BioMed Needs Reassessment

We have arrived in Kampala once again to follow-up on several ongoing projects, primarily focusing on the state of biomed engineering at Mulago. The team this time includes Keita Ikeda (Biomed engineer from Duke) and Helder Chin (UCSF anesthesia research assistant).


First order of business was checking in with operating theatres to update the Mulago equipment inventory list and to make sure each operating theatre has a functioning anesthesia machine vent/vaporizer, pulse oximetery, capnography, and vitals signs monitors.

Though we haven't been able to test the functionality of the equipment (because the step-down transformers are kept under lock and key on the weekends), each theatre did have "full set" of machines. Most had the usual homemade/makeshift cables, as well as "disposable" BP cuffs and pulse ox probes which seem to have been on their last life quite some time ago. Between the vitals monitoring, vent, and capnography there are a hodge podge of at least 3-4 manufacturers per theatre to complete a set.

Some of the machines were obviously missing cables (an thus not likely functioning or being used) and others (like a vent which was slowly but obviously leaking oxygen) were in need of some quick fixes.

We also have met with engineers at the hospital to identify some of the major problems the encounter around the hospital. They have identified several areas that we began brainstorming about how best to support them.

One area identified was providing some support resources such as access to service manuals and basic repair equipment.

Another was helping to define rules for donated equipment. Equipment donationes are a double edged sword at Mulago. Inappropriate equipment donation is as much of a problem as the general lack of equipment.

Engineers here say they spend significant amounts of time trying to make donated equipment functional. Because they have no clinical and/or engineering support or training for these devices their efforts are often unsuccessful and equipment ends up in piles in hospital store rooms - making it impossible to keep track of smaller parts like proprietary cables, etc...

Through the course of this trip we hope to make some progress in the areas idenitifed by the engineers.

We were excited to hear that progress is being made with a technical biomed engineering program to begin at Kyambogo University here in Uganda in the Fall of 2009. Mulago is likely to be the skills training center for the program.