Doc-in-a-box

Vad sägs om att använda övergivna containers för att bygga mobila, transporterbara hälsokliniker som kan användas i utvecklingsländer? Det är precis vad ingenjörer på Rensselaer Polytechnic Institute har gjort. För cirka 30 000 kronor har de byggt en prototyp på en sådan klinik. "Doc-in-a-box" kallas idén – läs mer på engelska nedan!

As a thought experiment, the Council on Foreign Relations' Global Health Program has conceived of Doc-in-a-Box, a prototype of a delivery system for the prevention and treatment of infectious diseases. The idea is to convert abandoned shipping containers into compact transportable clinics suitable for use throughout the developing world.

Shipping containers are durable structures manufactured according to universal standardized specifications and are able to be transported practically anywhere via ships, railroads, and trucks. Because of trade imbalances, moreover, used containers are piling up at ports worldwide, abandoned for scrap. Engineers at Rensselaer Polytechnic Institute converted a sample used container into a prototype Doc-in-a-Box for about $5,000, including shipping. It was wired for electricity and fully lit and featured a water filtration system, a corrugated tin roofing system equipped with louvers for protection during inclement weather, a newly tiled floor, and conventional doors and windows. Given economies of scale and with the conversions performed in the developing world rather than New York, it is estimated that large numbers of Doc-in-a-Boxes could be produced and delivered for about $1,500 each.

Staffed by paramedics, the boxes would be designed for the prevention, diagnosis, and treatment of all major infectious diseases. Each would be linked to a central hub via wireless communications, with its performance and inventory needs monitored by nurses and doctors.

Governments, donors, and NGOs could choose from a variety of models with customizable options, ordering paramedic training modules, supplies, and systems-management equipment as needed. Doc-in-a-Boxes could operate under a franchise model, with the paramedics involved realizing profits based on the volume and quality of their operations. Franchises could be located in areas now grossly underserved by health clinics and hospitals, thus extending health-care opportunities without generating competitive pressure for existing facilities.

On a global scale, with tens of thousands of Doc-in-a-Boxes in place, the system would be able to track and respond to changing needs on the ground. It would generate incentives to pull rapid diagnostics, easy-to-take medicines, new types of vaccines, and novel prevention tools out of the pipelines of biotechnology and pharmaceutical companies. Supplies could be purchased in bulk, guaranteeing low per-unit costs. And the sorts of Fortune 500 companies that now belong to the Global Business Coalition on HIV/ AIDS, TB, and Malaria would be able to provide services and advice.

Over time, Doc-in-a-Boxes could emerge as sustainable local businesses, providing desperately needed health-care services to poor communities while generating investment and employment, like branches of Starbucks or McDonald's.