No child should die for lack of oxygen
Stephen Howie, a doctor and researcher at MRC Unit, The Gambia, recently received a grant from the MRC Developmental Pathway Funding Scheme to develop and test a low-maintenance oxygen supply system for children with pneumonia and other diseases. Here he explains why traditional oxygen cylinders don’t fare well in developing countries, and what he plans to do about it.
I joined the MRC’s unit in The Gambia in 2003, a fresh-faced paediatrician from New Zealand, excited to be in a place where need and expertise meet to save children’s lives. Ten years later I’m still excited about this place for that very reason.
One day, early on, I was seeing children at the government hospital in the capital, Banjul. The staff there told me about the struggle they had to make sure that oxygen was available to children with severe pneumonia and other serious illnesses. Pneumonia is the number one cause of death in children worldwide, and it affects those in developing countries far, far more often than in other countries. Severe pneumonia stops the lungs doing their job of getting vital oxygen to the body properly, and giving oxygen can save lives. The staff at the hospital were just managing, but efforts to try to improve their system for oxygen delivery had not quite worked.
Traditional oxygen cylinders are big, awkward to manoeuvre and expensive. In an attempt to alleviate these problems, donors had given more than 20 oxygen concentrators to the hospital — these are electrical devices that sit by a bed and deliver oxygen to the patient by filtering nitrogen out of the room’s air.
But despite these well-meaning efforts, the concentrators had broken down. They need reliable power and good maintenance, and the reality is that most health facilities in countries like The Gambia don’t have either of these.
This early experience made me aware that oxygen is a big issue — in big hospitals and even more so in smaller hospitals and clinics where many children go; and not just in The Gambia but all over the developing world.
I realised that oxygen system that can work cost-efficiently 24 hours a day, seven days a week even with unreliable power and little maintenance could save a lot of lives — and it’s become my mission to develop one.
I share this ambition with my colleagues, including David Peel, a UK engineer and oxygen expert, and Bev Bradley, an engineer from Canada, as well as the Biomedical Engineering Department at the unit. We have been working on prototype systems to suit developing countries, and with the MRC Developmental Pathway Funding Scheme support we can take this work further. We will be making use of robust oxygen concentrator technology and power storage solutions along with alternative power sources like solar energy to find the best way to achieve our goal.
We believe that no child should die for lack of oxygen, and we hope this work will do something about it.