[HN Gopher] Flatpack field hospitals that can be airdropped to d...
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       Flatpack field hospitals that can be airdropped to disaster zones
        
       Author : tosh
       Score  : 171 points
       Date   : 2023-12-08 12:42 UTC (1 days ago)
        
 (HTM) web link (www.theguardian.com)
 (TXT) w3m dump (www.theguardian.com)
        
       | syndicatedjelly wrote:
       | This is what innovation in healthcare and med tech looks like.
       | Versatile, affordable inventions that serve those in desperate
       | need. Western med tech could learn a thing or two here.
        
         | gumballindie wrote:
         | Why would we downgrade to a tent?
        
           | zakary wrote:
           | Because in many places, especially disaster zones, a tent is
           | a massive upgrade from the bare patch of dirt they often
           | currently have to make do with.
           | 
           | This isn't to replace an inner city hospital, this is the
           | make it fast and cheap to deploy the basic necessities of
           | medical care.
        
             | carlosjobim wrote:
             | My impression is that when a disaster strikes a Western
             | country, they have the capacity to airlift the people in
             | need of medical attention to real hospitals in areas that
             | weren't struck, instead of putting up tents and barracks in
             | the disaster zone.
        
               | gumballindie wrote:
               | Exactly, plus western countries are usually smaller and
               | services arrive quickly at the scene.
        
               | user_7832 wrote:
               | Minor nit, but countries like the US or Canada are huge
               | and rescues can take a lot of time. However you don't
               | need a portable hospital more than a rescue helicopter
               | for a few injured/lost hikers.
        
           | pests wrote:
           | There's nothing to downgrade. Youre starting with nothing.
           | This kick-starts the process then you can upgrade to current
           | levels if needed.
        
           | darth_avocado wrote:
           | Because it's cheaper, not everyone has pentagon budgets to
           | set up a modern hospital in a disaster zone.
           | 
           | Plus even if you did have all the fancy equipment, it takes
           | forever to set up relief centers. After Hurricane Maria in
           | Puerto Rico or after fired in Maui, it took days to setup
           | basic relief centers. Imagine if you have these cheap "tent"
           | hospitals available at every small nearby town, you could
           | setup relief in a matter of hours.
        
             | gumballindie wrote:
             | Correct - but op said the west could learn a thing or two,
             | when in fact it's the other way around.
        
               | syndicatedjelly wrote:
               | The West could learn a thing or two about how to produce
               | affordable medical technology. Did you read the original
               | article?
        
       | robert_foss wrote:
       | That.. is a tent.
        
         | reactordev wrote:
         | Yes, it is. A mobile field hospital is usually built around the
         | premise of a tent. Germany, USA, UK, Russia - all have tent-
         | based forward deployable field hospitals.
         | 
         | https://www.dvidshub.net/image/6787138/348th-field-hospital-...
        
           | jessriedel wrote:
           | OK but the American field hospitals often only need to
           | stabilize people because the expectation is that anyone
           | needing serious treatment will be airlifted to expensive
           | military hospitals in Germany or the US. In contrast, the
           | victims of humanitarian emergencies in poor/developing
           | countries usually need to be fully treated on site because
           | they aren't getting airlifted anywhere :(
        
             | reactordev wrote:
             | That is correct. The forward deployable field hospitals are
             | really nurse stations to stabilize any active medical
             | emergency for transport or otherwise stop the emergency
             | (not necessarily treat it, they'll do what they can).
        
             | creshal wrote:
             | This is a side effect of recent US conflicts being low-
             | intensity COIN operations involving brigade sized or
             | smaller assets that spend most of their time in garrison.
             | 
             | In a conventional conflict mobilizing entire divisions, as
             | the US is now preparing for again, you will see far more
             | capable field hospitals again, because the US won't have
             | the necessary capacity (either in terms of airlift volume
             | nor existing hospital beds) to afford this luxury.
        
           | Beached wrote:
           | significant difference between the quality and stability of
           | the two tents. the one in the article looks like a stick will
           | tear it asunder.
        
           | ant6n wrote:
           | That's a proper, large military tent, not some 3ppl Retail
           | campground affair.
           | 
           | Which is kinda weird, even in retail, u can get 3m x 8m tents
           | (or so) that could be carried in a helicopter.
        
         | burntbridge wrote:
         | Pretty sure this is just a PR exercise for the very gullible.
         | Anyone who has seen a real operating theater and had experience
         | of being outside will know this is nonsense. That tent is
         | simply not big enough for one thing.
        
       | rdl wrote:
       | When I was in Iraq/Afghanistan 2004-2010, one of my favorite
       | things was working with the military hospitals (I sold satcom to
       | a variety of clients, including medical use for radiology, and
       | then worked on radiology PACS stuff).
       | 
       | The Army Combat Support Hospital (think MASH tv-show...) guys
       | could set something up like this really fast, but it was
       | expensive hardware, required their own personnel, etc. This makes
       | sense for the US military (massive logistics, budget, etc.), but
       | not for others. Also worked (volunteer/charity) with some local
       | clinics who didn't have these kind of resources, but did have
       | great personnel, who could use more locally-acquired or bespoke
       | solutions -- problem was it was slow, not uniform standard, etc.
       | 
       | A cost-reduced, standardized, easily transportable hybrid is
       | great. Ideally you'd use existing standardized readily available
       | stuff with minimal medical/flown in stuff on top.
        
       | omneity wrote:
       | In terms of "airdroppability to disaster zones", hardly anything
       | beats cardboard beds[0].
       | 
       | It is true that the field hospital in TFA is a much comprehensive
       | solution. I just wonder what an equivalent would be if designed
       | with similar minimalistic principles to the cardboard bed.
       | 
       | 0: https://www.fastcompany.com/90962654/this-simple-design-
       | turn...
        
         | etskinner wrote:
         | I don't really get the point of this bed, how is it better than
         | sleeping on the ground? The only reasons I can think of are
         | insulation (which just a couple sheets of cardboard would do
         | well, a 50% savings on material), and keeping away from pests
         | like mice and cockroaches. Granted, those are decent reasons,
         | but I wonder if spending the money elsewhere for disaster
         | relief would be better. Am I missing something?
        
           | azmodeus wrote:
           | Could be good for hygiene for patients to not sleep on the
           | floor though disinfecting a cardboard bed could be hard
        
             | creshal wrote:
             | Single-use / regularly replaced disposable beds might be
             | more hygienic in practice than to hope the staff has enough
             | time for thorough disinfection.
        
           | SanjayMehta wrote:
           | It can be hard to get up from the ground without assistance
           | especially if you're injured or old.
           | 
           | Also, an elevated position makes it easier for medical staff
           | to check on patients.
        
           | OJFord wrote:
           | In addition to your reasons, and sibling's 'easier to get
           | up', I'd add:
           | 
           | - does actually look much more comfortable than the ground to
           | me. The middle would give a bit into the cavity of the base,
           | it's not just a sheet on the ground as I imagined reading
           | your comment.
           | 
           | - being raised makes it easier for medical personnel to
           | attend to any injuries etc.
           | 
           | - looks like a more clearly delimited arrangement, I imagine
           | it would more easily become difficult to walk around people
           | sleeping on the floor, as they'd sprawl out, lose the
           | organised grid arrangement, etc.
           | 
           | But I don't have any relevant experience to comment on how
           | important any of that is, or if it's the best way to spend
           | whatever cardboard beds cost in such a scenario.
        
           | anigbrowl wrote:
           | Have you ever slept on the ground? The air is a lot colder at
           | ground level than even a foot or two above.
        
       | lionkor wrote:
       | Looks and sounds like it could use TeleSAN[1] as well!
       | 
       | [1]: https://telesan.de/?lang=en
       | 
       | disclaimer: i work at one of the companies that worked on this
        
       | adhesive_wombat wrote:
       | I've always thought it strange that countries like the UK with
       | the NHS haven't standardised a modular hospital design where you
       | can slot prefab modules into some framework. Need a CT suite on
       | floor C? Labs on floor F? Need a new floor on top?
       | 
       | And then (assuming the British government isn't feeling
       | charitable, which is a good bet) you can export them at a profit
       | or licence the design to other countries.
       | 
       | Instead, every single hospital seems to be a money-pit full-
       | custom design and changing one after the fact is almost entirely
       | impossible without huge effort, which is why my latest medical
       | appointment was done in an old laboratory, complete with lab
       | benches round the walls with a high-school-style desk and two
       | chairs awkwardly plonked in the middle.
       | 
       | Obviously it's not a simple thing to design such a thing (not
       | least the plumbing!), but the immense resources that go into full
       | custom hospitals, the pain it causes when they become not what is
       | needed, and the expense of modifying them really makes me think.
        
         | bluedino wrote:
         | The hospital construction industry is huge and wouldn't want
         | that.
         | 
         | And, a lot like college dorms, hospitals have become luxury.
         | Basic hospitals would be a hard sell.
        
           | adhesive_wombat wrote:
           | > The hospital construction industry is huge and wouldn't
           | want that.
           | 
           | Sounds very much like a them problem (assuming a government
           | since 1948 could show such intestinal fortitude).
           | 
           | > hospitals have become luxury
           | 
           | Only if you allow the private sector to completely capture
           | the entire industry from top to bottom including government
           | and regulatory function (in the same way the US automotive
           | industry made light trucks basically illegal where they
           | could).
           | 
           | That process of top-to-bottom capture having not yet been
           | fully completed in the UK, I don't think you'll find an NHS
           | hospital, even a new one, especially luxurious. A BUPA one,
           | probably yes (but they also don't have expensive money sinks
           | like grubby un-insured and un-moneyed patients, A&E
           | departments to run or junior staff to train).
           | 
           | And there's no reason you can't have luxury modules as an
           | upsell, or even third party compatible models. It's how
           | aircraft are configured. You get an empty fuselage and you
           | choose the modules. But the difference is you could fit the
           | same modules to the medical versions of Airbuses and Boeings.
        
         | phone8675309 wrote:
         | Some of this is already occurring. The company I work for makes
         | mobile imaging solutions (CT, MRI, PET) that fit in the size of
         | a shipping container and are often transported by semi-truck.
         | There are hospital designs that leave bays for these trucks to
         | pull into with a door on the side to get patients in and out on
         | detachable tables. So a small hospital system that only has the
         | money for a single CT or MRI scanner can move it from site to
         | site in rotation to see patients instead of siting it at a
         | single hospital and having to send patients further from home.
         | 
         | Doing that on a larger scale would be the next step.
        
         | bluGill wrote:
         | Everyone wants their city to have.unique hospitals. Plus it is
         | rare to build a new hospital, what they do typically is remodel
         | an existing one so there is less gain.
         | 
         | Elementary schools could also use a standard modular design,
         | but every town would prefer to spend just a little extra for a
         | custom design. The cost of a custom design isn't much more
         | anyway, as all the parts are standard off the shelf. What a
         | standard really gives is they don't make the gym too small for
         | a.regulation basketball court and other details that are easy
         | forget when specifying a custom building.
        
           | adhesive_wombat wrote:
           | Admittedly not much gain up front, if anything it might be
           | more expensive than a really efficient custom design (though
           | I think most recent UK hospitals are not cheap, one near me
           | cost something like PS200 million and has 500 beds and took
           | quite a while to design and build, would be interesting to
           | what went to the design consultants).
           | 
           | You can still put a custom fascia on it. Most recent large
           | buildings fundamentally work that way anyway. Concrete
           | inside, panels or bricks outside.
           | 
           | The real gain comes in 20 years when you need to change
           | things (medical technology changes, demographics change,
           | multi-hospital organisations-trusts in the UK, networks in
           | the US-change), and you find that you need to gut the whole
           | place to do anything at all. So you either do that at huge
           | expense, or you make do and do your consultations in a
           | disused lab area with a waiting room in a corridor (because
           | labs don't have waiting rooms, but now the lab work is done
           | elsewhere, so it's what you got).
           | 
           | Of course when it's all about "profit this quarter" (US) and
           | "being tough on spending" (UK), having a major problem in 20
           | years is not your problem.
        
         | jakogut wrote:
         | Lots of things are this way. School busses and fire engines are
         | mostly all custom built to order. Fire apparatus at least make
         | some sense, as the needs of every district vary, but school
         | busses? I would think a few common models would suffice.
        
         | vlovich123 wrote:
         | I don't know. Are CT or MRI machines ever found on anything but
         | the ground floor because of the weight of them / installation
         | complexity?
         | 
         | I agree that you want standardized designs, but modular stuff
         | gets tricky because it's physical infrastructure not code (eg
         | things can fairly physically in unintended ways if the supports
         | aren't designed for it and designing supports for arbitrary
         | undefined loads to be added later is tricky).
         | 
         | At least that's my uninformed take.
        
           | repiret wrote:
           | At my local hospital, the MRI and CT are on the upper of two
           | floors. They are heavy machines, but buildings can be built
           | to support heavy machines.
        
         | dwd wrote:
         | Especially as the British did it first over 150 years ago. One
         | of Brunel's lesser known innovations and highly successful as
         | well.
         | 
         | https://en.m.wikipedia.org/wiki/Renkioi_Hospital
        
       | senthil_rajasek wrote:
       | I love these IKEA hospitals and the quote at the end of the
       | article assembled it all together,
       | 
       | "The hospital is a small contribution by India to humanitarian
       | work around the world," she said. "We are now ready to share it
       | with any country that needs it."
       | 
       | It reflects a new way of thinking and a fresh world view. A
       | vastly different view from the one I grew up in (80s)... Which
       | was huge headlines in NYT about how poor countries need aid and
       | western aid organizations are helping them. When in reality it
       | was "relief theater".
       | 
       | Good luck.
        
         | netaustin wrote:
         | Totally. During the early months of the pandemic when NYC was
         | hit super hard, Samaritan's Purse set up a tent hospital in
         | Central Park directly opposite the main campus of Mt. Sinai
         | which was a marvel to see, I would run and cycle past it nearly
         | every day. Another of my common running routes took me past the
         | USNS Comfort, docked at Pier 90, and the Javits Center, which
         | hosted yet another modular hospital. Then a little later, a
         | modular morgue on Randall's Island, which is now the site of a
         | modular migrant encampment.
         | 
         | I later read that because of strict policies relating to a
         | notion that only the "simple" cases, of which there were few,
         | could be transferred, the temporary hospital facilities ended
         | up underutilized. But the ability to surge capacity in a
         | specific area is hardly constrained to parts of the world with
         | fewer hospital beds. Public health crises and natural disasters
         | in the USA are perfect candidates for this technology.
         | 
         | I hope we can test this quickly, and if it works, buy a bulk
         | pack.
        
       | sbrorson wrote:
       | Inflatable buildings used for disaster relief. They can be
       | trucked or air-lifted into place, then quickly inflated.
       | 
       | https://federalfabrics.com/
        
         | cushychicken wrote:
         | Proudly made in Lowell, Massachusetts. <3
        
           | sbrorson wrote:
           | Yes, they still make textiles in Lowell!
        
       | Finnucane wrote:
       | "can be . . . assembled faster than an Ikea bookcase. . . . It
       | takes five trained people one hour to assemble the cubes "
       | 
       | Unsaid--five trained people need more than an hour to assemble an
       | Ikea bookcase.
        
         | kjkjadksj wrote:
         | Must have gotten the Ikea assemblers from McKinsey
        
       | malwarebytess wrote:
       | I'm not seeing any innovation here as distinct from what is
       | already done for inexpensive field hospitals, except that it's in
       | a retail tent.
       | 
       | > Sharma says the hospital is the first of its kind in India, but
       | is reluctant to make any grander claim as she is not certain of
       | similar developments in other countries.
       | 
       | Oh.
        
       | jeffrallen wrote:
       | MSF uses inflatable hospitals: https://msf.org.au/innovation-
       | inflatable-hospital
       | 
       | More choices for more contexts is more good!
        
       | AlphaWeaver wrote:
       | > A tablet computer included in the cube pack is programmed to
       | minimise assembly errors, and an alarm sounds if the wrong
       | equipment is put in any given cube.
       | 
       | This is incredibly smart! Guessing Ultra Wideband beacons in some
       | of the equipment, so you know what cube it's in!
        
       | westurner wrote:
       | The red ResponsePod tents tare designed for temperature extremes,
       | 100mph wind, and rain.
       | 
       | They're not very disposable.
       | 
       |  _Cardboard_ tents are more sustainable than single-use tents.
       | 
       | Med tents, sheets, and scrubs could be made of antimicrobial hemp
       | fabric.
       | 
       | Pop-up _Hub tents_ like ShiftPod, Gazelle, and the Coleman
       | Instant are quick to set up and sturdier than replaceable and
       | splintable tent poles.
       | 
       | - [ ] ENH: Tent pole splint and/or spares
       | 
       | Tunnel tents also have high ceilings.
       | 
       | Round structures like [geodesic] domes fare better in wind than
       | sharp corners due to wind shearing force.
       | 
       | Geodesic dome hub kits work with local lumber or other.
       | 
       | Heaxayurt: https://en.wikipedia.org/wiki/Hexayurt :
       | 
       | > _A hexayurt is a simplified disaster relief shelter design.[2]
       | It is based on a hexagonal geodesic geometry adapted to
       | construction from standard 4x8 foot sheets of factory made
       | construction material, built as a_ yurt. _[3] It was invented by
       | Vinay Gupta. [4] Hexayurts are common at Burning Man. [5]_
       | 
       | Is there a passive thermal roofline container modification for
       | latrines and dispensaries? TODO link
       | 
       | - [ ] Heat pumps for disaster relief shipping containers
       | 
       | In searching for the shipping container by the ResponsePod folks,
       | I just found an awning specifically for the area between multiple
       | shipping containers in a corral configuration; prefabricated
       | container shelter.
       | 
       | I couldn't find the link. It's a standard sized shipping
       | container emergency response disaster relief dispensary with HVAC
       | but not yet heat pumps FWIU.
       | 
       | - [ ] An open set of plans and modular interface specs for
       | disaster relief shipping containers
        
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