This past weekend, Vani and I journeyed over to Katse Dam, which is the second largest dam in Africa. It is an engineering wonder, a 185-meter tall slab of concrete standing 1993 meters above sea level that provides water to South Africa and hydroelectric power to Lesotho.

Refreshed after our weekend adventures, we set ourselves busily at work. We were finally able to complete the frames for the phototherapy lights and delivered one set each (along with the lights) to the nursery and the pediatric ward. Frames were needed to hold up the lights over the cribs, so we worked with the maintenance staff to recycle used parts from the junkyard to create frames as well as a crib. It was tough work to sand down the metal parts and coat them with primer and then white paint, but the end product came out quite nicely. The before and after pictures are rather striking:

We also made our first plastic bottle inhaler spacer and trained the staff in their manufacture. A little background: young patients needing aerosolized medication (such as asthma patients) often have trouble coordinating the puffing of the metered-dose inhaler (MDI) with the inhalation of the medication, which needs to happen simultaneously. A spacer is a container with a mouthpiece on one end and an opening on the other, into which an inhaler can be inserted. The medication gets trapped inside the spacer, and thus the patient can inhale the medication from the spacer without having to coordinate inhalation with deployment of the inhaler. Research has shown that more medication reaches the lungs when using an MDI with a spacer than when using an MDI alone. Additionally, spacers are more compact and readily available than nebulizers, and they also help to reduce side effects from the swallowing and absorption of medication in the mouth. Research has also shown that 500 ml plastic water bottles can be effectively constructed into homemade spacers, thus providing an alternative to more expensive commercially available spacers for resource constrained settings in developing countries. We worked with the maintenance staff to create a metal mold in the shape of the MDI mouthpiece. We then “branded” a 500 ml plastic water bottle with the mold to create the opening to which the MDI can be attached. Next week, we plan to demonstrate the spacer to the doctors and help the maintenance staff develop a system for mass producing more spacers after we leave.

In addition to the above work, I was also busy using my knowledge of Spanish to translate troubleshooting and repair documents for an electric scalpel unit, a medical device used in surgery that allows for both the cutting of tissue and coagulation of blood vessels. According to the surgeon who asked us to look at the documents, there seems to be a problem with the power supply, for the unit is unable to deliver adequate power to cut the tissue. It was a bit difficult getting through all of the unfamiliar technical terminology (it would’ve been challenging enough in English!), but I believe I managed to translate everything to a decent level of accuracy, and I hope that it will be helpful. Next week, we will go through the suggested repair procedures with the hospital engineer, and hopefully we will be able to identify the source of the problem.

Hasta luego!
Eric