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Cécile Denayrouse and Bertrand Beauté
Pristem: bringing radiology to the global south
Authors: Cécile Denayrouse and Bertrand Beauté, firstname.lastname@example.org or email@example.com
According to WHO, two thirds of the global population do not have access to diagnostic imaging. A start-up from Lausanne, Switzerland, is looking to change this thanks to their new device, designed specifically for developing countries.
What do a traffic accident, pneumonia and a leg fracture all have in common? These afflictions all require the use of a medical imaging device for a doctor to properly diagnose you. This can be quickly and easily done if you’re living somewhere like Switzerland, but it’s a very different story for anyone living on the African continent. “Two thirds of the global population still don’t have access to this technology, which is incredible considering that the X-ray was first invented more than a century ago,” explains Bertrand Klaiber, the founder of Pristem.
To address this global health problem, this Lausanne-based entrepreneur wants to bring a robust and inexpensive X-ray machine to emerging markets. But what’s so different between his idea and the models already being used in African and Asian hospitals today? The key lies in the design, which has been tailored to the different conditions and constraints found in these hospitals. And that changes everything.
“In most countries of the global south, hospitals are facing a shortage of resources, sudden and frequent power cuts, flooding due to torrential rain, bombardments of dust and wind, and the heat – they’re nothing like the aseptic and air-conditioned hospitals that we know and use. In these conditions, the machinery that’s designed and manufactured in and for the global north quickly breaks down. And since there are no spare parts or maintenance personnel in place, these appliances quickly become unusable,” Klaiber continues. In sub-Saharan Africa up to 70% of the medical equipment currently in place is non-operational.
In designing a machine that can work in these conditions, Pristem was starting from scratch. “We asked our future users in Africa, who know what the conditions are like, to explain their needs to us – which we then fully integrated into the development process,” says Klaus Schonenberger, cofounder and chairman of Pristem’s board of directors. Under the direction of the EssentialTech programme of the Centre for Cooperation and Development at the Swiss Federal Institute of Technology in Lausanne (EPFL), a team of 35 researchers and engineers - notably sourced from the University of Applied Sciences of Western Switzerland (HES-SO), the Paul Scherrer Institute and the Lausanne University Hospital (CHUV) - developed a prototype.
The result of their hard work comes in the form of the GlobalDiagnostiX X-ray machine – which is designed to withstand temperatures of up to 45°C and 98% humidity levels, as well as high quantities of dust. The electric motors used in industrialised countries to make the arms move have been replaced by a mechanical system, while digital technology has taken the place of radiological films in order to cut back on costs. In the event of a power cut, a specially designed generator will allow the radiology machine to operate independently for a few hours.
“The medical equipment industry has always focused on innovation, but in Africa the priority lies in meeting basic needs. A patient at the Yaoundé hospital in Cameroon doesn’t need the latest technology. Before any of that, they just need equipment that works. This is what we’re offering, and this requires a certain amount of invention to provide high-quality images in a reliable and sustainable manner,” states Bertrand Klaiber.
Pristem is also showing originality through its inclusive contracts. “We believe there is a real market for this type of machinery,” says Klaus Schonenberger, “but offering lower purchasing prices and a higher level of resistance to the elements isn’t enough. We also need to ensure that they will be maintained.” With costs at around 10% of the purchase price per year, maintenance for medical equipment can prove expensive in the long run. “Governments often buy or receive these machines, which are manufactured in Europe or in the United States, without thinking to budget for the on-going maintenance costs, or without hiring personnel to take care of them. However, our model includes a six-year warranty, which is unique in this field. Where there’s an Internet connection, it will be possible to monitor the state of our devices remotely, and offer support to local personnel to help them conduct preventive maintenance checks. The Internet will also enable remote radiology services to be carried out using out technology, which could prove vital in areas that severely lack medical specialists.”
In terms of hard numbers, Bertrand Klaiber’s growing project plans to create nearly 400 jobs in Africa alone, as well as 25 jobs in Switzerland. “The issue is not only economic, it’s also ideological. I left my job in marketing because I needed to regain meaning. Today I have the satisfaction of being able to tell myself that my work is serving a purpose. Of course, we are not pretending to create a machine for Africa without including Africa. This is why we’ve forged a close connection with a hospital centre in Cameroon, so we aren’t forgetting any crucial elements.”
The project has potential benefits lined up for local populations and governments as well as for hospitals. Both African and Swiss investors have already jumped on the Pristem ship. The start-up needs 10 million to put its product on the market – and is currently halfway towards meeting this target.
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