COVID-19, a blessing in disguise: the experience of a Nigerian radiotherapy engineer

The health technology sector of low- and middle-income countries (LMICs) is bedeviled by performance failures that make it a significant obstacle to effective patient healthcare interventions. The predominant factors behind the sector’s poor performance have been identified as (a) inadequately trained technical personnel and (b) the unserviceable condition of medical equipment. Past studies show that after adequate training, there is an increase in the proficiency of in-hospital biomedical engineers, but the studies have been limited to the maintenance job description of the engineers. We present a case study of the successful installation of sophisticated medical equipment by an in-hospital engineer to demonstrate that comprehensive training can also develop the installation expertise of local engineers. The installation, which is usually accomplished by the equipment manufacturer, was delegated to the trained in-hospital engineer due to the COVID-19 pandemic. Furthermore, the bulk of medical equipment in LMICs is imported, which has led to an over-dependence of their health sectors on non-indigenous technology to the detriment of local alternatives and know-how. The World Health Organization estimates that 7 out of 10 sophisticated medical equipment imported by LMICs are unserviceable due to the issue of compatibility and adaptability with the setting. Previous research focuses on equipment subsidy, frugal innovation, and health technology management to better adapt foreign equipment to the environment. Still, this paper explores the option of indigenous technology and expertise to provide in-country development of suitable and sustainable medical equipment.