Is 3D printing a humanitarian technology?
Well… maybe not right now, but Field Ready is learning how it could be.
We are trying to answer this question in Nepal with the help of the DFID Frontier Technologies Livestreaming Programme.
Since the devastating earthquakes of 2015, Nepal and its international partners have redoubled efforts to develop disaster risk reduction capacities and systems in many areas. In support of these efforts Field Ready, alongside DFID Nepal, has been exploring ways of supporting a more resilient humanitarian aid supply system.
Resilience in supply often depends on short, robust supply chains and local production capacity. With this in mind, Field Ready have been supporting the development of Nepal’s 3D printing sector and assessing the value of 3D printing for potentially life-saving products like umbilical cord clamps, oxygen supply fittings and other medical consumables for hospitals and health posts, especially in rural and resource constricted environments.
In a post-disaster context, the ability to print medical supplies on demand, when supply chains may have been compromised or broken down, could be the difference between safe treatment versus risk to the quality of treatment and ultimately to the life of the patient.
Understanding our end user
With DFID Nepal’s support, Field Ready undertook 11 needs assessment visits to health posts, public and private hospitals and medical centres of all kinds throughout Nepal in 2017 and the first quarter of 2018. Before investing heavily in technology, it is crucial to understand exactly what our potential end users would need from 3D printing.
Based on this discovery work, Field Ready and local partners in Nepal are developing, printing and testing a significant and localised catalogue of 3D printable items for use in the health sector. Some examples to give you a taste are below…
Example 1: wrist braces for broken joints
One health post was using discarded cardboard to improvise wrist braces for patients with broken wrist joints and carpal tunnel syndrome. Field Ready were able to demonstrate the benefits of having a mobile design and production capacity by developing an entirely new form of wrist brace and printing it for patients on-site, in collaboration with a Doctor visiting Nepal from the US. We created a thermoformable, biodegradable wrist brace which the doctor demonstrated and trained local health workers in its safe use.
Example 2: safe needs storage device
On a needs assessment visit to a flood-affected health post in Malangwa, Sarlahi District, Field Ready saw a full cardboard needle storage box on the floor of a facility that had been underwater two weeks previously. Using international design partners and local input, Field Ready produced a 3D printed bottle cap that turns a plastic bottle into a waterproof safe sharps storage device. Printed for under $2 and safer for users, the Sharps Box is currently undergoing trials.
Making sure we’re solving a development problem
Medical equipment such as nebulizers, ECG machines and baby incubators play an essential role in delivering a basic quality of healthcare, and a lot of time and money is spent enabling hospitals in challenging environments to access this kind of equipment.
In Nepal, many hospitals and health clinics have relied on generous donations to supply much of their advanced medical equipment. This is fantastic news, until that equipment breaks down. The same constraints that make it difficult for these hospitals to obtain the original equipment also make it very challenging to obtain spare parts.
Often the search for spare parts turns up nothing. Some items are simply unavailable because the equipment is very old and no longer in production. Spares, when found, are transported from Kathmandu or imported from international sources at great cost. The consequence of this is that hospitals must either raise funds to replace the equipment in its entirety, or go without.
Field Ready are seeking to bridge this gap by exploring alternative ways that hospitals and health posts can 3D print their own spares to maintain equipment cost-effectively. Until now, work has been conducted at a grassroots level by responding to the individual needs of a number of health centres. Field Ready, since 2016, has identified and fixed thousands of dollars’ worth of broken and damaged equipment using 3D printed parts.
Replacement connectors for suction pumps
In early 2017 Field Ready identified a broken suction pump in a rural health post in Gorkha district that would have taken weeks and hundreds of dollars in parts and procurement time to replace using the original part shipped from Kathmandu. Within an hour of arriving at the site, Field Ready’s Design and Production Engineer, Ram Chandra Thapa, had measured, designed and printed a replacement connector piece, which worked first time. The print cost under a dollar in materials and took 45 minutes to design and print, an estimated 50 patients over the next 6 months would have benefitted from this fix.
Electrical connectors to power health wards
Seemingly small, but perfectly targeted, interventions can have a huge impact. In early 2016, Field Ready visited a temporary ward at a hospital in earthquake affected Nuwakot and identified a broken power supply unit supplying the ward. The fault was due to a broken housing of a loose electrical connector and was causing intermittent power for medical machines and monitoring equipment, meaning that the ward was virtually useless.
Field Ready learned that the whole power supply unit would have taken weeks to ship from Italy and cost over $3,000 to replace, including shipping, taxes, duties and delivery. After a few hours Field Ready were able to produce a replica of the original complete part using 3D design and on-site printing. The part cost around $7 in materials and the same again in design time.
The Next Frontier: Different Routes to Scale
Following from our work outlined above, solving specific problems quickly with 3D printing, we are now considering how best to scale the technology and approach. One hypothesis: digital catalogues of products and the mobile manufacturing capacity of 3D printing can bring production to the point of need, meaning that procurement cost, supply chain & procurement staff time and lag is much reduced.
Whilst actively fixing products using 3D design and on the spot 3D printing, we can develop and add to a comprehensive digital catalogue of spare parts that would typically be required to fix or service standard equipment in a government healthpost or hospital. This catalogue could be used by health centre staff to print items they need, on demand, and without any design work or technical skill necessary. Common items like connectors, brackets, handles, hinges, knobs, caps and so on, could all be easily mapped, digitally rendered and then become part of a catalogue that biomedical engineers or healthpost staff could 3D print from if their equipment breaks down. This is still an idea under development but initial cost-benefit studies on fixing things this way point to a great deal of potential.
The Frontier Technologies Livestreaming programme, funded by DFID, has allowed for more than just medical sector support. During the scoping and design phase for the project, Field Ready were able to deliver 3D printing training to members of Miss Tech, a group of young women working to get women into engineering in Nepal. This project led to a commercial 3D print to fulfill a production contract followed by a funded apprenticeship for Pradita Pradhan with Field Ready in Nepal. Pradita is getting an immersive learning experience in digital design and 3D printing skills. She is one of the new generation of Nepali engineers riding the wave of the fourth industrial revolution.
We’ve seen the value of making sure we bring together a range of stakeholders at the beginning of our journey, all committed to lean methods and all passionate about the problem and technology.
The economic and humanitarian applications for 3D printing technology dictate that Field Ready, working with DFID and other humanitarian partners, can be pioneers for the benefit of the humanitarian and development sectors and the people they serve.
3D printing has unparalleled potential as a responsive and efficient production method and, when combined with a deep understanding of the needs of people in post-disaster contexts, can have incredible impact on people’s lives. There is a compelling argument to say that 3D printing, while immature, can surely grow to become a powerful humanitarian technology.
