UNIVERSITY PARK, Pa. — Getting rural South Africans health care means literally bringing the clinic to the patient. Though the country uses mobile clinics, a solution by Penn State engineering students may make them more flexible and efficient, and able to reach more people.
The team looked at health care in South Africa's Western Cape Province.
"While there are permanent clinics throughout the Western Cape, a significant percentage of the population lives in areas which are unreasonably far from these locations," explained Erick Froede, a second-year master's student in mechanical engineering. "Agricultural workers, who are largely tenants at their farm, do not typically have their own vehicle or the ability to take time off."
The government provides mobile clinics fashioned out of trucks or vans. Staffed by nurses, the vehicles travel the countryside providing health care to rural farm workers.
While the mobile clinics, then, are a helpful solution in theory, they do not always work the way they are intended. Current clinics in service have limited and outdated technology, and their lack of features make it difficult for the nurses to do their jobs efficiently.
"This is a major problem because chronic illnesses which require regular treatment, such as high blood pressure and AIDS, cannot be addressed. Also, acute illnesses run the risk of becoming more serious and even life-threatening if ignored," Froede said.
The South African Medical Research Council (MRC) and the Western Cape Province Department of Health have launched an initiative with Global Engineering Teams and Stellenbosch University in South Africa to improve the mobile clinics, the quality of care provided to rural farm workers and the work environment of the traveling nurse practitioners.
Global Engineering Teams is an educational network of universities dedicated to projects that bring graduate-level engineers together from across international boundaries. Penn State is currently the only U.S. partner in a network that includes the Technische Universitaet Berlin in Germany, the Universidad de Chile in Chile, the University of Botswana in Botswana and Stellenbosch University in South Africa.
Froede led the Team MRC effort through Global Engineering Teams to design new specifications for the modern mobile clinic with teammates Bryan Lewis, a second-year mechanical engineering doctorate student at Penn State, and two first-year mechanical engineering graduate students from Stellenbosch University — Hendrik Bosman and Barend deVilliers.
The team visited Cape Town, South Africa, last April to learn about the clinics and the needs of nurses and patients in the Western Cape Province. They were able to view some of the existing clinics and gather firsthand information from field nurses who use the equipment.
"There is a wide variety of problems inherent in the current mobile clinic design. These include extreme temperatures during the summer and winter, lack of storage space for patient files and medication, unreliable vehicles that break down and permit dust to enter the cabin, and more," Froede said.
Lewis adds that, because the equipment was so outdated, nurses were often unable to keep up with standard procedures. For example, the vans could not carry enough water for the nurses to wash their hands after every patient encounter.
Between April and September, the team worked to develop a final prototype design for a vastly improved mobile clinic that will improve the efficiency of the mobile clinic nurses and, ultimately, the health of the agricultural workers in the Western Cape. They selected a new vehicle platform — a Volkswagen Crafter 35, selected equipment for the inside of the mobile clinic and designed the entire interior workspace.
According to Lewis, the three main improvement points of their design include the addition of modern medical equipment and facilities; the use of a modular interior design, which allows for nurses to move and exchange equipment depending on their patients' specific needs; and the employment of anthropometric analysis.
"Previous designs didn't consider the stature and body build of the population," Lewis said. "The standard measurements used in previous designs weren't working because most patients were shorter than the average."
In mid-September, the team traveled to Berlin with a detailed overview of the project and presented their final prototype design. Rotary International has provided funds to create the prototype vehicle, which will be tested at Stellenbosch University. After a full year of prototype testing, the South African government has a three-year plan to replace its full fleet of outdated mobile clinics with the new design.
Matthew Parkinson, associate professor of engineering design and mechanical engineering at Penn State, and Cornie Scheffer, professor of biomedical engineering at Stellenbosch University, served as mentors on this project.