Low-Tech Life Savers

Jordan Schermerhorn, winner of the 2012 win-a-trip contest, with Nicholas Kristof in southern Africa. Ben Solomon for The New York TimesJordan Schermerhorn, winner of the 2012 win-a-trip contest, with Nicholas Kristof in southern Africa.

 In her fifth post, Jordan Schermerhorn, the winner of the 2012 win-a-trip contest, writes about low-tech, low-cost technology innovations that are saving lives in Malawi. 

My five days in Malawi brought me back in time. While there, we spoke with three Rice University students tasked with field-testing health technologies developed in the classroom.  Most undergraduate engineering programs in the U.S. culminate in an extended design project, in which students work in teams to produce a physical prototype. At Rice, many bioengineering students use this year to produce health technologies suitable for the developing world.

Hearing the progress my classmates have made and the eagerness with which doctors and nurses have adopted our technologies is rewarding. The willingness to work with new medical devices in Malawi is unparalleled, and that comes in part from desperation: health conditions here are dire, and funds for improvements are severely lacking. I’d like to highlight some of the most pressing health challenges, as well as the technologies Rice undergraduates have created to tackle these issues.

  1. Cost barriers. Infants with underdeveloped lungs don’t stand much of a shot at survival without respiratory assistance. Continuous positive airway pressure, or CPAP, is the gold standard for treatment, but standard CPAP devices can run $6,000 in the U.S. – unaffordable for a hospital here in Malawi. Enter the Bubble CPAP, which is currently undergoing a clinical trial in Blantyre. By using a plastic water bottle to control the air pressure and two off-the-shelf aquarium pumps to force air into a baby’s lungs, the cost for manufacturing a single device falls to under $400.
  2. Complexity.  The most effective technologies for this part of the world are simple, elegant, and ingenious. Simple functionality is a plus; as with the famous Steve Jobs formula, too many settings or extraneous features detract from a device.  One instance of simplicity in supply is IV bags: they all come in the same size. While convenient for production, this is a huge problem when a baby needs fluid because a standard-size bag will kill an infant from overhydration. The equally simple solution? The IVRaid, created by a team of Rice University freshmen, harnesses the same technique you’d use to clamp a gardening hose. A weighted mass system that triggers a simple mousetrap to clamp down on the IV tube at the right time, kinking the tube to prevent fluid flow.
  3. Lack of personnel. Finally, hospitals and clinics in Malawi are chronically understaffed. This obviously lengthens wait times, but becomes more serious when patients – especially patients who can’t call for help – need to be monitored. Half of all premature babies experience apnea, “forgetting” to breathe while sleeping due to underdeveloped nervous systems. Without monitors, they rely solely on nurses to keep vigil and intervene. Working with a team of four other women, I built the Babalung Apnea Monitor during my final year in college. A stretch sensor wrapped around the infant’s abdomen expands and contracts with each breath, setting off a vibrating module (much like the one used in a cell phone) when the baby goes 20 seconds or longer without breathing. This system manages to treat patients automatically, simultaneously saving lives and easing the burden on nurses.

 Of course, each of these technologies is rough when first produced. The monitor we created, for example, was initially fitted for premature babies in the United States; my teammate working in Malawi had to resize it for the unfathomably tiny preemies coming into the world in these wards.  But there is no source of free labor quite like students gunning for an A in a capstone course, and one benefit to low-cost technologies is that they can be tested, altered, and scaled quickly.

There’s so much potential for individuals with technical training – with the knowledge and capacity to make things – to effect positive change. I’ve always found engineering for the developing world to be an intellectually engaging challenge: dealing with electrical power limitations and working around limited clinical personnel poses more design constraints, and finding the ultimate elegant solution to a health problem is like solving a puzzle.

I’d love to see more local Malawians working on products like these, but with a formidable education gap I think it’s going to take a few years. Nurses and doctors have become tremendously skilled at wrangling solutions out of thin air, but it’s high time we use technology to let them get back to what they do best: caring for patients.