Some medical innovations need to be simple and inexpensive to be truly effective. That’s why Thomas F. Burke, MD, and his Massachusetts General Hospital colleagues are taking on postpartum bleeding in the developing world with a device that consists of a length of catheter tubing, a bit of sterilized string and a condom.
Known as the Uterine Balloon Tamponade (UBT), the device is designed to halt the life-threatening bleeding that often follows childbirth. Worldwide, postpartum bleeding is the number one killer of pregnant women on earth, killing or disabling about 3.1 million women annually. Its toll is particularly devastating in poor rural areas of Africa and Asia.
The UBT was designed with such locations in mind. “We’re developing a sustainable model to deliver health care among the very poor,” says Dr. Burke, chief of the Mass General Division of Global Health and Human Rights.
Seeking Sustainable Strategies
The development of the UBT reflects Mass General’s broader effort to help medical professionals in low-income countries improve their healthcare systems using strategies that are effective, affordable and long-lasting.
Dr. Burke, an emergency physician with two decades of global experience, knows there is nothing more important than the safety of newborn babies and their mothers.
The MGH Division of Global Health and Human Rights has been in the forefront of such endeavors, says Ann Prestipino, senior vice president for Surgery, Anesthesia, Emergency Medicine and Clinical Business Development. “Emergency care is virtually unknown in the poorest parts of the world if you compare it to the very organized system we have in the United States,” she says. And Dr. Burke, an emergency physician with two decades of global experience, knows there is nothing more important than the safety of newborn babies and their mothers, she points out.
Halting Postpartum Bleeding
At Mass General recently, Dr. Burke spread out the UBT parts on a table to show how it works. Tying a string around a condom, he attached it to the catheter tube and, through it, filled the condom with water. When inserted through the vagina, into the uterus and filled, Dr. Burke says, the balloon puts pressure against the uterine wall and stops the postpartum bleeding.
Dr. Burke’s team has demonstrated the safety and effectiveness of the UBT in a groundbreaking study of more than 240 women in four countries. The study demonstrated that the device saved the lives of 98% of women whose lives were in critical danger due to postpartum hemorrhage. At the United Nations recently, the UBT was named as a top-30 high-impact innovation as part of Countdown to 2030, the United Nations program for sustainable goals.
Working out of a small hospital in rural Kenya, Dr. Burke and his colleagues are training midwives and other health workers to use the device to treat postpartum bleeding.
One midwife in Kenya described how she received the training one day and used the UBT the next day to save the life of a mother who was in danger of bleeding to death after giving birth. The UBT was left in place for 24 hours and the healthy new mother went home with her baby a day later.
For decades, outsiders with good intentions have tackled pressing healthcare issues in the developing world. “Billions, if not trillions, of dollars have been spent and there’s an enormous pileup of ideas and solutions,” Dr. Burke says. He adds, however, that the resulting improvements often disappear when donations dry up.
Harnessing the Market’s Power
Dr. Burke hopes a market-driven model for the UBT will give it staying power and ensure it becomes widely available to treat postpartum bleeding in regions with few healthcare resources. Major medical manufacturers make similar devices but they cost about $400 each and can be used only once. In contrast, the UBT can be manufactured for only $2.85 and can be used five times.
A market-driven model for the UBT will give it staying power and ensure it becomes widely available.
Dr. Burke is working to help establish small companies in Africa that will manufacture the UBT. Already one small company in Kenya is planning to employ local people to produce the device. Other companies are in the discussion stage.
The MGH Division of Global Health and Human Rights is working on several other projects to embed sustainable healthcare improvements in underserved areas. The division has built the first modern emergency department in a rural region of Kenya. It also has set up training in simple anesthesia methods for doctors and nurses who are not anesthesia professionals. Another training program educates clinicians to recognize the signs and symptoms of “human trafficking,” where people are sometimes held against their will as sex slaves or servants.
For more information about the work of the Emergency Department Division of Global Health and Human Rights and how to support it, please contact us