Dr Arkadip Choudhury, Assistant Professor, Department of General Medicine, Tripura Medical College & Dr BRAM Teaching Hospital, Hapania, Agartala, Tripura sets a good example of handwork and real innovation in these times of need
Necessity is the mother of all innovations and in recent times, mother necessity has compelled several frugal transformations to bear fruit. Here we have a story of a doctor from Tripura who has understood the need and necessity of a simple protective gear such as face shields and developed it in an extremely cost-effective manner. He believes that it can be made available to masses at a very low cost.
In an exclusive interaction, Dr Arkadip Choudhury, Assistant Professor, Department of General Medicine, Tripura Medical College & Dr BRAM Teaching Hospital, Hapania, Agartala, Tripura talks more about the face shield and the concept behind its invention.
The significance of the face shield for healthcare workers
The face shield is light in weight, gives a comfortable fit, offers high optical clarity, provides an extra coverage area in the lower half around the neck. It is washable (headband only), and is a ‘one size fits all’ product.
“The concept of face shields is not new at all. But what is unique about this piece is that firstly it is made of totally inexpensive and readily available materials thereby keeping the production cost low. It ensures that the product reaches out to the masses who need the most. Secondly, it comes in a kit and assembly form which enables the product to be customised for various medical and surgical branches with minimum alterations. One important thing is that the product is absolutely handmade and needs no complicated machinery. So at times of high demand, the production can be up-scaled readily even from the house of the common man”, Dr Choudhury informs.
While Dr Choudhury points out that these face shields can be customised for various medical and surgical branches with minimum alterations, it mainly has great significance for protection against COVID 19.
Dr Choudhury explains further, “Let me put it this way. There are two major routes of transmission of a respiratory virus like the SARS CoV-2 we are dealing with now. One is an airborne transmission which can either be in the form of aerosols or a direct spatter of respiratory droplets on the mucous membrane of the nose, mouth and/or eyes. The second one is direct and indirect contact ( fomite ) based transmission. While the exact nature of aerosol-based transmission for SARS CoV-2 is under research and requires really expensive protection equipment, contact-based transmission can be significantly reduced by maintaining proper hand hygiene. However, when there is a direct spatter of droplets on the face, which can occur during acts of coughing, sneezing, vomiting or even face-to-face conversation in close proximities, which may occur in multiple numbers of times within a single working shift of a frontline worker, face shields offer excellent protection in covering all three, the mouth, nose and the eyes (of course in addition to a mask). Besides, a doctor wearing a face shield can come in closer proximity to the patient as may be required during medical examinations. This can otherwise be preferably avoided due to the fear of aerosol generation, besides also protecting a patient in such cases, if the doctor is infected. So, it gives you bi-directional protection.”
The efforts and initiative taken by Dr Choudhury are very commendable especially because of the nationwide lockdown where local manufacturers had many restrictions on the supply of material. He explains his challenges further.
Hard work that pays
“Firstly, when I started conceptualising the shield, India was in its first phase of lockdown. So, there was no chance that I could have gone for a market scouting to select the suitable materials required. I had to order the products over the phone and no one would dare open their stocks until an order big enough was received. So, I would have to think about the material and is virtually sure that it will work, order the material in bulk. Luckily I had contacts among some very kind-hearted people like Salim Bhai who makes seats for my cars, or Shyamalda from a local printing press who came forward and made all that I needed available.
The second challenge was time. My college was the first user of this product and they needed the product fast. The entire project took ten days of time from acquiring raw materials to making the prototype, testing it, designing the ‘kit and assembly’ mechanism and finally making it on a large scale and supplying it. As I said earlier it is a very simple product, but keeping it simple perhaps was the biggest challenge”, he narrates.
But even when Dr Choudhury toiled day in and day out to come up with these protective gear, his biggest support was his family. “I did not actually ask for one and burden the government any further. Besides, the biggest support required in this project this far was one that I got from my family and suppliers. In fact, it was my mother, who is a senior pathologist at the Regional Cancer Centre, Agartala, who was my biggest driving force behind this project. My wife silently bore through the mess that I had made of our daily routine and living room turned workshop. But it was my father, a senior physician and a GI Endoscopist himself, who thought that the common men should know about this concept of mine.”
Government support and future inventions
When asked about whether he would be interested in working with the government, Dr Choudhury happily expresses, “Considering the price that we are able to offer for the product out of the workshop, I believe it will be an effective and value for money procurement for the health departments should they wish to. Besides this product can also be used in the field by our defence personnel handling crowds on a daily basis, municipality workers and also for journalists on the field, who can use it comfortably without disturbing the vision.”
This is just the beginning for this ingenious doctor. He has plans to come up with a portable nebulisation system. “Yes. I am planning to use the STOPDROP platform to devise a portable nebulisation enclosure so that patients in need of nebulisation for respiratory ailments can be given the same with minimal chances of aerosol generation at places where airborne infection isolation rooms are not available”, he adds.
As on May 6, 2020, Tripura had 40 active cases of COVID-19, all from a BSF Battalion posted at Ambassa a small town located in Dhalai, a district in the North-Eastern part of the state. Two other cases were previously diagnosed COVID-19 positive, but have been successfully treated and discharged to institutional quarantine. There hadn’t been any deaths from COVID-19 in the state till May 6, 2020.
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