|
Hospitals serving the needy in
developing countries often do not have the means to maintain
and repair their medical equipment in terms of either
qualified personnel or adequate test and calibration
equipment. The costs of services procured from
manufacturers’ representatives are usually extremely high
in these countries. Improperly maintained hospital equipment
can also be hazardous to life.
AMRF establishes self-sufficient
Centers of Training and Maintenance. These Centers, managed
and staffed by local in-country personnel, are equipped by
AMRF with modern medical equipment test and calibration
facilities that can be shared by groups of hospitals in a
region, thereby reducing the costs to each individual
hospital to provide the same services. At the same time such
Centers provide technical employment and training to local
personnel.
Over the past 12 years AMRF has
focussed on its objective to improve the economic and health
care structure in developing nations by donating medical
equipment and technical services to hospitals serving the
needy in those countries. To date we estimate that over 16
million people have benefited by AMRF donations to over 160
hospitals world wide. These hospitals as a rule do not have
trained personnel to maintain and repair their medical
equipment. AMRF establishes centers which can
- Train professional personnel in the
use and maintenance of modern medical equipment,
- Serve as a center for repair of
hospital equipment in the region which will become a
self-sufficient revenue producing facility within 1-2
years by providing its services to public and private
hospitals and other health care facilities in the region
on a profit or non-profit basis.
In addition to improving the health
care of the region the centers provide direct employment as
well and provide continuing technical education to important
elements of the local work force. Generally, these Centers
can be established to work within the existing institutional
infrastructure such as existing hospitals, universities and
vocational schools.
The centers provide an immediate
capability of repairing and maintaining modern medical
equipment and instruction to physicians and nurses in its
use. Simultaneously, AMRF trains managers for the centers
and a corps of local medical engineers to become instructors
in the Center for Training to upgrade the capabilities of
engineering personnel in the region. The Centers can very
quickly offer technical training services to hospital
personnel in the region and can be developed to obtain
enough revenue through this work to be ultimately self
sustaining, independent of AMRF. (AMRF can continue to serve
as a consultant if desired.)
Through the successful work of
the Centers and in particular the effect on improving the
skills of hospital personnel, the general health care
capabilities of the region will be increased. In addition
each Center can serve as a focus point for introducing and
managing newer, more modern medical equipment into the
region. It is anticipated that the management skills of the
local personnel will be similarly enhanced. In this manner
“shared hospital services” (maintenance, repair and
calibration of equipment) can be developed by the Center to
serve groups of hospitals more efficiently than can be
achieved by each hospital operating entirely on its own and
each replicating these necessary skills. The training
program is structured to provide intensive training to the
personnel that will operate the center and provide medical
equipment repair services and to the candidate
engineer/doctor/nurse instructors-to-be over the period of
one year who will themselves become teachers in the various
technical equipment areas under the sponsorship and
management of local personnel. Included in the cost is a
repeat of the courses during a second year to ensure the
certification of the participants. AMRF personnel will
support the Center to continue the training program with
these teachers as they teach other professionals in the
surrounding regions during the following year and support
the center technically as it begins to offer its repair
services to hospitals in the surrounding area. Training will
be provided through a series of formal and well structured
teaching modules/classes using modern medical equipment
provided on this program.
The basic goals of the training
programs to be established at the Center of Training are:
- Introduction of local engineers,
technicians, doctors and nurses to the application and
use of western modern medical instrumentation.
- Introduction to trouble shooting
techniques for modern medical instrumentation using
modern test equipment and test methods.
- Introduction to the standards of
repair and calibration of medical devices that are
required for properly functioning equipment.
- Introduction to safety requirements
for patients, staff and themselves so that the devices
are safe to use and will not injure themselves and the
patients.
These four goals are a part of each
module of training to be taught by AMRF and are stressed in
each module. In addition application knowledge and how
interaction can be achieved between physicians, nurses,
technologists and administrators will be stressed.
- A core group of biomedical
engineers, nurses and doctors will be selected by the
participating hospitals in the region to become the
instructors-in-training for the local Center of Training
to be formed.
- A survey on site will be performed
by AMRF to establish the number and technical level of
the core group to be instructed. the technical needs of
the hospitals, confirm the availability and or need for
additional equipment to be used in the course material
and to assure that the teaching facilities are
sufficient.
- Arrangements for the housing, room,
board and local transportation of the AMRF
engineer/instructors will be confirmed.
- Agreements will be developed with
the participating hospitals to govern the availability
of personnel and facilities for the Center of Training
and Repair. The Center in partnership with AMRF will
provide services to accomplish its responsibilities on
the proposed program. The center personnel will provide
time, facilities for the Center for Training, the board,
room and local transportation for the visiting AMRF
personnel.
Nine modules of training are
recommended to be presented, generally one module per month.
Each module will be presented twice, six months apart, in
the course of the first year.
The current modules are:
- Cardio/Pulmonary
- Perinatal
- Anesthesia/Ventilators
- General Hospital
- Imaging (Radiology and Ultrasound)
- Laboratory Equipment
- Ophthalmic Equipment
- Infrastructure Support and
Technology
- Hands on training of Eye-Care
Providers
Additional modules can be developed to
address specific needs. Each module will consist of formal
lectures and laboratory/hands-on work with the actual
equipment. As time is available field trips will be made to
individual hospitals in the region to trouble shoot and fix,
if possible, existing equipment there that is out of order.
These field trips will provide additional teaching
experience as well as to provide an immediate benefit to the
hospital(s) involved in the way of equipment repair.
In addition AMRF management specialists
(US hospital management personnel) can provide special
training to the management personnel of each center aimed at
developing skills in selling and managing the services of
the training and repair facilities to hospital and medical
organizations in the region.
Test equipment for inspecting,
repairing and calibrating commonly used medical equipment
and tool kits will be provided by AMRF to the center which
will remain in the Center for Training. The
instructors-to-be will be trained in the use of the test
equipment and the hospital equipment for which it is
intended. Generally, the test equipment will be new
equipment purchased especially for this program. This test
equipment will be applicable to service the medical
equipment to be found and/or to be provided to the
participating hospitals in the region. The test equipment
must be bought new since this type of equipment is rarely
donated to AMRF by functioning hospitals. It is suggested
that test equipment and tools remain in the Centers for
Training for future training but be borrowed for hospital
use when not required for teaching.
During the second year of the program
the trainees will teach the modules to new students with
AMRF assistance as required. AMRF will evaluate the
effectiveness of the program by monitoring these classes.
Supplementary assistance will be provided by AMRF as
required. During both years of the proposed program AMRF can
serve as a procurement agency for spare parts and components
requests, technical questions and a source of manuals and
technology support to the Center for Training.
LOCATIONS OF CURRENT AND PREVIOUS AMRF
TRAINING
AMRF is currently being contracted by
the Orbis Foundation in New York City to survey and initiate
the development of a Center in Ethiopia to accomplish the
proposed objectives in that country. AMRF is also in
negotiation to assist in the establishment of a Center in
Beirut, Lebanon. A pilot program was completed successfully
in Nicaragua in cooperation with the Ministry of Health in
1992. AMRF has sent biomedical engineers to train resident
engineers and technicians at a variety of hospitals world
wide primarily in Latin America, Africa, Eastern Europe,
Russia, India and Vietnam. The purpose of these courses has
been (1) to help each individual hospital establish a
biomedical/clinical engineering capability, or (2) to
improve the capability on site, particularly in the
maintenance and repair of increasingly sophisticated
equipment, the use of sophisticated test equipment and
software systems to ensure that comprehensive and accurate
periodic maintenance procedures are followed. Individual
Short Courses have been presented by AMRF personnel covering
all hospital equipment including ultrasonic and x-ray at the
following institutions:
- Catholic University, Santiago de
Chile, Chile
- Hospital São Lucas, Catholic
University, Porto Alegre, Brazil
- Hospital de Caridade de Ijui, Ijui,
Brazil
- Hospital Mae de Deus, Porto Alegre,
Brazil
- Hospital Regina, Novo Hamburgo,
Brazil
- Hospital del Niño Rodolfo Nieto
Padron, Villahermosa, Tabasco, México
- Hospital “Dr. Juan Graham Casasus”,
Villahermosa, Tabasco, México
- Hospital Emilano Zapata,
Villahermosa, Tabasco, México
- Hospital Gustavo A. Rovirosa,
Villahermosa, Tabasco, México
- Hospital San Juan, Sacatepequez,
Guatemala
- Hospital Retiro, Sumpango, Guatemala
- Hospital Regional de Escuintla,
Guatemala
- Hospital Escuela Oscar Danila
Rosales Arguello, León, Nicaragua
- Ministerio de Salud de Nicaragua,
Managua, Nicaragua, including visits to other area
hospitals.
- Malhotra Heart Center, New Dehli,
India
- Calcutta Mission of Mercy Hospital,
Calcutta, India (for Mother Teresa Foundation)
- University Hospital, Cluj, Romania
- University Hospital, Kiev, Ukraine
- Estonia Heart Centre, Tartu
University, Tallin, Estonia
- Latvian Physicians Association,
Riga, Latvia
- Kiev Institute of Cardiovascular
Surgery, Kiev, Ukraine
- Karcergine Policlinics, Kuano,
Lithuania
- Mulago Hospital, Kampala, Uganda
|
