DevC, MD: Medical Solutions for Developing Countries

For infants born in especially poor areas incubation can sometimes be a problem.  However this problem was recently solved by a team of students at Stanford University.  See the attached image for a description of how the incubator functions.  Also the group has set up a non-profit organization, Embrace Global, whos goal is to try and promote awareness of their solution.  Additional information along with a video description can be found here.

Here are a couple of interesting facts about world health, according to the World Health Organization (WHO):

• The poorest paid 85 percent out-of-pocket for their health care costs in 2006.

• More than 60 percent of medication in low-income countries are only available through the private sector, where the cost is more than six times the international market price.

• Two doctors tended to every 10,000 residents in Africa, while 32 did that same job in Europe.

• There are 112 million underweight children worldwide; nine million died before age five.

• More than half a million women die every year in pregnancy or in childbirth complications, 99 percent of them in developing countries. This rate barely changed from 1990 to 2005, the most recent year for which there is data.

• The maternal mortality rate in Afghanistan and Niger in 2005 was 1,800/100,000 live births; births attended by skilled health personnel in those countries were 14 percent and 18 percent, respectively.

• More than three billion people were at risk of malaria in 2006; 27 countries reported halving malaria infection and/or deaths from 1990 to 2006.

• Thirty-three million people were living with HIV. Less than one-third requiring HIV treatment in Africa are receiving medicines.

• More than one billion were affected by neglected tropical diseases.

• Thirty-six countries reported more than 25 percent of their youths smoked.

• Fifty-four countries reported less than half their populations used safe sanitation facilities.

• People living in Southeast Asia spent US$31 each on health while those in the Americas spent on average more than $2600 each in 2006.

• Forty percent of children’s deaths in Africa occurred within the first 28 days in 2004, most in the first week.

Welcome all of the new users which have joined the past week. Its been a pleasure getting to know all of you.

I’m proud to present an official collaboration between the Indian Biomedical Engineers and Technologists Association and DevC,MD.com. It is a pleasure having you onboard.  If you have any additional questions about the association please contact Chintak Dholakia at chintakdholakia@gmail.com.

If you had a chance to login to the ProjectPier platform you will see the new projects which are being added.  Many of these projects are excellent places to get started developing in the community.  Some projects which need some immediate help are:

• Writing blog reports for devcmd.com-DevC, MD started as a blogging site which emphasized medical solutions for developing countries.  As I have continued to work on other aspects of the website I need some help continuing this.  There are new solutions/products which I have posted in the ProjectPier (under the project “New to devcmd” project).
• Creating Printed Circuit Board Layouts-  Anyone that is interested in electrical engineering and has access to Eagle Layout Editor.  This would be a great opportunity to get familiar with the software package as well as helping with building the pulse oximeter and spirometer.

Also some updates on the pulse oximeter and spirometer development:

Pulse Oximeter

• The first verision of the schematic has been completed.  Once a PCB layout is done we will be able to start testing the inital prototype
• Internship team has been working this summer on developing the algorithms which will be used for acquiring SpO2 data.  They have developed this algorithm in MATLAB, but they are now working on implementing in C (which will be loaded onto a microcontroller).

Spirometer

• Team of University of Wisconsin-Madison Biomedical engineers is developing the hardware for the spirometer.  They have recently created a Fleisch design.
• Amit Nimunkar will be working on creating the electrical hardware design which will be used to acquire data from the spirometer and send the data over USB.
• Team of interns is working on creating algorithms which will be used in analyze spirometer data.  The team is working to comply with ATS Standards.  Currently the algorithms have been implemented in MATLAB, now the team is working to implement in JAVA.  The JAVA platform will serve as the GUI (graphical user interface) for the USB based spirometer.

Finally continue to contribute to the website.  Take a look at the task lists for projects see what you think.  Please send me any questions you have.

The DevC, MD community is rapidly growing and you are encouraged to participate in the development of all products. By working on an open-source platform, the DevC, MD team will be able to make healthcare accessible throughout the world.

In order to create a structure that will assist in the development, I have recently installed an application, Project Pier, which will help us manage the collaboration. To create an account sign-up here.  This platform allows for To-Do lists, messaging, and file uploading which will all be very useful once everyone get working together.  I encourage everyone to sign-up today!

The MedCal, an idea which was designed at MEDECAL Labs to be a handheld device with the capability to monitor different vital parameters.  The goal is to incorporate the simpler pulse oximeter and spirometer into this compact device.  The pulse oximeter and spirometer would function as stand-alone units, but they could also be connected the MedCal for increased functionality.

Here is a mock-up of the final prototype, created by Chris Esser of the mechanical engineering department.  The prototype is currently displaying a pulse oximeter signal.  Would Doctors in developing countries be interested in a device like this?

I encourage all of you to think outside of the box in regard to making all of these solutions a means of bringing about a sustainable change.  One of my partners, Amit J. Nimunkar, and myself gave a presentation at the Steven G. Burrill Business Plan Competition at the University of Wisconsin-Madison.  Our plan was to try to put together a plan that could provide affordable healthcare for developing countries, while at the same time making the entire process sustainable.

Unfortunately we did not win the competition, but we were able to learn quite a bit through the entire process.  Please take a look at the presentation and express our thoughts.  I also encourage you to perform a similar thought excercise to determine how we can all bring about a sustainable social change.

Times may be changing.  The new generation of entrepreneurs are not focused just on making profit, some are using these ventures as a means to being about social change.  This is why social entrepreneurship is one of the main topics which this blog is built around.  Social entrepreneurship refers to a process of creating a venture to use it as a vehicle for social change.

Interesting methods of going about designing for social change are currently being discussed.  One of the best I have seen is from IDEO, a global design firm.  They have developed a human centered design toolkit.  The toolkit was developed with funding from the Gates Foundation and provides a framework for designing a social venture.  They describe the process as being three fold first you ‘hear’, then you ‘create’, finally you ‘deliver’.   ‘Hearing’ puts yourself in the shoes of the individuals.  ’Creating’ is used to determine the viability of a design.  Finally, ‘deliver’ discusses how you can determine if the entire venture will be viable or not.

Each of these aspects translates directly into the healthcare field in developing countries.  Many times entrepreneurs are not familiar with how developing countries function.  Thus there is a need to place the entrepreneur in the developing countries to ‘hear’ what needs to be accomplished.  Also ‘creating’ is important to ensure the problem can be solved, and ‘delivering’ is needed to ensure the viability of the operation.

Finally after getting this blog up, I wanted to post some opinion articles that hopefully stimulate some thoughts within the community.

I am not your average humanitarian.  In fact, I have never been to a developing country (hopefully that will change soon).  I have never witnessed the healthcare problems in developing countries firsthand.   I had never found engineering for developing countries particularly interesting.  I was always interested on the cutting edge, what had never been accomplished before.  However, my thought process changed a couple months back and I am here to tell you why anyone interested in lowering their healthcare bills (which should be everyone) should be paying attention to healthcare in the developing world.

Healthcare in the United States is in disarray.  Incentives throughout the entire industry are misplaced.  Many indviduals within the industrys are getting paid for patient volume not for outcomes.  Unlike every other article that you read about this topic, I am not here to place blame on one specific group of people.  That would be too easy and it would not address the true problem.  The entire system is at fault.  I would like to offer my opinion from an industry that I am familiar with medical device companies.

Medical companies, which drive much of the technology that is currently in use have also been approaching the process wrong.  These medical companies are producing technology which is increasingly more advanced and thus more expensive.  However, it does not stop there.    Companies are continually driven by their cusomters and business strategies to build sustaining innovations, or innovations that continue to build upon existing products. Unfortunately, these innovations add little or no value to the end users.  These high costs associated with development are then passed onto patients which incur a large hospital bill.

For example, the MRI machine, probably one of the most complex and ground-breaking instruments of the last century has become a fixture of the modern hospital.  These scans cost well over USD $2,000, but I argue is it really worth it?  I’m not here to argue the benefits of the MRI scan, as a graduate student in biomedical engineering, the instrument is one of the most sophisticated I have ever seen.  You have to be a genius to understand the technology behind these instruments.  In my communication with doctors, they say much of the technology is useful but not necessary.  Much simpler ultrasound machines could accomplish many of the same tasks.  These scans come at a much cheaper costs, with many of the same benefits.  So why are MRI’s so commonly used?

Also these innovative devices are having unintended consequences.  Doctors are becoming more and more reliant on these expensive diagnostic tests as opposed to relying on their equally expensive training.  I ask…Why are doctors not pooling their knowledge? Why isn’t there more communication?  This is a topic for another day.

How does this all relate back to developing countries?  Well, I argue they are the only communities which are keeping healthcare simple.

More thoughts to come…

The use of SMS texting to relay medical information is becoming more prominant in developing countries. An interesting new organization which I found today is called FrontlineSMS:Medic.  The organization has built a network around SMS technology which is specfically targeted for developing countries.

For around USD $500.00 a laptop is placed in a central clinic and a number of cell phones are distributed to healthcare workers in the community.  The network has been built using a free, open source software package which allows workers to communicate back to the central clinic where supplies, tests, drugs, etc. can be ordered.

This organization again goes to show that technology which is commonplace can be used in a variety of innovative ways to help people across the world.