Meet Mohamed Chisti- The doctor who uses plastic bottles instead of expensive ventilators to save babies with pneumonia
11 September 2018|01 Muharram 1439|India times
Pneumonia is one of the leading killers among infants around the world. And while most hospitals in first world countries can afford expensive ventilators, poorer countries have to make do otherwise.
That’s how Mohamad Chisti decided to just use a shampoo bottle.
Last year, pneumonia claimed the lives of 920,000 children under the age of five. It’s the result of a bacterial, viral, or fungal infection in the lungs, which causes pus to build up in the alveoli, the oxygenation agents we rely on. To counter the effects, the body makes the lungs work harder and faster, which is what causes breathlessness.
The problem is that, in poor countries infants tend to be malnourished. As such, their tiny bodies just don’t have the energy to keep up the laboured breathing for very long and they tend to succumb. Ventilators make this easier, but they cost upwards of $15,000 (approximately Rs 10.8 lakh), which is why poorer hospitals use just a face mask or tubes placed near the nose. They might help in a healthier child, but they don’t make it any easier for a malnourished one to breathe.
Bangladeshi Mohamad Chisti experienced this first hand as a paediatrician in Sylhet, watching three children die of pneumonia on his first night. He wanted to find a better way to treat the condition, and the idea came to him on a trip to Australia, according to a piece in the Dhaka Tribune. There, he saw a new type of hospital ventilator called a bubble-CPAP (continuous positive airway pressure), used to help premature babies breathe.
With this device, an infant’s exhalations are channeled through a tube that has its other end immersed in water. The exhaled breaths bubble up from the liquid, which causes fluctuations in the air pressure of the tube. These rapid pressure changes are fed back to the child’s lungs, which help the alveoli exchange carbon dioxide for oxygen, thus requiring less effort from them and making breathing easier.
Unfortunately, the bubble-CPAP also costs about Rs 4.3 lakh, much too expensive for the hospital where Chisti works. Instead, he figured out an alternative when he picked up a discarded shampoo bottle that had bubbles in it.
Using an oxygen supply (which is normally used with a face mask or tubing anyway), some tubing, and a plastic bottle filled with water, he was able to build his own version of the device for much cheaper.
The best part is how well the device worked. In 2015, Chisti and his colleagues published the results of their trial with the jury-rigged ventilator in the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research. The hospital now regularly uses the device, and consequently their number of infant deaths due to pneumonia has been slashed by three quarters. That makes it almost on par with the survival rate of such children treated in richer facilities across the world.
As a bonus, Chisti says the hospital’s spending on pneumonia treatment has also reduced by as much as 90 percent.
It’s simple enough math when you calculate that he built a ventilator for about Rs 90, as well as it consuming less oxygen than the face mask method.
Dr Chisti and his team now aim to conduct more trials in Ethiopia. If all goes well, it’s possible this little plastic-bottle ventilator could spread to poor hospitals around the world, saving hundreds of thousands of children in the process.