Oxygen Therapy in Malawi: Revising Oxygen Concentrator Filtration and Use for Improved function in Low-Resource Hospitals

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Date
2017-07-20
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Virginia Tech
Abstract

The quality of healthcare in low-resource countries is often limited by the environment, lack of funds, staff availability, electricity availability, and more. In the words of a Malawian physician, medicine can feel like improvisation, wherein one must make due with available resources rather than desired resources. One prevalent problem among low-resource hospitals is the functionality and longevity of medical equipment. A large percentage of all medical equipment in Malawian hospitals is donated, resulting in a wide spectrum of models, necessary spare parts, and functionality. These machines can break quickly due to heavy use prior to donation, missing user and maintenance manuals, and a lack of replacement parts. Thus, finding necessary life-saving equipment in Malawian hospital wards can be a challenge. One such piece of equipment is the oxygen concentrator, necessary for treatment of respiratory disease, use with CPAP machines, and in the administration of surgical anesthesia. This device fills many roles in low-resource hospitals, but in many Malawian hospitals it is the most frequently malfunctioning piece of equipment.

A survey administered to medical personnel and maintenance personnel in hospitals in Malawi’s Central and Southern Regions isolated some common causes of oxygen concentrator malfunction. Prominent among these were poor oxygen concentrator ventilation and the lack of consumable replacement parts such as the intake bacterial filter. A stand made from locally-sourced materials was developed to encourage better oxygen concentrator exhaust and raise the device out of dust and cleaning fluids on ward floors. Intake bacterial filter alternatives were researched, designed, constructed, and tested, manufactured from housing materials and filter media available in Malawi or continental Africa.

A primary source of difficulty for low-resource hospitals is lack of autonomy, requiring aid from affluent nations to supply equipment and consumable materials. This work suggests that sustainable innovations, such as allowing consumables to be produced in-country, can replace aid with development and create more accessible materials to hospital maintenance personnel. Collaboration with material suppliers and engineers in Malawi can provide sustainable designs and systems to help hospitals access the supplies they need to service oxygen concentrators and other equipment.

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Keywords
Filtration, Respiration, Oxygen Therapy, Oxygen Concentrator, Malawi
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