The engineer, Kirk Evans, developed the machine on site using parts available in Vietnam, while members of Project Vietnam and American neonatologists worked with him on a long-distance basis. In 2002, Evans created a version of CPAP that could be produced and maintained from within Vietnam. The new version costs only $400 to $500 in Vietnam, while CPAP usually costs $6,000 or more in the industrialized world, according to Ringer.
Once the new CPAP was developed, Ringer, Evans and other members of Project Vietnam had to convince local doctors that the technology actually worked and would be affordable.
After two years, there are about 100 machines in operation, which have treated over 2,000 infants. These machines save two to three babies a day, estimates Evans.
Evans, who still lives in Vietnam, commends Ringer’s commitment to the cause.
“The thing that makes him stand out over so many other visiting doctors here in Vietnam, is his long term commitment,” Evans writes in an e-mail. “He continues to come back, and each time his understanding and advice is more appropriate and focused.”
Ringer says CPAP has now received approval from Vietnam’s Ministry of Health, and Project Vietnam is currently in the process of spreading the technology throughout the country—a procedure made easier by increased interest from officials at other hospitals who have heard of the dramatic results of the trials in Hanoi.
“I think we’ll probably face different issues…in less sophisticated hospitals,” Ringer says, noting that some Vietnamese hospitals probably do not have the right oxygen hookups that can be connected to the CPAP equipment and that doctors will have to learn how to use the technology.
But Quynh Kieu, the chairperson of Project Vietnam, says that the low cost and relative simplicity of the technology will play a key role in its spread to rural areas.
Kieu says that the Ministry of Health’s endorsement of CPAP is important because the ministry is the only source of medical resources and direction in the country. The Vietnamese government has adopted newborn care as a priority and hopes to have a newborn unit in each of its provinces by 2010.
Like Evans, Kieu says that she has been impressed with Ringer’s commitment.
“He has fulfilled beyond my expectations his promise of being, for the long term, involved with [Project Vietnam’s] neonatal program and leading it,” she says.
Once CPAP becomes widespread throughout Vietnam, Ringer and Evans hope to bring it to other developing countries as well.
“I expect I will have a long term working relationship with [Ringer] to save babies, hopefully all over the world,” Evans writes.
—Staff writer Matthew S. Lebowitz can be reached at mslebow@fas.harvard.edu.