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PLoS One. 2015 Aug 7;10(8):e0134332. doi: 10.1371/journal.pone.0134332. eCollection 2015.

Alternative Ultrasound Gel for a Sustainable Ultrasound Program: Application of Human Centered Design.

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University Health Network, University of Toronto, Department of Emergency Medicine, Toronto, Canada.
Western New England University, Department of Industrial Engineering and Engineering Management, Springfield, Massachusetts, United States of America.
University of California San Francisco, Department of Emergency Medicine, San Francisco, California, United States of America.
HEAL Africa Hospital, Department of Emergency Medicine, Goma, Republique Democratique du Congo.
Black Lion Hospital, Department of Emergency Medicine, Addis Ababa, Ethiopia.
Black Lion Hospital, Emergency Medicine Research Center, Addis Ababa, Ethiopia.
Georgetown University, School of Medicine, Washington, D.C., United States of America.
Addis Ababa University, Tikur Anbessa Specialized Hospital, Department of Emergency Medicine, Addis Ababa, Ethiopia.
Kindu General Hospital, Department of Internal Medicine, Kindu, Democratic Republic of Congo.
Albert Einstein College of Medicine of Yeshiva University, Department of Obstetrics & Gynecology, New York, New York, United States of America.


This paper describes design of a low cost, ultrasound gel from local products applying aspects of Human Centered Design methodology. A multidisciplinary team worked with clinicians who use ultrasound where commercial gel is cost prohibitive and scarce. The team followed the format outlined in the Ideo Took Kit. Research began by defining the challenge "how to create locally available alternative ultrasound gel for a low-resourced environment? The "End-Users," were identified as clinicians who use ultrasound in Democratic Republic of the Congo and Ethiopia. An expert group was identified and queried for possible alternatives to commercial gel. Responses included shampoo, oils, water and cornstarch. Cornstarch, while a reasonable solution, was either not available or too expensive. We then sought deeper knowledge of locally sources materials from local experts, market vendors, to develop a similar product. Suggested solutions gleaned from these interviews were collected and used to create ultrasound gel accounting for cost, image quality, manufacturing capability. Initial prototypes used cassava root flour from Great Lakes Region (DRC, Rwanda, Uganda, Tanzania) and West Africa, and bula from Ethiopia. Prototypes were tested in the field and resulting images evaluated by our user group. A final prototype was then selected. Cassava and bula at a 32 part water, 8 part flour and 4 part salt, heated, mixed then cooled was the product design of choice.

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