With the dearth of vital medical equipment for the survival of Covid-19 patients and the protection of medical frontliner staff, the cry was: “Why are they not available? And even if they were, how come they’re so expensive?”
While frontliners are responding to the immediate needs of Covid-19 patients, there is another group of frontliners who are inventing, innovating, and creating new technology to enable cost-effective, evidence-based, and more affordable care for Filipino patients.
In the latest episode of “Stop Covid Deaths” webinar of the University of the Philippines, “Laging Handa: World-Class Filipino Covid-19 Innovations,” presented together with the UP Manila NIH, National Telehealth Center and in cooperation with the UP Philippine General Hospital, the organizers digressed a little bit from the country’s woes regarding this pandemic.
Instead, they focused on the scientific, engineering and medical wins of the country in terms of providing biomedical equipment through the ingenuity and creativity of brilliant and persevering Filipino scientists and engineers to produce local ventilators, personal protective equipment, decontaminating systems, and even robotics that can protect frontliners from exposure to viruses.
A bit of history
Based on a World Health Organization 2011 report, almost all medical devices in developing countries were designed for use in industrialized countries. They are often expensive and cannot adapt to low resource settings, according to a case study of medical device companies from India.
“These statements were made more than 10 years ago and I think these haven’t changed very much. When you look at medical devices, everything is imported so it’s no surprise that we can’t afford them and worse, if it breaks down, spare parts are unavailable,” according to Dr. Edward Wang, Professor, PGH Orthopedics and Program Leader of the “Surgical Innovation and Biotechnology Laboratory” or SIBOL.
So SIBOL was born in order to “Innovate, Invent and Create” locally made biomedical equipment and devices in the Philippines, using local expertise and locally available material.
He explained that making a medical device requires engineers and scientists on one hand, and health-care workers and clinicians on the other, and most importantly, they must work together. Through SIBOL, they were able to institutionalize innovation in the medical equipment field.
In March 2019, the head of the UP College of Engineering got in touch with UP Manila for their clinicians to collaborate on certain proposals. “Traffic from UP Manila to Quezon City was horrendous and so we resorted to teleconferencing. So, in April 2019, clinicians from UP Manila went to UP Diliman and presented medical problems that needed science and engineering solutions. In turn, we invited the engineers to visit UP Manila to take a first-hand look at what’s going on to help us in areas we needed to innovate on.”
After several months, they came up with four different innovative projects under SIBOL. The program proposal was submitted to the Department of Science and Technology-Philippine Council for Health Research and Development (DOST-PCHRD), and was given a grant to start the program.
But it all hit a snag because of Covid-19, and many of their comrades fell because of this disease and because of the lack of protective equipment. They had no equipment, no infrastructure, no money, and SIBOL had to do something, but they had Zoom and Viber.
“We convened in March 2020 and in three months’ time, we had 11 projects divided into three teams—“Protect,” “Disinfect” “Distance”—the PPE team, the Disinfection team and the Telemonitoring team.
They also looked for funding mainly through private sponsors who provided initial seed money for their prototypes. One of the earliest was the “SaniPod.”
The SaniPod
The SaniPod is a no touch self-contained disinfection cubicle which provides an additional layer of protection for frontliners, those who come out of heavily infected Covid areas with their PPEs. However, during “doffing” or removing the contaminated PPEs, that is the major source of contamination to the health-care worker, the safety officer and the disposal teams of the PPEs.
Before doffing, the health-care worker goes through the SaniPod. The objective is to disinfect the PPE before it is doffed to protect the health-care worker, the safety officer and the disposal team.
The SaniPod is also very timely now that the country is again experiencing another surge, where the SaniPod allows the PPE to be reused to address the short supply of PPEs.
Aside from being self-contained and no touch, the SaniPod also has many mechanisms that help decrease decontamination like the HEPA filter, irradiation, etc., and is evidence-based for safety, efficacy and other parameters as added assurance for the user because it was tested and passed international standards.
Just like any innovation, it goes through an evolution process. From a condemned air shower that was donated to SIBOL came Prototype 1. “We learned as we evolved, went through several trials and errors, we relied also on the feedback of the actual users so we can improve on our succeeding prototypes,” Dr. Wang said, and right now, they are in Prototype 5 already.
He also thanked the entire DOST-PCHRD team because they were heavily invested in the SIBOL program and the microbiologists, clinicians, engineers, scientists. “Our efforts serve as tribute to fallen co-health workers and to the other frontliners who continue to work at the frontline despite all the risks.”
Actual use
Right now, the SaniPod is being used at the UP-PGH Emergency Room, according to Dr. April Llaneta, Chair, Emergency Medicine, UP College of Medicine. She said it is important that they look after the health of the ER staff to guarantee continuous service to patients.
Dr. Llaneta said they stopped using it for a while because of technical issues but everything was fixed and it’s back to normal. They use it after eight or 12-hour shifts, or even during the middle of the shift after handling toxic patients. At any given time, she said around 50-60 ER staff use the SaniPod.
“SaniPod was a big help for us because aside from the infection control measures at the ER like the PPEs, face mask and physical distancing, the SaniPod was able to provide protection like sanitation and disinfection of the ER staff. We are happy that we are in the fourth week of using SaniPod.”
Next week, we shall continue with the other innovative medical equipment developed under SIBOL: the “PAPR” or the Powered Air Purifying Respirator,” the my Bot Ensuring Safety and Health in Isolated Environments or “myBESHIE,” a telepresence service connected wirelessly with or without Internet to help health-care providers interact with isolated patients remotely, and “GINHAWA,” a compact, safe and effective ventilator designed for use of both children and adult Covid-19 patients confined in the Intensive Care Unit (ICU).