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South Africa: Rural Physician of the 12 months – Craig Parker – the Physician-Engineer Who Created a Covid Lifeline for Rural Areas

The Pro Garden by The Pro Garden
October 2, 2022
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Dr Craig Parker’s oxygen machine – the OxERA – saved a whole lot of lives throughout COVID-19, notably across the rural Japanese Cape. Now, the machine has earned a worldwide nod because it was listed within the World Well being Group’s 2022 Compendium beneath “progressive well being applied sciences for low useful resource settings”.

A brochure describes OxERA as an “all-in-one machine utilizing an oxygen accumulator bag, an anaesthetic masks and an adjustable mechanical peep valve (a spring-loaded valve which the affected person exhales towards) that’s cost-effective and oxygen environment friendly”. The machine requires an oxygen supply, however makes use of much less oxygen than conventional ventilators and is easier to function.

With a background spanning each mechanical engineering and medication, Parker pioneered the concept for OxERA in March 2020.

Constructing options

Training as an anaesthetist at East London’s Frere Hospital – a tertiary authorities hospital – he says, “I had been within the UK visiting my grandmother for her a centesimal birthday. The UK was then collapsing and imploding with COVID. I realised that in the event that they weren’t coping, then goodness, we have been in hassle. And I felt ventilators weren’t going to repair our downside. To have any individual ventilated, you want a ventilator. You additionally want an ICU-trained [Intensive Care Unit] nurse and house in an ICU. You want ICU-trained docs. So I got here again and I put a name out on Fb for anybody who needed to hitch me to attempt construct an answer.”

Rapidly, a gaggle assembled in East London. “I referred to as in a few of my mining buddies. We had De Beers mortgage us two engineers at one level,” says Parker. “A colleague at Frere was serving to me with a few of the ICU stuff, Dr Brendan Toy. We have been tossing concepts round, constructing prototypes, testing them. I feel it is the toughest I’ve ever labored – like 18 hours a day.”

Ultimately, their arduous work paid off, and so they had a prototype.

Within the throes of lockdown that 12 months – with as much as 50 COVID sufferers being admitted to Frere Hospital day by day – Parker and his colleagues efficiently used the machine, stopping lung collapse and saving lives.

We have been tossing concepts round, constructing prototypes, testing them. I feel it is the toughest I’ve ever labored – like 18 hours a day.

Up the coast at Madwaleni District Hospital, overlooking the Xhora river – the place oxygen needed to be ferried in by bakkie over two hours through rutted roads from Mthatha – determined docs welcomed the machine too.

“It was difficult,” says Parker. “The machine was nonetheless a prototype we have been testing, however healthcare employees have been determined and discovering them helpful and so they have been saving lives. So we have been simply making them and donating them to those that requested.”

Their most enjoyable suggestions was from Zimbabwe.

“Zimbabwe in comparison with South Africa was a lot worse,” says Parker. “Actually, when you have been something past mildly unwell there, it was a dying sentence. That they had no hope of huge bulk oxygen provides that might assist high-flow nasal oxygen options. They did not have gear or the talents to ventilate sufferers. And they also used OxERA gadgets so much, by way of an NGO there referred to as Kufema… “

Every day realities

Wearing docs’ scrubs, Parker makes huge gestures along with his palms whereas placing his factors throughout. He’s chatting with Highlight after a protracted day administering anaesthesia at Frere Hospital. One affected person, a 78-year-old girl, didn’t reply properly to the anaesthetic for her hip-replacement surgical procedure and needed to be resuscitated.

“So many sufferers needing hip replacements are aged sufferers who fall and break a hip,” says Parker. “So that they’re often fairly sick and frail. , they do not tolerate an anaesthetic very properly. You want a superb, wholesome coronary heart to deal with a spinal anaesthetic properly. One in all my girls as we speak, a 78-year-old, fairly a frail outdated girl; I imply, at one level she, , we needed to resuscitate her. It is fairly tense. I imply, she is any individual’s granny, and she or he’s a candy outdated girl who needs to hopefully make it by way of the operation. We managed to kind her out, however ja it was a little bit of a scramble.”

Born in Harare in Zimbabwe, Parker’s father died within the Zimbabwean civil battle in 1974, when Parker was two years outdated. “My father was a trainer at a technikon however he’d skilled as a discipline medic, as a paramedic for the military,” says Parker. “He was killed in a medical evacuation. At evening, the airplane crashed on takeoff and my dad and the affected person they have been transporting and the pilots have been all killed.”

In 1981, Parker’s mom moved to South Africa, the place she took a job as a laboratory technician on the College of KwaZulu-Natal [UKZN] in Pietermaritzburg.

In 1993, Parker accomplished a BSc in Mechanical Engineering at UKZN, after which he labored in mines in South Africa and Zambia. For some time, Parker, his spouse Catherine, a nurse, and their two kids lived within the Zambian Copperbelt city of Chingola. His distaste for what he describes because the “wealthy getting richer” ethos of mining began to put on him down.

A ‘midlife disaster’ and a Leatherman

In 2011, aged 39, a “midlife disaster” noticed Parker rethink his profession. The next 12 months, he enrolled in medical college on the College of the Witwatersrand.

“So there was a number of soul looking,” he says. “I learn slightly e-book referred to as The Dream Giver, which speaks concerning the dream that God places in your coronary heart. And I stated properly, Lord, I am the one you forgot. I am the one you overlooked! And over a couple of week of wrestling with this, medication dropped into my coronary heart and the minute it did, it simply felt so proper.”

Virtually, he says this felt “ridiculously unattainable” – financially and time-wise. However along with his spouse Catherine’s assist, he made adjustments.

“We needed to save like mad, promote the automobiles and purchase little runaround automobiles,” he remembers. “There have been just a few miracles by way of getting accepted at college – properly, first getting rejected, then accepted – white knuckle stuff in direction of the top. I used to be solely in a position to graduate as a result of the medical college really paid my charges. All the things was maxed out. I would offered my home, however I hadn’t been paid but. After I graduated, the certificates nonetheless stated ‘Diploma, not awarded: charges excellent’. , it had been printed earlier than they settled the charges.”

A two-year internship at Frere Hospital adopted. Then a 12 months of neighborhood service at Victoria Hospital in Alice, within the rural Japanese Cape, the place Parker “used [his] Leatherman to make things better as a lot as his stethoscope”. Again at Frere Hospital, he labored in paediatric surgical procedure after which in anaesthetics.

There have been just a few miracles by way of getting accepted at college – properly, first getting rejected, then accepted – white knuckle stuff in direction of the top.

Ubuntu within the Japanese Cape

On healthcare challenges within the Japanese Cape, he says, “So it is a very difficult province as a result of it is a province that for thus lengthy was uncared for, for many years actually. After which as soon as democracy got here, it form of continued alongside that pattern. The place politicians appeared to be voted in simply because they have been within the favorite get together, however nobody’s being held to account. And so we prime the lists of poverty, of all the things adverse actually. It is fairly troublesome to reinvent that.”

He factors out the galvanising impact of catastrophe. “However one factor is, it is fairly a homogenous province. So it is primarily isiXhosa-speaking individuals and there is a nice sense of unity. [And] amongst that catastrophe and disaster, a way of we’re all in it collectively. And I feel that actually shone by way of when you consider COVID. I assume ubuntu might be stronger within the Japanese Cape than wherever else. There have been some individuals, the darker it bought, the brighter these stars shine.”

Democratising healthcare know-how

In December 2020, SAHPRA [the South African Health Products Regulatory Authority] authorized the OxERA machine for emergency use. It’s being manufactured and distributed by Gabler Medical in Cape City, by way of a “social enterprise mannequin” firm referred to as Umoya, which sees all revenue ploughed again into the undertaking.

Parker says they need to set a precedent in democratising healthcare know-how. “So our authentic plan was to create a design that was open-source in order that anybody may [3D] print their very own unit. However that is not how the medical machine world works. We realised that there’s regulation for a purpose. So we arrange and registered an organization referred to as Umoya, a social enterprise. Now, this isn’t one thing that’s well-known in South Africa but. What it means is that your corporation will not be arrange for a standard capitalist goal, however a social goal.

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“Normally, corporations exist to create shareholder worth. [With] our product, the income go straight again into the corporate. We predict this can be a new, sustainable mannequin for medical gadgets within the growing world due to the massively rising hole between fancy new stuff that is revolutionising healthcare, however which is totally out of attain for almost all of people that want it.”

Dr Parker’s management, data, and understanding of engineering, medical, and social fields was instrumental within the growth of the OxERA product – Rudasa

‘Rural Physician of the 12 months’

Earlier this month on the Rural Well being Convention in Oudtshoorn, Parker acquired the Rural Physician of the 12 months Award for 2022, a title bestowed yearly by RuDASA [the Rural Doctors Association of Southern Africa].

RuDASA stated in an announcement: “Dr Parker’s management, data, and understanding of engineering, medical, and social fields was instrumental within the growth of the OxERA product. He continues to offer management at Umoya, as they’ve been requested to help with various different improvements to enhance healthcare, particularly in resource-constrained environments.”

Through the interview, Parker’s sentences have a self-deprecating bent. “Maybe I’m a median engineer, and a median physician,” he says. “However this mixture of expertise is kind of distinctive, and so they have been massively helpful throughout COVID.”

For extra element on the machine, see this video on the Discovery web site.



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