Strengthening Health Systems through Biomedical Engineering
The late Dr. Paul Farmer once described one of his guiding moral imperatives: “If you're in front of someone who's suffering and you have the tools at your disposal to alleviate that suffering or even eradicate it, you act.” One of the great frustrations for our health partners in Bolivia and Paraguay is the common experience of seeing suffering in front of them, but lacking access to the necessary tools to alleviate it. These tools include a range of biomedical technology. In some cases, our partners have those tools, but the equipment isn’t working and they can’t find the parts or expertise to fix it. Functioning biomedical equipment and the workforce to maintain it are a pillar of a strong healthcare system. Without those, health systems are unable to provide effective care and alleviate the suffering of the populations they serve.
This was the impetus for a Biomedical Engineering (BME) trip to Bolivia earlier this month organized in partnership with the TriMedX Foundation. The focus of the trip was to repair and provide in-service training in the use and maintenance of previously-donated surgical microscopes and other equipment. As part of our surgical programs, Solidarity Bridge works with our partners in Bolivia and Paraguay to identify and fill priority equipment needs. It is equally imperative to continue to work with those partners to ensure the equipment remains in good working order. That means having access to spare parts and consumables, and to local biomedical engineers and technicians with the skills to provide ongoing maintenance and repairs.
The BME team included two engineers from the US, Nathan Gibson (microscope specialist from Prescott's Inc.) and Kevin Collazo (TriMedx Foundation), accompanied in Bolivia by José Choque of Puente de Solidaridad and Francisco Decker, a recently-graduated biomedical engineer who provided language interpretation for the visiting volunteers. The team traveled to three cities to work on surgical microscopes and other equipment at leading public hospitals serving patients from across Bolivia’s eastern, southern, and central regions. They provided maintenance, calibration, adjustment, and repairs of anesthesia machines, electrosurgical units, light sources, CO2 insufflators, and neurosurgery and ophthalmologic surgery microscopes, all while in dialogue with the Bolivian nurses, neurosurgeons, residents, and biomed engineers working in each of the hospitals.
Bolivian surgical team operating with the freshly repaired ophthalmologic microscope at Santa Barbara Hospital in Sucre.
As one example, the BME team successfully repaired an ophthalmologic microscope donated a few years ago by Solidarity Bridge to the Santa Bárbara Hospital, in the city of Sucre. The microscope had broken down and sat unused. The hospital’s eye surgeon was overjoyed when Nathan successfully repaired it. Just a few hours later, Nathan was invited to attend a pre-programmed surgery, where he demonstrated safe and effective use of the microscope to provide high-quality care to the patient.
Our partnership with the TriMedX Foundation is also part of a long-term vision to expand the field of biomedical engineering in Bolivia. Undergraduate biomed engineering education in South America has grown significantly in the last twenty years with curricula focused mostly on electronics and bio-instrumentation. It is a novel but growing field in Bolivia, responding to urgent need for professionals in healthcare centers to install, manage, and maintain complex equipment. We were delighted to have the volunteer support of Francisco Decker, who studied at the Universidad del Valle in Cochabamba. Francisco explained his calling to the field: “The work is important because health workers care for patients with all the tools available to them. Sometimes they have to take risks during surgery because they do not have the necessary equipment. By giving new tools to the staff, they can attend to more cases. Patient risks are reduced, and health personnel are further safeguarded. As a result of exchanges like this, patients will have more opportunities to reliably resolve their health problems. They can be assured they will have medical equipment that has been maintained by experts.”
Kevin Collazo, Biomedical Mission Specialist for the TriMedx Foundation, declared his week in Bolivia not only a great success in terms of objectives achieved, but also “one of my best trips ever!” While there, Kevin also identified a few missing accessories and parts for equipment he inspected, which TriMedX will donate for delivery to Bolivia on our upcoming maritime container shipment. Kevin also proposed virtual training sessions with the Puente de Solidaridad staff to facilitate provision of basic equipment maintenance.
Kevin Collazo of TriMedX explains how to read the hour meter on a Xenon light bulb to young biomed engineers Carlos Baldez and Ernesto Jimenez at the Children’s Hospital in Santa Cruz.
Solidarity Bridge and its partners heed the call of the World Health Organization (WHO) for a comprehensive approach to healthcare system strengthening. That includes access to safe and reliable surgical care, for which biomedical technology is an essential tool. The WHO goes on to affirm that local investment and production is essential to bridge inequity gaps in access to medical devices. In that spirit, our long-term vision is for Bolivia and Paraguay to have all the local technological infrastructure and expertise to meet these needs nationally. This trip is one step toward achieving that vision.
We would like to extend a heartfelt Thank You to TriMedX and Prescott Inc., and especially to their dedicated and compassionate engineers, Kevin Collazo and Nathan Gibson!