Author Archive for IDEAS-globalchallenge

Mass Customization in Prosthetic Care

We’ve been up to a lot here at The BETH Project. Thanks in part to the support of the IDEAS Global Challenge and MIT Public Service Center, we’ve been busy prototyping, testing and talking to patients and prosthetists.

The BETH Project team first  came together at a MIT H@cking Medicine conference in early 2012, gathering around Asa’s proposal to leverage desktop 3D printing technology to respond to the need of low cost prosthesis in developing countries. Early on we identified that the challenges in providing prosthetic could not be simply solved by reducing existing device cost to increase availability. We began to investigate how the system of care was limiting affordable healthcare and mobility solutions for the global population.

A central problem to addressing the developing world was the lack of trained prosthetists, which essentially creates a bottleneck to meeting the demand for prosthetic care. Even today’s most advanced sockets are made using a half-century old iterative artisanal process that can take weeks and requires expensive specialized machinery.  The limited labor force in combination with the overhead costs results in care facility consolidation making it even more challenging for patient with limited mobility to access the care they need. The World Health Organization estimates there is a shortage of 40,000 prosthetists in the world today and at the current rate it will take 50 years to train another 17,000. This insight led us to design our solution from the ground up instead of trying to attach our ideas onto the existing fabrication and care paradigm.

As with many personal medical devices, understanding the challenges requires getting up close and personal with the problem. Unless you are close to a loved one who wears a prosthesis or you work in the industry, you would not be aware of the daily routines and maintenance that comes with using an artificial limb. After speaking with amputees who have worn prostheses from anywhere from a few months to sixty years, the one concern that came up over and over again was comfort. The difference between comfortable and uncomfortable is quite subtle and a common means to adjust for greater comfort is to grind the hard socket as shown in the image below.



The socket is the core component to a comfortable fitting prosthesis because forms a crucial interface between an amputee’s residual limb and his or her prosthesis. Structurally sockets are unique in that they are required to carry heavy loads and function as an  extension of our skeletal structure, but at the same time provide a comfortable interface where contact is made with an amputee’s soft muscle and skin tissue. Our goal of providing a comfortable fit with a simple fitting process led us to explore socket material alternatives. Conventionally, this is the rigid composite receptacle that is attached to the top of lower-limb prostheses. Unlike the rest of the prosthetic limb, which is generally a standardization part, the socket must be custom fabricated for each individual then painstakingly fitted, adjusted and replaced over time. Ill-fitting sockets are common because of the natural volume changes in our bodies which leads to and uncomfortable fit and if not adjusted, sores that can lead to infections that ultimately compromise amputee health and mobility.


The BETH Project is focused on addressing these challenges with an adjustable socket design that provides the ability to accommodate natural volume changes and reduce pressure on sensitive areas to promote faster healing of sores while extending the usability of a prosthetic limb. Our chosen material provides the opportunity to tap the benefits of mass manufacturing rather than local fabrication, thus lowering costs for all care providers and creating a consistent quality standard for sockets. In places where trained personal and facilities are a premium we hope to relieve care providers from the complexities of socket fabrication, and in some cases providing the opportunity for physical therapists who have transferable skills to fit and provide rehabilitative care to amputees.

Essmart: Building a channel through which products can sell

It has been a busy few months for the Essmart team. After the encouraging results of our pilot in January 2012 and the support of organizations like the IDEAS Global Challenge, we returned to India to launch our enterprise in August.

For the past two months, we have been focused on doing – on building our distribution network and getting essential technologies into local shops. We found office and warehouse space in Pollachi, Tamil Nadu, India. We brought on board our Director of Field Operations and a sales agent. We built relationships with 20 retail shops, and then cut this down to the 12 most promising shops. We started marketing our catalogue of essential technologies to shop owners and rural households. We tested and added a few new products to our catalogue. We have sold over 50 units through our retail shop network, and we are bringing on two new sales agents in the coming week to start expanding our reach.

It has all been very exciting, but in the midst of all this doing there has been little time for thinking. We have been focused on building relationships with shop owners so that we can sell products and get our business off the ground. But it is important for us to remember that our mission is not, in fact, to sell products. That is the task of our partner retail shops. Our mission is to build a channel through which products can sell.

To this end, we would like to forget all of the numbers for a minute and focus on our process. At the heart of our channel are retail shop owners, and we have been learning a lot by watching them over the past few months. First, we are learning about how crucial it is for shop owners to understand our product catalogue. It is not enough for shop owners to want to sell the products for profit; they must understand and believe in each product before they feel comfortable marketing it to their customers. Our demonstrations in shops have been critical in building understanding and confidence in our products. We’ve watched the comfort levels of our shop owners increase over time, to the point where they’re ready to take over the marketing.

Second, we are learning how important it is for shop owners to trust and believe in Essmart. The effort that we put into our relationships with shop owners far exceeds other distributors’. In rural India, companies come and go, taking advantage of the locals. As an enterprise based on a social mission, we take a different approach. We’re in this business for the long haul, and we need to build up our presence and brand. This begins with gaining the trust of the shop owners, who are more willing to sell our products when they know that we’ll be around to service them.

Each shop owner is different, which brings us to our third lesson learned: How much structure is needed to help our enterprise scale while also giving us the flexibility to cater to each shop? This is more of a question than a lesson learned, as we’re still trying to figure out the answer ourselves. We’re aiming to strike a balance between flexibility and structure as we’re creating this channel that facilitates and supports the flow of information and goods.

Despite lots of doing in the past few months, we still have a long way to go in building a sustainable, scalable channel for technologies that will change the lives of people in rural India. Some of this will be accomplished by doing – by repeatedly testing new ideas, increasing product sales, and marketing and servicing the products that are sold. But a good chunk will come from focusing on relationships with shop owners and end users, information exchange, and customer feedback. In a sense, these are non-tangible items that are not reflected in the numbers that we post. Yet although they don’t contribute to the nitty-gritty building of Essmart’s channel, they ultimately inform the shape of it.

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Written by Diana Jue and Jackie Stenson with Essmart Global, a 2012 IDEAS Global Challenge award recipient.

Essmart creates a marketplace for life-improving, essential technologies in places where people already shop. www.essmart-global.com

Changing attitudes about recycling in Lagos

In August, after months of market research, partnership development, fundraising, and planning, the Wecyclers team left Cambridge for Lagos, Nigeria. We want to improve urban environments in low-income areas by empowering communities to tackle the problem of unmanaged waste. Our solution is to offer convenient recycling services paired with a rewards program. We knew that seeing our program in action in Lagos would be a true test. We were ready to send collection bikes out into the community to collect materials and reward redeemable points. But we wondered, exactly how would households react to us. Would the excitement that we heard in early customer interviews translate into practice?

Our first collection bike in action.

Our first day of collection was August 24th, 2012.  To prepare for this day, we held a community recycling awareness day in partnership with the city government’s waste management agency, we did outreach in the neighborhoods, and we held mini-workshops to describe exactly how the collection program would work. We had signed up 107 interested households who agreed to start separating their recyclables for us. Still, on that first day, we weren’t quite sure what to expect. We ended up collecting 32 kgs of plastic and aluminum from 16 different houses and the excitement we had hoped to find was clearly there. After all the talk, people were delighted to see that our collection bikes actually existed. And not only that, people were amazed to find that they did receive SMS texts with their rewards points within 24 hours after their recycling pick-up. We were starting to gain traction.

And our momentum has only grown since that first day. Everyday we sign-up new households and we’re collecting more material each week. Our average collection is now over 100kgs per day. We’ve hired three local staff members and we’re building trusted relationships in the communities where we work.

Wecyclers subscribers showing their recyclable materials.

The most rewarding aspect of this work though, is seeing the true change in people’s perspectives and behavior around waste, especially among the youth. Parents have told us about how their kids are vigilant about separating out their recycling at home. One 12-year old boy always has his eye-out for recyclable materials, even in unlikely situations. One day, his family held a graduation party for him and after the formalities were finished, instead of dancing or chatting with his friends, he went around from table to table to collect the empty plastic bottles so that he could recycle them with Wecyclers. Another 8-year old girl has led her family to be one of the highest Wecyclers points earners in our network. Seeing that level of engagement motivates us to keep expanding our fleet of bikes so that we can continue to expand the households we serve.

 

By Alex Fallon with Wecyclers.