These tools or equipment have been requested by personnel working with Engineering World Health in developing world hospitals. These project specifications are intended to be used as guidelines. You should design your device to deliver the maximum possible performance while still staying within the cost specification. Some deviation from the cost specification may be tolerable if the benefits in performance warrant. Where superior performance specifications are given, they need not be followed for the design to be acceptable.

We cannot accept designs which are not on this list. However, we can accept suggestions for items to be added to the list. Feel free to suggest a new design project. If the project is accepted, it will be added to the list for everyone to see, and you will be able to submit your design as well. Write an e-mail describing your idea in one paragraph to info@ewh.org to find out if it is a project that we can support.

In the following paragraphs, all costs are for parts only (no labor costs) and include all the costs of production, even costs that you may not encounter in the prototype, like the box or printed circuit boards. You can assume that the parts are purchased in the developing world or the US.

PROJECTS:

LEGACY PROJECTS:

Non-electronic Oxygen Concentration Test

Engineers are often faced with oxygen concentrators of unknown quality.  This device should allow the engineer to quickly determine if the device is producing concentrated oxygen (perhaps greater than 80% or 90%) without using electricity (batteries, etc).  An ideal device would allow a crude (within 20%) estimate of the oxygen concentration.  The designer can assume access to elements often found in hospitals (CO2 absorbing material, matches etc).

Legacy:  A team has designed a system based on the burning time of match, coke bottles and a lump of clay.  However, the system is a bit hard to read and needs to be calibrated for every size of coke bottle.  Is there a way to calibrate the device based on the volume of the coke bottle?  Can it be made easier to read?

Pulse Oximeter for Heart Rate

The pulse oximeter is one of the most common medical instruments, and is the most frequently requested piece of medical equipment.  Prices have dropped for this product to the point where nearly every patient in a US hospital will be connected to such a device.  However, in the developing world, pulse oximeters are still difficult to find.  The most important function is to display heart rate.  Displaying oxygen concentrations is a secondary desire.  The device must use non-disposable sensors.  It should operate on a finger of an adult.  It should provide audible (beeps) for each heart beat and ideally also provide a digital display of heart rate.

Legacy: A team has designed a low-cost circuit that beeps on every heart beat.  Now someone needs to add the display of heart rate.  Probably needs a PIC programmer.

Relevant additional specifications
Device available for kit design or local production only
Cost: <$8 in quantities of 1

Universal Surgery Light Bulb Replacement

Approximately 80% of the surgery lights that are found unused by Engineering World Health are sidelined by the lack of lighting.  These older machines have light bulbs that are broken.  While the replacement is simple, the bulbs are expensive, not available in many developing world countries, and in some cases not available anywhere due to the age of the surgery lamp.

What is needed is a system for replacing light bulbs in lamps with LED light bulbs.  What circuitry would allow the housing of the bulb to be spared, but the new bulb to be wired into place?  What intensity of bulb could be found to match? 

Legacy: A team has developed a preliminary circuit that appears to meet the needed specifications for surgery lights.  However, the circuit does not work over a wide enough range of voltages.  Also, it has no housing. 

Relevant additional specifications
Device available for kit design
Cost: <$5 in quantities of 1000

 


Non-Legacy PROJECTS:

Bovie Pen Hardening

Electrosurgery is the most common form of cutting, perhaps even more popular than the scalpel.  However, most developing world hospitals must re-use the same disposable bovie pen time-and-time-again.  This project is to develop a technique for hardening disposable bovie pens so that they can survive reuse. 

Relevant additional specifications
Device available for local intervention only
Cost: <$1 in quantities of 1

Hardened Non-Invasive Blood Pressure Machine

Non-invasive blood pressure machines are now available for about $25 at some drug stores and on-line shops.  The expectation is that they would be used once or twice per day at home (about 300-600 cycles per year).  These devices will last many years when used according to expectations.  However, when these are donated to the developing world, they are used 24 hours per day, seven days per week (about 5000-10,000 cycles per day).  The devices last only a few days under these conditions.  This project should adapt a low-cost, non-invasive blood pressure machine, designed for home use, for continuous use in the developing world.

Relevant additional specifications
Device available for kit design or local production (prefer local production)
Cost: <$5 in quantities of 1
Cost: <$2 in quantities of 500

Respiratory Rate

During surgery it can be critically important to monitor the presence or absence of breathing, as well as during recovery.  This device should produce an audio pulse (a “beep”) each time the patient breaths.  If the impedance plethysmography approach is used, the electrodes should be permanent and reusable.  Display of the respiratory rate is a secondary feature.  Alarms for respiratory rate are a secondary feature.  Device must be highly reliable.

Relevant additional specifications
Cost: <$20 in quantities of 1
Cost: <$5 in quantities of 500

Nebulizer

The rates of asthma and pneumonia are very high in the developing world.  However, their access to appropriate medicine is hindered by the lack of robust nebulizers.  While home use nebulizers are inexpensive, they last for only a few weeks or months once transported to the continuous, heavy use environment of a developing world hospital.  However, the basic components of a nebulizer are available in the developing world.  This project is aimed at using commercially available (in the developing world) air compressors and tubing to construct a robust, hospital grade nebulizer.

Relevant additional specifications
Only available for local production
Cost: <$100  for single compressor with ability to treat 4-8 simultaneous children (manifold type).

BP Assist Device

While many philanthropic studies focus on “high-profile” killers such as HIV and malaria, the primary cause of death throughout the developing world still stems from issues related to the heart. The WHO has begun to seriously consider the growing number of hypertensive patients throughout the world, and as a result we are focusing specifically on improving the diagnostic capabilities of hospitals throughout developing countries.

This project will develop a low cost, easy to use, device is to assist a minimally-trained person in taking the blood pressure using a sphygnomanometer.  Assuming the assistant has inflated a cuff around the arm and is now slowly allowing the pressure to drop, the device should “beep” when the pressure should be read for systolic and “beep-beep” when the pressure should be read for diastolic.  The device should not measure pressure.

Relevant additional specifications
Only available for traditional production
Cost: <$5 in quantities of 2000 or more

Hardened Pulse Oximeter

It is now possible to purchase a pulse oximeter for about $100.  Yet, this is one of the most requested pieces of medical equipment in developing world hospitals.  The problem is that donated, low-cost, pulse oximeters quickly break in the continuous use environment of the hospital, and the batteries can be difficult to replace.  The objective of this project is to take the elements of an off-the-shelf, low-cost, pulse oximeter and adapt them for long-term continuous use in the developing world.

Relevant additional specifications
Adaptation should ideally be accomplished as a kit.  However, traditional manufacturing can be considered
Cost: <$25 (for the adaptation kit/parts in quantities of 100)

Hand Cranked/Shaken Otoscope

One of the most basic pieces of examination equipment is the otoscope.  However, when physicians are stationed in remote locations far from electricity and replacement batteries, standard otoscopes are ineffective.  This project is intended to adapt a standard otoscope to use in remote, resource poor settings.  The device should operate by cranking, shaking, pulling or otherwise generating energy without batteries or access to electricity.  Only the energy storage/delivery apparatus must be adapted, not the optical sections.

Relevant additional specifications
Only available for traditional production
Cost: <$100 in quantities of 10 or more

 

Liquid Medication Delivery System (2 projects)

The number of children infected by HIV continues to grow. There may be as many as 2.1 million children worldwide infected with HIV.  Over the past 15 years, several options have become available for treating children and preventing the transmission of HIV from mother to child, including zidovudine (AZT), didanosine (ddl) and nevirapine.  However, infants are unable to swallow pills, and so the drugs are donated to developing world pharmacies in 20-200 ml bottles. 

The problem is that a single, small dose of 0.5 ml must be provided to a mother so that when she gives birth, some number of months later and many miles away, she can deliver the dose to her newborn.  In poor countries, liquid medications are now given in plastic bags, open syringes or recycled plastic bottles, all of which lead to medication spoilage and loss.  For the poor pharmacy, extracting the correct dose from the bottle without contaminating the bottle and presenting it to the mother in a form she can transport home and use safely and effectively has presented serious challenges. 

This project will develop a medical device for the distribution point (usually a pharmacy) that includes Project 1) a bottle topper capable of resealing the bottle and measuring the correct dose, and Project 2) a packaging system that places the medication into a sealed, foilized, polyester pouch (without requiring electricity).  The pouch is similar to the foil pouches used for mustard or ketchup at fast-food restaurants. 

Relevant additional specifications
Only available for traditional production
Cost: <$2 in quantities of 2000 or more


Stimulator to Prevent Post-Partum Hemorrhage

Worldwide, nearly 540,000 women die every year from complications due to pregnancy or childbirth, many of them from post-partum hemorrhaging (bleeding after birth).  When women give birth in health facilities where drugs, equipment, blood supplies and the people who know how to use them effectively can be found, the odds of survival are much higher.  However, in developing nations such well-equipped facilities are a rarity.  Most women deliver at home in the presence of a traditional birthing assistant (a midwife).

Medications, such as oxytocin, are particularly powerful at causing the uterus to contract, terminating maternal hemorrhaging.  However, most nations, including those in the developing world, restrict access to medications, including oxytocin, to medical professionals.  This leaves women, who largely deliver at home where there are no medical professionals, without access to treatment.

This project is intended to adapt a medical device for the purpose of contracting the uterus.  Specifically, preliminary data (Uterone 1, Khasin 1984, 1985) shows that an electrical stimulator like a cardiac pacemaker can effectively contract the uterus.  The proposed device would be hand cranked and could sit idle in a village for months or even years before a minimally trained traditional birthing assistant could apply the therapy, saving the mother’s life.

Relevant additional specifications
Available for traditional or kit production production
Cost: <$100 in quantities of 10 or more


Research Projects

Medical Waste Incineration

This plea came to our attention:  “It seems that our hospital in Congo is forever plagued with waste, bandages, and other things that need to be incinerated.  But most of it just gets buried in a hole and then we find children and others climbing down into the hole to get stuff which is usually quite contaminated.”  The problem of medical waste incineration plagues hospital far beyond Africa.  We find this problem in hospitals throughout the world. 

The project is to design a medical waste incinerator that can be built entirely from locally available materials. 

However, we were not able to find any preliminary work on this project.  The first task is to scour the literature and determine whether anyone has worked on this project in the past.  Secondly, determine minimal specifications that a device could reasonably meet.  Will it be possible to meet a minimal set of specifications with locally available materials?

 

Infusion Pump – Cartridges

Over the last several years, many manufacturers of infusion pumps have moved from a model of using standard infusion tubing to using specialized cartridges that fit inside the pump.   The cartridges are specific to each manufacturer, and sometimes each model.  The result is that developing world hospitals can easily get donations of infusion pumps, but those donations are not usable because they cannot afford the cartridges.

The project is to determine if there is a possible universal infusion pump cartridge, or at least a set of easily available cartridges that can be recommended.  Or, would it be possible to design one after-market cartridge that would fit into most donated pumps.  As an alternative, could cartridge-based  IV infusion pumps be retrofitted with something that made them compatible with standard IV tubing.