Turning to auto parts for cheap incubators

The main causes of newborn death—infections, preterm birth and asphyxiation—are readily treatable with the right expertise and equipment, said Dr. Kristian Olson, principal investigator on the project. He called them the “low-hanging fruit” of global health interventions.
“It’s so frustrating to see these preventable deaths,” he said. “They won’t name babies in Aceh, Indonesia, until they’re two months old. It’s a cultural adaptation to expect a death.”

Mechanically, incubators are simple devices, providing a warm, clean, womblike environment in which a baby can mature (though state-of-the-art models may have accessories like built-in X-ray machines and rotating mattresses). Low birth weight and other problems make it especially difficult for newborns to regulate their body temperature, a condition that can lead to organ failure.

In the car parts incubator, infants born at 32 weeks’ gestation or longer can receive supplemental oxygen while their lungs gain strength, antibiotics if they have infections, and low-lit quiet in which to sleep if their mothers are away or are otherwise unable to hold them. In an emergency, the incubator’s bassinet can be removed and carried to another part of the building or even to another hospital.

In truth, experts say, the developing world doesn’t need more incubators. It needs incubators that work. Over the years, thousands have been donated from rich nations, only to end up in “incubator graveyards”—most broken, some never opened. According to a 2007 study from Duke University, 96 per cent of foreign-donated medical equipment fails within five years of donation—mostly because of electrical problems, like voltage surges or brownouts or broken knobs, or because of training problems.

To compensate for this philanthropic shortsightedness, medical staffs either crank up the temperature in “incubator rooms” to 100 degrees or more, or swaddle babies in plastic to hold in body heat. Such makeshift solutions led the Boston team to ask: How can we make an incubator for the developing world that will get fixed?

One person pondering that question in 2006 was Dr. Jonathan Rosen, then director of Cimit’s technology implementation programme. A proponent of sustainable biomedical technology, Rosen, now at the Boston University School of Management, uses the term “organic resourcing” to describe the principle of fashioning medical devices from whatever materials were locally abundant.

In his discussions with doctors who practice in impoverished settings, Rosen learned that no matter how remote the locale, there always seemed to be a Toyota 4Runner in working order. Cimit then hired Design That Matters, a nonprofit firm in Massachusetts, to design the machine. What resulted was a serious-looking gray-blue device that conjures up a cyborg baby buggy, but fits comfortably in hospitals and clinics with few resources. For one thing, the supply of replacement parts is virtually limitless, because the modular prototype can be adapted to any make or model of car.
MADELINE DREXLER, NYT