A systematic approach to blood shortages in LMICs: Design of a device for whole blood auto transfusion

Abstract

This report follows the activities of team ugHealth in an effort to fulfil the requirements of the design course series for the period of 7th September, 2018 to 20th December, 2020. The report is structured in four sections, section one expounding on the needs finding exercise, problem statement, the synthesis of the proposed solution to solve the identified problem, and its justification. Section Two comprises of the prototype design, section 3 – testing protocols and section four – redesign and the design, development & business plans. On Tuesday 11th September 2018, we carried out a needs finding field work exercise in two hospital environments that is CoRSU and Pan Dental Hospital. From the two environments, we interacted with different medical specialists and staff, and noticed some problems. The needs assessment exercise offered a vivid perspective of the problems faced in the Ugandan health care system. However, we were required to identify a single problem; the team used an elimination matrix to choose a principal challenge. From the needs assessment exercise, UgHealth found that a lot of blood is lost during surgical operations by the patients, and there is a shortage of blood for transfusion especially for rare blood types. We had an interview with Dr. Antonio Loro an orthopaedic surgeon; he informed us about the deficit in the supply of donor blood at the blood bank and the high costs associated with current blood recycling methodologies in particular the cell saver machine. The hospital (CoRSU) carries out about 420 surgeries weekly and in over three quarters of these surgeries, the patients suffer haemorrhages. The hospital currently resorts to the expensive and un reliable method of blood bag transfusions which in recent research findings are not the best for trauma patients. An innovation for blood recycling and transfusion is of the essence. After profound desk based investigative research into this problem, we discovered shocking revelations like: “surgery deaths in Africa are twice the global average.” Furthermore, we found out that haemorrhages are the leading cause of death in the surgery setting of Africa and this in turn is accelerated by lack of blood donations and galore direct/indirect costs incurred by different stakeholders including patients. The revelations from the needs finding exercise convinced us that it was important to solve the problem at hand. We carried out research pertaining the current solutions and their limitations in order to shape our solution. Our goal in this course series was to design of a device to carry out autologous blood transfusion. We believe that our solution - haemoSAVE will be a major driver in achieving universal health care as regards the surgery setting of Africa and other developing economies, it will further save stakeholders great amounts of money which can be directed to other problems in the health sector.