AAMI News January 2018

Tech World: An Uncle’s Heart Restarts and a Biomed’s Career Is Born

Ratish Kumar Mohan
Ratish Kumar Mohan (right) checks a colleague’s vital signs using equipment donated to Grace Hospital in Vogan, Togo.

During a serious illness, families want the best care for their loved ones—the best doctors, the best nurses, and the best biomedical equipment. In the intensive care unit, for example, families find comfort in the beeps and the graphs of monitors that signal a loved one’s stable vital signs. As a 12-year-old boy growing up in India, I was intrigued by stories of the machine that restarted my uncle’s heart and restored him to life. From this early age, I knew that I would enjoy a career in healthcare, and my interest in math and mechanics led me to study biomedical engineering.

Hospitals in India typically invest in large biomedical teams that are challenged with keeping expenses low by extending the usable life of costly equipment. As a new biomedical engineer working for Sri Ramachandra Medical Center, a multispecialty hospital in Chennai, India, I learned the importance of appropriate use and regular maintenance, and I became adept at repairing older equipment. At the time, I did not know that my future would include a warehouse of used, and yet useful, medical equipment and the opportunity to advocate for user training and maintenance.

Following my work in Chennai, I moved to the United States to complete a master’s degree in biomedical engineering at the University of Texas at Dallas. I was then faced with an unusual choice: move into a corporate or hospital setting or accept the challenge of working with a nonprofit organization that provides biomedical equipment to hospitals serving the poor around the world. I chose the opportunity offered by Hospital Sisters Mission Outreach, which serves 89 countries around the world.

My first adventure with the organization was an August 2017 trip to Togo with representatives from the Ole Miss chapter of Engineers Without Borders and Rotary International. During planning discussions in Springfield with Eric Lohse, an ophthalmologist and vice chair of the Mission Outreach Board of Directors, and Abram Wodome, the clinical lead for Grace Hospital in Vogan, Togo, we identified the supplies and equipment that would be sent in the first 40-foot container. One of the specialties of the hospital is eye care, so Mission Outreach pulled a number of relevant items from its inventory, including Marco slit lamps, a Zeiss surgical microscope, and a Bausch and Lomb phacoemulsification (phaco) machine.

Prior to my trip to Togo, Dr. Lohse and I attended Bausch and Lomb Millennium Phaco application training. Subsequently, the phaco machine was tested in our biomedical shop in Springfield, along with all of the other items selected from the inventory. We also assessed the need to convert the voltage of all the donated items in Togo and sent transformers and plug adapters in the container, which saved time during the installation process.

While in Togo, I set up and installed the equipment shipped by Mission Outreach, including vital signs monitors, infant warmers, incubators, and ultrasounds. I also assessed the equipment provided by other donors and unfortunately found that 90% of this equipment was nonfunctional and without reference manuals.

This experience highlighted for me how biomedical equipment can be a blessing or a curse for hospitals in low-resource countries. Decades of poor donation practices have resulted in graveyards of discarded equipment that was sent without repairs or without investigating whether the equipment could be used. In recent years, the World Health Organization, Engineering World Health, USAID, and others have spotlighted the need for donation standards and follow-up support.

At Mission Outreach, we are adopting a learning collaborative model that will allow more accurate budgeting and equipment acquisition for hospitals in low-resources countries and establish equipment maintenance plans. We are also looking to bring innovative strategies to lend remote biomedical support through the Looksee.do platform, which enables equipment experts from anywhere in the world to help technicians in the most remote and poorly connected areas operate, maintain, and fix medical equipment at a fraction of the cost and with reduced downtime.

Ratish Kumar Mohan is a biomedical engineering supervisor at Hospital Sisters Mission Outreach, a medical surplus recovery organization in Springfield, IL.