Since 2018, Creating Hope in Conflict: A Humanitarian Grand Challenge has provided proof of concept (Seed) and transition to scale (TTS) funding to 75 innovations intended for use with conflict-affected populations in over 20 countries. We embarked upon a learning journey to better understand how innovative products and processes could be tested and pointed towards scale in humanitarian settings, in order to help solve some of the most complex problems and barriers within the humanitarian sector.
This post is one of many SEED Stories: a series of blogs reflecting on what HGC-funded innovators have achieved and key lessons learned during the duration of their seed grant periods.
Civilians, increasingly the target of hostilities in conflict areas, represent the majority of casualties from explosive weapons, landmines, and military attacks in current conflicts. Shortages in medical supplies and personnel make it difficult for humanitarian actors to respond to mass casualties and provide ongoing wound care. Poor hygiene in other under-resourced contexts, such as post-natural disaster or in poverty-affected communities, also lead to high levels of injury-related infections. With a dearth of inadequate wound and trauma care, infections are a common cause of death and loss of limbs in conflict-affected zones. Excess fatalities from otherwise treatable ailments, or infections that become resistant to antibiotics, increase the civilian toll from conflict.
How Griffith University Tackled this Challenge
MedMagLabs received a seed grant of CAD $250,000 to address the need for more reliable and effective wound treatment in conflict and disaster setting. MedMagLabs—a research group at the School of Medicine and Dentistry at Griffith University—developed novel approaches to the supply of medicinal maggots for maggot therapy, which is the application of living fly larvae to remove dead tissue from wounds, control infections, and promote healing. The project team prototyped and optimized a shipping container lab (C-lab) for large-volume medicinal maggot production, while also developing small do-it-yourself production set-ups (DIY-labs) for affected communities to build and operate the systems locally. Multi-lingual illustrated training manuals were developed to permit professionals and lay people to safely produce maggots and treat wounds on site in humanitarian response settings.
Although the innovator faced challenges with field deployment, throughout the HGC funding period MedMagLabs have succeeded in creating a successful foundation for future implementation of maggot therapy by humanitarian partners. During their HGC grant, MedMagLabs created and published treatment manuals, DIY-Lab and C-Lab instructions, and related knowledge products needed to implement maggot therapy in emergency settings. A key achievement has been the DIY-Lab and related user manuals that empowering communities to take charge of their wound care needs not only in humanitarian aid settings, but also more generally in low- and middle-income countries.
The treatment manuals were created with engagement from Griffith University students who studied the communication approach with healthcare providers and patients from India through a variety of networks, confirming the suitability of the communication approaches used in the manuals. Thanks to these efforts, two maggot therapy treatment videos have now been produced in three languages in addition to a highly visual , and which are also richly illustrated to make information more accessible.
Throughout the research and development stages, MedMagLabs also collaborated with student citizen scientists who represented proxies for conflict-affected communities. The have contributed to much-improved manuals for medicinal maggot production.
A welcome information dissemination opportunity for the MedMagLabs project has been the contribution of content to several chapters of the landmark publication , edited by Dr Frank Stadler, and published at the creative commons publishing house Open Book Publishers.
Partnerships Built
While developing their product, the team engaged with several potential end users. In Yemen, the team spoke with the Vice Minister of public health and population, who expressed interest in the use of maggot therapy for low-cost, low-resource wound care in Yemen. Similar interest was expressed by representatives from Afghanistan’s Relief Humanitarian Development Organization. MedMagLabs also encouraged the White Helmets in Syria to implement the DIY-Lab technology, but this work was interrupted by the recent devastating earthquake.
In Fiji, MedMag Labs met with and delivered presentations to several key health sector experts. During discussions, locally relevant uses for maggot therapy were identified including treating diabetic foot ulcers, which are highly prevalent among the Fijian population, and managing tropical cyclone-related wounds and injuries.
MedMagLabs has also initiated a collaboration with SwoopAero to explore the potential of medicinal maggot distribution and shipment in low- and middle-income countries with the help of drones.
Lessons Learned
Some key lessons learned over the course of Griffith University’s seed grant include:
- While access to end users and affected communities is vital for ground testing of innovations, much development work can be undertaken remotely with educated assumptions and consultation with key informants.
- A sufficient human resources budget is needed in order to optimize the engagement of multidisciplinary research teams in varying and sometimes remote locations.
- Supply chain innovation is essential to streamlining the provision of maggot therapy in challenging healthcare settings.
- Hard-shelled container-based medical infrastructure is difficult to move at short notice. Medicinal maggot laboratories in emergency settings may be better set up in soft-shelled infrastructure or existing buildings.
What’s Next?
Having completed the design phase, the MedMagLabs team has embarked on an information dissemination and awareness-raising campaign through their networks, social media platforms, and professional organizations, while targeting already-interested parties in Afghanistan, Yemen, India, Fiji and elsewhere. MedMag Labs is currently:
- Seeking and encouraging collaboration with communities or organizations interested in implementing their DIY-Lab with the aim of monitoring and evaluating the production methods and the user-friendliness of the manuals.
- Driving further supply chain innovations to improve accessibility and commercialization in markets where the logistics infrastructure does not support rapid shipment of perishable medical goods.
MedMag Labs’ long-term plans include facilitating the establishment of professional production facilities in both high-income and low- and middle-income countries. They will also translate existing manuals for different contexts and conduct further research and development to refine their technology for use in other challenging healthcare environments such as disasters, rural and remote communities, fragile and volatile settings, and military medical aid.
MedMagLabs innovations and maggot therapy in general will also require further research and development addressing institutional and attitudinal barriers preventing maggot therapy the requirements for mainstreaming maggot therapy, creating efficient and resilient supply chains, and establishing profitable for-purpose business models for maggot production and therapy in various healthcare settings. The latter will be particularly important as MedMagLabs has spun-out from Griffith University in 2021 and become a fully-fledged independent startup looking for funding and investment opportunities as part of a long-term scaling vision.