The Lifebox Foundation, a global charity working to improve the safety of surgical care in low-resource settings, today welcomed the spotlight on the issue of environment-inappropriate medical equipment and restated its commitment to appropriate, effective technology.
As a report released by the Technologies for Global Health Commission last week shows, much of the medical equipment available in austere environments is developed in wealthy countries. When used in the wrong setting it can be inefficient, difficult to maintain, and ultimately dangerous. The Lifebox mission is underpinned by the conclusions announced in the commission, a partnership between The Lancet and Imperial College London: To be effective, medical equipment must be suitable for the environment in which it will be used, and supported by training and education.
“We agree wholeheartedly with the Commission’s recommendation for use of frugal technologies,” says Dr Iain Wilson, Lifebox Foundation Trustee. “The Lifebox pulse oximeter is an outstanding example of a product which has been developed specifically for poorer countries. It takes into consideration the challenges of delivering healthcare in these settings without compromising quality or cost. The education programme it comes with means that it is used to maximum effect.”
The ideal pulse oximeter for a low-resource setting
The pulse oximeter is taken for granted in high-resource nations: a small non-invasive device that is essential for measuring the level of oxygen in a patient’s blood during anaesthesia or critical illness, it has contributed to a more than 90% reduction in anesthesia deaths in high-resource countries since the 1980s. However, in over 70,000 operating rooms around the world, healthcare professionals have to deliver surgical care without access to a single oxygen monitor. Frustratingly, sometimes low-resource hospitals have a pulse oximeter, but are unable to use it as it is built into equipment that has the wrong plug type, no spare probe, or relies on mains electricity, which is unreliable in these settings. The destiny of these machines is therefore often the ‘equipment graveyard’ – a warehouse full of inappropriate technology, a familiar sight in low-resource settings.
In 2008 the World Health Organization and the World Federation of Societies of Anaesthesiologists started designing specifications for the ideal operating room pulse oximeter for low-resource settings. The result was the Lifebox pulse oximeter; a tough and high quality device – but until now, an impossible extravagance in low- and middle-income countries.
How Lifebox is making a difference
By working directly with hospitals and clinicians, Lifebox is able to channel significant numbers of orders to our partner manufacturer, making the cost of the device lower. Lifebox has made a significant breakthrough by lowering the cost of pulse oximeters and making these available to hospitals in low-resource settings, either as a donation or at a cost of only £160 (US$250) per oximeter (delivered) This is normally less than a third of the price of similarly featured monitors available on the commercial market. Replacement probes (Universal or neonatal) cost £16 (US$25).
To date, 3,000 pieces of equipment have been distributed to hospitals in 70 countries. We have completely met the need for oxygen monitoring during surgery in Eritrea, Sierra Leone, Uganda, Fiji, Papua New Guinea and Tonga, and we have trained thousands of healthcare workers in how to use and maintain the equipment to ensure safer surgery long-term.
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