Biomedical Engineers : More Than 'Repair Boys'

More Than 'Repair Boys': The Hidden Battles & Unsung Triumphs of Nepal's Biomedical Engineers

Every accurate lab report in Nepal hides an untold story—not just of skilled technicians, but of the Biomedical Engineers fighting silent battles to keep machines alive. Imagine this: In a busy Nepali hospital, a critical diagnosis hangs in the balance. A life potentially saved, or lost, depending on the results out by a complex machine – a hematology analyzer, a chemistry system, an immunoassay reader. Behind that machine, ensuring its silent, precise operation, stands an unsung hero: Biomedical Field Service Engineer.

As a Beckman lab equipment service engineer in Nepal, I carry more than just a toolkit—I carry the weight of misused machines, unpaid overtime, and a system that undervalues my expertise. This isn’t just a job. It’s a daily war against preventable breakdowns, corporate shortcuts, and a healthcare system that treats us like "repair boys" instead of professionals.

This is not just a list of issues — it’s my lived experience, and that of many fellow biomedical engineers across the country.

🔴 Brutal Realities Killing Nepal’s Biomedical Engineers

🔍 1. Improper Use and Mishandling of Equipment

The Challenge: Lack of user training leads to repeated issues — analyzers are overused, calibration is skipped, and sensitive reagents are stored incorrectly.
Impact: Equipment fails prematurely due to user error, not technical faults.
Our Role: We’re stuck fixing the same preventable problems, while hospitals grow frustrated.

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⚡ 2. Unstable Power Supply

The Challenge: Frequent voltage fluctuations, surges, and power outages. Many labs operate without UPS or voltage stabilizers.
Impact: Damaged circuit boards, corrupted software, and extended machine downtime.
Our Role: We repeatedly repair damage that could have been avoided with basic safeguards.

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💰 3. Inadequate Compensation

The Challenge: Despite technical degrees, travel, and high-pressure responsibilities, most engineers earn between NRs. 18,000–35,000 per month.
Impact: Skilled professionals leave for better opportunities abroad or switch careers.
Our Role: We continue to serve despite burnout and minimal recognition.

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🧭 4. Ethical Dilemmas

The Challenge: Pressure from some suppliers to conceal recurring faults, avoid warranty claims, or offer temporary fixes.
Impact: Compromises trust, erodes accountability, and risks long-term system failures.
Our Role: We face difficult choices between professional integrity and employer expectations.

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⏰ 5. Lack of Work-Life Balance

The Challenge: Biomedical engineers are expected to be on-call 24/7, without additional pay or time off.
Impact: Chronic stress, fatigue, and mental health issues.
Our Role: Despite this, we continue responding to emergencies around the clock.

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🧑‍🔧 6. Lack of Professional Recognition

The Challenge: Engineers are often treated as “repair technicians” rather than specialists with critical knowledge.
Impact: Exclusion from planning, procurement, and key decision-making.
Our Role: Our expertise is vital, but frequently overlooked.

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⚠️ 7. Use of Incompatible Reagents

The Challenge: Labs often use third-party or unapproved reagents to reduce costs.
Impact: Machine errors, failed calibrations, and damaged sensors.
Our Role: We are often blamed for faults caused by incompatible inputs beyond our control.

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🧰 8. Ignored Preventive Maintenance (PM)

The Challenge: PM is treated as optional and often skipped due to cost concerns.
Impact: Minor wear turns into major breakdowns, causing unnecessary downtime.
Our Role: We recommend PM routinely, but our advice is frequently dismissed — until a crisis occurs.

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🔧 9. Lack of Spare Parts and Tools

The Challenge: Engineers are often expected to repair machines without proper parts, tools, or manuals.
Impact: Pressure to improvise with unsafe, temporary fixes.
Our Role: We either perform risky repairs or face pushback for refusing.

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🖥️ 10. Software Incompatibility with LIS

The Challenge: Imported analyzers often do not integrate with local Laboratory Information Systems (LIS).
Impact: Lost results, patient ID mismatches, system crashes.
Our Role: Despite limited IT training, we are expected to resolve complex integration issues.

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🔧 Proposed Solutions: Reforms That Can Make a Difference

To address these systemic issues, we propose the following reforms:

1. Mandatory User Training

   • Place clear “Do’s and Don’ts” next to each machine.

   • Enforce penalties for repeated misuse.

2. UPS & Stabilizer Requirement

   • Include power protection in all equipment procurement contracts.

3. Minimum Salary Standard

   • Set a base salary of NRs. 50,000 for biomedical engineers with degrees.

   • Introduce service-call-based incentives.

4. Ethics & Accountability Framework

   • Protect whistleblowers and ensure transparent fault reporting systems.

5. Fair Overtime Compensation

   • Pay double for on-call work outside business hours.

   • Introduce shift rotations or backup teams.

6. Professional Inclusion

   • Involve engineers in procurement and lab design decisions.

   • Recognize our role in quality care delivery.

7. Enforce Reagent Compatibility

   • Make warranty conditional on the use of approved reagents.

   • Allow engineers to reject unsafe service conditions.

8. Link PM to Warranty Validity

   • Require signed PM contracts and offer subsidized plans.

   • Hold suppliers accountable for promoting regular PM.

9. Maintain Spare Inventory

   • Suppliers must stock essential parts (at least 5% of equipment value).

10. Standardize LIS Integration

    • Develop national standards for analyzer-LIS compatibility.

    • Ensure pre-installation testing and coordination between vendors.

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🙌 Let’s Recognize the Real Backbone of Diagnostics

We are not background staff. We are not “just technicians.” We are biomedical engineers — the ones who ensure your diagnostic results are accurate, your machines calibrated, your labs functional.

Nepal’s healthcare system cannot grow without supporting the people who support the machines.

🧰 It’s time to shine a light on our stories, and stand up for the respect and resources this profession deserves.