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.
It was his “Aha!” moment, he recalled later: Why not make the incubator out of new or used car parts, and teach local auto mechanics to be medical technologists?
CIMIT then hired Design That Matters, a nonprofit firm in Cambridge, Massachusetts, to design the machine. “The idea was to start with a 4Runner,” said Timothy Prestero, the firm’s founder
and chief executive, “and take away all the parts that weren’t
an incubator.”
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.
“Junkyards are great sources for parts,” said Robert Malkin, director of Engineering World Health, a program based at Duke University, who is not affiliated with the incubator project. “We have designs for pumps and a surgical aspirator that are based on car parts.”
And the repair people will be right on the scene. “The future medical technologists in the developing world,” Malkin said, “are the current car mechanics, HVAC repairmen, bicycle shop repairmen. There is no other good source of technology-savvy individuals to take up the future of medical device repair and maintenance.”
Not everyone agrees that the car parts incubator is the best
solution for infant deaths. Skeptics cite a 2005 series of articles in the British journal The Lancet listing proven interventions — including outreach visits during pregnancy, skilled care at delivery and emergency treatment afterward — that could eliminate up to 72 percent of neonatal deaths worldwide.
THE POTENTIAL TO SAVE LIVES
The car parts incubator has received US$150,000 in initial financing from CIMIT. The project team is looking for foundation support to develop a working prototype.
Meanwhile, the team is refining its business model and solidifying business partnerships abroad. “The technology is the least difficult part of the problem,” Prestero said. “Manufacturing, financing, distribution, regulatory approval: those are major barriers. There aren’t many examples of a successfully scaled product to serve the poor.”
Olson says his determination to create a cheap, reliable incubator — and medical training to go with it — was reinforced on a trip this year to Cut Nyak Dhien Hospital, a one-story concrete building in the tsunami-stricken city of Meulaboh, Indonesia.
“When I walked in the incubator room,” he said, “a whole family was sobbing around a crib.” Their seven-day-old baby boy, who was born slightly underweight and suffering from infection, had just died, after lying for hours on a cold cot. With warmth and proper care, he would have survived.
Crowding the room were six donated high-tech incubators from the West. None of them worked.
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