In Focus: How One Camera is Changing Oxygen Access in Malawi

Equitable oxygen access remains a challenge in low-resource settings around the world. To deliver critical and lifesaving oxygen medicine, Build Health International’s team of biomedical engineers and global health experts work around the clock with ministries of health, on-the-ground-partners, and local hospitals to strengthen oxygen systems according to the unique needs of each facility.

This post will discuss piping design as it relates to oxygen system strengthening. Learn more about BHI’s oxygen work.

Typically known for its commercial uses, the Matterport camera is changing how engineers at Build Health International deliver oxygen to patients in Malawi. Photo Credit: Sarah Godschall, BHI

The Challenge

As Build Health International’s oxygen work has expanded to forty countries–and counting–so has each project’s complexity. Assessing and understanding the full range of unique needs to design an effective oxygen delivery system that benefits patients at hospitals remains a challenge, as a lack of detailed, accurate existing conditions that biomedical engineers use to design solutions may be based on assumptions and account for uncertainty. While these engineers can travel to facilities to assess existing conditions, identify areas for improvement, provide technical feedback, and even train on-the-ground technicians, these visits are often not long enough. When biomedical engineers attempt to troubleshoot oxygen systems remotely, there are another set of challenges. Hospital master plans, which often show where oxygen can be supplied to patients, are frequently outdated, not readily available for sharing, or may not even exist, making it difficult for biomedical engineers to see the full picture of existing oxygen systems.

The Solution

To save on time and resources, BHI’s oxygen team has prospected new technologies and tools that can help plan, design, and implement effective and expedited oxygen delivery. Sarah Godschall is one of the engineers at Build Health International who has been testing these solutions and is working to bring equitable oxygen access to patients at facilities in Malawi and beyond. One of these solutions has been largely thanks to the help of a camera.

Steve Mtewa, a biomedical engineer for Build Health International, poses next to the Matterport camera outside of Balaka District in Hospital in Balaka, Malawi. Photo Credit: Sarah Godschall, BHI

The Matterport camera is a unique tool that is addressing challenges with providing oxygen globally. According to Sarah, the device is a prime example of how commercial technology can be repurposed to design, build, and enhance existing and future health infrastructure in low resource settings. Typically used in the real estate, architecture, and construction management industries, a Matterport camera is an infrared tool that takes three dimensional images of physical spaces. When the images are combined, they accurately gauge and measure spatial distances between objects, such as rooms and hallways in a building. “It’s very similar to Google Earth in that you can simulate walking through a site as you make design decisions,” remarks Sarah. “This has allowed us to reach an elevated accuracy in our design drawings. The tool allows us to consider more details through every piece of the oxygen delivery system and how it will be incorporated into the existing conditions.”

In Malawi, the Matterport camera was utilized in partnership with Partners in Health through the Bring O2 Initiative and carried out at six different district hospitals, including sites at Lisungwi, Neno, Mwanza, and Chikwawa–and provided documentation on designs and drawings, as well as technical specifications for each facility.

The Matterport was used to assess oxygen conditions at six different hospital sites throughout Malawi.

While BHI’s architecture team had previously used a Matterport for designing purposes, this was the first time that the Matterport had been applied to oxygen engineering. In addition to taking images, a Matterport camera expedites measurement processes, allowing engineers to quickly and accurately gather critical information about a facility’s infrastructure and layout. The models generated by the camera can be used to automatically generate spatially accurate 2D architectural floor plans that can be processed in Autocad and Revit software.

“The tool allows us to consider more details through every piece of the oxygen delivery system and how it will be incorporated into the existing conditions.”

— Sarah Godschall, Project Engineer at Build Health International

Lessons Learned

The Matterport has fundamentally changed many design and technical aspects around BHI’s oxygen work. There have also been several lessons learned, which will continue to inform future oxygen work and provide long-term system strengthening in the many countries which we work.

A 3D Matterport image shows clinical spaces in Neno, Malawi. Photo Credit: Sarah Godschall

• Stakeholder involvement. Because a Matterport is sensitive to environmental conditions, it can sometimes disrupt the ebb and flow of a hospital facility’s operations, especially as patients receive care. Actively involving and working with clinical staff to take photos is critical. Equally as important is ensuring that staff understand the importance of a Matterport’s ability to provide high-quality data to deliver even better care for their patients. Better yet, when the Matterport photographs patients, it blurs their faces in the shots, guaranteeing their rights to privacy and confidentiality.
• Clinical perspectives. Although Matterport images have provided outstanding visual information, clinical perspectives are equally critical. While in Malawi, Sarah and the BHI team engaged with hospital clinicians and staff administering patient care, as well as facilities management who would be overseeing oxygen delivery to understand the needs of their patients. “ Without oxygen distribution systems, clinicians often have to save their limited supply of cylinders for the sickest patients and make a decision regarding who would receive oxygen and who would not,” says Sarah. These perspectives supplemented the Matterport images, ultimately shaping the final engineering recommendations. Going forward, Sarah hopes to add even more clinical voices when designing oxygen delivery.
• Addressing seasonal changes. The Matterport provides several insights into a facility’s operations and layout. However, as hospital conditions are constantly changing, future applications of the Matterport will hopefully be able to capture a greater extent of those conditions, especially as patient volumes fluctuate throughout the year.

Rosanna Giorlandino serves as Build Health International’s Communications and Development Manager. She writes about accessibility and innovation in global health systems.