How to Make a Hardware Store Drill Into a Surgical Tool

When it comes to global public health, a lot of effort goes towards stamping out disease like HIV, malaria, and tuberculosis—and rightly so. These are plagues in many parts of the world. But something we typically focus less energy on, is surgery.

"People call it the neglected stepchild of global health," Florin Gheorghe, CEO and co-founder of Vancouver-based Arbutus Medical, told me. He's visited hospitals in some African countries where people were laid low by terrible motorbike injuries, which can lead to all sorts of economic and social hardships down the road for their entire families when they aren't treated properly, he said.

Hospitals in remote or rural areas don't always have access to surgical drills, which can cost upwards of $30,000 each. Doctors might have nothing better than a "hand-crank" drill, an instrument that works by turning it by hand—or they might have to improvise with a non-sterile construction drill, according to Grand Challenges Canada, a government-funded agency that supports global health projects in the developing world.

Gheorghe's company has come up with a fairly unorthodox solution to making surgical tools cheaper and more accessible. They've developed an attachment that, when fitted on a regular hardware store drill, can turn it into a sterile surgical instrument.

The work is considered so promising that, on Thursday, Grand Challenges Canada announced that it's investing $1 million in Arbutus Medical, to speed up its development and extend its reach. (Six Canadian companies are being funded in this latest round, including Arbutus.)

Arbutus' design involves, essentially, a bag that fits over a regular drill, and can easily be sterilized and re-used. You can imagine a hospital keeping a stack of them on hand in the operating room. In clinical tests comparing this to hand drills, the drill cover cut surgery time by about 30 minutes per patient, and surgeons reported fewer problems when drilling bone, said Grand Challenges Canada, which funded that bit of research.

"Think of it as a drybag for camping," he told me. "You put the drill inside the bag, which is waterproof and pathogen-resistant." The drill bit is then used on the patient.

It's mostly for fixing bones after injury, he said, although it's also been used by plastic surgeons, who are trying to help children who've burned their hands. "They might end up with contracture," which is when the fingers bunch together as they heal, Gheorghe explained, "and the doctor needs to put in wires and screws" to straighten them.

Arbutus Medical launched in 2013. Their device is already in use in many parts of the world, including in Syria and in Nepal (where healthcare workers relied on it after the 2015 earthquake), and in several African countries, Gheorghe said.

Private investors will match the Grand Challenges Canada money, and the company is growing quickly. It recently became FDA-listed, and should be approved by Health Canada soon. Partnerships are in the works with humanitarian groups and medical distributors. It's looking at developing other products, too, like surgical saws.

There are a whole lot of challenges in providing healthcare in rural or remote parts of developing countries, Gheorghe said. "Access to safe equipment is a big one."

An estimated 5 billion people around the world don't have access to safe surgical care, according to Grand Challenges Canada. For them and their families, something as basic as a sterilized hardware store drill could actually make a huge difference.

Correction: The last image was incorrectly attributed. Photo credit has been updated.