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Rob Shutt: My Time in Djibouti

June 2021

My time in Djibouti consisted of having four hospitals, which needed to be assessed to see how we could help prepare them for another wave of COVID-19 cases. The problems faced were generally mutual and some of them could be corrected with training and encouraging good practice.  

General safety and the necessity of recognising the risk of handling equipment that was used with COVID-19 patients were among the first problems that needed to be addressed.

No one was doing any thorough decontamination procedures of medical equipment and any related appliances. Their first reaction would be to dive in and interact with the equipment.

Thus, a system was put in place to slow down the user and think before they act, to ensure they don’t put themselves at risk or increase the likelihood of others being infected. COVID-19 is only one element to be wary of. Hospitals can harbour a wide variety of bacteria and viruses.

The promotion of thorough visual inspection of equipment was another way to slow down people before they rushed in headfirst. Scenarios were incorporated to highlight the possible faults we can miss if this isn’t carried out. Visual tests allow the clinician and technicians to know if the unit is being used to its full potential – suction machines were being used improperly with suction tubing on the wrong connections and suction filters in the wrong place.

Items like oxygen concentrators didn’t have filters in place or were not properly washed. We also carried out demonstrations to ensure we don’t damage components by connecting them in the wrong place – e.g. with patient monitors and their applied parts. There were opportunities to test outputs for oxygen concentrators, CPAP machines, suction units and hospital pipeline and bottled supplies for oxygen.

During the time we were in Djibouti we also helped commission new ventilators and CPAP machines for a dedicated COVID-19 unit. The standard of the new equipment is great, so it was great to see they will be well suited to respond in the future when required.

Due to the circumstances with treatment around COVID-19, oxygen generation has been at the forefront of everyone’s mind. There was an opportunity to see the current output and advise where it could potentially be increased.

In the future, we hope further development opportunities will allow the current setups to manage ebbs and flows of demand efficiently and to account for any maintenance down time.