21 Jul Shining a light onto a vital health profession – Biomedical Engineers: They Make it Work!
Biomedical engineers are among healthcare’s unsung heroes. In the past two years, as a global respiratory pandemic raged in almost every country, biomedical engineers have been called upon to rapidly deploy COVID-19 diagnostic tools and treatments, including oxygen and the many devices that go with it. Without them, the procurement, installation, operation, maintenance, and repair of COVID-19 equipment simply could not happen.
But what about countries without enough biomedical engineers or the technologies to treat patients? This was, and remains, the reality in many low-resource settings. The World Health Organization (WHO) has documented wide regional disparities in the availability of biomedical engineers with many countries, mostly in Africa, lacking sufficient numbers. This has put enormous pressure on biomedical engineers and technicians to perform the impossible. In the past two years, we have heard of many heroic efforts – some with a happy ending but often not (see Mtheto’s Story). Most of these stories remain untold and the role of biomedical engineers under-appreciated.
To spotlight the contributions of biomedical engineers working in some of the most challenging conditions – and to encourage governments, hospitals, and international donors to invest in the profession as a vital part of strong health systems and pandemic preparedness and response – Every Breath Counts is highlighting biomedical engineers in a new campaign, Biomedical Engineers: They Make it Work!
Inspired by Dr Madhukar Pai’s article Engineers are Unsung Heroes of Global Health (Forbes, June 2022), Every Breath Counts called for nominations of outstanding biomedical engineers working in low-resource healthcare systems. The response was overwhelming. We received 130 nominations from 40 countries, most in Africa. We were delighted to see 32 women nominated – a testimony to their growing numbers in what remains a very male-dominated profession. The WHO reports that just 23% of biomedical engineers are women.
Each week we will be spotlighting the work of a biomedical engineer by sharing their name, their place of work, and their home country. Where possible, we will link to more details about their work.
We are kicking off with Jonas Twizeyimana from Rwanda, a registered biomedical engineer under the Rwanda Allied Health Professions Council, currently working at the University of Global Health Equity, a new university educating the next generation of global health leaders and change makers to deliver more equitable, quality health services for all.
In addition to championing individual biomedical engineers – current and future leaders of their profession – the campaign will call on national governments, regional bodies, and international health and development agencies and their donors to take six key actions to strengthen the biomedical engineering profession, including by:
- Recognizing the vital role of biomedical engineers in all relevant national, regional, and international health policies, regulations, and standards;
- Setting national targets for the appropriate number of biomedical engineers per 10,000 population and for 50% representation of women in the profession;
- Requiring all hospitals to have in-house biomedical engineering capacity represented among senior hospital leadership;
- Requiring international donors to extend their support beyond procurement of medical devices to investments in the training and deployment of the people who are needed to keep the equipment working;
- Defining professional standards and codifying them in relevant national laws and regulations to protect the quality and integrity of the biomedical engineering profession; and
- Strengthening the professional development of biomedical engineers and national, regional, and international professional associations.
During the campaign we will be sharing examples of initiatives that advance these six actions. For example, upgrading the professional standing of biomedical engineers with a specific classification in the International Standard Classification of Occupations (ISCO) managed by the International Labour Organization would enhance action 1. National employment schemes offering paid internships for new biomedical engineering graduates would incentivize hospitals to recruit more biomedical engineers contributing to action 2. National standards that require all hospitals to have a Chief Biomedical Engineer represented among senior hospital management would advance action 3.
Increasing donor funding for the retention of biomedical engineers and for new regional training and maintenance programs, including spare parts hubs, would increase the longevity of donor-funded medical devices and ensure biomedical engineers have access to the tools they need to maintain and repair medical equipment (action 4) and meet professional standards (action 5). And properly resourcing national and regional professional associations and platforms such as the African Biomedical Engineering Consortium (ABEC), would give biomedical engineers new avenues for collaborating and aligning their efforts, and strengthening advocacy to governments (action 6).
What does success look like?
Imagine every national health system with biomedical engineers in sufficient numbers, with the right skills, properly remunerated, supported to conduct their jobs effectively, and with a career path that incentivizes them to stay working in the health system.
Help us get there! Share the names of the Every Breath Counts biomedical engineers who are making healthcare work every day and advocate for the specific initiatives that will strengthen the profession so they can contribute more to health system strengthening and pandemic preparedness and response.
 Members include Addis Ababa Institute of Technology, Cairo University, Dar es Salaam Institute of Technology, Jimma University (Ethiopia), Kenyatta University (Kenya), Kyambogo University (Uganda), Makerere University (Uganda), Malawi University of Science and Technology, Mbarara University of Science and Technology (Uganda), Muhimbili University of Health and Allied Sciences (Tanzania), Technical University of Mombasa (Kenya), Uganda Industrial Research Institute, University of Cape Town (South Africa), University of Eldoret (Kenya), University of Ibadan (Nigeria), and University of Lagos (Nigeria).
What is a biomedical engineer?
Every Breath Counts adopts the WHO definition of biomedical engineers – which encompasses medical engineers, clinical engineers, and technicians with both university-level and other forms of technical education – who optimize and promote safer, higher quality, effective, affordable, accessible, appropriate, available, and socially-acceptable technology to strengthen health systems to deliver better health outcomes for patients.
Specific roles and responsibilities include:
- Advancing health and wellness using technologies for prevention, diagnosis, treatment, rehabilitation and palliative care across all levels of healthcare delivery;
- Innovating, designing, developing, regulating, managing, assessing, installing, and maintaining such technologies for their safe and cost-effective use throughout their life cycle;
- Applying engineering principles and design concepts to medicine and biology for the pursuit of new knowledge and understanding at all biological scales;
- Designing devices, software, processes and techniques to be used in wellness and healthcare, including consumables, artificial organs and prosthesis, diagnostic and therapeutic instrumentation and related systems such as magnetic resonance imaging, and devices for automating insulin injections or controlling body functions;
- Designing, developing and managing technologies used to promote and support life quality and longevity, including assistive technologies and technologies for monitoring or rehabilitating activities of daily living; such as wheel chairs, prosthesis leg, hearing aid and personal emergency response systems;
- Designing, developing and managing technologies for focus areas such as reproductive, maternal, neonatal, and child health;
- Designing, developing and managing systems for optimal sustained health-care operations in both resource-scarce and well-resourced settings as well as during challenging events such as disasters; and
- Designing, developing and applying safety programme methodologies to mitigate risks when dealing with medical devices and procedures throughout their life cycle. Including biosafety and environmental health such as waste disposal and personal radiation protection. Health-care technologies include: health, wellness and rehabilitation products and systems, artificial biological structures, organs, and prostheses, instrumentation, software and multi-technology systems.
World Health Organization (2020), Global Strategy on Human Resources for Health: Workforce 2030.World Health Organization (2017), Human Resources for Medical Devices: The role of biomedical engineers.World Health Organization (2016), High-level Commission on Health Employment and Economic Growth: report of the expert group.