In developing countries, especially in rural areas or small cities, medical facilities often operate with the bare necessities. Electricity is unreliable and there is little to no access to specialized equipment like an autoclave, which is used in modern hospitals to sterilize surgical equipment between patients.
These medical facilities are critical to the communities they serve, but one-third of patients who undergo surgery in these settings end up with surgical-site infections. These infections can at best lead to a longer hospital stay and at worst lead to death. The cause is surgical equipment that hasn't been completely sterilized.
Public policy professor Douglas Schuler at Rice University and his graduate students have developed a way to bring off-grid sterilization to these areas and it's called the Sterile Box.
The station, built into a standard 20-foot steel shipping container, features everything necessary to prepare surgical instruments for safe reuse, like a water system for decontamination and a solar-powered autoclave for steam sterilization. The team has been experimenting with solar sterilization for years and first designed a solar-thermal set-up that focused sunlight and heat on the instruments, but they realized that it was limited by only being usable when the sun was shining.
They then focused on creating a self-powered, drop-in system that could be used anywhere, anytime.
“We tried to really think hard about social context,” Schuler said. “We laid out the elements to minimize human error and water and energy requirements to the extent that we can. I really like that about our design.”
The Sterile Box is made up of two rooms: the main room where the four-step sterilization takes place and a separate foyer where outsiders can receive the sterilized equipment through a special window. Two water tanks handle the water distribution and roof-top solar panels and an energy storage system provide the power. There are fans and ventilation to keep the people working inside comfortable.
In testing, the team said the system had a near perfect performance in sterilizing and preparing instruments for surgery over the course of 61 trials.
The next step is to test the system in a surgical setting. They are teaming up researchers at Baylor University who are testing their Smart Pod system, a mobile surgical unit for developing countries also housed in a shipping container. The teams will perform tests on the units in Malawi in 2017.
The team sees its Sterile Box being used beyond just surgical sites, but also to help with maternal and neonatal care, dental care and disaster relief efforts.