I guess it can no longer come as a surprise that I have learned far more from continuing my tech surveys than I expected. In the past couple weeks I’ve spent more time talking to clinicians, which has given me different insight than I have gotten from the nurses. Generally the nurses were helpful in figuring out the logistics of using a device at Queens, while the doctors I’ve talked to have illustrated what potential exists for a device to make a difference.

I had a particularly helpful conversation with one of the visiting physicians from the UK who was working in the nurseries and children’s wards. She had a lot of good feedback for all of the devices, but the thermometers in particular. She said that apart from the simple idea of detecting a fever, the thermometers have a lot more to contribute that may be slightly more subtle. A thermometer given to a mother isn’t just a signal of a fever, but also proof to a doctor or nurse that the mother was paying attention. She could give more specifics as to the child’s symptoms, feel confident in her decision to bring the child in, and have a way to keep an eye on whether or not their condition was improving. If she didn’t know before exactly what a fever was, the responsibility of a thermometer would serve as a platform for mother’s education on health in general. In short, as the doctor put it, the thermometers had potential to be empowerment for mothers. Empowerment as such could easily be as important as any technological advancements available.

This conversation tied well into a book I’ve been reading that speaks some about medical interventions in third world countries. Intervention is not a one-step process where we can bring equipment or medication and leave. Awareness and education is key to making any help sustainable in a new environment. Follow-up and continued assistance is necessary to ensure that whatever investments in time or money were made were used to their worth. In the 2000’s when the US and other nations made a large push to deliver antiretrovirals to developing countries, they were not just healing the sick. They were stimulating economic development because fewer resources were being put towards healthcare and more people were able to participate in the economy. They were bringing education about AIDS, but also about healthcare in general, about safe sex, and even about rape (in many African countries, it was commonly believed that the cure for an STD was intercourse with a virgin). I don’t want to argue that the AIDS intervention didn’t have it’s problems and setbacks, only that each change made to global healthcare has ramifications that extend past the goal of the change.

This is also relevant to the feedback I’ve received from the tech surveys about the importance of the nurses’ and clinicians’ attitudes for a new device to be successful. A device like the Chemoseal or Biliquant may have a lot of potential and Queens may have the resources to implement it but if the nurses aren’t in favor of using it in the nurseries or oncology wards it’s no use. The way we present each device is very sensitive; in my surveys I always try to emphasize that the goal of my program is to make the job of the healthcare provider easier by giving them the tools they need. When a device is misunderstood, it won’t be put to use. If it is presented as a lot of work to use or difficult to comprehend, it is less likely that the nurses and doctors will feel positive towards it.

I’m only here for a matter of days more; the people that work in the hospital year round are the ones to whom the responsibility of implementing a technology falls. Without the support of the healthcare workers, a device is next to useless in a setting so far from where it was developed. Sustainability of any intervention is in the hands of the people who will be there when the intervenors have disappeared.