We had the opportunity to visit the Mulago Hospital Engineering Department. One of the students at Makerere University, Bryan, showed us around the hospital to gain a better appreciation of some of the technical and technological challenges experienced by the hospital.
First, we examined the healthcare waste management system, and in particular, the incinerator at the hospital. There is only a single incinerator at Mulago Hospital, and there is a large backlog of waste to be burned. Only a single waste disposal worker is hired to sort the waste and run the incinerator, and he works for 15 hours a day. Even more critically, the waste segregation infrastructure is not well established at the hospital and the waste disposal worker needs to separate general waste from toxic and infectious waste at the point of incineration. This has resulted in 12 waste disposal workers dying in the last 12 years due to complications suffered through this unsafe exposure.
Second, we learned about the oxygen generation system. One of the main challenges faced here was that the oxygen generation machine had not been functioning for a few weeks. We were told than a contractor would be having it back in operation within a few days. Another challenge in this system was also that the contingencies for power outage involved moving multiple oxygen tanks and running to the back of the building to close a valve; very manual and labor-intensive processes.
Finally, we visited the Microbiology and Molecular Biology labs at the hospital. This experience was in contrast to the other two domains that we had seen, in that both of these labs were very well equipped with modern equipment. I was surprised that most of the equipment that is present in laboratories in the U.S.A. was present in Mulago. Indeed, I was even able to see a genome sequencing machine in the Molecular Biology lab. We were informed that many of these equipment had been donated from higher-income countries and NGOs. Once again, a key challenge was that it was difficult to service malfunctioning equipment. Given that they were expensive donations, local engineers and technicians were wary of fiddling with the instrumentation when malfunction occurred because they were not familiar with the equipment and because of its high cost. More often, the laboratory users would wait for a service crew from the donors to arrive – this would happen once every few months. As such, long periods of time often passed with certain equipment being unavailable for use.
It was a very beneficial experience for us to see these places and hear first-hand about the challenges faced. It gave us a fantastic opportunity to learn about specific needs of the hospital, and also to gain a better idea of the conditions and circumstances under which some of our designs would operate.
Post by Manish and Picture by Denali.