COVID-19: Small community-focussed projects can make a big difference where the burden of disease is greatest

14th July 2020

While the COVID-19 pandemic has sent a shockwave through every country in the world, perhaps nowhere is the challenge greater than in low- and middle-income countries, where lifesaving resources, such as face shields, are either scarce or impossible to find. Roger Harrison, Senior Lecturer in Public Health at the University of Manchester, describes how a student-led project in Uganda is helping to meet the urgent need...

It’s not hard to understand why Personal Protective Equipment (PPE), including plastic face and eye protection, is essential for health workers during the SARS-CoV-2 pandemic. In the UK, part of the shortfall in PPE has been met by local volunteer groups responding to the challenge. But what about countries such as Uganda, Rwanda or Tanzania, where I’m involved in projects on antimicrobial stewardship and maintain contacts through the International Student Partnerships’ for Antibiotic Drug Resistance Education. The photographs sent from contacts were far more telling than official statistics.

I set myself the challenge of donating 500 shields to a number of high-risk settings in northern Uganda. #ShieldingUganda soon took off. At that time, I needed an Export License, which was surprisingly quick to obtain (overnight!) but identifying the quickest, cheapest methods for transportation was not easy, with lockdown affecting couriers and airlines around the world. A recommendation to Tudor Freight in Leeds worked out well, and soon I had a batch of not 500, but 2,500 face shields ready to ship! Almost all of these were donated through the Dean Trust and Ashton-on-Mersey High School. The school had massively increased their production capability by shifting from 3D printing, to die-cut shields and headbands. Having supplied tens of thousands of shields to the north of England, they were keen to help support resource-poor settings like Uganda. The University of Manchester also donated several hundred headbands, and a previous employer arranged a further 400 through BIG architects in Denmark.

While I started to learn more about die-cutting equipment and injection mould techniques, I embarked on discussions with another organisation called Augment Bionics that was examining different manufacturing methods, rather than the slow, 3D printing approach. Augment Bionics, is a new medical start-up company, initially set up by students at the University of Edinburgh to create technologically advanced, affordable myoelectric prosthetics. Recognising the global lack of PPE, they turned attention to enhancing production techniques, and producing face shields on an industrial scale, underpinned with a fantastic fundraising and income-generation scheme to fund the work. With the help of Augment Bionics, 10,000 shields have been shipped to Uganda.

To distribute the face shields we worked with a local medical technician known to us, and paid expenses, mainly fuel, for the 2,500 km journeys. The face shields have gone to district and regional hospitals in the northern and eastern territories; and to pharmacy, medical, nursing and dental students at two teaching universities as the projet emphasises the need to protect students in-training.

Together it’s amazing what has been achieved, and while it has taken up a lot of my own time, a small team from around the UK and across to Africa has been flexible and responsive to overcome many hurdles. However, the sense of achievement quickly goes, once the requests from other parts of Uganda, are received. Shipping is relatively the biggest cost and advice on how to reduce this will be appreciated. But ultimately, the ideal is for Uganda to produce its own PPE, with financial donations sent instead. However, that is an entirely different challenge my weekends are not ready to take on.

Senior Lecturer in Public Health, in the Centre for Epidemiology at The University of Manchester, England. Follow Roger on Twitter: @roger_manc

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