortality at her hospital to zero.
Determined health workers improvise where they can. Above, the “octopus” that Nurse Christine made to split oxygen lines.
Margaret, another inspiring healthcare worker we met, is a pediatrician who specializes in infant care. She recently left her high-profile job at the local public hospital and is now building her own affordable care children’s hospital. During our time with her she talked about her dislike for the words “low-resourced” and “developing”. She believes that Africa has ample resources, and that purchasing devices versus receiving donations is an important part of a hospital’s ability to sustain itself appropriately.
These are just two of the many examples we saw of a transformation in the mentality and actions of healthcare workers in East Africa. We have been inspired to be a part of D-Rev’s mission to deliver user-driven design to those in need, and in a way that supports their desire for sustainability.
Lastly, a thank you to the National Collegiate Inventors and Innovators Alliance for supporting our work with a Sustainable Vision Grant.