The disparity in mortality rates and access to quality and affordable care, between rural and urban Pakistan, is hardly a revelation. Yet, we have resigned ourselves to accept it among the harder truths of life. While access may be a ubiquitous problem all over the world, the disparity need not be this stark.
So the question to ask is: what can we do to improve the situation? This was the same question I asked myself after a recent meeting at the World Health Organisation on affordable and quality medical devices in the developing world.
When you talk to doctors in the rural areas and sometimes even in urban centres, they would talk about lack of equipment or more precisely, lack of equipment that works. They may also tell you about lack of local capacity to maintain the equipment. All these are valid and legitimate concerns. Yet, what they often won’t tell you is the lack of local capacity to innovate. Probably, because they cannot imagine local solutions to these grand challenges. But local solutions are not only the right answer, they are the only answer. Yes, a world where we address (some, if not all) technical needs for diagnostic, cure and disease management is within reach. A world where our own engineers are able to innovate and come up with low cost and robust diagnostics is actually a lot closer than we may think.
I am not saying that in a country where manufacturing of electronics is non-existent, we will be able to manufacture large-scale CT scans, but I am proposing that we have the capacity, even now, to develop hardware and software for small-scale diagnostics. Things like small probes to monitor the pulse and oxygen of an acutely sick infant may be powered by a cell phone. This small probe, called a pulse oximeter, will be the difference between the life and death of a baby. Or maybe, a handheld device can be made available to distinguish between TB, typhoid and dengue that works without power and in poor sanitation conditions. If this can be done in sub-Saharan Africa, Southeast Asia, India and Latin America, it can be done in Pakistan. So why don’t we do it?
Well, it gets a bit tricky here. In our educational system, we ask our talented students to choose between pre-med and pre-engineering when they are barely 16. The physical and mental barriers that we create then, condemn the imagination to life imprisonment. I am not arguing about changing the educational system — though it desperately needs to change — but arguing about changing the mindset. It’s a call to arms for our doctors to tell our engineers, our innovators and our scientists about the tools that will help them save babies and cure the sick.
Now, two more questions are worth thinking about. First, how and where should we start? Well, for a change, let’s be bold. Imagine, that every week, just for half an hour, on primetime TV, a team of doctors give out challenges to the engineers and innovators of the nation about what their needs are. It is very likely that there will be a lot of people responding to that call. Some may succeed and many may fail, but at the very least, we will have a discussion, an exchange and hopefully a solution.
The second question is: how and who will fund the projects? I am certain that if we can get enough good ideas, there will be a market for these products. As an example, a couple of weeks ago, the Bill and Melinda Gates Foundation announced the recipients of their ‘Grand Challenges’ grants, which focused on innovation in global health. Half were from India, South Africa, Uganda, Botswana and other developing countries, each grantee getting a million dollars or more for the transformative change they will bring.
Bigger than an individual grant or a product, the outcome of the bridge between doctors and innovators will be a self-sustaining eco-system that will eventually improve the state of our healthcare system.
Published in The Express Tribune, January 5th, 2012.
COMMENTS (11)
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True, our education system produces robots and when in some position of authority and power, become machines churning out money and delivering self sustaining mechanisms, not tools for saving or facilitating any one else's life. The blame list is long but its time to work out practical solutions for the dark realities of our system. And for that we have to find messiahs from within.Thanks for the inspiration and the fruitful ideas. We in our limited capacity might be able to get some relief too.
I agree with what is stated in the article and to extend the point where the author writes about the tender age at which most students are compelled to join either medical or engineering field, it is a sad truth that most students out of peer pressure opt for such careers which do not excite them. I firmly supports author's idea that it is high time to bring about a change in the education system of the country. Unfortunately Pakistan lacks universities where technical research can be carried out to come up with fancy devices but there is no denying that the quality of our students is such that even with limited facilities they are able to generate quite astonishing outcomes. I would like to add a recommendation here, since there are a lot of Pakistanis professional working abroad who are eager to contribute to the nation, it would be a good idea to engage their expertise and make it a joint venture.
Great article! The Idea of having a tv show is particulalrly intersting. Might as well get something of value from the electronic media than just seeing the same old corrupt politicians on the same talk shows.
Better yet we can start a website and collaborate... call it DrEngineer.com :-)
But yea I agree that we call collaborate and move forward, with software cost of doing business have already gone down. Why not apply it for practical or health problems?
As an engineer , I 110% agree with you. Keep writing good for engineers.:)
Very informative article, enjoyed reading the creative solutions the writer has offered.
I agree with you 100%. Let us create a culture in which we can innovate small tools to facilitate us. You have given a solution that can work.
Excellent!!! Hope it opens up few closed minds.
Apart from big machines, our engineers are more likely to be successful in designing implants or other such biomaterials to improve the quality of life of so many patients. Especially in light of the war on terror and the subsequent victims who have lost limbs or have been inflicted with many injuries to their musculoskeletal system, our engineers can design and fabricate implants. The rest of the world is making advancements in the fields of tissue engineering and regenerative medicine and we do not have even a single biomedical engineering program in Pakistani universities. Well except for Comsats lahore I think which is a relatively new department.
Biomedical engineering and the subsequent tissue engineering/regenerative solutions it can result in - I believe is a goal our universities and students can achieve provided support by the HEC.
I am currently doing my higher studies in these areas and look forward to creating an environment like I've mentioned above in Pakistan in the future.
Nice piece Dr Zaman. We certainly need local solutions for local problems.
hmmmm, as a doctor i agree with most part of your article........we need vision , new innovation to revolutionize our health structure. You are right, simple pulse oximeter an glucometer is sometimes a difference between a death and a life and i am damn sure our engineers are quite much capable of developing these instruments, if facilities provided to them they will be able to design ct scan, mri n pet machines.