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The new medical oxygen distribution system at San Diego Hospital in Cereté, Colombia has drastically improved patient health outcomes. (Courtesy of PAHO)
When the Covid-19 pandemic hit in 2020, hospitals around the world quickly realized they were hugely lacking in a seemingly simple treatment: oxygen, which plays a critical role in treating conditions like pneumonia, childbirth complications, surgical emergencies, and infectious diseases. As more and more people struggled to breathe, it became clear that having reliable access to quality medical oxygen often meant the difference between life and death.
Though ambient air contains oxygen, medical oxygen is specially processed to ensure a high purity, for use in medical treatments and to support patients with conditions that cause low blood oxygen levels. Medical oxygen can be much harder to access in low- and middle-income countries, where fewer than one in three patients who need medical oxygen receive it.
Investments in medical oxygen have increased since the start of the Covid-19 pandemic, but the gap to fulfill the global need remains large. Direct Relief is investing in oxygen infrastructure around the world, including through recently completed projects in North Africa and South America, to help close access gaps, strengthen health systems, and prepare for future pandemics.
Community Hospital in Eastern Libya Equipped with Oxygen Distribution System
When Cyclone Daniel caused catastrophic flooding in the coastal Libyan city of Derna in 2023, Al-Wahda Hospital’s ICU was overwhelmed. Without a centralized oxygen distribution system, the hospital was forced to use oxygen cylinders — metal containers filled with compressed oxygen that are delivered to patients through tubes, masks, and other devices.
The cylinders, though portable, are heavy and bulky, making them extremely difficult to transport during emergencies like the Derna flood. That delay posed a major risk to patients at Al-Wahda Hospital.
“In most cases, they struggled with having those oxygen cylinders on time,” said Mohammed Eshkal, Head of External Relations at Shaikh Tahir Azzawi Charity Organisation, or STACO, a Libyan nonprofit focused on health, education, and disaster relief.
With grant funding from Direct Relief, STACO oversaw the installation of an oxygen distribution network at Al-Wahda Hospital that pumps oxygen to patients at their bedsides through a piped system, removing the need for cylinders.
The new infrastructure has already significantly improved patient health outcomes. According to staff, approximately 200 people per month directly benefit from the new oxygen delivery system, especially those with critical and ongoing oxygen needs.
Al-Wahda Hospital in Derna, Libya, now has a centralized oxygen system that pumps oxygen directly to patients’ bedsides. (Photo courtesy of STACO)
“Around 85% of the medical staff observed improvement [in] patients’ outcomes, particularly in critical and surgical,” Eshkal said. “Also, around 89% of the patients in the critical care and recovery units reported improvement in their comfort and recovery times.”
Direct Relief provided STACO with $78,000 in grant funding for the project. The funds also covered training for hospital personnel to ensure they can operate and maintain the oxygen system in the long term.
Al-Wahda Hospital’s ICU serves approximately 50,000 people, many of whom are migrants and Internally Displaced People who are often subject to violence and a lack of healthcare access.
Libya is facing widespread violence and a migrant crisis as people try to reach Europe via the Mediterranean. It’s one of many countries in the Middle East and North Africa region with significant gaps in medical oxygen capacity.
Meanwhile, the city of Derna is still recovering from Cyclone Daniel, which killed thousands and destroyed much of the city. The disaster marked the first time Direct Relief provided support in Libya.
Oxygen Systems Overhauled at Three Rural Colombian Hospitals
Colombia, like Libya, faces significant shortfalls in medical oxygen access. Three hospitals in rural Colombia now have access to reliable, high-quality medical oxygen thanks to a collaboration between a Colombian nonprofit, government agencies, and Direct Relief.
To fund the construction of these three projects, Direct Relief supplied a $650,000 grant to its longtime partner Banco de Medicamentos, a Colombian aid group that stores and distributes medications across the country. The organization has been responding to the Venezuelan migrant crisis in the country for years.
With input from the Colombian Ministry of Health and the Pan American Health Organization, or PAHO, Banco de Medicamentos overhauled medical oxygen systems at three hospitals across the country. Previously, the hospitals’ oxygen systems could not meet their patients’ needs due to deterioration and design issues.
Juan Pablo Reyes, Banco de Medicamentos’ head of Legal and Regulatory Affairs, said this is a widespread problem in the country. When Direct Relief and PAHO approached the organization with the project, it was an easy yes.
“This is sad to say, but choosing public hospitals in need of help or improvements in Colombia is not a difficult job,” said Reyes. “Most of them lack the most basic facilities and equipment. This is a dramatic situation here.”
The three hospitals are located in the rural municipalities of Cereté, San Marcos, and Cumbal. Before this project, their medical oxygen systems were functional but insufficient, with several safety risks, design flaws, and missing parts.
In addition to creating safer and more reliable oxygen systems, the new upgrades also allowed the hospitals to expand care. The increased capacity enabled Hospital San Diego in Cereté to add six neonatal beds, allowing them to treat infants who need intensive care.
Along with reliable access to quality oxygen, the new beds will likely save many infants’ lives, according to Reyes.
San Diego Hospital in the Colombian city of Cereté expanded its neonatal weird thanks to Direct Relief grant funding. (Courtesy of PAHO)
“You cannot depend on portable oxygen while having plenty of patients to take care of, especially children and newborns,” Reyes said. “They were hopeless without oxygen. Now, they have the hope to be born and raised in Colombia.”
The project was part of the Pan American Health Organization’s Smart Hospitals Initiative, which aims to make hospitals more resilient through structural improvements like the addition of medical gas infrastructure or renewable energy systems.
Thanks to the collaboration between Banco de Medicamentos, PAHO, and Direct Relief, Colombia is now the second country in South America, after Guyana, to receive an intervention through the Smart Hospitals Initiative.
Direct Relief’s grant included funding for training staff on how to use and maintain the new equipment, along with administrative and logistical costs.
The three hospitals are critically important healthcare facilities for their regions, with a combined 400,000 patient population in their service areas. Rural regions of Colombia face severe public health challenges like a shortage of doctors, high vulnerability to natural disasters like earthquakes and floods, and the strain of the Venezuelan migrant crisis on healthcare facilities.
Working to Make Every Breath Count
Erick Molina, Direct Relief’s Regional Director for Latin America and the Caribbean, learns about the new medical oxygen system during a tour of San Diego Hospital. (Courtesy of PAHO)
Hospital oxygen plants are just one of many interventions that can help improve oxygen access in resource-limited settings like rural Colombia and Libya. Small community health centers, mobile clinics, and at-home care settings also have a great need for reliable oxygen, and Direct Relief employs a range of solutions to help bring oxygen access to the last mile.
Since the start of the Covid-19 pandemic, Direct Relief has invested over $25 million in a wide range of interventions across the U.S. and abroad, from repairing oxygen plants to supplying oxygen concentrators and distributing pulse oximeters.
