When COVID-19 began spreading in Tanzania, many hospitals witnessed a dramatic increase in the demand for medical oxygen.
“Our oxygen usage has almost tripled since March 2020 following the outbreak of COVID-19,” says Dr. Bahati Msaki, Medical Officer in Charge at the Sekou-Toure Regional Referral Hospital in Mwanza, Tanzania.
Meanwhile, health facilities were reporting that much of their oxygen equipment was out of order, putting COVID-19 patients at risk for further complications and preventable deaths.
In response to this growing need for medical oxygen, PATH’s Tools for Integrated Management of Childhood Illness (TIMCI) program, with support from Unitaid, worked with Tanzania’s Ministry of Health to support COVID-19 response and respiratory care systems in the regions of Tabora, Tanga, and Mwanza.
“We were training frontline health care workers and providing technical assistance to support COVID-19 response,” says Dr. Deusdedit Mjungu, TIMCI Project Lead with PATH Tanzania. “But in these regions, we really focused on repairing respiratory equipment. There weren’t many other development partners doing this, so the need was great.”
And because oxygen needs were growing around the world, it was particularly urgent—high global demand for medical oxygen equipment meant long waits to purchase new equipment.
“Repairing existing equipment was the only near-term option to increase oxygen supply,” Dr. Mjungu says.
Furthermore, PATH has extensive experience in this area, from its respiratory care work in the Democratic Republic of the Congo, Indonesia, Kenya, Malawi, and Senegal dating back to 2015.
Restoring lifesaving tools
Building on our expertise, PATH, in partnership with the government of Tanzania, began with an assessment of respiratory equipment across all public facilities in Tabora, Tanga, and Mwanza.
PATH’s rapid assessment showed a shortage of oxygen supplies in almost all of the hospitals visited, including regional, district, and faith-based organizations’ facilities.
“The COVID-19 outbreak worsened the situation. The equipment was overburdened by the abrupt increase in demand. Facilities didn’t have the funds, or the trained specialists, to conduct ongoing maintenance,” says Dr. Alex Sanga, Emergency Preparedness and Response Officer at the Ministry of Health, Community Development, Gender, Elderly and Children in Tanzania.
Through the rapid facility assessment, the teams identified which equipment, in which facilities across the three regions, was in need of repair. Many facilities have limitations and technical specifications that make certain equipment vital.
“Our hospital is on an island, so it’s not easy to deliver oxygen cylinders here,” says Dr. Raphael Mhana, District Medical Officer for the Ukerewe District Council. “For this reason, we depend solely on oxygen concentrators, but these devices break easily. They require technical specialists for maintenance and repair.”
Based on fresh data on facilities’ specific needs, Dr. Sanga worked with PATH to urgently put repair plans in motion. They brought together expert teams, including technicians, to conduct major repairs of oxygen plants, oxygen concentrators, patient monitors, and other devices such as suction machines and autoclaves as needed.
Around 500 respiratory devices across 26 facilities were repaired and recalibrated. This included the oxygen plant at the Tanga Regional Referral Hospital, 135 oxygen concentrators, and several other devices. After the repairs, all 135 oxygen concentrators attained the goal output of 90 to 96 percent oxygen purity.
More than 98 percent of the out-of-order equipment at all 26 facilities was brought back to life, enabling these tools to efficiently provide oxygen therapy to patients.
“Thanks to PATH’s support, we now have well-functioning oxygen concentrators to serve the 400,000 people who depend on this hospital,” Dr. Mhana says.
Oxygen therapy systems
Oxygen therapy saves millions of lives every year. From treating heart failure and pneumonia to asthma and now COVID-19, oxygen is an essential medicine—but maintaining access to oxygen can be complex and expensive.
Producing and administering medical oxygen requires trained health care professionals as well as a range of equipment, which needs regular maintenance and repair by trained specialists.
“Whether we procure oxygen cylinders or use an oxygen concentrator to produce oxygen at the patient’s bedside, we still need tubing, regulators, nasal canula, and much more to actually administer oxygen to the patient,” Dr. Mjungu says. “Each of these devices has many parts that all require special knowledge to maintain and repair. If just one breaks, it could mean that no one is getting oxygen until it’s fixed or replaced.”
Oxygen therapy equipment must be well maintained, but this is just one part of the overall system. PATH works with its partners around the world to strengthen oxygen access and delivery systems to ensure longer term, sustainable solutions for oxygen therapy.