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TEDx Talks
Published: 2017-09-15
Source: https://www.youtube.com/watch?v=F6eXnzaMLAM
%HESITATION this is I met Kenny in Nigeria last year when she was admitted to hospital with pneumonia a common language can we needed a particular simple medical therapy Kevin needed oxygen the same oxygen that we breathe in the air around us the same oxygen that many of you will have in her words if you've ever been a patient oxygen is an amazing medical therapy and we've
been using it to save lives for over one hundred a little bit of oxygen for a sick child like Kimmy is almost miraculous however there are thousands of children around the world you need oxygen right now but he won't get it children with pneumonia but kidney others with meningitis malaria babies born prematurely this simple life saving therapies simply doesn't so how do we get simple life
saving therapies like oxygen children who need them well first we need to stop pretending that seem this is a children's hospital just down the road at first glance providing oxygen here might look simple teaching comes from the wall nurses give it to patients however when we look behind the scenes we see a different nurses will tell you how they're trying to give oxygen safely hello I
fully guidelines so that every child who needs oxygen engineers will tell you that is a three story high tank sitting at the front of the hospital it contains thirty thousand leases of liquid oxygen I'll tell you this twenty kilometers of piping taking that oxygen to every single room in the up in the hospital I'll tell you about quality control maintenance and backup system in short we
never run out of oxygen this is a hospital in Nigeria a couple of years ago I asked the director here about oxygen and he said I took the Irish oxygen is my biggest headache oxygen supply was always running in doctors were having to choose which charge would get oxygen which child would be set and technicians had piles of broken equipment I couldn't fit providing oxygen to
children is conflict the technical complexity administrative complexity and then I see enormous complexity of human behavior how do you get fallible humans like you and I to give oxygen to the right child at the right time it reached and what's he doesn't mean it we throw it in the too hard basket but it does mean we need to understand how complex interventions actually were in messy
real life situation okay your example in Nigeria part of their plan was to use oxygen called concentrate is Eric amazingly machines that Joran area take out the nitrogen and give a continuous supply of medical grade oxygen we know from experience that concentrated can work well for many years with minimal repair or maintenance concentrators are a great alternative to traditional oxygen cylinders which run out after a
few days an editorial Slee unreliable and expensive however when we first proposed concentrate is in Nigeria doctors from one hospital told me that in their experience concentrators didn't really seem to work that so when a randomly tested its every concentrated on the wards every concentrated over using and we found they were absolutely brought most of the concentrators were not even giving oxygen that would just blowing
out in imagine that you think you're giving life saving oxygen therapy to a patient and it's fine air so we sat down to try and work out what was going on and we found that the concentrators were not suitable for use in hot humid dusty Nigerian can many of them were poor quality many were donated second hand from abroad many would dead on arrival concentrate its
were flowed into light died with no routine maintenance and no way of doing repairs or even getting spit but understanding how concentrators were actually use in this particular environment we were able to work together to improve since we selected simple concentrate is that work well in hot installed reliable solar power we built teens have nurses technicians and doctors who could look off the comp an axis
hope and we worked with nurses to make sure that oxygen therapy was integrated seamlessly there exists they went over loaded with more work simple solutions that came from understanding and wrestling with the conflict we worked so well lessons when we look to hell oxygen was being used for example we heard that someone else's work tanning children's oxygen all over not when they thought no one was
watching shocking raw well it turns out that many nurses and patients were actually scared of oxygen you see it's generally the sickest patients and oxygen and sometimes a sick they are not because of the oxygen but because they're very very sick so businesses had seen some children who died while they're on oxygen so they associate oxygen we did I went stopping children's oxygen to be nasty
but because they're under the misconception that oxygen according by understanding how people perceived oxygen hell Mrs actually used we were able to find ways to help nurses use oxygen well and confidently part of this involves oximes oximeters machines which enable nurses to be out and measure the blood oxygen level this means I can tell you needs oxygen and they can immediately see the beneficial effect when
they put someone on oxygen neck and even share this with them by making the effort to understand the complexity of hell nurses were using oxygen we were able to come up with effective likely appropriate a chemical oxygen when she needed it and it helps cycle chemical oxygen because we worked together to understand how an oxygen system would work in the local because and then we built
on what people were already doing well but this is not just a story about ox this is about how we did basic life saving therapies the people who not just in the easy to reach places but especially the diff bisik rehydration for children with diarrhea basic resuscitation for newborn babies basic prevention of malaria you didn't basic health interventions that we know are safe and this involves
only healthcare workers technicians manages research is it so let's stop pretending that bicycle therapies every health intervention conflict to do in messy real well in and it's in price that miss and try to understand how the convicts into been should we work on and let's start with what's working let's build on people's insights that's which I
