Healthcare

GLOBAL INVESTOR 2.12 — 39
cubators. Finally, taking advantage of locally
available parts to produce medical equipment
helps to lower production costs and increase
fabrication know-how, which in turn promotes
adoption of technology.
Design strategies
Once the design criteria have been established,
the key is to figure out how to achieve
them. This process of invention and design
can be kick-started using a series of strategies.
For instance, hybridization is a mash-up
of two very different objects that transforms
them into more than the sum of their parts.
Cell phone microscopes, such as those from
MIT’s Camera Culture group, are a good illustration.
At its most basic, the device is a
lens on a camera connected to a walkietalkie.
The long-run potential of such combinations
is a network of devices armed with
image recognition algorithms that can share
information and predict disease: the end result
is an early warning system you can store
in your pocket.
Another strategy is the combination of
vintage technologies with modern applications.
What we call “improvisation hunting”
seeks inspiration in the daily efforts of people
in developing country settings to cobble
together their own medical solutions. One
example is the origami asthma spacer designed
at Stanford University in California
after researchers noticed that physicians in
Latin America used cut-up Coca-Cola bottles
to serve as inhaler spacers. This is a 50-cent
innovation for a disease that affects 40 million
Latin American patients.
Once we have decided on a design strategy,
we begin the process of rapid prototyping
through trials in the field. A month in front
of potential users in real-world settings is
worth more than a year in a lab full of whitecoated
engineers. This approach produced
technologies such as our Solarclave (a solarpowered
device for sterilizing surgical tools),
microfluidic (lab-on-a-chip) technologies for
diagnosing diseases and environmental conditions,
low-cost prosthetics, and a DIY device
toolkit.
Arbitraging the supply chain
In the developing world, being locally available
need not mean bamboo and “natural” materials.
Toys have emerged as part of a vast global
supply chain that offers opportunities for
dual-use engineering. For example, the ratchet
mechanism in a toy helicopter can double
as trigger mechanism for a dry powder inhaler.
Electronics inside a talking doll can be
José Gómez-Márquez was born and raised in Honduras. He directs the Little Devices Lab
at the Massachusetts Institute of Technology (MIT) and teaches D-Lab: Health, a course on
designing global health technologies. He is a three-time MIT IDEAS Competition winner,
including two Lemelson Awards for International Technology. In 2009, he was selected for
“Technology Review” magazine’s list of young innovators under 35 (T35), which also named
him Humanitarian of the Year.
repurposed to prototype an alarm for an intensive
care unit. The tight manufacturing
tolerances of Lego bricks lend themselves to
precision diagnostics for modular lab-on-achip
applications.
Helping to foster ingenuity
Construction sets like those of our MEDIKit
Project, now part of LDTC+Labs LLC, consist
of building blocks – traditional devices transformed
into modular, color-coded parts – that
empower doctors and nurses in developing
countries to invent their own medical technologies.
The kits span six areas of medical
technology: drug delivery, paper diagnostics,
microfluidics, prosthetics, vital signs and surgical
instrumentation. The kits show users
how the devices work, enabling them to rearrange
the different component parts to create
a variety of unique devices.
Medical technologies for developing countries
must be affordable and contextually
appropriate. With the right combination of
research and development investment, they
can be profitable. The combination of growing
government health expenses, persistent lack
of infrastructure, and rapid advances in enabling
technologies (rapid prototyping, mobile
telephony, programmable electronics) is
opening the door for many devices to have
an impact on health systems. There is a
strong case for investing in the research and
development and commercialization stages
of the sector. There is also growing evidence
that these technologies can trickle up to developed
world markets. Adherio, a technology
we created for ensuring that Pakistani
patients with tuberculosis follow through on
their medication, is now being transferred to
the USA, where lack of patient compliance
costs an estimated USD 290 billion a year.
Distributed (i.e. non-centralized) and “pop-up”
labs in developing world hospitals are becoming
an attractive option for expensive institutional
research and development centers
with high overheads.
The future is bright for DIY medical technology
thanks to enabling technologies,
global networks of everyday innovators and
the promise of helping scores of patients who
With special thanks to Anna Young of Little Devices Lab
for analysis and research.