One of the most prevalent conditions requiring surgical care in resource limited areas is orthopaedic trauma and musculoskeletal disease. The exorbitant cost of necessary equipment and implants is a primary factor that prevents adequate treatment resulting in disability and morbidity. The Darwin Project provides financial and technological support for the design and development of affordable innovative surgical equipment to address this issue.
Affordability of surgical equipment can be achieved through design innovation. Our team has been developing and testing an affordable mechanically simplified ventilator system, a better surgical drill system, and a Negative Pressure Wound Vacuum treatment/drainage device. Mutengene Baptist Hospital has volunteered to work with us on testing this equipment.
Infection of open wounds is a highly prevalent cause of disability and death in the continent of Africa and other low resource areas. There is often limited pre-surgery prep and post-surgery follow-up of both open wounds and surgical site infections. Typically a long period of time passes between the times when someone is injured with an open would or broken bones and when they actually are able to present themselves to central hospital for treatment.
A Negative Pressure Wound Vacuum is highly effective in treating such infection and accelerating healing, allowing for both safe surgery and healing of major open wounds as preparation for successful skin grafts. Wounds heal from the inside out. This is precisely what the NPWV device helps to accelerate, by creating the optimal environment for healing.
The primary barrier to applying Negative Pressure Wound Devices in low resource areas is the exorbitant cost of such equipment. A typical cost for a NPWV pump starts at $8,400.
In January 2021 our associate Stefan Dorssers, Beye Be, of Stogger NL, took MIT’s open source emergency ventilator project https://emergency-vent.mit.edu/ to actual production and has improved its overall functionality. His company has provided six initial units to Mutengene Baptist Hospital in Cameroon for post-op support.
Stefan also is in the process of re-designing a negative pressure wound therapy device to make it affordable, simple, battery powered and long lasting. A low cost negative pressure wound device, known as the Turtle Vac, and originally developed by the Cooperacion Orthopedica Americano Nicaraguense (COON) https://www.youtube.com/watch?v=BRioWrBk_10 , has been built by Kiran Agarwal-Harding MD, and currently is being tested at the Mutengene Baptist Hospital and Meskine Baptist Hospital Maroua in Cameroon, and Kamuzu Central Hospital and Queen Elizabeth Central Hospital in Malawi.
The Jonathan Haar, Darwin Project Director, recently has finished the fourth generation low cost NPWV device. While the first three iterations were tested by several hospitals in Africa, and found to be highly effective, the most recent NPWV is standardized and easily repairable, made specifically with analog parts that can be obtained locally, is outfitted with a case to secure the components, and has a dedicated vacuum pump rather than using the exhaust pressure of a positive pressure pump, which could not generate enough negative pressure for this use.
DPI is raising funds to build 40 of these new pumps and distribute them to seven countries in Africa. The facilities using them will provide feedback data to our surgical team of Harvard Medical Residents on effectiveness, durability and ease of use. SIGN International Fracture Care has generously volunteered to ship the equipment as they have long seen the need for this medical care which enhances the effectiveness of their innovative surgical implant system. https://www.signfracturecare.org/programs.