Symba: An Exploration of Appropriate Medical Device Design for the South African Context

Medical devices are essential for the successful delivery of almost every form of health care. The medical device industry is currently one of the fastest-growing and dynamic sectors of the global economy. However, the global market is heavily dominated by high-income countries (HICs) with low to middle-income countries (LMICs) constituting only 13% of the global market. As a result, up to 80% of medical devices in LMICs are donated or imported. A medical device needs to be appropriate for the context in which it is intended. Imported medical devices, which are manufactured for use in high-income countries, however, are often inappropriate and ineffective when used in low-resource settings. This results in approximately 40% of donated/imported medical devices being out of service, 70-90% never functioning as intended, and up to 98% broken within five years. The lack of appropriate medical devices in LMICs suggests the need for a shift towards a more human-centred, design-oriented medical device industry which promotes local manufacture. Like many LMICs, South Africa's local medical device industry is underdeveloped. Approximately 90-95% of medical devices in South African hospitals are imported/donated. However, in a 2014 World Health Organisation feasibility study, South Africa showed great capacity to support the local production of medical devices. Furthermore, recent success stories such as Jed Aylmer's Symba paediatric bed indicate that local designers and manufacturers can successfully compete with international suppliers of sophisticated equipment-highlighting an opportunity for increasing medical device design in South Africa. This paper presents the design process followed in the development of Symba in the form of a retrospective case study. The purpose of the paper is to share appropriate local design strategies which better enable local industrial designers to pursue more appropriate medical device design outcomes in the South African context.