Archive for the 'global health' Category

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.

Embrace and Me: A Follow-Up to ‘Notes “Product Development for the Other 90%”’

By guest author: Hamsika Chandrasekar

I read Bina’s Notes on “Product Development for the Other 90%” and felt a spark of interest when I came across her description of Embrace, a social enterprise that has developed an innovative, low-cost infant warmer to help keep low-birth-weight and premature infants warm. Thanks to the combined support of the MIT Public Service Center, Baker Foundation, and Kelly-Douglas Fund, I was able to spend the last month in India, working to launch Embrace’s infant warmer at the Shamlaji Tribal Hospital in Gujarat.

This hospital is located in the small village of Shamlaji, about two hours outside Ahmedabad, Gujarat’s largest city. It is managed by a husband and wife doctor team, Drs. Haren Joshi and Pratima Tolat, who ensure that the free treatment provided at Shamlaji Tribal Hospital is of high quality. Working with Embrace, I selected Shamlaji Tribal Hospital for my service project due to its focus on rural healthcare and its high numbers of low birth weight infants. When I arrived at the hospital, I found two packages, both marked ‘most urgent,’ waiting for me in the hospital office. I opened one quickly and happily held up its contents: the Embrace infant warmer. Looking back now, I still remember that sense of excitement and purpose I felt when I unwrapped the device. I couldn’t believe that after all the emails, the training sessions, the conference calls, and the planning, I was finally at Shamlaji Tribal Hospital, working with an organization I had heard about through a TedTalk and immediately loved.

My first day, unwrapping an Embrace infant warmer

I spent nearly three weeks in Gujarat, conversing with the doctors and nurses and showing them how to operate the infant warmer.

During my time there, nine infants benefited from the Embrace product, absorbing the warmer’s heat and gaining weight during their hospital stay. Together, the nurses and I monitored these babies and collected data on each infant. I was happy to see that the nurses quickly became comfortable with the Embrace product, taking it out whenever a newborn weighed between 1.5 kg and 2.5 kg, the recommended weight range for product use.

A (2.5 kg) infant sleeping peacefully in the Embrace infant warmer

The biggest challenge for me was the language barrier: I spoke no Gujarati and very little Hindi, the two most prominent languages in the region. I worked with the hospital staff via an interpreter, pausing at the end of each sentence and allowing her to translate what I had said. With her help, I also explored some of the other healthcare needs in the area, meeting with the head of Shamlaji Village and traveling out to the Himmatnagar Civil Hospital, to which many patients from Shamlaji Tribal Hospital are referred.

For me, this project served not only as an opportunity to perform hands-on service work but also as a reminder of the realities in impoverished regions and the challenges involved in the improvement of rural healthcare. For every baby born in Shamlaji Tribal Hospital, many more are born at home, never receiving proper care and often dying due to preventable reasons. Parents, desperate to have kids that survive past infancy, pay little attention to established family planning methods. Poor education makes it difficult for villagers to comprehend the dangers associated with at-home deliveries and improper antenatal care. Throughout my time in Gujarat, I was reminded of how much more I – and for that matter, anyone in the world – could do to help.

Hamsika Chandrasekar is currently a junior at MIT and a previous PSC expedition grant recipient. She is double majoring in Computational Biology (Course 6-7) and Neuroscience (Course 9), hopes to enroll in medical school following her undergraduate years, and ultimately wants to pursue a career in global health. 

From the Field / Solar-Powered Autoclave

The Solar-Powered Autoclave team is working on harnessing the sun to power autoclaves for improved sterilization of medical devices. This week they’re down in Nicaragua working with women from the solar tech start-up Solar Women of Totogalpa.

Two quick peeks into what they’re working on:

SolarAutoclave / Nica July 2011

Teammate Ted working with the women in Ocotal.

From Anna: The photos are from Ocotal, Nicaragua outside of the IIH-MEDIK lab and include Alejandra, Yelba and Maria from the Solar Women of Totogalpa and Juan Miguel a local lab technician who was part of the MEDIK class taught by IIH.

And the winner is…

Congratulations to IDEAS 2010 team Sanergy for your winning entry into the IDEAS and Global Challenge video pitch contest! Judges voted Sanergy’s pitch the best for the clear connection between your team’s accomplishment and the resources offered through IDEAS and the Global Challenge. Most importantly, the video did a wonderful job emphasizing a multidisciplinary team drawn from across the MIT community and a deep connection to community and MIT resources on the ground, like FabLab. Here’s the vid:

Sanergy from Ani Vallabhaneni on Vimeo.

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Thanks so much to all of the teams that entered a video into the pitch contest – the range of projects represented is amazing, and I hope that through the MIT Public Service Center we’ll continue to find ways to support your work. View all of the entries here.

Global Health “Game Changers” – But Will the People Play?

Today the Huffington Post carries a story by USAID Administrator Rajiv Shah describing a new approach to tackling – and solving – development: identify “game changers” through “grand challenges.” What this means is, USAID is actively seeking out innovative scientific research and technological innovation that hold significant promise to reduce large-scale barriers to human well being around the world. By way of illustration, the authors lead with a celebration of microbicide trials. What they fail to point out is that in U.S., women’s AIDS activists have been pushing for greater access to microbicides for years; politics has been the principle barrier to widespread access in the past, not technological shortcomings.

I fear the same dilemma will play out for many of the technological innovations that could help us make headway in other areas identified by the administration:

  • How tosustainably provide electricity to rural and hard-to-reach communities in the developing world;
  • How to make education available anytime, anywhere, for anyone;
  • How to better manage and coordinate responses to humanitarian crises and conflicts;
  • How to create resilience in staple grain crops to environmental change and variability; and
  • How to provide high-quality, affordable, primary health care in rural communities.

So while the administration, and readers of the Huffington Post, will likely take it as a given that the public “goods” described and promoted through the “grand challenges” will be well served through ongoing innovation (what isn’t?), much more daunting will be the necessary political will to ensure that research and deployment occurs within a lasting political framework for widespread adoption. To complicate the landscape further, the success of political action will turn on good amounts of social, cultural, and individual acceptability and behavior change – domains that have proven surprisingly selective in terms of technological uptake.

Research carried out by economists like Esther Duflo at MIT’s Jameel Poverty Action Lab (J-PAL) is exciting in this regard. It has long been said that “economics” is as much about good guess work as it is about hard science. Working to understand the behavioral and environment conditions under which economic well-being does and does not flourish, Duflo and her colleagues are revolutionizing the field. For the “grand challenges” to work, it will be important to better understand the conditions under which “solutions” can be implemented successfully. Through the information collected over the years in fields such as health, finance, and agriculture J-PAL is developing an unparalleled – and often myth-busting – view of what works and what doesn’t work when it comes to technological adoption.

A “disruptive” technology is hard to forecast; a “game changer” is even harder to discern. USAID’s strategy to shift the global development needle toward positive outcomes for more people would be well-served to champion not just the technologies but the political and social barriers that will inevitably impede the widespread adoption necessary for success.

    Turn Your Smartphone Into an Optometrist

    Remember sitting in front of that hulking, weird Hardware-like device as a kid, the nose of your optometrist inches away as you both peered through the phoropter? A group at MIT might be changing all that – at least for some folks in resource-strapped communities where a $2500 piece of diagnostic equipment and maintenance is beyond their capacity. With the introduction of a new device developed my researchers in MIT’s Camera Culture group in the Media Lab, the phoroptor may be headed the way of the oviraptor.

    Dubbed PerfectSight, a 2010 IDEAS winner profiled today by MIT’s News Office (with a splashy home page spotlight!),  the Smartphone attachment is able to detect a range of refractive eye disorders within seconds. This turns the traditional model of optometry on its head: now eye specialists can get out of the costly eye care centers and into field, creating greater access to care, potentially revolutionizing the number of diagnoses carried out on any given day.

    Learn more about the device and the Camera Culture group.

    eHealth, telemedicine, capacity building, and learning

    Love this video of the incredibly articulate Chris Moses ’10, who was awarded a Davis Projects for Peace Fellowship and participated in the Public Service Fellowship and Grants program. Here, he discusses Sana (formerly MocaMobile). Sana earned a development grant from the MIT IDEAS Competition, and went on to win the mHealth Alliance Award and Vodafone Wireless Innovation Prize. The $150,000 in awards will enable the group, of which Chris is an integral part, to improve their telemedicine-based health care delivery system for rural underserved populations.


    Chris Moses on MIT TechTV

    Why social entrepreneurs do what they do

    A recent article in Stanford’s Business Magazine profiled the social enterprise D.light, which delivers affordable LED lighting to rural, off-grid communities. A powerful quote caught my eye, one that really threw into sharp relief the power of what students everywhere are doing to change the world:

    “Chaudhary purchased a light for about $30 and soon noticed that his family’s eyes no longer burned and their chests no longer hurt. Even better, they could see at night. His sister, Rama, was able to stay up late knitting sweaters. His father, Gajinder, could read without straining his eyesight. His aunt, Suman, stopped charring the flat chapati bread she baked over the wood stove.”

    All these benefits from a light? Its almost inconveivable in our comfortable lifestyles. To communities with less, simple, smart changes add up to significant quality of life improvements.

    Read the complete Stanford article here.

    Winners of the 9th Annual MIT IDEAS Competition

    Graduate students Aaron Zinman and Greg Elliott at the IDEAS Competition Project Display and Judging Session. Photo: Aditi Verma

    Graduate students Aaron Zinman and Greg Elliott at the IDEAS Competition Project Display and Judging Session. Photo: Aditi Verma

    The ninth annual MIT IDEAS Competition celebrated student achievement on Monday evening, May 3, at MIT’s Raymond and Maria Stata Center. Seven student teams received IDEAS awards to implement their projects over the next year. IDEAS — which stands for Innovation, Development, Enterprise, Action and Service — recognizes student teams that have developed outstanding projects that apply invention as a public service. Each award, funded by a corporate or individual sponsor, will enable a team to develop their prototype into a working solution in collaboration with community partners around the world.

    The awards, presented by a selection of MIT staff and sponsors, went to the following teams:

    Konbit was awarded the $8,000 IDEAS Award sponsored by the Office of the Dean for Graduate Education. Team members Greg Elliott and Aaron Zinman designed a service via phone, Short Message Service (SMS), and web that helps communities rebuild themselves after a crisis by indexing the skill sets of local residents, and allowing NGOs to find and employ them.

    Continue reading ‘Winners of the 9th Annual MIT IDEAS Competition’

    Black Carbon and Poverty

    Cooking in Kohlua, India. Soot from tens of thousands of villages in developing countries is responsible for 18 percent of the planet’s warming, studies say. Adam Ferguson for The New York Times  

    Cooking in Kohlua, India. Soot from tens of thousands of villages in developing countries is responsible for 18 percent of the planet’s warming, studies say. Adam Ferguson for The New York Times

    A recent New York Times article in the Environment pages points out some of the climate-risks associated with the burning of dirty fuels, and makes the case for introducing new, cleaner burning stoves to the poor. Skipping over the massive health benefits to women and children who most often tend to the family fires, the article places priority – in part justifiably – on the worlds disappearing glaciers, especially in the Himalayas – linking their demise to a looming water crisis in areas fed by Asia’s big rivers. 

    Continue reading ‘Black Carbon and Poverty’