Ubuntu is a proposal for a new type of a low cost and dignifying beds in case of an epidemic outbreak. The concept was developed as a reaction to the insufficient capacity of hospital beds during the Ebola Outbreak 2014-2016 in West Africa. Ubuntu offers the possibility of quick assembling containment beds on-site using locally produced bamboo, zip ties and disposable sheets of Tyvek® functioning as mattress and barrier between the beds. The Tyvek® sheets will come as one large roll where each sheets, with instructions printed on it, can easily be cut off and assembled into an containment bed.

Studying the 2014-2016 West Africa Ebola Outbreak

The World was far too slow to react in connection with the Ebola Outbreak in West Africa 2014-2016, which led to 11,323 deaths out of 28,646 known cases. One of the major problems during the outbreak was the lack of capacity. Due to the fact that only 30% of the needed capacity was available, many of the contagious incoming patients had to go back to their communities, ended up infecting others. In addition, patients with other diseases were not able to receive treatment. Figures show that an additional 10,623 deaths occurred due to the outbreak's impact on local healthcare.

The treatment beds introduced by the British government and aid organizations in Sierra Leone during the height of the Ebola epidemic prevented an estimated 57,000 infections and about 40,000 deaths, according to findings published on November 17, 2015. But had that help arrived just one month earlier, researchers estimate that it could have prevented an additional 12,500 Ebola cases and saved thousands more lives. (Source: Measuring the impact of Ebola control measures in Sierra Leone. / Kucharski AJ, Camacho A, Flasche S, Glover RE, Edmunds WJ, Funk S. / 17.10.2014)

On top of that, some parts of the community did not believe in the disease's existence, and the healthcare provision that health-care workers were offering. So, while most of the hospitals were overwhelmed by Ebola patients, some hospitals did not receive a single patient.The one underlining reason for the lack of capacity during the outbreak was that Liberia, Guinea and Sierra Leone are some of the poorest countries in the world. They simply did not have enough resources and financial capabilities to implement rapid treatment centers for Ebola patients.

Besides the insufficient resources in the affected countries, there was another factor that slowed down the containment operations which was that the logistics were not fast enough. Due to the size and mass of the ordinary beds, they could not receive the help they needed in the specific hospitals and treatment centers.

The initial research findings were followed-up by interviews with the health workers from Sierra Leone, to understand the adversities of the environment in the existing containment wards and procedures. The insights related to patient's environment and the challenges the health workers face, listed below, were analyzed, addressed and solved through the Ubuntu concept.

Problems to be tackled;

- When the patient's environment was contaminated by vomit or diarrhea, it is very hard to clean the patient, involving two health workers for up to 45 minutes. The cleaning and continuous exposure increases the risk of the health workers being contaminated.

Patients need to be transported between wards and showers quite frequently and it requires three health workers carrying the patient with direct contact due to the lack of stretchers.

- There is a lack of privacy and dignity for the patients in the visually and mentally harsh environment.

Ubuntu

Given the scarcity of resources as well as a lack of institutional trust, instead of sending plain hospital beds from nearby or from countries far away, Ubuntu offers to build the containment beds with locally produced bamboo rods in order to bypass the challenges of logistics during emergencies, enhance collaboration and trust within the community.

The containment bed kit which will be shipped on site, includes color-coded zip ties and a roll of Tyvek® which has good microbial barrier properties. Assembly instructions on how to assembly the containment bed out of bamboo is printed directly on the sheet of Tyvek®. Once the bamboo rods are collected, the simple bamboo frame is easy to construct and can be built by a single person using the color-coded zip-ties for easy assembly. Then the Tyvek® is looped around the structure to create a comfortable mattress and a privacy barrier for a dignified care environment. Every Tyvek sheet is identical and has the instructions printed on, which means any one of them can be used either to make a new bed, as a privacy barrier or a replacement.

The concept does not require any extra manufacturing and all of the three materials are compact, lightweight and durable, making the Ubuntu an accessible, cost-efficient and rapid solution to alleviate a health crisis.

Due to the light-weight of the product (1 Bed = 13 kg), the bed can be used to transport the patients between wards with less workers, less effort and without direct physical contact with the patient.

When the bed gets contaminated, mattress or barrier can be easily replaced with another Tyvek® sheet without having direct contact with the contaminated fluids, which reduces the secondary infection risk and offers much less time and effort needed by the health workers for the task, so they can focus on healthcare giving. In a scenario with extreme risks for contamination, the entire bed can easily be discarded and burned and a new one assembled.

Ubuntu offers each patient a bit of privacy in a visually and emotionally harsh environment, at the same time as healthcare access is possible from both sides, due to the curtain like cover.

The artwork printed on the Tyvek® mattress and barrier, aims to comfort patients by visually reducing the alienation of the environment by implementing the region's traditional and cultural graphical styles. The artwork in the present concept was done by a designer inspired by the West African patterns and traditionally empowering Adinkra symbols. The actual proposal is that the artwork can be done by artists with personal knowledge from the affected area.

The top bamboo piece's height is specifically adjusted for hanging the IV drips with using a zip-tie. The proposal also includes a patient tag, and a tray surface made out of Tyvek®.

Bypassing the Logistic Challenges

Despite the recent advancements by humankind in the 21st century, it was shocking to see that we were not ready for such an epidemic outbreak. Epidemics are not going to stop if we consider the mutations with the viruses and the climate change.During an outbreak we need to mobilize our resources as fast as possible and we need to have the right products to do it. Otherwise the devastation of the economy and healthcare is unbearable especially for countries like Liberia, Guinea, and Sierra Leone.

Using already manufactured materials which are light-weight and space efficient with locally sourced bamboo to bypass the conventional logistics makes Ubuntu a quicker, more logical and cost efficient and above all a more dignifying solution. Currently, the options in the market are limited to plain hospital beds which are not covering the specific needs of an epidemic scenario, and bio-containment units are expensive and not made for an epidemic response.

Back to the Community

The conventional way of humanitarian aid has not been so successful as a long-term solution in the underserved communities, and in some cases even made the consequences worse. As a cost and resource efficient proposal, Ubuntu aims to empower to the local community in creating employments and collaborations on bamboo farming and assembly operations. Also by using local resources the aimed is to enhance the interest by the local community and create awareness and understanding.

Additionally, since the idea is about rapid capacity response, there could be iterations made to be able to use it in other areas, such as mosquito-borne epidemics or as disaster response.