The Facebook post
that launched a
thousand shields
(and counting)

‘Malawian engineer Maya Nkoloma is manufacturing 3D printable face masks that are re-usable’

These words were enough to start a cascade of events in Cambridge that would support a ‘maker’ community responding to the pandemic 7,000 miles away – and kick-start a blueprint for using digital fabrication technologies in future emergencies.

Cambridge PhD student Sandile Mtetwa spotted the message as she scrolled through Facebook. The date was 7 April 2020, four days after Malawi had confirmed its first three cases of coronavirus and a week before Malawian healthworkers walked out of their hospitals in protest at the already severe shortages of PPE face masks and face shields.

Zimbabwe-born Sandile had been keeping a close eye on developments in Africa since the beginning of the pandemic: “COVID-19 poses a serious threat to the health care system in countries like Zimbabwe and Malawi. How African countries like these are able to respond to the pandemic will be different to elsewhere in the world and I was worried.”

She knew that access to PPE, a challenge globally at the time, would be a particular problem in Africa – “and suddenly here was this guy in Malawi making masks on his own 3D printer” – so she made contact.

Sandile spoke to Sara, who spoke to Amit, who spoke to Lara, who spoke to Lucia, who spoke to Maya* – and a project was set in motion to support the Malawian makers.

It was just over a week since Sandile had seen the Facebook post.

_{*Scroll to the end of the article for who’s who in the chain and in the wider team.}

Makerspace opens in Malawi

Lucia Corsini, a researcher in the Design Management Group at the Department of Engineering, takes up the story: “Right from the beginning of this crisis we have seen the ‘maker’ community worldwide step forward to help in the COVID pandemic – whether it’s making scrubs for local hospitals or putting 3D printers or laser cutters to a new use.”

Maya agrees: “At the start of the crisis there were big shortages in Malawi and all the supply chains were blocked. Seeing what was happening around the world, I immediately started thinking about how we could use 3D printing to manufacture solutions locally.”

“When I spoke to Maya I already knew that digital fabrication technologies were in a good place to make a difference,” continues Lucia. “During my PhD I studied how digital fabrication could be used in the humanitarian sector, and in the early stages of the pandemic we saw a huge uptick in maker responses to tackle shortages of critical items.”

Lucia and Maya quickly assembled a team from the University of Malawi (The Polytechnic and The College of Medicine), the Malawian Ministry of Health and Cambridge’s Centre for Global Equality, and successfully applied for funding from the Cambridge-Africa ALBORADA Research Fund COVID-19 Emergency Award.

Their first priority was to start ordering and shipping 3D printers to Blantyre, Malawi, where Maya had a team testing designs for face masks and face shields. By June, a digital fabrication facility had been established with 12 3D printers and one laser cutter. Once the core team of nine male and six female Malawian students were recruited and trained, the non-profit organisation Twenti Makerspace was up and running.

“The team has been split to focus on the design of face masks and the production of face shields,” explains Maya. “Additional students and local community members are supporting with production and assembly of face shields.”

“We are currently seeking regulatory approval by the government. After that, the team can ramp up quickly,” adds Lucia. “Our initial target is 6,500 face masks and 15,000 face shields for local hospitals, and we’ve been granted a temporary exemption from regulatory approvals by the Ministry of Health to start these donations.”

By the end of July, 1,000 face shields had been donated to Kamuzu Central Hospital in Lilongwe and a further 1,000 to Queen Elizabeth Central Hospital Blantyre. Meanwhile, the team has also been producing and distributing face shields to local SMEs and hospitality staff.

The project has also created much interest in Malawi, with the Malawi Agricultural and Industrial Investment Corporation providing additional funds to cover the cost of donating 2,000 face shields to healthcare workers.

Blueprint for a crisis

“Since the beginning of the crisis we’ve seen many inspiring initiatives worldwide focus on supporting low- and middle-income countries to produce PPE and medical equipment,” says Lucia.

In Cambridge, for instance, researchers have developed the printable HappyShield design to mass produce face shields for health workers in the poorest countries. The Open Ventilator System Initiative has designed an open-source ventilator in partnership with local clinicians, engineers and manufacturers across Africa for treating COVID-19 patients.

“These kind of initiatives have really showcased the potential of using digital technologies and Open Source Hardware, where designs are made freely accessible so that anyone can use and modify them, to respond to crisis. I think our project is the final link in understanding the impact of this new ‘maker’ world on the ground.”

But, as hopeful as Lucia is that the team will make a difference in Malawi – and in Ethiopia, where a similar project has now begun – she is only too aware that, in the future, there will be another acute need somewhere in the world.

“It could be another pandemic, a natural disaster, a human catastrophe,” she says. “Normally 60–80% of humanitarian aid is spent on logistics. Digital fabrication can help to produce locally what’s needed, from spare parts to water pipes and connectors, to shelters and assemblies, to life-saving tourniquets and medical equipment. This is critical when supply chains are disrupted.”

And so, as the team in Malawi continues to turn filaments into life-saving equipment, Lucia has started creating a ‘rapid response roadmap’ to identify what’s needed in a crisis to deploy digital fabrication tools in places with limited manufacturing infrastructure and resources.

“It’s about improving preparedness for future crises,” she explains. “We are mapping-out how to deploy a digital fabrication facility, such as assessing the context of local needs, the nitty gritty of how you set up the facility and who operates it… all of the stages that you go through to make sure that the project can effectively respond to the crisis.”

The roadmap also looks to ‘build beyond the crisis’ – to understand how whatever support structure is put in place can slot into the broader local manufacturing ecosystem once the crisis has lessened. “We can reframe crisis as a trigger for long-term sustainability and social impact,” she says.

Reflecting on the past few months, Lucia adds: “It’s been a difficult and challenging time for everyone, but we’ve seen this amazing maker community – people like Maya – get to work on solving a practical challenge. It’s been inspiring. It’s nice that we’ve been able to contribute in some way.”

*Who’s who in the chain of contact?

Sandile Mtetwa, Cambridge PhD student in the Department of Chemistry.

Dr Sara Serradas Duarte, Programme Manager of the Cambridge Global Challenges Strategic Research Initiative, which has been advancing and coordinating projects in low-income countries in response to the pandemic.

Dr Amit Bhasin, Programme Manager of Cambridge–Africa, which administers the Cambridge-Africa ALBORADA Research Fund COVID-19 Emergency Award. Very sadly Amit passed away in June this year.

Dr Lara Allen, CEO of the Centre for Global Equality in Cambridge.

Dr Lucia Corsini, postdoctoral researcher in the Department of Engineering’s Institute for Manufacturing.

Maya Nkoloma, Director of Twenti Makerspace in Malawi.

The wider team now includes...

Dr Ndifanji Namacha, Deputy Director Health Technical Support Services and Head of Physical Assets Management Unit, Ministry of Health and Population Malawi.

Professor Kamija Phiri, Head of School of Public Health and Family Medicine, College of Medicine, University of Malawi.

Dr James Moultrie, senior lecturer and Head of the Design Management Group, Institute for Manufacturing, Department of Engineering.

Alasdair Grant, Director of Carramore International Ltd, a supplier of customised services to medical and life science research in low and middle-income countries, and which supported the team with shipping equipment to Twenti Makerspace. 

How you can support Cambridge’s COVID-19 research