'My machine is saving lives globally'

By Jane Elliott
BBC News Health Reporter

Operations can keep going even if the electrics fail

The electricity goes off as Dr Roger Eltringham continues his round in an intensive care ward in a Vietnamese hospital.

The lights go out and the life-saving machinery flickers momentarily, but within seconds and by working in the dark, doctors get the ventilator back on stream again, keeping the vital oxygen pumping into the patients.

As the creator of the machine, Dr Eltringham is introduced to the relatives sitting round beds in the hospital in Thanh Hoa, 150 miles (241 kilometres) south of Hanoi.

Although he cannot understand what the doctor with him is saying, he assumes it is complimentary because they all bow.

There was no panic when the electricity failed, partly because this is a common occurrence in Vietnam and partly because the anaesthetic machinery being used has been specifically designed to cope with situations like this.

In countries like Vietnam, the Glostavent, as the machine is named, is literally proving a life-saver.

The sophisticated machines we use in the western world simply can't cope in the developing world Dr Roger Eltringham

It is a cheaper alternative to the more expensive western machines.

As well as being able to run without mains electricity, it is more simply designed.

It does not rely on compressed gasses and is therefore easier to repair and maintain than the complicated western machines, making it a popular choice in the developing world.

And crucially if the oxygen or electricity supplies fail, the Glostavent continues to function without interruption whereas modern sophisticated machines are immediately rendered useless.

Dr Eltringham, a consultant anaesthetist at Gloucester Royal Hospital, says the machine, designed largely in his spare time, is already saving lives and improving treatment in Africa, Asia and parts of Eastern Europe.

It was while working in the developing world that he noticed the western machines were unsuitable.

Colleagues implored him to try to help develop something more suitable that they and their staff could operate and maintain in-house.

"I got involved in working in the developing countries and one of their biggest problems was that they were trying to use equipment which would need sophisticated back-up to keep it working.

"But they would have electrical failures and run out of oxygen so they could not use it.

"The sophisticated machines we use in the western world simply can't cope in the developing world.

"Old anaesthetic machines get donated by other countries, but often they don't have the operating instructions, or they simply don't work.

"They join the graveyard of anaesthetic machines that litter countries like Africa."

Machine

Dr Eltringham originally began work on developing a prototype with the help of Dr Roger Manley, the man who invented a ventilator which bears his name in the 1960s.

He carried on alone when Dr Manley died in 1991, creating an elegant machine that incorporates the Manley ventilator technology with a mechanism to supply anaesthetic.

So far Dr Eltringham has sold about 50 of the machines, which cost about £15,000, compared with the £40,000 a traditional machine costs.

"The British ambassador bought some out of his budget and took them to Vietnam," he said.

"He said they were proving resilient in coping with the frequent cuts and saving about $10 a day per machine on running costs, because they use oxygen concentrate.

"And if the oxygen goes off, they just turn on the reserve oxygen cylinders and the transfer is done in dark - it only takes about five seconds as the operation or ventilation can continue without interruption."

Gasses

Dr Eltringham said that because they used oxygen concentrate, the machines also lasted longer before they ran empty.

A traditional machine would normally have about 1 hour 40 minutes worth of oxygen. The Glostavent will last for up to 14 hours.

"I spoke to one technician in Vietnam and she said they had had seven of the machines in the hospital for the last three years and that there had not been a fault that she could not repair herself."

The machine works on and off mains electricity

But he said some countries took a lot of persuading that the machines were the most suitable as they felt they would like the more sophisticated machines, even though these are often the least suitable.

But Dr Eltringham said the Glostavent was a great machine, which he regularly uses on patients in the UK.

Dr Paul Cartwright, a member of the Royal College of Anaesthetists, said the machines were perfect for their use in the developing world.

"This machine works at its best when there is electricity, but the great advantage is it can be used without electricity too.

"If it happens here we have to have a back-up generator or mayhem ensues.

"It is better for them to have something simple that works most of the time, than something sophisticated that works just a fraction of the time.

"This is a clever piece of kit."

Dr Eltringham's story was originally featured in the BMA News Review.