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Advancing Access to Appropriate Medical Devices in Resource-Deprived Settings

21 October 2021

Dinsie Williams (Pearson College UWC, 1991-1993) is a biomedical engineer, researcher and technical adviser with an interest in facilitating access to medical equipment in resource-deprived settings - from scaling-up oxygen during the COVID-19 pandemic to ensuring that policies and personnel are in place to safely operate radiation-emitting devices. In this interview, Dinsie shares how she found her way towards this path, the challenges and complexities she faces in her work and why she felt it was important to her to contribute to the welfare of Sierra Leoneans, both with her biomedical expertise and the work she continues to do with the UWC Sierra Leone National Committee.

 

Where are you from and how did you end up at UWC? 

I was born in Freetown, Sierra Leone. My mother and father encouraged me to apply to UWC because they wanted me to be well-positioned for tertiary-level education opportunities. They had saved up enough to pay for one year of university education for my sister and brother who were both older. By the time I came along, they did not have enough funds. Little did they know the UWC would deliver beyond their expectations. UWC has continued to influence my life far beyond university.

As a UWC national committee volunteer and an alum - what do you think it is about a UWC education that makes it special?

The UWC education liberates students from unquestioned submission to arbitrary, divisive cultural norms that hinder universal progress. By limiting discriminating facets of society, albeit artificially, UWC attempts to give its students the opportunity to imagine a world that favours the ideal of the common good. The UWC education not only prepared me to earn a living, it prepared me to see the world differently. Only a select group of people can say this about their secondary education experience.

Did you always know you wanted to work in the field of healthcare? And in advancing access to appropriate medical devices in resource-deprived settings?

I grew up as a curious child who loved to tinker with radios, clocks, and other sorts of machinery, trying to understand how they worked. So during my second year at Dartmouth College in the US when I came across a Biomedical Engineering journal in the library, I was utterly fascinated by the idea of designing equipment that would help doctors save lives.

I started sneaking into graduate-level seminars on biomedical research at the Thayer School of Engineering where they discussed concepts that went completely over my head. I kept at it until I could understand some of what was being discussed. The free pizza that was available at the seminars helped me get through the sessions!

My first internship in the field was on photodynamic therapy for breast cancer with Dr. P. Jack Hoopes at Dartmouth-Hitchcock Medical Center. He was a brilliant teacher and an unsuspecting mentor who fuelled my interest in biomedical research. By the end of my senior year when Dr. Mae Jemison introduced me to the idea of advancing appropriate technology to improve healthcare in developing countries, I knew exactly what I was going to do with the rest of my life.

What makes you passionate about this field of work?

Advancing access to appropriate medical devices in resource-deprived settings just makes sense to me. It is all about being intuitive, innovative, and inclusive with how healthcare is delivered. The approach guarantees that healthcare resources are distributed fairly, irrespective of the amount of resources available. Patients end up with the best possible outcomes with minimal residual harm to the environment. Advancing access to appropriate medical devices in resource-deprived settings, combines three things I truly love: working with devices, helping people feel better irrespective of their social status or geographic location, and learning. 

What are the principal challenges you face in your work currently - and what helps you to keep going? 

Working in an environment where the appropriate or rational use of medical resources is still a novel concept makes it challenging to contribute at my full potential. I have had to be creative and often take “the road less travelled”. Opportunities to conduct research are also rare. I keep going because I have a clear vision of how appropriate medical devices can transform healthcare delivery in resource-deprived settings.

Lack of accountability to patients to provide sustainable solutions is also a real barrier to advancing access to appropriate medical devices in resource-deprived settings. International funding organisations provide the majority share of resources for acquiring medical devices in these settings. But along with recipient governments, some funders sometimes focus on the procurement of goods as the transfer of physical items creates opportunities for media coverage. At the same time, they may give insufficient attention to factors such as the cost of powering devices, establishing a supply chain for spare parts,  and the overall impact on patient outcomes.

For example, if funders are interested in increasing vaccination rates in Sierra Leone they will likely focus on donating a certain number of doses and publicising this information. They might not think of what proportion of the targeted population will be receptive to being vaccinated or eventually access vaccines, the psycho-social impact of vaccine discrimination within communities, how the vaccines will be refrigerated, who will pay to power the refrigerators, who will purchase spare parts, and safely disposing of the units when they are no longer useful. These “sustainability factors” are the first things I think about. 

It is a similar story when it comes to prioritising procurement over impact. Funders might be intent on purchasing oxygen-generating equipment and diagnostic imaging devices to address gaps in healthcare, while leaving the operation and general management of these equipment to administrators of public healthcare systems. In countries that do not enforce radiology safety regulations, or that do not have personnel to operate or monitor radiation-emitting devices, these technologies represent significant safety hazards. My role is to inform funders and public healthcare administrators about the long-term implications of owning such medical equipment and their responsibility in ensuring that the effects on patient outcomes are measurable and sustained. 

My work will be done when everyone prioritizes sustainability and safety at the outset when acquiring medical equipment, rather than when all the lights and cameras have been turned off and the photoshoots have ended at the handing over ceremonies. 

Was it important to you to make an impact in your home country? 

The challenges of daily living aside, being able to work in Sierra Leone has been a dream-come-true for me. Everything I did after leaving Sierra Leone at age 16 was aimed at preparing me to return and contribute to the welfare of Sierra Leoneans. I was determined to give back to the country that had given me everything during my formative years. For several years while living in Canada and the United States, I sporadically provided technical advice to small clinics in Sierra Leone and explored the feasibility of delivering biomedical services sustainably within this healthcare system. I believe I am making a difference, now that I live here.

While I kept my eyes on Sierra Leone, as a graduate of the UWC program it was important that I also made contributions globally. I fervently conducted research and development work on digital X-ray, MRI, CT and electrical impedance systems in the United States and in Canada. I co-authored journal papers on detecting cancer and other abnormalities and was listed as a co-inventor on a US patent. It was important to me to give-back to both countries that expanded my horizon beyond the foundation that my family had given me in Sierra Leone. Canada particularly has offered professional and cultural latitude that still evade me in my country of birth. For that I will always be thankful.

As past chair and a current advisor to  the UWC Sierra Leone National Committee, I have also been actively involved in guaranteeing a free, fair, and transparent selection process for future UWC students from my home country. I stay connected with students to learn from them and provide moral support throughout their time at the UWC and beyond. It is important to me that every member of the program succeeds on their own terms; and working alongside other graduates toward a common goal has been rather rewarding. Hearing from one student that my work inspired him to pursue Biomedical Engineering is one of the highlights of my time with the UWC Sierra Leone National Committee. In this male-dominated field it is unusual for any student, much less a male student, to look up to a female as a role model.

 

 

 

 

 

 

 

 

I will take this opportunity to encourage other UWC graduates wherever they are to make small contributions to their National Committees using their time, treasure, or talents!

In what ways do you think your UWC education helped you to ‘reimagine’ your future and - more broadly speaking - the future of the wider world? 

While my parents raised me to be comfortable around people of different religions and nationalities, UWC made me believe in a completely open and fair world where everyone would shorn prejudice and attempt to understand "the others". UWC taught me that one day in the future, nations will come to see the futility of advancing cultural supremacy and instead prioritize universal progress.