Introduction - Medical Devices and Biomaterials for the Developing World - page 6

Imagine that a blood pressure machine is donated to a small village clinic with
the aim of increasing its technological capabilities. Because there is nowhere
to plug in its AC adaptor and there is no way to obtain batteries in the immedi-
ate area, the machine, while more advanced by some standards, is totally use-
less in this setting. It may sit unused for months or indefinitely, and the
problem of being able to measure and record patients' blood pressure for diag-
nostic purposes is still unsolved. Did the clinic gain the technological advan-
tage that should have been conferred by automation of this process? For the
price of the automated machine that sits on the shelf, the center could have
been equipped with ten sphygmomanometers. Ten patients could have their
blood pressure checked simultaneously, or additional health facilities in other
villages could each be equipped with an additional sphygmomanometer.

Fig. 1.1 Same-quality equipment substitutions. Source : Coloma and Harris (2008 )

Other similar substitutes have been identified by the Sustainable Sciences
Institute (Coloma and Harris 2008) and include not only relatively simple medical
tools such as the sphygmomanometer but also items with household uses that are
likely to be commonly found in any setting (see Fig. 1.1 ).