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Πέμπτη 7 Ιουλίου 2016

Bogotá, Colombia – A Study of Medtech Contrasts

Bogota
Chances are, when you think of the country of Colombia, the two "C's" come to mind: cocaine and crime. While this may have been true 30 years ago, the country has come a long ways in terms of eliminating drug and crime issues and shedding its bad reputation. Just a couple weeks ago, the Colombian government signed a ceacefire treaty with the Revolutionary Armed Forces of Colombia (FARC), a guerrilla organization, paving the way for a peace treaty and stability in the country.

Invest in Bogotá, a public/private organization dedicated to helping existing businesses with promotion and exposure within the capital city, as well as encouraging new national and international companies to set up shop in Bogotá, invited us on a press tour of the city to learn more about its healthcare sector. Starting at the Meditech Conference that was going on in the city's convention center during our visit, we circled around the city over three days, visiting various device companies, medical foundations, and clinics.

The current medical scene in Bogotá (and the entire country) that we witnessed was an interesting mix of both high- and low-tech, highlighting the difficulties and triumphs within the healthcare industry.

Bogota-production-facility
One of our first stops was to the Cirec Foundation, a clinic that provides prosthetic limbs to the many Colombians who cannot afford them. As we toured the facility, we observed how each prosthetic arm and leg was hand-crafted using techniques that would probably be considered outdated in some countries. But we also heard stories of the many patients, namely children whose limbs were blown off by old landmines or amputated as a result of falls into illegal mining pits, who have been served by Cirec. We also learned about Cirec's work with Carlos Arturo Torres, a Colombian industrial designer who developed an award-winning Lego-based prosthetic limb called the IKO.

EditorDespite the difficulties Colombians have to face in terms of healthcare, the country has actually long been a pioneer in medical innovation. During our visit to the Shaio Clinic with its emphasis on cardiology, we had the opportunity to meet Dr. Jorge Reynolds, who played a major role in realizing artificial cardiac pacemakers.  His pacemaker was literally a car battery and vacuum tubes to regulate the voltage and timing, connected to the inside of the patient's chest with a few very large wires. Though 80 years young, Dr. Reynolds directs research at the Shaio Clinic and has recently developed a self-powered "nano-pacemaker" smaller than a grain of rice, and will be starting clinical trials of it in just a matter of months. His also is involved in the development of a digital stethoscope that utilizes the cloud to assist with the diagnosis of heart sounds.

Another medical pioneer we met was Dr. Carmen Barraquer, of the Barraquer ophthalmology schools and clinics in Barcelona, Spain and Bogotá, and one of the foremost experts in the field of refractive vision correction. Throughout the 1940's-50's, her father, Jose Barraquer, developed the surgical technique that would evolve into LASIK and related vision correction surgeries. Today, the Barraquer Clinic in Bogotá constantly receives the most advanced ophthalmological devices and utilizes new, cutting edge surgical procedures. We were told that Dr. Barraquer, who is in her 70's, still receives laser vision correction systems direct from manufacturers in Germany for guidance and testing before they are released for sale.

Insimed
One final example of advanced medical technology in Bogotá was Insimed, a training center for physicians that uses the latest in medical simulation technology. Much like Stanford University's medical simulation center that we visited a few years ago, Insimed's training approach uses high-tech mannequins, laparoscopic and endoscopic simulators, and even a daVinci robotic surgery trainer. The didactic simulations also include additional discussion and feedback in one of Insimed's connected conference rooms. According to Insimed's director, the center is the only fully independent training center in the Americas, and Colombia's location and low cost makes it attractive to physicians from not only Latin America, but even from the U.S. and all around the world.

Our tour of Bogota ended, appropriately, in the emergency department of San Ignacio University Hospital. There, we witnessed the reality of Colombian healthcare; overcrowded halls and extremely long wait times reminded us that we were still in a developing country. But even in the hustle and bustle of the ER, the hospital staff prided themselves in a specially made waiting room chair that could recline, hold an IV drip, and accommodate a meal tray to make the long stay just a little more bearable.

In conclusion, Colombia has a very pioneering spirit when it comes to medical technology. Despite some lack of resources as a still developing nation, an imperfect healthcare system, and a not-so-positive reputation based on its checkered history, Colombians have found a way to make things work, and in some cases, have shown themselves to be ahead of the curve in medical technology. With numerous tax incentives, a strategic location, and a friendly culture with a low cost of living, the government is hoping to make Bogotá the capital of medical technology in Latin America. If the country continues to make as much progress in the next 20 years as they have in the past 20, we think it's certainly possible.

Scott would like to thank Ligia Escudero, David Canal, Juan Sebastián Pérez, and the rest of the Invest in Bogota team for hosting!

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