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The new Bioinnovation Center, housed at Academic City University College in Ghana and in partnership with Northeastern, will develop novel solutions to complex problems in West African health clinics.
In the West African country of Ghana, “there’s somewhere between 5,000 and 6,000 rural health clinics” that provide the majority of health care services to its population, says Lee Makowski, professor of bioengineering and chemistry and chemical biology at Northeastern University.
“Current biomedical devices,” Makowski says, “are very expensive,” and many — if not most — of these clinics cannot afford them.
Makowski also points to a lack of training on such devices — “they’re over-engineered, they’re overly complex” — and an inability to receive spare parts or maintenance as further problems the rural health clinics face.
With the Bioinnovation Center, in partnership with Northeastern and housed at Academic City University College in Accra, Makowski envisions a hub of development — aligned with entrepreneurship — that could change the face of health care in West Africa.
“We need to develop a consortium that includes health care workers” and physicians, Makowski says. But you also “need engineers, and you need entrepreneurs who will help those engineers learn how to commercialize products and get them into the marketplace. That’s the only way you will be able to scale up the solution to match the scope of the problem.”
Take for example the ventilator, which provides oxygen to patients — patients who might be anywhere along a spectrum of critical to stable.
Ventilators, Makowski says, can cost over $20,000. Shortly after the start of the COVID-19 pandemic, “one of the businessmen we talked to in Accra contacted me and said, ‘Can you buy ventilators for Ghana?’”
Makowski says he spent “enough time looking into it to discover that every ventilator on Earth had already been purchased probably twice, and that every ventilator that was going to be made for the next six months had already been purchased.” Not only were they priced beyond the means of most West African health care clinics, they were, for all intents and purposes, completely unavailable.
While building out a new bioengineering department at Northeastern, Makowski says, “I was delighted and somewhat surprised to find — as we grew the department — the number of students who are very interested in trying to contribute to improving health care delivery in West Africa, sub-Saharan Africa.”
But despite his students’ interest and a few professional connections, “It soon became clear that for me to actually make any progress, I would have to go and see what things look like.”
Delivering health care in West Africa, even beyond the economic realities, is a tall order. “You see patients at 30, or maybe even 37 degrees Celsius,” roughly 86 to 99 degrees Fahrenheit, “or in very high humidity. High levels of dust and variable electrical current,” Makowski says.
“Most medical instruments do not last long when used in those conditions.”
Further, medical services in these health clinics are primarily provided by non-physician health care workers — which doesn’t mean they aren’t well trained, Makowski is quick to note, but “the devices they use need to be matched to the environment they are used in and the training that health care workers have received.”
“In the U.S., we’ve got one physician for every 200 people. In Ghana, there’s one physician for every 10,000,” he says.
While he was still considering the problem of ventilators — their expense and complexity — Makowski ran into triple Husky Craig Smallwood, a respiratory specialist at Children’s Hospital.
Smallwood had an idea for a “mind-bogglingly simple respiratory assist device that he could put together for not $10,000, not $5,000. But he figured maybe $30 or $40.”
“The most expensive parts were a $1 one-way valve and a container for water that could be fashioned from a plastic food storage canister,” Makowski says.
While their new ventilator isn’t suitable for the most critical cases, it can help wean recovering patients off of assisted oxygen, making room at more expensive machines for patients in serious need.
“Craig was an incredible inspiration, with an incredible set of ideas and creativity,” Makowski recalls.
After Smallwood passed away unexpectedly, Makowski and his colleagues were able to make about 100 of the low-cost ventilators and distribute them to Ghanaian clinics — a success, but far from enough to satisfy the need in Ghana, let alone throughout West Africa. So “how do you make an impact?” Makowski asks.
“If you don’t get it in the hands of someone who knows how to scale these things up to the level where you approach the need, then you know it’s just a research project.” Entrepreneurs, he says, are what’s needed now to bring projects like the Smallwood ventilator to scale.
“Establishing the Bioinnovation Center was made possible through the kind generosity of Joel and Michelle Holsinger — Northeastern parents,” Makowski wrote in a follow-up.
In addition, several anonymous donors have made contributions, along with the nonprofit For Ghana Biomedical Innovation (4GBI), which connects “business people in Accra with health care professionals throughout Ghana.”
Already, the Bioinnovation Center “is a success in the sense that we were able to put on the ground, in clinics, devices that really work,” Makowski says, but “this is too big a task for a single institution, so we’re now in the process of creating a consortium of institutions in west Africa.”
This consortium will provide opportunities for collaborations aiming “to commercialize medical devices specifically designed to meet the needs of West Africa” — collaborations that will hopefully lead to even greater, life-preserving invention.