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Be prepared to improvise even the most basic medical equipment. In developing countries and other resource-poor settings, even some of the largest medical facilities lack equipment and materials considered standard elsewhere.1 Louis Pasteur reportedly said, “Chance favors the prepared mind.” This book supplies ideas about how to make-do when faced with shortages. Problem-solving skills will take you the rest of the way.

“When improvising medical equipment, consider whether it (a) Will accomplish the purpose for which it is intended? (b) Is practical? and (c) May cause an accident or increase danger to the patient or clinician?”2


Health care resources, whether purchased, donated, or improvised, should be matched to the skills of the practitioners and the type of facility in which they are to be used. Table 5-1 describes the spectrum of health care facilities worldwide and is the basis for the “Essentials” tables in this chapter (Table 5-2) and elsewhere in the book.

TABLE 5-1Spectrum of Health Care Facilities
TABLE 5-2WHO Basic Diagnostic/Monitoring Essentials

Given the rustic clinical facilities in resource-poor environments, basic ethical standards of privacy and even confidentiality may be compromised. Little or nothing provides privacy between adjacent patients in the clinic and other inpatient settings when they relate their medical histories or undergo physical examinations and procedures. However, with a little effort, sheets, blankets, and makeshift dividers can be used to provide some privacy.

Improvised (Safe) Medical Structures/Modification of Existing Structures

Any available site may be used to provide immediate ...

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