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“Fishing” App Designed To Empower Healthcare Workers In Uganda Wins Major Award
It
is one thing for more affluent countries to donate medical
equipment to developing countries, but how can we ensure the
healthcare workers receiving the equipment know how to use
it? This was the issue that Kiara
Miller, a PhD candidate at the Auckland Bioengineering
Institute (ABI) encountered when she went to Uganda on an
Engineering World Health (EWH) internship for three months
in 2019/2020.
She and her fellow interns, Jay Anand, an
engineering student at UNSW, Sydney, and Moreen Kyomukama, a
biomedical engineering student at Makerere University, were
struck by the scale of the problem.
They also came up
with solution; they developed a training app for healthcare
workers for particular medical equipment, which has been
awarded first place in the EWH (Engineering World Health)
Design Competition for students.
Their e-platform is
called “Fishing: An E-Learning Platform and ERP system for
Limited Resource Environments”. It was named in reference
to the aphorism, “Give a man a sh and you feed him for
a day, teach a man to sh and you feed him for a
lifetime.”
The EWH internship, which Kiara was able to
participate in with the support of the ABI, involved
visiting and working with a number of different clinics and
hospitals in Uganda. While she was had read up, and knew
that the misuse and poor maintenance of medical equipment in
developing countries was a problem, seeing it first-hand
took her aback.
“I had read about these medical
equipment graveyards, but when you get there you realise how
huge the problem is, how much equipment was just sitting
there, not being used. User training was rarely given to
on-the-ground healthcare workers or training about how to
maintain and manage the equipment.”
“In one hospital
a bacterial incubator was incorrectly labelled as an
autoclave and being used to sterilise dental equipment, and
in another health centre, medical equipment in the maternal
department was being sterilised in a water
bath.”
While her primary role as an intern was to
repair medical equipment, it became clear that the problem
required more than a drop-in-and-fix solution. “Often we
would repair equipment, and money was spent on spare parts,
only to return the following week to nd the same piece of
equipment broken or lost.”
She and her fellow interns
concluded there had to be a better way. As she notes, while
they worked in places where the power supply was
unpredictable, and internet connection poor, most people had
a mobile phone, and used them in myriad and innovative ways.
“So we thought this problem could addressed in a different
and quite simple way.”
In their last month on the
internship, the team of three repaired the medical equipment
by day and (enlisting the help of colleagues and friends)
developed and designed the “Fishing” App by
night.
“It was initially quite challenging to build the
app when we were over there, because of limited internet
availability and power surges,” says Kiara. “We would
have to ensure we charged our devices when power was
available so we could still develop the app during the
outages.” They also relied on Bluetooth capabilities,
including an app called Xender, which the locals used to
distribute content without depending on the
internet.
“That experience was really critical in
understanding how Ugandans interact with technology
differently and do so ingeniously without relying on the
internet and 24/7 power,” says Kiara.
The prototype
they developed is currently being used by healthcare workers
in Entebbe Hospital, where it has been well-received.
The
EWH internship is largely aimed at engineers, and Kiara
isn’t an engineer. She completed her bachelors and post
graduate diploma in Applied Science, and completed a Master
of Engineering last year, in which she focussed on the
investigating gastrointestinal physiology. As a PhD
candidate at the ABI, she is working in the GI group
developing tools and techniques to improve our understanding
of the GI system. (Her research is focussed on non-invasive
electromyography recordings for assessing swallowing and
creating biofeedback therapy for patients with dysphagia –
that is, people who have difficulty
swallowing.)
“However, I did design for technology as
one of my majors in my undergrad years, so I have always
been passionate about human-centred design, particularly
frugal innovation. So the ‘Fishing’ app has come out of
that.”
The rst stage of the “Fishing” project
involved the development of the app, and an oine
E-Learning library called Health Care Technology Trainer.
They are now hoping to gather more evidence of how it is
being used by healthcare workers, and identify what
improvements need to be made.
Their ongoing research has
been frustrated by restrictions resulting from the pandemic,
which is what makes receiving first place in the EDW awards
so timely. “The impact of Covid-19 has meant that we
haven’t been able to follow up on this as much or as soon
as we’d like to, but this award has really motivated us to
develop the software. There’s a lot of good medical
resources that are sitting in storage in hospitals in Uganda
and other countries, which properly used and maintained
could really benefit a hospital and their
patients.”
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