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FREO2 - Helping Children Breathe

Foster sustainable local businesses that provide life-saving medical oxygen to rural community health centres.

Photo of Roger Rassool
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Explain your project idea (2,000 characters)

Pneumonia is the biggest killer of children globally, and accounts for more than 900,000 deaths each year or 15% of all under-5 deaths. More deaths happen at home and in small health facilities than in bigger hospitals. Oxygen is a life-saving medicine, effective in every form of pneumonia, whether caused by bacteria, viruses or other microbes. But current supplies aren’t adequate in low- and middle-income countries (LMICs). By engaging with local communities and experts we have developed a thorough understanding of the oxygen problem and created appropriate and affordable technologies for use in LMICs. The next step is to create a sustainable model to distribute and maintain these systems. Health workers are busy people with specific training, and are rarely able to take up the maintenance and repair challenge. Biomedical engineers are almost never seen outside major hospitals. Training local experts often results in them leaving the community and using their new skills to seek employment elsewhere. This leaves a skill gap in all but the major health facilities and so, the world is littered with donated equipment which has been discarded due to repairable, minor issues. We believe that these losses of talent can be avoided by creating markets where those trained can proposer and grow their own entity. Our vision is to support local entrepreneurs to provide around 10-15 health centres with a guaranteed supply of medical oxygen. We will support these new businesses with access to our IP, equipment and training which they can use to maintain and repair oxygen equipment. We have already demonstrated in Uganda that a young plumber or electrician has the sufficient skills to maintain an oxygen system. To deliver high quality medical care, health workers need support – our vision of financially sustainable businesses providing this support throughout rural communities will reduce costs, improve care, and empower not only entrepreneurs but entire communities.

Who are the beneficiaries? (1,000 characters)

Our proposal will increase the prosperity of entrepreneurs, health workers and communities receiving the improved health care. The majority of children suffering from pneumonia will not reach a large hospital but seek treatment in smaller front-line health facilities. Most of these facilities do not have medical oxygen. The families will rarely have access to or funds for transport to a major city with a larger hospital. By providing the local health centre with oxygen, and the medical staff with training in the use of oxygen, unnecessary death of young children will be avoided. And so, the primary beneficiaries of our proposal will be families with young children under 5, the group with the highest mortality.

How is your idea unique? (1,000 characters)

In most LMICs, the conventional method of supply of medical oxygen is a pressurised oxygen cylinder. However, these come with many disadvantages with high cost, logistical problems with delivery, and leakage. An effective alternative is to create the oxygen locally in the clinic when and where it is needed. Other groups have proposed the use of small domestic oxygen concentrators, but have also witnessed very poor long-term performance in the field. Our idea has two unique advanatages: 1) by carefully studying the failure modes of other devices in the field, we have developed affordable and appropriate technical solutions, which dramatically increased the lifetime performance of oxygen concentrators in the field. 2) we propose a unit exchange program as the service model for the support businesses, where faulty units are immediately swapped with refurbished ones. This allows minimal down time for health facilities and the ability to share tools and resources at a central local.

Idea Proposal Stage (choose one)

  • Early Adoption: I have completed a pilot and analyzed the impact of that pilot on the intended users of the idea. I have begun to expand the pilot for early adoption.

Tell us more about your organization/company (1 sentence and website URL) FREO2 Foundation Australia is a not-for-profit organisation based in Melbourne, Australia whose purpose is to reduce the number of deaths of babies and children from hypoxia and improve the treatment of mothers, babies and children suffering hypoxia in remote health centres in low- and middle-income countries.

Expertise in sector

  • 3-5 years

Organization Filing Status

  • Yes, we are a registered non-profit.

In 3-4 sentences, tell us the inspiration or story that encouraged you to start this project.

It was a chance meeting of individuals from very divergent backgrounds that led to the formation of FREO2. Our physicists had worked extensively on high-energy particle experiments at the Large Hadron Collider at CERN in Switzerland and our global health expert had spent much of his early career in Mozambique. This meeting drew our attention to the plight of childhood pneumonia and the need for oxygen. We decided then and there to change career paths and establish the FREO2 Foundation.

Please explain how your selected topic areas are influenced, in the local context of your project (1,000 characters).

The prosperity of the communities which we work with have been adversely affected by limited access to basic social services like education and health. This is further complicated by unemployment. Uganda has a large young population (30%). Despite the numerical strength of the youth, they continue to lead marginal lives. It is claimed by some that they lack useful skills for better life. We disagree. The young people we have worked with are as creative as our western colleagues, in many case more so. What is lacking is opportunity and support. In resource-poor settings decision-makers find it difficult to justify expenses for new preventive health-care interventions. Out-of-pocket expenditures pose a barrier to access to health care for poor populations. Our proposal will see established local enterprises which will provide small health centres with affordable oxygen. Families will be able to secure treatment within their own community and avoid the costly journey to a larger city.

Who will work alongside your organization in the project idea? (1,000 characters)

We aim: -for the highest standards of ethical behaviour in all of our interactions -to give greater control to health workers -to minimise costs and avoid reliance on distant experts. We have been actively working in Uganda with the Mbarara Regional Referral Hospital & Mbarara University of Science, the USAID Program Management Specialist in Maternal and Child Health/Uganda Mission developing our technology. In Tanzania, we are piloting in collaboration with a faith based organisation the social enterprise in Dongobesh, a small community 2.5 hrs from Arusha. Both Ugandan and Tanzanian Ministries of Health have agreed to assist with the selection of appropriate health facilities and the evaluation. The major corporations Sealed Air, SMC Pneumatics and Kröber Medical are assisting us with design for manufacture, commercialization and regulatory approvals. In support of our proposal, a private donor has agreed to providing matching funds for equipment and in-country costs.

Please share some of the top strengths identified in the community which your project will serve (500 characters)

A recognised existing and unmet demand for medical oxygen Access to a large pool of vocationally trained young people. A demonstrated willingness of people willing to be trained and work. Experience and trustworthy local collaborators to manage the finances. Well established and respectfully relationships with the communities (2015-)

Geographic Focus

Sub-saharan Africa: Uganda, Tanzania.

How many months are required for the project idea? (500 characters)

30-36 months.

Did you submit this idea to our 2017 BridgeBuilder Challenge? (Y/N)

  • No


Join the conversation:

Photo of Kate

Rodger, this is a captivating idea. I am curious to know how this technology works without using electricity!

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