AAMI News October 2017

The Challenges of Being a Biomed in a Tropical Paradise

Nehal Kapadia worked for the Fiji Ministry of Health for three years as a biomedical technician, procurement officer, and biomedical coordinator before spending four years supporting a regional project focused on strengthening specialized clinical services in the Pacific. Kapadia now lives in Boston, MA, where she is completing a master’s degree in clinical engineering from the University of Connecticut. Kapadia won an AAMI Foundation Scholarship in 2017 to support her studies.

Nehal Kapadia
Nehal Kapadia (right) helps Taaren Toanikai, a biomedical
equipment technician on Kiritimati Island, repair a dental chair.

Providing biomedical services in Pacific Island Countries (PICs) has been a challenge since the inception of the field in the 1980s. Healthcare facilities in PICs are separated by miles of ocean and are run mainly by the government. Limited tools, test equipment, service training, and funding are all realities that biomedical technicians face every day.

Although PICs generally recognize the importance of biomedical services (the term “healthcare technology management” is not used), governments are not able to invest substantially in them as most of the available resources are used for other needs, including providing clinical services in the country, sending patients overseas for further treatment, and training clinical personnel.

Using the limited resources at their disposal and their knowledge of electronics, biomeds in the Pacific try their level best to repair the majority of equipment found in healthcare facilities, including general biomedical, laboratory, dental, and basic radiology equipment. This is a big responsibility because very few devices are placed under a service contract.

Some biomeds also must maintain nonmedical equipment, such as lighting and laundry equipment, because although some PICs have a dedicated biomedical engineering department, there are others where the biomedical technician is part of the maintenance or facilities department.

In PICs, members of the biomedical engineering department are mainly seen as repairers; however, this responsibility is complicated by a lack of service manuals, parts, and contacts for technical support, especially if the equipment being repaired is an obsolete make or model that has been donated to the healthcare facility. As a result, equipment can remain unrepaired for a prolonged period, and clinical services staff will continue to acquire new equipment (either purchased or donated).

Because of these unique realities, local biomedical staff are not commonly involved in procurement decisions or major projects. However, this is slowly changing in larger countries such as Samoa and Tonga, which now have a local biomedical engineer. Regional efforts have increased awareness of biomedical issues, increased biomedical capacity-building activities, and continue to provide support for management of biomedical services in PICs.

While I was working in Fiji, I experienced many of these challenges. And as PICs begin to purchase more complex and expensive equipment, such as digital imaging systems, without the expertise to manage procurement and ongoing maintenance, a higher level of biomedical support is going to be needed.

I hope that the experience I gain through my clinical engineering master’s program and internship at Massachusetts General Hospital, which I’m currently undertaking, will prepare me to better manage healthcare technologies and biomedical departments in developing regions with limited resources, like those back home.