...rendering the X-ray machine useless. Almost a month later, the machine was still down and affected the hospital in many ways—some obvious, others not as much. In the words of Malawian X-ray Assistant Thomas Kamanga, “It’s been like going to the garden without a hoe.” While the staff struggled to repair the machine, patients were sent to nearby public and private hospitals for X-rays.
Jon Edwards, CURE’s Biomedical Engineer, took the lead on trying to fix the X-ray machine. After struggling with the lack of resources online, he finally pinned down the problem as a faulty board in the X-ray digitizer, the machine that converts the analog plate to a digital image. The X-ray machine itself was still functional, but useless without a way to process the image.
“It’s a waiting game, all about waiting… From the beginning, we tried to go back to the old film system, and that machine hasn’t run for almost three and a half years. It needed an overhaul and cleaning, so we stripped it down, rebuilt it, and put it back together... and then something else blew—a part that’s not available here, so that’s being sent from the US as well. In the meantime, we have no backup system.”
Jon Edwards, Biomedical Engineer
While Jon worked to fix the analog machine, the rest of the hospital struggled. Often, our weekly clinic patients need X-rays in order to see what is wrong and make plans for their operation. The lack of a working X-ray machine on-site caused massive delays and lots of extra work.
“It’s really difficult. We’re sending our patients to different hospitals… so much time is wasted. Providing care here for our patients, we waste a lot of time going to the different hospitals to do the X-rays. It’s hard as nurses. Even here, if you have two nurses on duty, it means one nurse is spending a lot of time taking patients to get X-rays while the other struggles to care for the patients well.”
Paul Nyson, Nurse
Queen Elizabeth Central Hospital generously allowed CURE to use their X-ray machine, but because of their already-busy radiology department and the breakdown of another hospital’s X-ray machine, we were only allowed to use it on specific days. Yohane, below, was unable to get his X-ray the day before and had to be rushed first thing Wednesday morning before surgery, causing a delay in operations.
“When we take our patients [to Queen's], it’s us who have to do the X-rays, so normally when we go there they tell us to wait till they’ve finished their work, so we are there for long hours. When we are X-raying patients who are going to the operating room on Monday morning, we need to do the X-rays on Sunday. We start X-raying from 4:00pm up to 10:30 in the night. So this makes our work to be very tough and tiresome.”
Thomas Kamanga, X-ray Assistant
Patients who have had operations need to have post-op X-rays taken. Unfortunately, for kids like Sati, below, this means transportation in the ambulance—a painful journey just two days after surgery.
“My husband and I have always had a good experience taking our children to CURE’s private clinic. Recently, our 17-month-old daughter needed a chest X-ray. Unfortunately, the X-ray machine was broken so we had to go to the public hospital. With such a young child, X-rays are never a pleasant experience, but it would have been much less stressful to be able to take her to a familiar location where we trust the doctors. We got the services we needed at the public hospital after waiting for two hours, but we would much rather have remained at CURE and hope to be able to do so if needed in the future.”
“By having no X-ray machine here we have lost a lot of revenue [from our private practice], revenue which we need to run our charitable pediatric ward. Now, our clinics have been affected and we’re losing out a lot. We need this problem to be solved once and for all.”
Thomas Kamanga, X-ray Assistant
On July 13th, an analog X-ray film developer arrived from Lilongwe. Jon Edwards and the team at CURE Malawi managed to get the machine up and running. Although the digitizer, which enables us to convert the film to digital images, was still down, having access to the X-ray machine was a massive improvement for the hospital.
“We are very happy now that we don’t have to go back and forth to Queen's anymore. A good job well done."
Stanley Mndoli, X-ray Technician
Although the X-ray saga is (hopefully) nearing its end, this sort of breakdown is a regular reality of hospital life in Malawi and other CURE hospitals. A few months ago, one of the C-arms (an in-theater X-ray machine) broke down, causing delays in operations and a lot of hassle. There are other “single points of failure,” as Jon Edwards calls them, where, if an expensive piece of medical equipment breaks down, there is no backup. Until last July, we had only one autoclave to sterilize surgical tools, and other areas such as the laboratory are still vulnerable without backup machines.