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Why Biomedical Equipment Technicians Matter

  • May 8, 2018
  • Blog
Ed Hutton, Chief Operating Officer, Engineering World Health

Ed Hutton, Chief Operating Officer, Engineering World Health

Ed Hutton is the COO for Engineering World Health. He is an honor graduate of the US Army Medical Equipment and Optical School and a CBET. Ed manages – and sometimes teaches – EWH’s BMET Training programs, located in Honduras, Rwanda, Cambodia, and Nigeria, as EWH builds biomedical engineering community to improve health care delivery in the developing world.

It isn’t unusual to see multiple babies in a single incubator in developing world hospitals. Many people don’t know the machine is designed to maintain the temperature, oxygen level, and humidity of a single baby. Somewhere near the hospital there is likely a pile of broken incubators ready to donate parts for repairs, if someone knows how to use them.

Frequently, the more mundane supplies we take for granted in the developed world will also be missing.  Correct lubricants, solvents, sealants, fuses, and all of the little bits and pieces a technician thinks of as bench stock are often hard to get or unavailable.  Hand tools on-site will be non-existent or limited.  Specialty tools (gas analyzers, temperature monitors, etc.) are never available.

During my very first visit to Africa, I was looking at medical facilities. I am a Certified Biomedical Equipment Technician, an Electrical Engineer, and tech industry executive. I worked for almost ten years in U.S. hospitals. I had set up technology development companies in the developing world. I had not spent any time in a hospital in a developing country.

I was, frankly, not prepared for what I would see.

A colleague and I had been asked to look at an X-ray machine with a collimator that didn’t work. The problem turned out to be the light bulb. A few dollars and a few minutes in the United States and all would be set right. But there were no parts, no money to buy parts, and no local place to purchase them.  I commented to my far more experienced colleague, “It seems a shame the machine will be down for something as small as a collimator bulb.”

He replied ruefully, “Oh, it won’t be down. They will just open the collimator wide and blast away.” I was shocked and said, “But children!?”  He was not so easily shocked: “Toe nails to eyeballs: they’ll irradiate everything for a simple broken bone.”

I was new, and I was horrified.

I was about to MacGyver my first piece of medical equipment in Africa. The closest bulb I could find was for a computer projector. We fixed the collimator with this bulb.  It wasn’t as bright as it’s supposed to be, but it was bright enough that babies wouldn’t get full-body radiation exposures.

I have since seen far worse, but I understand the landscape now. Engineering World Health sets up schools and trains local people to fix medical equipment. Due to the lack of parts, this often includes creative solutions to problems.

Medical missions abroad are often surprised to find half of the medical equipment at the hospital they have come to work at is broken. EWH has had students repair a hospital’s only defibrillator, while other students worked in a hospital with no functioning patient monitors. We’ve encountered operating rooms that couldn’t be used because there were no working lamps and hospitals that couldn’t do surgeries because they had no suction pumps.

In the U.S., we have health specialists called Biomedical Engineering Technicians (BMETs). BMETs install new equipment, teach the staff how to use it, perform routine planned maintenance, and repair equipment. This specialty is missing or severely limited in most low income countries. When there are personnel assigned to medical equipment, they often have little or no training and few tools or parts.

At a minimum, if you are going abroad as a medical outreach team, be sure you bring a BMET with tools, instruments, and some bench stock and parts. We have seen NGO doctors and nurses with no way to work because all of the Operating Room equipment was out of service where they were. Make sure the BMET understands your clinical mission and what equipment you expect to have available. Even if you are bringing your own equipment, expect to need the support of a team BMET.  Electrical power will be very questionable in quality and perhaps availability. Sanitation may mean boiling instruments. Oxygen might come in a blue gas bottle instead of out of the wall. Depending on how you provision and set up your outreach mission, your BMET might be the only reason your doctors and nurses can actually do their job. Little today is done in medicine without technology: you will need a BMET on your team to be as successful as you can be. Many NGOs who do global medical outreach bring an experienced BMET along for this reason.

An experienced BMET with time spent in the developing world can help you plan for your technological needs on deployment. Your BMET will be a critical part of you medical outreach team.