East London’s Dr Craig Parker’s oxygen device – the OxERA – saved hundreds of lives during COVID-19, particularly around the rural Eastern Cape, and has now received global recognition, being listed in the World Health Organisation’s 2022 Compendium under “innovative health technologies for low resource settings”, writes Biénne Huisman in Spotlight.
OxERA is described as an “all-in-one device using an oxygen accumulator bag, an anaesthetic mask and an adjustable mechanical peep valve (a spring-loaded valve which the patient exhales against) that is cost-effective and oxygen efficient”. The device requires an oxygen source, but uses less oxygen than traditional ventilators and is simpler to operate.
With a background spanning both mechanical engineering and medicine, Parker pioneered the idea for OxERA in March 2020.
Building solutions
An anaesthetist at East London’s tertiary government Frere Hospital, he says: “I had been in the UK visiting my grandmother for her 100th birthday. The UK was then collapsing and imploding with COVID. I realised that if they were not coping, then goodness, we were in trouble. And I felt ventilators were not going to fix our problem. To have somebody ventilated, you need a ventilator. You also need an ICU-trained nurse and space in an ICU. You need ICU-trained doctors. So I came back and put a call out on Facebook for anyone who wanted to join me to try to build a solution.”
Quickly, a group assembled in East London. “I called in some of my mining buddies. We had De Beers loan us two engineers at one point,” says Parker. “A colleague at Frere was helping me with some of the ICU stuff, Dr Brendan Toy. We were tossing ideas around, building prototypes, testing them. I think it’s the hardest I’ve ever worked – like 18 hours a day.”
Eventually, their hard work paid off, and they had a prototype.
In the throes of lockdown that year – with up to 50 COVID patients being admitted to Frere Hospital daily – Parker and his colleagues successfully used the device, preventing lung collapse and saving lives.
Up the coast at Madwaleni District Hospital, overlooking the Xhora river – where oxygen had to be ferried in by bakkie over two hours via rutted roads from Mthatha – desperate doctors welcomed the device too.
“It was challenging,” says Parker. “The device was still a prototype we were testing, but healthcare workers were desperate and finding them useful and they were saving lives. So we were just making them and donating them to those who asked.”
Their most exciting feedback was from Zimbabwe.
“Zimbabwe, compared with South Africa, was so much worse,” says Parker. “Really, if you were anything beyond mildly ill there, it was a death sentence. They had no hope of big bulk oxygen supplies that could support high-flow nasal oxygen solutions. They didn’t have equipment or the skills to ventilate patients. And so they used OxERA devices a lot, through an NGO there called Kufema…”
Born in Harare, Zimbabwe, Parker’s father died in the Zimbabwean civil war in 1974, when Parker was two-years-old. “He was a teacher at a technikon but he’d trained as a field medic, as a paramedic for the army,” says Parker. “He was killed in a medical evacuation. At night, the plane crashed on takeoff and my dad and the patient they were transporting and the pilots were all killed.”
In 1981, Parker’s mother moved to South Africa to work as a laboratory technician at the University of KwaZulu-Natal (UKZN) in Pietermaritzburg.
In 1993, Parker completed a BSc in Mechanical Engineering at UKZN, after which he worked in mines in South Africa and Zambia.
For a while, he, his wife Catherine, a nurse, and their two children lived in the Zambian Copperbelt town of Chingola. His distaste for what he describes as the “rich getting richer” ethos of mining started to wear him down.
In 2011, aged 39, a “midlife crisis” saw Parker rethink his career. The next year, he enrolled in medical school at the University of the Witwatersrand.
Practically, he says this felt “ridiculously impossible” – financially and time-wise. But with his wife Catherine’s support, he made changes.
“We had to save like mad, sell the cars and buy little runaround cars,” he recalls. “There were a few miracles in terms of getting accepted at university – well, first getting rejected, then accepted – white knuckle stuff towards the end. I was only able to graduate because the medical school actually paid my fees. Everything was maxed out. I’d sold my house, but I hadn’t been paid yet. When I graduated, the certificate still said ‘Degree, not awarded: fees outstanding’. It had been printed before they settled the fees.”
A two-year internship at Frere Hospital followed. Then a year of community service at Victoria Hospital in Alice, in the rural Eastern Cape, where Parker “used (his) Leatherman to fix things as much as his stethoscope”. Back at Frere Hospital, he worked in paediatric surgery and then in anaesthetics.
Ubuntu in the Eastern Cape
On healthcare challenges in the Eastern Cape, he says: “It’s a very challenging province because it’s a province that for so long was neglected, for decades really. And then once democracy came, it continued along that trend. Where politicians seemed to be voted in just because they were in the favourite party, but no one’s being held to account. So we top the lists of poverty, of everything negative really. It’s quite difficult to reinvent that.”
Rural Doctor of the Year
Earlier this month at the Rural Health Conference in Oudtshoorn, Parker received the Rural Doctor of the Year Award for 2022, a title bestowed annually by RuDASA (the Rural Doctors Association of Southern Africa).
RuDASA said in a statement: “Dr Parker’s leadership, knowledge and understanding of engineering, clinical, and social fields was instrumental in the development of the OxERA product. He continues to provide leadership at Umoya, as they have been asked to assist with a number of other innovations to improve healthcare, specifically in resource-constrained environments.”
Parker’s words have a self-deprecating bent. “Perhaps I am an average engineer, and an average doctor,” he says. “But this combination of skills is quite unique, and they were hugely beneficial during COVID.”
See more from MedicalBrief archives:
SA suppliers race against time to secure essential medical equipment
Technical and ethical issues mean split ventilation should be used as last resort
WHO to investigate Eastern Cape’s high COVID-19 death rate
Oxygen stocks run low in Gauteng as strain mounts