Africa Health: Engineering improves healthcare

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Dr Megan Russell is using her engineering knowledge to find practical solutions to the problems of healthcare in poorer countries by helping develop medical technology appropriate for more primitive conditions.This young South African's enthusiasm for engineering earned her a place on this year's Mail & Guardiannewspaper list of 200 remarkable young South Africans, an annual campaign recognising people under the age of 35 who are doing extraordinary things.

Russell, an engineer, lectures in the faculty of engineering and the built environment at the University of Johannesburg (UJ). Here she has an opportunity to do what she enjoys most - rekindle a love for science through teaching and show how useful science can be.Throughout her studies Russell has dipped into various forms of engineering. She studied electrical engineering and then she did an MSc in biomedical engineering at the University of Cape Town (UCT). In 2007 she moved her studies to Wits University, and last year completed her PhD, specialising in biomedical engineering.

Moving beyond theory Russell's interest extends beyond pure science to how it can be applied to help people. Now she's found her niche. She hopes that her work will create more interest in biomedical engineering, which applies engineering principles to medicine and biology.

Her most recent project is an initiative that encourages engineering students to develop customised medical equipment suitable for developing country conditions. She hopes healthcare facilities in South Africa and other African countries will be the first to receive these devices.

"We have the engineering skills in South Africa to design our own medical equipment, drawing on the expertise of the best local minds," she says. "I firmly believe the solutions for Africa's problems must come from the continent." The initiative forms part of UJ's Women in Engineering and the Built Environment project, for which she is an ambassador.

One of the biggest problems for healthcare in developing countries is the use of imported equipment, she says. If these devices break down, parts are often not available and local technicians can't repair them.

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The new devices will be more robust. The must, for example, be able to run without electricity, using only solar power. If a machine requires purified water to operate, it must have a built-in water filter. The availability of machine parts is another requirement.

The idea is that engineering students would apply to design medical devices such as blood pressure monitors or infant incubators as part of their final year design project.

All the devices to be designed are on the World Health Organisation's list of necessary technology for healthcare facilities, and many hospitals have a shortage of them.

The best designs will be selected and, by commercialising the devices, the project can become self-sustaining. Opening up the project to students can yield good results, Russell says. "Students are driven and want to make a difference. We need to harness their ideas and great engineering designs."

If all goes according to plan, the project could start next year. "To do this we will need funding and people who are willing to invest in students," she says.

Helping tuberculosis patients

It is Russell's previous research work that got her interested in developing new and accessible medical technology. For her Masters project at UCT, she helped develop an automated microscope with a built-in digital camera to detect tuberculosis (TB), a leading cause of death in South Africa.

"I am very interested in TB and I'm always on the lookout for new technology to apply to this field," she says.

The conventional way to diagnose the lung disease is by X-ray, but this is labour intensive and requires the time of a skilled technician. The new screening device is much faster and decreases technicians' workload.

Further research at UJ is looking into using computer-aided diagnostics to identify TB in patients' X-rays. Russell recently presented the project's latest findings at an international congress in Beijing.

Now she's working on developing novel point-of-care laboratories that can improve primary healthcare and disease testing. Depending on how the mobile laboratories are set up, nursing staff can test for TB, CD4 counts and monitor glucose levels.

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This portable laboratory contained in a box would be used by nursing staff based in remote areas of South Africa, reducing the reliance on the country's already over-burdened laboratory facilities.

"This product could address a huge need in South Africa," she says.

A patient's sputum sample would be deposited in the laboratory box which, using fibre optic biosensors, would provide a positive or negative TB diagnosis.

The portable laboratory will be designed in modular form, making it easier for facilities in developing countries to repair parts. With modular design, broken parts can be fixed in isolation. "People do want to maintain technology and can, but often the parts aren't available and this is where the problem lies."

Rekindling a love for maths and science

Perhaps it was her childhood curiosity about how things work that influenced the way Russell thinks about science. "I come from a very science-oriented family," she says. Her father and both brothers are engineers, and her mother is a chemist. "Everything was always explained to us, we asked lots of questions and if no one knew the answer, someone would find out."

Today she is still asking questions and exploring the possibilities of using engineering to change lives. "I love to use cutting-edge technology to radically improve people's lives," she says.

"With pure science you further knowledge and this can be very abstract, but engineering is the application of science to solve problems," she explains. "It just has so many uses for society."

Through her work, Russell is breathing new life into subjects such as maths and science among her students.

And she believes the key to nurturing a love for these subjects is to start early.

"It starts at school and family life. Interesting and inquisitive parents raise children who are the same," she says.

She believes that good teaching is also essential to get children interested in science. "If you have a love for the subject you are teaching, it is catching," she says. "Knowing what engineering is, and how powerful it is, will get people interested."

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