New book by doctor licensed in the UK and Brazil: poorer countries have useful knowledge and methods they could teach about frugal health care

We have a "hidden curriculum" in all of our global health institutions in the West — that West is best — because we generally teach from those sources. So even though there might be excellent research being conducted in Brazil and Argentina and Rwanda and Ethiopia, we don't really draw on it very much. So, what are we teaching our students? We're perpetuating that worldview over and over and over again, which is that that kind of research (from other geographical regions) doesn't matter.

A good example of frugal innovation is hernia surgery. In India, instead of using commercial mesh to treat hernias in an operation, you can just cut a bit out of a mosquito net, sterilize it with ethylene oxide, and actually it's just as good if not better than the commercial mesh at a fraction of the cost.

Another example is postpartum hemorrhage in obstetrics. So when a mother delivers a baby and is bleeding and can't stop the bleeding, one of the devices that we use is called a balloon tamponade device, which you insert into the uterus. You fill it with saline, the balloon gets bigger and bigger, exerts a pressure inside the uterus and stops the bleeding. But you can have the exact same outcomes just by tying a condom onto the end of a urinary catheter. It does exactly the same thing at a fraction of the price. That's being used in Bangladesh and in sub-Saharan Africa as well.

There are many other examples. There's one from the Brazilian Amazon, where researchers have discovered that by using the skin of the tilapia fish, you can treat severe burns, second-or-third degree burns, just by placing the [fish] skin after it's been sterilized onto the burn and leaving it for 10 days. [Unlike topical creams, the fish skin sticks well to the surface of the wound, preventing secondary infections and reducing the need to change dressings as often.] It heals and leads to perfectly good outcomes without needing skin grafts or bandage changes which are painful and can lead to infections. The phase 3 trials that have been conducted in Brazil suggest that the outcomes are just as good and it only costs $11 for a course of treatment