Hassan Mohammed Abdu cuts orthoplast into strips for the headbands. Jessica BARRY / ICRC

Sudan: Making face shields for health care heroes

In normal times, the National Authority for Prosthetics and Orthotics (NAPO)’s Rehabilitation Centre in Khartoum is a bustling place, crowded with people of all ages and different physical disabilities.
Article 28 May 2020 Sudan

At present, however, with a COVID-19 related lockdown in place across Khartoum state, beneficiaries are no longer able to come to the centre for treatment, and the production of prosthesis and other appliances is at a standstill

For the staff, however, this pause has been an opportunity to contribute to people's well-being in another way. Under the supervision of their technical director, Yousif Musa, and with the support of the ICRC's Physical Rehabilitation Programme (PRP) team, NAPO staff are using ingenuity and innovation to produce lightweight but durable protective face shields as part of much needed personal protective equipment (PPE) for front line health workers and other medical staff caring for COVID-19 patients, and people in quarantine.

Raphael Ewoi Kerio discusses the visor with NAPO's technical director, Yousif Musa. Jessica BARRY / ICRC

"We began brainstorming together after seeing what fellow professionals in other countries were designing and sharing on social media," explains ICRC ortho-prosthetist, Raphael Ewoi Kerio, who is part of the ICRC team supporting seven NAPO Centres in Khartoum, Darfur and Blue Nile. "We also received encouragement and inspiration from our line managers and PRP colleagues in headquarters, so it was very easy to take on the challenge."

After looking at different designs, a team of six ortho-prosthetists, three each from NAPO and ICRC, chose one that was suited to the centre's existing resources, equipment and supplies all of which are provided by the ICRC. Orthoplast for making splints, for example, could be moulded easily to make the headband; velcro could be used for the straps to fit the shield comfortably around the head. Only the transparent plastic needed for the visor would have to be bought but was available locally.

Hassan, Muhanad and Yousra worked together on the project for 14 days. Jessica BARRY / ICRC

The next step involved setting up a production line in NAPO's spacious gait training area.

After making a prototype shield that was light but robust and didn't fog up when worn for several hours, the team was ready. With the verbal approval of the Ministry of Health's technical evaluator, it was decided to make the first batch of 1,000 shields which would take around 14 days.

To ensure physical distancing, the floor of the gait training area was marked out with tape to ensure enough space between each workbench. Handwashing was obligatory before entering the room. Other protection measures were also introduced for team members living far from the Centre.

The team keeps busy even though the pandemic has put a temporary stop to the PRP work. Jessica BARRY / ICRC

"Four of them are staying here throughout the production process," explained NAPO's Yousif Musa. "They didn't want to put their families or other colleagues at risk by having to use public transport to get here each day."

When a visitor arrived at NAPO one recent morning, Hassan Mohammed Abdu was busy cutting strips of orthoplast for Murtada Abdalla, a student technician, who was filling a water heater. After soaking the strips for some time to make them pliable, Murtada moulded each one gently into a headband. He seemed completely absorbed in his work. When at last he looked up, he said very quietly, "We want to help others while we can't do our normal work. This is why we are all here."

After soaking in hot water, the orthoplast becomes pliable. Jessica BARRY / ICRC

Soon, Muhanad Mohammed arrived and helped Hassan cut the orthoplast. Yousra Ahmed, an ICRC physiotherapist, sorted the plastic sheets that had been shaped for the visors. When that job was done, she moved to the branding bench and began to fix strips of blue paper to the headbands that Murtada had piled up on her workbench. Each blue strip was printed with the NAPO logo and the words, "You are our hero. Stay safe".

Once assembled, the shields are quality checked, certified, and sanitized for packaging and eventual distribution.

"Once the pandemic has peaked and the current lockdown is lifted, beneficiaries will start coming back here again for treatment," commented Raphael, after showing his visitor around. "But we don't know when that will be so the chance to do something meanwhile that can help people keep safe is a real bonus."

Once assembled the face shields are quality controlled and sanitized before being packaged 100 to a box ready for distribution. Jessica BARRY / ICRC

Standing nearby was Imad Aldibee, the head of the ICRC's PRP, in Sudan. "If there is still a need once the first 1,000 face shields have been made, we will continue the production," he remarked. "Meanwhile, we are also exploring ways of making cloth masks in a tailoring workshop run by people with disabilities."

With the COVID-19 pandemic showing no signs of letting up in Khartoum or elsewhere around Sudan, it is sadly unlikely that the need for shields and masks to keep healthcare heroes safe will diminish any time soon.