A 3D printed stethoscope

In al-Shifa, the largest hospital in Gaza, there are only two stethoscopes in each department. Most doctors diagnose patients by putting an ear to a chest and listening the old-fashioned way.

“That would be the best-case scenario,” said Dr. Tarek Loubani, a Canadian doctor working in Gaza. “If someone’s full of blood, most doctors aren’t going to put their ears to the chest. So, doctors are making decisions without that piece of information.”

That’s a scary prospect, but stethoscopes and other pieces of medical equipment are scarce in Gaza. Thanks to a decade-long Israeli-Egyptian blockade, many medical devices are banned from entering Gaza without special consideration because of Israel’s dual-use concerns, meaning that there are concerns such items could be used for military purposes. There’s also the issue of cost. A stethoscope can cost as much as $300, which is about what a doctor in Gaza makes in a month.

If only there were a cheap alternative that could be manufactured right in Gaza – and thanks to Dr. Loubani, there is. A couple of years ago, he began working with the Glia Project, which aims to give doctors a way of manufacturing their own inexpensive medical equipment. Dr. Loubani designed and 3D printed a stethoscope that cost under a dollar but worked just as well as a more expensive standard model. He was moved to begin designing and 3D printing medical equipment after spending some time working in al-Shifa’s emergency room and seeing the frightening lack of basic medical supplies.

Mohammed Abu Matar

“During one of the wars in 2012, it became really obvious that you can’t provide proper care to patients with the equipment that’s available here,” he said.

For a while, he brought books and supplies with him whenever he came to Gaza as a visiting doctor, but that proved to be an unreliable method of aid.

“I can no longer travel through Egypt, because I was in jail there. On my way into Israel, they searched me,” he explained. “Even very simple medical equipment isn’t allowed in…With huge disruption in trade routes, it became obvious that we have to start making things in Gaza if we’re ever to be able to have a reliable supply of medical equipment.”

The problem was that 3D printers were also banned from entering Gaza due to dual-use concerns, so Dr. Loubani and his colleague, Mohammed Abu Matar, had to build one from scratch. Abu Matar had been building his own devices, including negative ion and ozone generators, for years, but he always ran into the issue of missing parts that were unavailable in Gaza. So he cobbled together some parts and built a 3D printer from open-source designs online. It wasn’t easy; 3D printer filament is too expensive to import, so Abu Matar made his own from plastic pellets and a filament extruder he built himself.

Once he had a working 3D printer, he could 3D print the parts for additional printers, and Abu Matar now runs Tashkeel 3D, Gaza’s first 3D printing business. He has been working with Dr. Loubani and two other colleagues to manufacture the 3D printed stethoscopes, which have been tested and approved and, according to al-Shifa personnel, work very well. Now clinical testing is underway for a 3D printed tourniquet and pulse oximeter, which shows how much oxygen is circulating in the body. Currently, there are only three pulse oximeters for 20 patients at al-Shifa, meaning that doctors often have to assess patients’ oxygen levels by looking at how blue their skin is.

MRIs and CT scanners are also considered dual-use and restricted from entering the Gaza Strip, so al-Shifa only has a few of them, and they operate for 24 hours at a time instead of the recommended 8 due to the large number of patients. Such heavy use means that there is an increased risk of the machines breaking down, and spare parts are unavailable. According to a World Health Organization report, almost half of Gaza’s medical equipment is outdated and the average wait for spare parts is about six months.

Shaker Shaheen, left, and Mahmoud Alalawi work on a 3D printer

“What’s happening here in Gaza is a real catastrophe,” said Ayman al-Sahabani, head of al-Shifa’s emergency department. “It’s difficult to speak about this all the time because it’s very painful for us. It’s very painful to speak about our patients, about the suffering, about our medical staff.”

That pain leads to determination, however, and Dr. Loubani, Abu Matar and their team are determined indeed. In addition to 3D printing medical equipment, they are doing their best to spread knowledge about 3D printing to as many people in Gaza as possible. They have taught a course in assembling 3D printers at the Khan Younis College of Science and Technology and are planning to introduce 3D printing into K-12 curriculum.

“You have a very special problem in Gaza; a rocket could come through this window and this place is gone. If that happens, what’s supposed to happen with this work?” Dr. Loubani asked. “So really, you need more than one place [that knows how to 3D print] in a place like Gaza, to know you can keep the culture going. We think that four, five places would be enough to keep [the culture] going no matter what happens here, so that if we all get killed in the next war, there’s two or three more places that can keep going.”

Discuss in the Gaza Strip forum at 3DPB.com.

(L to R) Shaker Shaheen, Mahmoud Alalawi, Tarek Loubani and Mohammed Abu Matar

[Source: Al Jazeera / Images: Mersiha Gadzo/Al Jazeera]

 

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