Loose Connection

Hello from Motebang Hospital in Leribe, Lesotho! Vani and I finally arrived in Leribe on Tuesday after nearly two full days of flights and layovers. Our adventures got off to an ominous start when, after bidding our friends adieu, we found ourselves stuck at the tiny Lesotho airport with no signs of our designated driver. (Later we found out that there was some miscommunication by our partners on site.) We quickly made arrangements to stay at Lancer’s Inn in the heart of Maseru, and took advantage of our time in the capital city to get phones and other essentials.

The next day, we drove almost two hours past quaint shops, dilapidated housing, and majestic mountains to Leribe, the small town we will work in for the next two months. Quickly noticing the colder temperature (high of around 50-60 deg F), we bundled up and made our way to our lodgings, a humble convent run by friendly nuns, or sisters.

The following day, we met with Dr. Obi, the chief physician of Motebang Hospital, which is government-run, and introduced ourselves, as well as what we hoped to contribute during our time in Lesotho. We brought with us a suite of technologies known collectively as the Nursery of the Future. Basically they are student-developed technologies designed to address needs as expressed by health care professionals in developing countries. The following is a quick laundry list of these devices (greater detail to come later): pediatric transilluminator, oxygen sensor and flowmeter, oral dosing syringe kit, fingertip pulse oximeter, handheld pulse oximeter, billirubin phototherapy lights, warming cribs, and an IV drip monitor.

Dr. Obi also took us around the hospital and showed us various medical devices that had become nonfunctional. X-ray film viewing lights, a hydraulic bench, and cardiac monitors are just a few examples. He then gave us some insight into the culture at the hospital. According to Dr. Obi, people at the hospital just “don’t care.” Once a medical device stops functioning, it inevitably gets stored away in a corner. Or becomes a doorstop. He referred to this attitude as a “disease,” admitting that he had fallen victim to it as well. We told him that we would try our best to uncover the reasons the various devices had failed and try to keep “caring” (hopefully it will catch on!).

We experienced the thrill of our first success later that day when we tried to fix the X-ray viewing lights. Only one out of the three lit up, so we decided to unscrew the covers to see if we could shed any light on the problem. Each screen contained two bulbs. Working as part bioengineers, part detectives, we decided that faulty bulbs were likely at the bottom of this mystery. We discovered that each pair of bulbs were connected in series (either both or none would light up). Thinking that we could get at least one more screen to work should there be at least two good bulbs among the two pairs belonging to the two non-lighting screens, we began to systematically reorder the bulbs. ..Success! We managed to light another screen up, so now only one screen out of the three X-ray viewing lights was out. We basked in our triumph for a few seconds, but then our curiosity egged us on to try still more combinations. The last light lit! …But now the other went out.. This curious cycle repeated itself for a while until we finally concluded that.. none of it made any sense. We eventually managed to get two of the lights working again to match our previous best effort and were about to resign ourselves to that when an idea popped up. I’d noticed that during the screwing and unscrewing of the bulbs, some were harder to fully “click” in than others. Perhaps this was not a bulb issue, but a matter of a loose connection between the bulbs and the electrodes. Hey, it couldn’t hurt to try. A few turns here, a couple twists over there. Voila! All three lit up, flooding our joyous faces with warm, bright light.

We explained everything to the head nurse. We emphasized that it was an easy fix. A simple solution that a few minutes of detective work could quickly uncover. We had decided that part of our goals for our project would be not only to try to fix these devices, but also to train (or perhaps, empower) the staff to be able to problem solve and address these issues in the future, when we would no longer be around. She first asked where we got the new bulbs. When we told her we had no new bulbs and that our solution was very straightforward, one that she could have solved herself, she informed us that she lacked the specialized tools we carried. We explained that the only tool we used was a humble screwdriver (actually a flat piece of metal we found lying around). Gradually, as our conversation went on, I think she began to understand what we were trying to get at. We asked her to teach the other nurses how we fixed the lights. She said she would oblige and thanked us. Still drunk from our small, first success, we happily made our way back home.