‘Considering local context and the end-user in designing solutions is the key to success’

In the southern provinces of Afghanistan, pneumonia affects many children, making it difficult for them to breathe. If not treated, it can be fatal for children under the age of five. Critical cases heavily rely on airway support to keep their lungs open and help them rest and recover from the illness.

To address the need for access to adequate care in Afghanistan, Philips employees worked together with the International Committee of the Red Cross (ICRC) to redesign a solution for airway support specifically for children. We interviewed Pascal de Graaf, Senior Scientist at Philips Research, one of the volunteers offering his skills and expertise to work on a solution suitable for Mirwais Hospital, a hospital that often lacks appropriate facilities and resources.”

Pascal, how did you come into contact with the Philips Foundation?

“In early 2019, the Philips Foundation, on request of the ICRC, launched a challenge to design a respiratory solution for younger children. I had been working for over ten years on respiratory projects within Philips; it is just so close to home for me and my expertise. After the kick-off meeting, all the volunteers were divided into teams, tasks were assigned, and clear action plans were identified. For some time, every week, we would come together and discuss our progress.”

Which challenges did you face?

“Well, to be honest, it’s not always been easy. After some time, we discovered that the challenge given did not entirely address the hospital’s problem. When we found that redesigning existing technology would not fit with the local hospital environment, equipped with less advanced resources, it was a wake-up call. As technicians, we too often jump straight into solutions without properly considering the local context or end-user, which is key to the success of our work. Looking back, we should have spent more time understanding and analyzing the problem.”

“As we advanced, after consulting the hospital’s clinical pediatric team, we focused on developing a training tool to guide hospital staff in the proper set-up and use of an improvised Bubble Continuous Positive Airway Pressure (CPAP) for newborns and children suffering from severe respiratory complications. The Bubble CPAP makes use of compressed oxygen, has a simple design and is made from basic materials already available at the hospital. However, to work as intended, it has to be constructed and applied correctly.”

One of the challenges was to create a poster to train local hospital workers. Beyond just asking the staff directly how they use the CPAP on children, we had to overcome a cultural and linguistic barrier. We asked someone from the area to translate the materials into Pashto, one of Afghanistan’s languages. Also, not every user of the CPAP is literate, so we needed to provide a clear and straightforward visual design for those who can’t read.”

Any key takeaways?

“When redesigning existing solutions for specific environments, it is crucial to always keep in mind who the end beneficiary of the solution is, mainly when translating more advanced technical solutions into solutions for environments without access to adequate medical resources.

Although we have spent quite some time reinventing the solution for this specific hospital in Afghanistan, I think we still could also look into other medically underserved areas where hospitals still lack expertise in respiratory care. Too many young children still suffer from pneumonia. It will be a matter of adapting the concept and changing the material to its cultural context.

After this first exercise, much less time and effort will be needed to reach the same impact in a different area. We are happy to present the materials to anyone interested in taking over the solution and applying it in a similar environment.”

What are your personal experiences of the initiative?

“When I heard that our solution had saved the life of a child suffering from severe pneumonia, I realized the incredible importance of this challenge!”

“It was such an inspiring challenge, where I was able to use my skills and expertise in a different context. This is what truly motivates me. Last but not least, we had a lot of fun, especially when we experienced the typical workflow, gathering strengths to create something unique.

I want to address that our team reached out to other Philips employees who were involved in several aspects of the challenge. It was not just our team who worked on the solution. There were many more people who had a critical, albeit small, role in the realization of the materials. It amazed me how many colleagues were willing to help out.

If there would be any similar challenges in the future, chances are likely I will apply again!”

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We interviewed Pascal de Graaf about his experience; however, a diverse team of Philips experts carried out the challenge. The Philips Foundation and ICRC are grateful to the whole team for their enormous commitment.