Monday, August 5, 2013

Mondays at Mt. Meru

I had a successful visit today with the students at Mt. Meru hospital. Maybe not "successful" by some definitions because we didn't fix anything...but we at least made progress.

At Mt. Meru Hospital there was an oxygen concentrator with a lot of problems. You don't see oxygen concentrators very often in the US because hospitals can afford to buy giant tanks of oxygen. In the third world, the oxygen tanks are non-reusable and expensive. Oxygen concentrators isolate oxygen from the air (21% Oxygen, 78% Nitrogen, 1% Other gasses) and provide up to 95% oxygen to patients. With one machine, you are replacing the need for non-reuseable oxygen tanks.

The oxygen concentrator we worked on looked like it had been tampered with in the past because some of the wiring was redone. We actually had to fix the wiring on the motor-start capacitor because part of the wire was exposed...that's a recipe for disaster (it's a big capacitor!). There was also a leak in some of the tubing that the students fixed in a pretty innovative way. It's always hard to find exactly what you need in Africa, so the students got creative. After fixing the leak, we had to fix the pressure-release safety so that oxygen would not build up too high in the canisters. Once we fixed that we thought we were all good to go! Unfortunately we were wrong.

Despite the flow from the concentrator being strong, we realized it was not concentrated oxygen. The oxygen machine failed the flame test (a candle should burn bigger with 95% oxygen coming out of the machine, but we did not see this). I would be so great if we had a device to reliably measure oxygen concentration (something to look into for the developing world design class offered at Duke)! The flame test works but it's still dangerous and you risk lighting the oxygen concentrator on fire by bringing the flame too close.

If oxygen concentrators aged like humans, this one would be an old man. It made sense that the machine no longer reliably produced concentrated oxygen. This machine had just over 20,000 hours clocked on it. For every 20,000 hours in operation, the zeolite canisters, which are responsible for separating the nitrogen from air, need to be replaced. However, replacing the zeolite canisters are beyond the budget for the EWH students. The cheapest you would be able to find them is about $150...and good luck finding them in Africa!

It's always disappointing when you can't fix something, but there is some consolation in diagnosing the problem. If the students find another oxygen concentrator with a broken motor, they can swap parts between the machines. I will keep my eyes open for spare parts when I visit other hospitals.


Also, don't forget! Do not smode near patient or device! :)


On a side note, one reason why I love Mt. Meru hospital is that there are really cute kittens that like to play where the EWH students work. What's a good day without kittens?


I saw a mouse run at my feet while working today so it's good that the hospital keeps some cats. Go little hunter, grow up and keep the hospital rodent-free!



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