Expanding Medical Oxygen, One Assessment at a Time
In 2007, Steve Mtewa was treated with medical oxygen as a patient at the Neno District Hospital in Malawi. 14 years later, he leads the repair of oxygen systems throughout Malawi, ensuring patients have access to the same life-saving treatment he received.
Steve Mtewa arrived at the Nkhata Bay District Hospital in Malawi after traveling from his hometown of Blantyre nearly 8 hours south. A Malawian biomedical engineer, Steve was preparing to spend the week completing a biomedical assessment of every non-commercial oxygen production facility in the country, and Nkhata Bay was his first stop. Upon arrival, the hospital’s Pressure Swing Absorption (PSA) plant seemed to be operating properly, but just a couple hours into the visit, the oxygen system broke down completely.
While the timing was fortuitous, the break was not uncommon for biomedical equipment in Sub-Saharan Africa. Globally, 40% of biomedical equipment, including PSA plants, is out of service, due to inadequate maintenance and a lack of access to the resources for repair.
COVID-19 brought the gaps in medical oxygen systems into sharp focus, as increased caseloads of patients suffering from respiratory distress lead to dire shortages in critical oxygen therapy. As the international health community looked for actionable ways to expand oxygen access, they turned to Build Health International.
At the forefront of BHI’s biomedical team, Steve’s experience repairing and maintaining PSA plants — and his personal experience with medical oxygen — started far before the pandemic began.
Steve’s journey into biomedical engineering began as a patient at Partner’s In Health’s Neno District Hospital where he was admitted in 2007. Following a near-death battle with illness, where Steve was put on a respirator to assist with oxygen flow, he emerged victorious. Years later, he returned to work at the Neno District Hospital where he eventually became the facility’s Infrastructure Manager. After years at PIH, working alongside BHI, in 2018, Steve transitioned to the BHI team full-time as a Facilities and Biomedical Engineer.
Over the past 3 years with BHI, Steve has helped complete biomedical projects all over the world, but he shares that working in his home country of Malawi to assess and repair medical oxygen systems is a project that he takes particular pride in: “I work at the other sites but now I’m home. This is my chance to make sure we get these things done for Malawians.”
Of the seven plants assessed by Steve’s team, three were found to be fully functional, one was in need of partial repairs, and three were completely non-functional. By repairing these PSA plants, Malawi can expect a 25% increase in oxygen capacity per day. The repairs themselves will cost 80% less than installing new plants — saving thousands of lives each year more feasibly and sustainably.
Since the assessments were completed, plans for facility repairs in Malawi are already underway. Steve is now leading BHI’s teams of biomedical engineers in the next phase of the PSA Plant ‘Find and Fix’ initiative, which aims to assess and provide recommendations for repair of oxygen systems across Sub-Saharan Africa and Latin America.
As Steve’s impact expands to other countries facing oxygen shortages, the training he provided to technicians at Malawian hospitals during his assessments will continue to have a lasting impact.
Steve recalls, “When I trained the technicians in Malawi and was speaking Chichewa they were like, “Wow! You’re from here, how do you know all these things?” And I said “Oh that’s PIH and BHI, they prepared me before COVID.”
With the pandemic far from over, BHI is grateful to have Steve and his biomedical engineering colleagues leading the way to increase oxygen access, both for the immediate future and the long run.
Olivia Duggan is Build Health International’s Communication Manager. She writes about the intersections of health and infrastructure, with a focus on the impact of BHI’s work on resource-constrained health systems.
