Little did he know that COVID-19 would present him with an opportunity to save lives across the region — and, pending FDA approval, the entire world.

After lots of thought and consultation, the team Parker put together in March 2020 decided that a blower-based BiPap (bilevel positive airway) system was the way to go. A core group of five or six people moved mountains to complete a working prototype by the middle of the year. While working on the BiPap machine, Parker also made a much smaller, cheaper and simpler system in his home workshop: OxERA 1.0.

Everyone in the team, which was now officially known as Umoya, expected the BiPap to be more effective than the OxERA. But when the two were put to the test, the OxERA was the clear winner. While both devices were very oxygen efficient, only the OxERA was effective at treating severe pneumonia, and it didn’t even require electricity to work (it’s controlled by the patient’s breathing and the oxygen source). “It was a massive win for scalability,” recalls Parker. “The BiPap system would have been really expensive to produce.”

PEEP valves are not especially complicated or expensive, but they are usually only found in high-end machines like ventilators. Their inclusion in the OxERA was revolutionary, says Nash, who found that — thanks to the support provided by the PEEP — the device could sometimes even be effective in treating COVID-19 patients when not connected to oxygen at all.

While the benefits for developing nations and low-resource environments are obvious, Parker has also spoken to doctors in rich nations who are excited to add the OxERA to their arsenal. “It would be really useful in ambulances, when bulk oxygen is unavailable,” he explains. “And even for taking patients who are on high-flow nasal oxygen out of their wards for X-rays or other procedures.”

Nash is also keen to point out that its applications extend far beyond COVID-19. “We’ve had great success using it to treat pregnant women with pulmonary edema. And it even seems to help with PCP pneumonia,” a serious infection that’s common in HIV patients.

Parker was born in Zimbabwe, so he has a soft spot for the place and a deep awareness of the challenges facing healthcare providers there.

Since receiving their first batch of OxERAs in September 2020, Kufema has leveraged its contacts with local municipalities to distribute 231 units to all 10 provinces of Zimbabwe. “The OxERA was incredible,” says Le Breton. “I’ll never forget the first time I got a message saying: ‘Your device saved a life last night.’ And it was by no means the last.”

The data Kufema has been able to gather from providers around Zimbabwe shows that the OxERA achieved a 59% recovery rate — quite something when you consider that in most communities in Zimbabwe it was mainly used on people in severe breathing distress. “Of course there were sad stories,” she adds. “But without the OxERA there would only have been sad stories.”

Nash tells a similar story about the rollout in South Africa’s Eastern Cape. Within months, “hundreds” of OxERAs were in use at almost every healthcare facility in the district. “As the pandemic progressed, we became really aggressive in how we used oxygen. We found giving patients the OxERA within 30 minutes of admission to be really effective,” she explains, before adding: “We should have them at every clinic in South Africa. And it would be wonderful if they could spread around the world.”

On that note, Umoya has already teamed up with Gabler Medical in Cape Town to mass produce the OxERA. Thus far, Gabler has sold around 13,000 units at an average price of $80 — although governments and NGOs typically pay less than this. Regulatory challenges mean the OxERA hasn’t yet made it much further than southern Africa, but Gabler is in the process of getting U.S. Food & Drug Administration approval for the device. If all goes according to plan, this should be in place by early 2023.