Meet the Innovators: This series highlights Humanitarian Grand Challenge supported innovators. Throughout this series you’ll get to meet the people behind the bold innovations, as well as hear about their experience working with our community.
“They weren’t cool about it,” says Dr. Michel Andre Rochat when asked how his family felt about him constructing revolutionary PPE equipment in his apartment during lockdown. “I tested everything in our apartment.The glue is a silicone glue which has a strong odour, so I had to use the extractor fan on the cooker. Then when it came to checking the suit’s airflow, my daughter had to show me how to get the data out of the treadmill. It was quite funny.”
Funny is one word for it. Determined might be a better one. But then, Dr. Rochat does not seem like the kind of person to let a global pandemic get in the way of developing the kind of equipment that will immeasurably improve the conditions for healthcare workers treating Ebola. Even if he does have to glue it together on his kitchen table.
The pandemic context itself was surely a driver – a constant reminder of the tragedies a virus can wreak. Of course, these days everyone knows that PPE stands for Personal Protective Equipment and that the frontline workers wearing it in awful conditions are anything but comfortable. However, seven years ago when Ebola was starting to spread widely across Western Africa, the issues were far less recognized outside of the region. Prof. Laurent Kaiser, the head of Virology at the Geneva University Hospital (HUG), saw the Médecins Sans Frontières (MSF) staff struggling with the difficult local conditions in Liberia, and approached EPFL’s EssentialTech Centre to ask if a new PPE solution could be developed.
Battling overheating, exhaustion and self-contamination
“From Prof. Kaiser, we got a real understanding of how awful it was for the MSF team to work in those conditions,” Dr. Rochat explains. “Basically it is as if they were wearing a plastic bag with goggles and they were staying in there for around 40 minutes before being totally exhausted from sweating and so on. It was really difficult.
There are many children in the Guéckédou Ebola case management centre. Some are orphans, which makes caring for them more complex. Staff easily become attached to these patients, whom they are the only ones to touch and comfort through two pairs of gloves and a mask. Photo Credit: Julien Rey/MSF /MSF141573
“The idea behind the SmartPPE project was, concretely, to provide a system that is reusable, which can be decontaminated, and which is comfortable as well as protective.”
This meant developing a one-piece suit that could be removed quickly and easily to avoid opportunities for contamination. Adding a full-face visor would enable patients to see more of the health care workers’ face and the field of vision from inside the suit. An innovative ventilation system would provide a continuous flow of fresh, clean air to keep the suit cool so users can spend more time working in it. The entire thing has to be cleanable to reduce the logistics and waste, as current suits are disposed of after each entry into the patient zone.
When Dr. Rochat joined the EPFL-EssentialTech team in summer of 2020, the SmartPPE was in the final stages of development in collaboration with SFTECH, an early partner in the adventure. But some crucial elements such as the ventilation system were still not finalized and MSF – the implementation partner of the project – needed to see a working prototype.
Getting to a fully-functioning prototype
“MSF really urgently needed a working prototype to be able to face their challenge,” explains Dr. Rochat. “So we applied for a grant from the Humanitarian Grand Challenge to finance the final phase. This was our last opportunity to develop the platform and to demonstrate to MSF that we have a system that is adapted to the field.”
Dr. Rochat explains his job, with typical understatement, as “understanding everything that was not working, making a fully functional prototype and then organizing some basic testing of the performance.” That meant conducting spray tests using coloured dye; cooling tests using a ‘sweating mannequin’; and filtering performance tests using a particle counter to compare the SmartPPE with a standard, non-reusable PPE suit to demonstrate that they achieved the desired amount of ventilation.
SmartPPE Headgear air diffuser. The Headgear is worn on the head of the user an connected to the ventilator through an air tube. Photo Credit: Michel Rochat / SmartPPE Headgear
There was also one further challenge to overcome: ensuring the suit could be safely decontaminated using a chlorine solution, right down to the filters which allow clean air to enter the suit. “Everything has to be decontaminated,” says Dr. Rochat. “The suit has to be decontaminated, but also the filters, because the filters are outside of the suit so they can come into contact with Ebola. Existing filters cannot be cleaned, which means MSF would need to deal with the logistics of bringing, say, 20,000 filters to the Democratic Republic of Congo (DRC) in case of a serious outbreak. I was able to buy the filter paper from China and I made some tests with chlorine and the airflow was tested. Then I sent the paper to Germany to validate the filtering performance. So now I had the data for the paper and also the design parameters.
“I made the design of the filter to integrate the paper with a glue that could withstand the chlorine and validated that it was watertight. I then tested the filter in the configuration that I had used before, using the particle counter to compare it to the normal filters. That way I was able to demonstrate that the suit was able to achieve the performance required within the constraints.”
The SmartPPE provides a new protection paradigm for health care workers in the context of sub-Saharan field operations that will impact all aspects of the fight against Ebola. “Extrapolating our cooling results suggest that the SmartPPE could be worn seven times longer than standard PPE,” says Dr. Rochat. “This would allow healthcare workers to stay with their patients for the entire four hours of the suit’s autonomy – a huge benefit. And while our current outbreak scenario would need a shipment of more than 21,000 PPEs to the field, using the SmartPPE would reduce it to 250 systems.”
The current cost for a PPE protection kit is $56 USD with more than half of the cost being disposables. As the SmartPPE is reusable the cost of entry is estimated to be less than $6 USD an hour. The long-term impact of the SmartPPE will be to provide a cost reduction associated with protection and safety allowing more resources to be allocated to patient care.
The pros and cons of innovating in lockdown
It’s at this point in the conversation that Dr. Rochat reveals that one of the constraints he himself was working under was having to do most of this work “at home in my bathroom and my kitchen.” But while the pandemic created a few logistical barriers for the SmartPPE project, the ‘new normal’ also had its upsides.
“Zoom was a very good tool,” Dr. Rochat says, “because I was able to meet a lot of people very quickly, without travelling. It was a bit difficult in the beginning but then everybody got used to this tool and it became extremely efficient to see and meet people.”
With PPE in high demand, it became more difficult for Dr. Rochat and the SmartPPE team to get the time they needed with testers and suppliers. But once they did, they were able to use tools like Zoom to present their ideas and their requirements quickly without losing time or money.
“I would even say that, by that point, COVID made our lives easier,” reflects Dr. Rochat. “I brought some tools home and I was able to buy anything I didn’t have. And it was almost easier because I was in my own environment.”
Impressing at MSF and next steps
Despite having to run tests out of his home, the results were very positive. The team was able to get the prototype suit in front of the right people at MSF and, as Dr. Rochat explains, he and his team also had some innovative ways of doing that:
“We were able to make a presentation at MSF to the medical team to demonstrate that we had something, and then one of the one of our partners, Dr. Manuel Schibler from Geneva University Hospitals, a medical doctor who had been in the field in the DRC, walked through the MSF headquarters in Geneva while wearing the suit! Even he was quite astonished that it was comfortable and he wasn’t sweating when he came out of the suit,”
Picture with Dr Manuel Schibler from HUG wearing the Smart PPE and Ms Reveka Papadopulo, President of Médecin Sans Frontières Suisse during the SmatPPE presentation tour at MSF headquarters in Geneva on September 23rd 2021. Photo Credit: Gregoire Castella/ SmartPPE.
“So, yes, it was very well perceived and the suit went to Belgium because they wanted to show it to the Ebola experts there, and that went very well also. We created a lot of awareness within MSF and now we are planning to do some field tests to test more functionality. We want to put people in real situations or simulated situations where they can test the PPE and do workshops to see how it goes. If this goes well, then we can really go into the industrialization phase.”
Making the most of the HGC opportunity
As for the benefits of being part of the Humanitarian Grand Challenge, Dr. Rochat is positive that, without the network of experts he was able to plug into, he would have wasted a lot of time and energy.
“Through HGC, I had the opportunity to get in contact with people working in biosafety in the United States because I was concerned about how to validate decontamination. And they were able to make it clear to me that testing the performance of decontamination was not the purpose of the project, it was beyond the scope. I just needed to make sure that the filter withstood the decontamination cycles, but not the efficacy of the process. Without those contacts, without the network of people I wouldn’t have been able to get into contact with experts like this and to have those types of discussions.
“Beyond that, I was able to get a better understanding from people in the humanitarian world. I come from the world of industry, mostly medical devices, so I have no knowledge of what is going on in the humanitarian world. Being able to discuss these things with people from that world in Syria or Turkey or India or the United States… That access to a broad range of people in different situations, with different ideas and different subcultures; that was really invaluable. I must also acknowledge Dr. Grégoire Castella, head of Humanitarian Innovation division at the EPFL-EssentialTech centre, for his support and guidance as a former employee for ICRC and MSF”.
Dr. Rochat also says that being part of the Humanitarian Grand Challenge has provided benefits outside of the SmartPPE project.
“This is the really interesting part! HGC provides this immersion into this humanitarian world, and discussing these issues with people who are having similar issues could, in the long run, also provide opportunities for other projects and collaborations.”