Mobile Medical Clinic | Dump Light

After working with Aaron Brown and Caroline McDonald on the beginning stages of our mobile medical unit, I broke off and started a new analysis of program and needs of a Haitian mobile medical clinic moving around Haiti.

I found that we had already addressed several important issues; however, I decided to make a few changes.

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I created a smaller version of our original ‘Dump Truck’ design, one that could be more applicable and in use in a more common way. The size made it more accommodating for any regular size bed of a pick up truck. It was meant to be (mostly) of a steel material, and once planted onto a site, it was designed to unfold into a multi space unit.

Because Haiti’s medical experience is several years behind the United States and our techniques and processes, I had to take numerous things into consideration. There, the pharmacy is meant to be separate from the actual medical examination process. I took this into account by allowing the actual original unit to become the secured pharmacy one arrival, helping to separate the check in/waiting area from the examination area.

 

Since this specific design is reliant on a vehicle, I provided an option for non-truck use, which would include using the main shelf wall located within the actual unit. The wall would actually be composed of backpacks with drawers and shelves, meant to remain on the wall, but with the possibility of pulling out and being carried on individual’s backs.

One of the main critiques I have come across with existing mobile clinics around Haiti is that most of them are designed to last a day, and there are well over double the amount of people that actually need to be seen. With this, the overall unit is meant to act as a multiday clinic, stocked with supplies to last for 4-5 days. Personal supplies for the workers and people visiting the clinic will be stored inside the unit and pulled out and used when needed (cots, benches, chairs, work surfaces). 

detachApack: A Versatile Medical Clinic System

Duffel Bag and Frame/Lounge components of detachApack

DetachApack is a system designed to allow medical personnel to reach their set destination whether it be across difficult terrain, deep rivers, or other obstacles. These packs allow clinics to set up at the furthest of villages even when trucks cannot drive there. If the backpacks are stored on the trucks, then at any point when driving becomes too difficult, each team member can grab a backpack and they can finish the remainder of the distance on foot.

Zip-off detachable ends and compartments for organization of supplies

Each backpack consists of a pack frame and a duffel bag. The pack frame is multifunctional. Not only is it used to add comfort and help support the pack while hiking, but it also converts into a lounge for the patients to lie on while being examined, a chair for the medical staff, and even a stretcher in case of a critical needs patient. The duffel bag consists of three color coded pieces. The charcoal pieces on the end can be zipped off and used in the exam areas by the doctors and nurses. The blue center piece is then used in the pharmacy area. All pieces have organizational dividers so that all supplies are kept in place throughout the hike and are easy to find once at the clinic destination.

Frame/Lounge can also be used as a stretcher in the event of an emergency

The final review was a very helpful critique. We discussed the ways in which the packs could be filled with the exact same supplies or labeled when they differ. I think that it would be most beneficial if each backpack’s medical (charcoal-colored) bags were the same and each pack’s pharmaceutical (blue-colored) bag were different. Each packs medical compartments need to be the same so that each doctor and nurse can have every supply they need at hand and not go search around for supplies in others’ bags. Each pharmaceutical bag needs to be different, perhaps a different category of medication. Therefore when setting up the pharmacy area, the bags can be arranged in a helpful order by prescription type.

PDF of detachApack presentation

The Kabwet Clinic

The Kabwet Clinic helps to both bring medical aid to Haitians in need that may not otherwise be able to travel to or afford a visit to a hospital.  It combines modular, secure storage units with a durable, versatile cart to bring supplies and opportunities to the more remote, rural settings of Haiti.  The cart was designed to travel over most terrains, to be easily repaired with the replacement of readily available parts (i.e. used car tires, scrap wood/metal), and to transform from a vehicle to a work surface.  

Transformation of Cart into Table

 The cart would be stocked and distributed from hospitals around the country.  They can be loaded onto a truck, towed by motor vehicle, donkey, or pushed by person.  This style of pushed cart is often used in Haiti, but with more found materials and handmade construction.  This cart could be manufactured in the US, but the use of simple construction techniques would allow for more carts to be built in Haiti with whatever material is available.  

Cart functioning as a work surface

The storage containers were designed for multi-functionality in that they are water-tight containers, can be used for seating or work surfaces, and include a detachable connection that allows for the use of other found containers with the entire unit.  A critique given about the containers was that they would initially have to be fabricated in the US, an unlikely and difficult solution to the problem at hand.  With the design of a specific connection detail, however, virtually any container could be used in this mobile clinic system.  

Connection Detail

One of the features of the Kabwet Clinic is the break-away medical kit.  In a response to an emergency, it would be used, once the cart had arrived to a village and set up camp, to venture into the more remote locations to address any problems found.  The break-away kit would also be used to travel to rural homes and help educate citizens on proper first aid.  One of the most frequent causes of serious injury or infection is the mistreatment or neglect to care for minor injuries when they first happen.  The break-away kit includes graphic directions to address the language barrier, and to help educated Haitians on proper first aid techniques.  

The Break-Away Kit

Update on Sunday, February 17, 2013 at 3:20PM by Mitzi Coker

I really like the design of the Kabwet Clinic.  The efficient use of space and the carts ability to be transformed into an examination table is a great idea.  The over-all design is pleasing, compact, and well thought out.  I think your thoughts on having the containers (baskets) woven by locals is a really good idea.  Everything that can be manufactured locally is great for the economy and also less expensive due to shipping costs and transportation issues.  Just curious...How did you come up with the name of the clinic?  Did it have to do with the tires you used on the cart?

Mitzi Coker

EMRM

This unit and shelving system was a modification of the Rolling On Haiti group early designs. 

complete packaged unit with polyurethane bag for protection and water storage.

The EMRM (Emergency Medical Response Module) is for emergency applications and rapid relief.  It does not contain enough supplies for an extended period of time, but enough for immediate relief in the wake of a disaster.  The module can be scaled up or down (in other words, it can have more or fewer shelving units) depending on the scale and amount of transportation available.  The unit consists of three components:  a tent, shelving unit (or units), and pack (or packs).  All components are modified of existing products.  After the initial group design, the shelving system was given a few more modifications that include:  transparent fold-down covers for the shelves, a more rugged shell, and watertight gasket (precedent:  Otterbox dry cases).  The packs were then specified to carry extra medical supplies and the tent itself.  Finally the tent was a more intensive design to approximate the packed weight and size for a doctor or nurse to carry in a pack.  The precedent for the tent was the Kelty Parthenon 8 (http://www.kelty.com/p-358-parthenon-8.aspx), a lightweight, tall car camping tent weighing only 27 pounds packed.  With the 143 square footage existing, once modified (width narrowed, length extended, peak height increased), the packed weight at 200 square feet (with a peak height of 7 feet) was estimated to be about 45 pounds.  The fabric of the tent was specified to be primarily mesh to accommodate ventilation while keeping bugs and dust at bay.  A rainfly could be placed over the top of the entire unit or one compartment to protect from the rain, protect patients during surgery, or add privacy if needed or desired.  The rainfly was specified to be a light color (with a printed logo) so that diffuse light would accommodate surgery and examinations.  Assembly of the tent would be dependent on how familiar the doctors and nurses are with the system, but could take between 20 minutes and 1 hour.             

elevations for the tent.  dotted lines are netting (the majority of the tent without rainfly is nylon netting).

Critique:  the individual components of this unit were designed, but not integrated with each other as fully as possible.  The tent was more developed while the system as a whole was slightly incomplete—a complete set-up image was needed.  Because of its modularity, the unit can be seen as a scale-able system, dependent on the size of the disaster and availability of transportation.  The tent is the main shelter portion that all components are housed within, in the configuration needed for the emergency, number of patients, and number of doctors and nurses.  Because of the lack of the complete integration drawing, the different uses (surgery, rain condition, examination, clinic, etc.) were not as evident as it could have been.  The final critique was the reality of doctors and nurses being able to carry a 40+ pound pack while carrying the shelving system.  In retrospect, a different system could be used in which either the supply packs were eliminated and the unit consisted of just the shelving system and the tent pack.  This would be faster travel, more compact, and give the possibility to add a lightweight folding cot or stretcher that could be more reasonable to carry than a heavy supply pack. 

completely opened shelving unit.  legs for stability (precedent aluminum cot poles hold 300 lbs).

Presentation version found here:  https://docs.google.com/folder/d/0B3vupU0SSB_Ma2FwMXFLYVRYb2c/edit?usp=sharing

U-haul-spital Mobile Clinic

U-haul-spital in use with material call-outs. My design partner (Tiffiny Hall) and I created the U-haul-spital, an Emergency Medical Response Unit (EMRU) based off a small, off-road trailer that housed enough supplies to serve a community in need for an average of 5 days.  As a team, we concentrated on the technical aspects and functionality of the unit, to insure the unit would accomplish its task; this included material and construction research and supplies organization

Tiffiny and I learned that research is the key to creating a successful project.  Through our research, we found new materials, construction methods, and possibilities that helped us in designing the EMRU.  Durability and mobility were major concerns as this unit is to be reused and will need to travel over any terrain; therefore, an engineered plastic trailer is to be attached to the aluminum alloy frame.  The storage carts and tents are a modular system allowing for a maximum of adjustability.  The reviewers—made from a group of design and medical professionals—believed that this aspect of the design was agreeable to the needs of Haitian and foreign medical practitioners alike.

Distribution of EMRUs throughout HaitiDuring the critique the main issue was the logistics of dispersing, securing, and transporting the trailers.  As a team, we spent a lot of time researching Haiti’s need for medical care in relation to the population density.  As a pre-disaster unit, it is also meant to be used as a mobile clinic; additionally, the EMRU were to be housed at airports for ease of restocking supplies and initial transport.  However, this prompts the question: Who funds, owns, and operates the units?

As a next step to the design process, we would need to look even more at the cultural aspects of post earthquake Haiti to answer the issues that were discussed in the critique.  The logistics of ownership would need to be fully worked out to insure the success of the units in Haiti.  

 Interior Perspective: Practitioner's View Final Presentation Board