At the start of 2021, the small southern country of Eswatini experienced a huge surge in coronavirus cases which overwhelmed their healthcare system. UK-Med sent out a team of 9 to support the country’s coronavirus response in January 2021, which included for the first time, a Biomedical Engineer – Sean Ryder.
We speak to Sean about how he became a biomedical engineer, the impact of COVID-19 and his experience on a humanitarian deployment.
Hi Sean! Can you tell us about your career to date and how you became a biomedical engineer?
I have been a qualified electrician for 30 years. After a head injury years ago, I decided it was time for a change in career and started working for a pre-owned medical equipment provider in the UK as a logistics manager, where we would send equipment out to mainly African countries.
The biomedical work was outsourced, however, so I put forward a proposal to put me through nine weeks of intensive training and purchase some test equipment then we could have our own biomed department. This grew and very soon we were asked to provide training to biomeds overseas.
I then went on to open my own company Optimum Biomedical Ltd. We are, predominantly, a biomedical training company that provides courses, looks after medical equipment (including the FCDO disaster relief equipment held at Kemble airport) and we also supply medical equipment too.
Can you tell us about the work you did on the national supply of oxygen in Eswatini?
During the second wave, Eswatini learned very quickly that the oxygen supplies – which were 100% supplied form South Africa – were going to leave them woefully short (approx. 55% shortfall) from what they required. Remember that South Africa was also struggling with the second wave at the same time.
With the help of the WHO, the MoH (Ministry of Health) decided to investigate the possibility of investing in PSA oxygen generation plants so that they were not totally reliable on external providers, should a third wave hit. (PSA oxygen generation works by taking in ambient air, compressing it, filtering it, removing nitrogen, and producing >93% medical grade oxygen).
The MoH and WHO asked if I could help with the assessment and possibility of getting some plants installed. We were able to arrange and engage with suppliers at two sites. We then worked on a plan to get a third plant installed covering a third region and a fourth plant was discussed as well.
All four plants in operation will provide more than 70% of Eswatini’s own oxygen requirements. The plants, if maintained well, will last for approx. 10 years, provide piped oxygen direct to the hospital at each site, and also have the ability to fill large oxygen cylinders that can be delivered to outlying areas in each region.
Could you tell us about the challenges that Eswatini was experiencing and how you helped?
The challenges in Eswatini were realising most of the issues (not all) were clinical staff misuse. This wasn’t their fault; they had never been trained properly.
For example, clinicians were connecting the patient monitors incorrectly to the patients and damaging the connection ends by forcing them into the sockets on the monitors. We simply put together a short training course and invited the clinicians and biomeds to attend. 17 participants attended and we saw a reduction in problems following the training.
Our medical team also witnessed oxygen misuse many times, which added to the oxygen supply shortages. Clinicians would use the wrong masks and cannular and would leave oxygen taps open when not in use which quickly drained the supply from the cylinders. The medical team corrected these issues with simple training sessions.
I repaired various equipment like CPAP, oxygen concentrators patient monitors and ventilators without any test equipment, so it is possible, but only with the correct training and experience.
What are some of the differences between biomedical engineering work ‘at home’ and when deploying abroad?
The thing that always amazes me is that wherever we go, we find medical equipment in a poor state of repair some with easy to fix problems and others requiring more technical repairs. We have meetings with management teams who say, “We need our biomeds to fix this equipment, why are they not doing it?”, but then we find that there is no investment at all in the biomed department – no tooling, no test equipment, no training.
I know that budgets are tight, but even with a little support these biomed departments can grow into strong effective departments that can make significant changes to their facilities.
Now, I know I may be biased, but a hospital would never expect a surgeon to operate without the correct training or instruments, but it is widely accepted that biomeds can repair what is becoming very technical equipment without the correct training or tooling! Why should it be so different? After all, the equipment we work on can help save a patient’s life or kill them if we get it wrong.
Overseas departments also tend to link estates management with biomed and this is a recipe for disaster – they expect a plumber to be able to fix an anaesthesia machine!! Gladly we don’t treat biomed departments like this at home; we see the need and reward for investment.
How has COVID-19 impacted biomedical engineering over the past year?
At each facility we’ve worked at or visited in Eswatini, the story was the same – they all ran out of oxygen totally at the peak of the second wave and felt helpless towards the situation. They were witnessing doctors having to make the incredibly hard decisions to choose who gets oxygen and who doesn’t.
This, however, filled them with a desire not to let it happen again, and with the support of UK-Med, UK EMT, FCDO and organisations like WHO, hopefully the next time wave hits they will be better placed to cope. They also see the need for further training to take place and biomed departments to become specialised and not linked with estates, but I am guessing this will take time!