What is “best” is not always “best”

This article was originally posted on International Program Development’s NU in South Africa blog. Blogger Sarah Uttal is currently in South Africa on IPD’s Global Healthcare Technologies program at the University of Cape Town and writes about an eye-opening immersion trip to Kwa-Zulu Natal, where she observed the ups and downs of South Africa’s healthcare system first-hand.

We spent an eye-opening 10 days in Kwa-Zulu Natal to begin our South African immersion. Our time was spent traveling around the province visiting different clinics and learning about the healthcare system here. We had amazing guides, including one of the best biomedical engineers in this part of the world, who showed us around and introduced us to healthcare professionals. There is no comparison to seeing the environments where patients are treated and talking with those who treat them to discover the strengths and failures within a healthcare system.

There are definite problems with the healthcare system that were exposed during our visits. One that shocked me most was the waiting time at some of the hospitals, like Grey’s Hospital in Pietermaritzburg. We saw patients waiting outside for hours in the heat not knowing if they would even be treated.

At another hospital visit we were able to observe a couple surgeries including a cataract removal. This was an amazing experience for those pre-meds among us, as getting to scrub into surgeries in the US is uncommon. The operating rooms did not have all the amenities of those I have seen in the US, but the surgeons were resourceful. When one of the vents in an operating room kept blowing hot air on a surgeon they simply patched it with a piece of cardboard and kept operating. It was impressive to see they did not let anything get in their way of caring for the patients.

We also saw examples of technology we would never expect to see in use in the US. We saw a bed that looked to be at least 70 years old still being used in an operating room. This bed clearly stood the test of time, was still functional, and was sturdy enough to last for years to come.

This was just one example of many technologies we saw that exemplified the concept of “appropriate technology.” What is appropriate is not always the most modern technology available, but is what will be most effective in the environment it is needed. This does not mean people in South Africa or anywhere else deserve substandard equipment, because everyone deserves quality healthcare. Instead it means redefining that word “best” to mean what will best serve the community where that care is being provided. What is best is what will work and last in the environment where it is needed. I think this concept is lacking from our biomedical engineering education and has sparked many discussions in our group during and after these hospital visits. We are learning what it means to be biomedical engineers and how to make the best technology for the community we aim to serve.

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