MOBILE HEALTH FACILITIES TONY ROYSTON – SENIOR BIOMEDICAL TECHNICIAN, THE AFRICA MERCY
Providing safe surgery in developing nations
The lack of access to safe surgery results in more deaths worldwide every year than HIV, tuberculosis and malaria combined, according to The Lancet Commission on Global Surgery. For nearly 40 years, Mercy Ships, the hospital ship charity, has made it a priority to provide safe surgery for people in developing nations.
The Africa Mercy hospital ship primarily serves West Africa, where the international volunteer crew of 450 spend 10 months at a time at the invitation of the local government. The service provides free surgical care in ophthalmic, maxilla facial, burns and plastics, obstetric fistula, cleft lip and palate and orthopaedic specialties for people living in poverty. Building the capacity of a country’s existing healthcare workers is a secondary role, which is of growing emphasis for Mercy Ships. The Africa Mercy has five operating
theatres, five wards and all the required axillary services such as radiology, pharmacy and pathology. The Ponseti method, physiotherapy and rehabilitation, ophthalmic and dental services are made available on shore at no charge to the patient. The Africa Mercy is a ‘first world’ hospital with good quality, modern and appropriate equipment. Unlike the hospitals on shore, it has stable power and environmental control that keep the equipment optimal. Storage space is limited, so equipment is rationalised and standardised. Most equipment is shipped in containers, which can take a few months to arrive, so vital spare parts are always kept in stock. A major consideration when choosing equipment for this environment is for it to be user friendly, as the international clinical crew may be seeing a specific model for the first time and need to use it soon after they arrive. While the
surgeries are conducted on board, the team are also responsible for maintaining the equipment used by those on shore. Dental, eye and other clinics are set up on shore during each
IFHE DIGEST 2019
The Mercy Ship is dockside for 10 months in one African nation, providing essential surgery and rehabilitation services, building medical capacity, running dental and eye clinics and providing HIV/AIDS counselling and chaplaincy services.
field service. Because of unstable local power supplies and dusty, hot and humid conditions, the equipment has to be rugged and durable. A different country each year may require building infrastructure modification including temporary cables, air hoses and other items. Everything must therefore ensure safety and reliability for patients and clinical teams.
Getting the single slice CT scanner
working after a hard drive failure was a major trial. The necessary part was impossible to find, but a modified
Tony Royston
Tony Royston is a senior biomedical technician who has volunteered with
the Africa Mercy for a decade. Prior to joining Mercy Ships he worked at a
university teaching hospital for many years and then for global medical
equipment company CT, Nuclear Medicine and Ultrasound Imaging Systems. He then
delivered technical training to newly qualified engineers at the Ford Motor Company for three years before joining Mercy Ships.
newer drive got the machine working. A programmer had long before written an error message for a too large drive capacity that said, “No way, you can’t be serious, that’s humongous!” Every piece of software, including the calibration backups, had to be reloaded. At the time, I was the only biomed on board and a patient needed a CT as soon as possible. It took many long hours. During the current field service in
Cameroon, West Africa, a hospital had an X-ray machine that was not working despite three attempts to repair it. It was the only X-ray machine in a region with a very large population. The machine was brought from the other end of the country to the port city for us to look at. It was almost 30 years old and we had to do the repairs to component level, which is uncommon these days. However, we were able to find the fault and repair it. We also replaced some other old parts and gave it some much needed general maintenance.
Medicine and surgery rely on
diagnostic and therapeutic equipment. Unless there are capable, trained and supported biomeds in the countries we
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