In many low-income regions of the world, there is insufficient trained clinical capacity to meet the needs of rural hospitals and clinics.
Traditional teaching methods take a long time and require access to patients, with a risk of pain and injury from untrained clinicians.
The emergence of medical simulation equipment has transformed the potential to enable junior  doctors, dentists, nurses, anesthetists and paramedics to practice skills on a simulated patient and gain feedback before they encounter live patients.
Simulation equipment includes human mannequins (adult, child and neonates) with the potential for them to be programmed to exhibit certain medical and physiological conditions such as fever. Such equipment is at the high-fidelity end, but more basic low fidelity devices are also available for basic training, depending on the needs and capabilities of both trainers and students.
Similarly, the medical equipment used in procedures is also available as simulation to exhibit monitoring traces, imaging results and other facets that help in the triage and decision -making process of trainees.
Finally, even the working environment can be simulated to create the lighting, temperature and other facets for the environment in which the trainees might eventually be working.
EN-Projects works with a range of suppliers offering a range of fidelity of equipment and has deployed in settings across Africa.

In many parts of the world, despite investment in district hospitals, the conditions of the roads and access to transport means that many patients cannot access adequate care facilities. This includes populations around river deltas where road access would take much longer, or in rural areas where the state of the roads means that vulnerable patients, pregnant mothers and others would struggle to travel.

In the early stages, towed clinic units were being used for outreach and often included mobile surgical facilities, but these suffered on hard roads leading to equipment breakage and damage to the mobile units.

The next generation include smaller mobile clinics in rickshaw or double-buggy units that are much better suited to the terrain and enable clinicians to reach rural village populations. They can also exploit solar power to remain operational even if there are grid outages, and there have been instances when a mobile unit keeps running even whilst the main hospital suffers a blackout.

In the same way, there are now pontoon-based solutions that can be tugged along river deltas to reach hard to access communities.

Typically, in this kind of outreach model, the clinics are being used for consultation and triage and to provide basic medication. For more complex treatment, patients can be referred to the nearest specialist center, but with the confidence that the initial triage has been conducted by a health specialist.

EN-Projects has worked on mobile units for dental, paediatric and maternity services in Africa, and is working with innovative partners.

At the start of 2020, the COVID-19 pandemic started a series of impacts that has had a profound impact on the global healthcare industry.

At an operational level, it exposed gaps in service delivery in hospitals in Africa and Asia requiring new investment in PPE, Oxygen Concentrators and Oxygen Plants as the numbers of respiratory patients grew rapidly. For countries with insufficient clinical capacity, it has also revealed the extent to which the focus needed to shift to training the next generation of doctors, nurses, anesthetists and paramedics.

Secondly, there was a gradual impact on supply chains. The growing shortage of shipping containers has resulted in delays and spiraling costs for shipping medical equipment.

An unforeseen consequence was the shortage of semiconductors that so much of the more complex medical equipment relies upon. This resulted in longer lead times for equipment and greater uncertainty as to when equipment, spare parts and consumables would be available.

For EN-Projects, it meant that when planning to equip new hospitals and clinics, we have had to be more aware in real-time of the impact of delays, shortages and timelines for maintenance.

Finally, for all of us, COVID-19 waves and variants have resulted in workforce shortages. We have all had to work with limited capacity and accept the impact on our clients and partners.

As we look to what the world looks like beyond the pandemic, we know that until key staff and vulnerable patients in all regions are vaccinated, the rest of the world cannot progress beyond the pandemic.